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1.
Neurology ; 74(13): 1030-2, 2010 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-20200339

RESUMO

BACKGROUND: A substantial proportion of ischemic strokes have an embolic mechanism, but the source of embolism is not detected. Coexistence of subdiaphragmatic visceral infarction (SDVI; e.g., renal, splenic, hepatic, bowel infarction) may be a suggestion of a common source of embolism. One large autopsy study found SDVI in 21.5% of patients with fatal stroke. METHOD: We performed diffusion-weighted magnetic resonance abdominal imaging and subsequently performed it in consecutive patients with stroke or TIA and a history of nonvalvular atrial fibrillation. RESULTS: Among 27 patients, 6 had SDVI (3 recent renal, 1 recent splenic, and 3 old splenic infarction). The median time between onset of ischemic stroke and abdominal MRI was 8 days (interquartile range 3-15 days). No predictive factor of SDVI was found in this study population with respect to demographic or ultrasound characteristics. CONCLUSIONS: One in 5 patients with nonfatal cardioembolic stroke or TIA may be associated with subdiaphragmatic visceral infarction (SDVI). Further study should evaluate the frequency of SDVI in patients with stroke of unknown cause.


Assuntos
Fibrilação Atrial/epidemiologia , Isquemia Encefálica/epidemiologia , Infarto/epidemiologia , Embolia Intracraniana/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Vísceras/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/patologia , Isquemia Encefálica/patologia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Embolia Intracraniana/patologia , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Acidente Vascular Cerebral/patologia , Fatores de Tempo
2.
Rev Neurol (Paris) ; 162(11): 1059-67, 2006 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17086142

RESUMO

INTRODUCTION: Sporadic cerebral amyloid angiopathy (CAA) is a microangiopathy identified by neuropathological examination in more than 30 percent of patients over 85 years of age. STATE OF ART: Boston criteria for diagnosis of CAA--related hemorrhage are as follows: "definite CAA", "Probable CAA with supporting pathology", "Probable CAA" and "Possible CAA". Clinical manifestations of CAA are either lobar, cortical, corticosubcortical or cerebellar hemorrhages associated with progressive dementia. Dementia, corresponding either to Alzheimer disease, vascular or mixed dementia, precedes hemorrhages in 25 to 40 percent of cases. Brain MRI can demonstrate microbleeding. PERSPECTIVES: This review compares data regarding CAA prevalence, intracranial hemorrhages, and their risk factors in old patients. Diagnosis and preventive strategies are discussed. It would be useful to identify those affected by CAA among elderly demented patients with atrial fibrillation requiring anticoagulation therapy. CONCLUSIONS: CAA is suspected in the presence of recurrent lobar or cerebellar hemorrhages, and moreover if associated with pre-existing dementia. In elderly demented patients, MRI criteria to detect CAA should be considered in order to prevent hemorrhage risk, particularly after anticoagulation therapy.


Assuntos
Angiopatia Amiloide Cerebral/fisiopatologia , Animais , Encéfalo/patologia , Angiopatia Amiloide Cerebral/diagnóstico , Angiopatia Amiloide Cerebral/patologia , Humanos , Imageamento por Ressonância Magnética , Fatores de Risco
3.
Rev Neurol (Paris) ; 161(3): 326-30, 2005 Mar.
Artigo em Francês | MEDLINE | ID: mdl-15800455

RESUMO

INTRODUCTION: BK virus has been described previously in renal transplant patients, but has also been reported in cases of progressive multifocal leukoencephalopathy. METHOD: A case of progressive BK virus multifocal leukoencephalopathy induced by long-term corticosteroid therapy is reported. RESULTS: In our case, BK virus was detected in cerebrospinal fluid by polymerase chain reaction (PCR). A detailed review of similar cases in the literature showed most of them occurred in AIDS patients, but four involved immunocompetent patients. CONCLUSION: Though BK virus infection usually leads to urinary tract symptoms in immunologically suppressed patients, it is important to be aware of its neurological manifestations and to recognize BK infections that can occur in immunocompetent patients.


Assuntos
Corticosteroides/uso terapêutico , Vírus BK , Encefalopatias/tratamento farmacológico , Encefalopatias/patologia , Encéfalo/patologia , Síndromes de Imunodeficiência/complicações , Infecções Tumorais por Vírus/tratamento farmacológico , Infecções Tumorais por Vírus/patologia , Idoso , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
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