Showing papers by "Alex Rovira published in 1997"

Thrombosis of the superior longitudinal sinus in patients with AIDS. A review of the literature

Abstract: Cerebral dural sinus thrombosis (CSDT) is a rare disease with a high rate of mortality Until now it has not been well-documented in patients with the acquired immunodeficiency syndrome (AIDS) Prompt diagnosis is essential for initiation of suitable treatment, especially in cases with progressive neurological involvement The diagnostic methods include computed tomography (CT), magnetic resonance imaging (MRI) and conventional angiography MRI and magnetic resonance angiography (MRA) have become the methods of choice because of their sensitivity and noninvasive nature An unusual AIDS-patient, who at the time of CSDT presentation had an associated toxoplasmosis infection is described To our knowledge, this is the first case of CSDT diagnosed by MRI and MRA in an AIDS patient In the follow-up, MRI and MRA showed the repermeabilitation of the sinus thrombosis Cerebral dural sinus thrombosis should be considered as a possible cause of neurological decline in a HIV-patient with central nervous system opportunistic infection

The development of multiple sclerosis following an isolated episode of optic neuritis. Magnetic resonance study

Abstract: BACKGROUND An important controversy on the development of multiple sclerosis (MS) after an isolated episode of optic neuritis (ON) exists. Magnetic resonance imaging (MRI) is the method of election in order to detect demyelinated lesions in MS. The current study was designed to determine the prevalence of brain abnormalities on MRI and to asses the further development of MS after an isolated idiopathic ON in our population. PATIENTS AND METHODS From 1991 to 1995, 60 patients with decrease of visual acuity were studied, 35 (28 women, half age 31 +/- 10 years) completed criteria of idiopathic ON. A brain MRI was performed in all patients after the diagnosis of idiopathic ON and they subsequently were followed in the outpatient clinic from our center for a mean time of 29 +/- 16 months. 24 out of the 35 patients were treated with corticosteroids in different ways. RESULTS It has been found 43% of the patients with idiopathic ON to have brain lesions by MRI. During the follow-up 14% of the patients developed a clinically definite MS; all of them had a pathological brain MRI at the basal evaluation (p = 0.009). None of the patients that were treated with high-dose of intravenously corticosteroids developed MS. CONCLUSIONS The prevalence of silent cerebral lesions in the MRI after an idiopathic ON is elevated in our population although further development of MS is lower possibly due to the short follow-up carried out. The presence of lesions in the MRI confers a high risk for developing MS after an idiopathic ON.