RESUMO
Neurosarcoidosis (NS) manifests itself clinically in approximately 8-13% of patients with sarcoidosis. Granulomas are localized in both the central and peripheral nervous system, mainly within the meninges and cranial nerves. Changes may spread interstitially, occupying different structures of the brain and spinal cord. Diagnosis of NS is made by characteristic clinical symptoms and the exclusion of other diseases, with the presence of specific changes in the magnetic resonance and cerebrospinal fluid, and it is mainly based on histopathological examination. The first choice treatment are corticosteroids. In case of failure or adverse events, methotrexate, azathioprine, cyclosporine, cyclophosphamide, mycophenolate mofetil and infliximab could be used.
Assuntos
Corticosteroides/uso terapêutico , Encéfalo/diagnóstico por imagem , Doenças do Sistema Nervoso Central/diagnóstico , Doenças do Sistema Nervoso Central/tratamento farmacológico , Imunossupressores/uso terapêutico , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Humanos , RadiografiaRESUMO
The authors presented a case of verification of pathological lesions as a cause of traffic accident where the driver--the culprit--was a fatal victim due to multiple injuries. Histopathological examination of postmortem samples of myocardium was conducted, using the hematoxylin-eosin, Nielsen-Selye and immunohistochemical C9 staining methods in order to verify the hypothesis about a possible myocardial ischemia triggering the accident. The results of "routine" (H&E) and--especially--immunohistochemical C9 staining showed myocardial damage due to ischemia, which was a morphological indicator evidencing the cause of "misbehavior" of the driver.
