Showing papers in "Arquivos De Neuro-psiquiatria in 1979"
TL;DR: The absence of treatment for brain cysticercosis is consistent with the persistence of CSF abnormalities in the specimens examined during the course of this disease, and calls for an integrated prophylactic to all Latin-American countries in order to exterminate this serious disease.
Abstract: Cerebrospinal fluid (CSF) changes in brain cysticercosis have long been known. Its characteristic features are a mild or moderate pleocytosis with eosinophils, a slight or moderate protein increase with an elevated gammaglobulin concentration, and a positive complement fixation test. Unfortunately all these abnormalities are not always present together and difficulties may be encountered in the diagnosis. This paper presents a study based on the experience acquired in the CSF Laboratory of the Neurological Department of Escola Paulista de Medicina (Sao Paulo, Brasil) after 35 years' work, and 120.000 CSF specimens examined. The material consists of 147 cases of brain cysticercosis confirmed by necropsy, surgery, subcutaneous or intraocular cysticercus, x ray of the skull, and of 509 clinical observation with suggestive CSF changes. It is the purpose of this paper to appreciate the importance of each of the CSF tests and to observe the CSF abnormalities during the course of this disease. The results of the study of the 79 cases verified by necropsy or surgery showed that the characteristic CSF changes that make the diagnosis of brain cysticercosis were observed in 54 per cent of the cases. The eosinophils were present in 82 per cent, protein changes in 78 per cent, complement fixation test in 70 per cent, hypertension in 55 per cent, and decreased sugar content in 27 per cent of the cases. In two cases the CSF was normal. As the eosinophils and the protein abnormalities may be seen in several other diseases, the complement fixation test for cysticercus should be regarded as the most important CSF test in the diagnosis of brain cysticercosis. The successive CSF specimens withdrawn of 40 patientes during the course of this disease have shown that the abnormalities went on for 4 to 18 years observation, suggesting that the parasites were alive. On the contrary, in 11 other cases it was verified the final CSF normalization after 5 to 14 years, suggesting that the parasites were dead. The CSF was normal in 31 out of 42 patients with opaque nodules visible in skull films (calcified cysticercus). in the remaining 11 cases, the characteristic CSF findings were observed in 3, but in 8 cases the only abnormalities were positive complement fixation test or eosinophils. In 14 out of 26 patients with subcutaneous or intraocular cysticercus there were the usual CSF changes but in the other remaining cases the CSF was normal. The absence of treatment for brain cysticercosis is consistent with the persistence of CSF abnormalities in the specimens examined during the course of this disease. This calls for an integrated prophylactic to all Latin-American countries in order to exterminate this serious disease for the well-being of the next generation.
14 citations
TL;DR: This study points out the importance of the methenamine silver stain (Grocott) in the identification of the degenerated embryo inside the fibrous and/or calcified lesions in cysticercosis.
Abstract: No estudo do envolvimento do SNC na cisticercose, verificou-se uma frequencia de 0,3%, sempre como achado incidental no estudo de rotina de autopsias; apenas um caso mostrou boa correlacao com a presenca de manifestacoes neurologicas. Esta frequencia que e baixa em relacao ao que e observado em outras regioes do Brasil, mostra que a neurocisticercose nao representa um grande problema na regiao. As reacoes do hospedeiro ao embriao do cisticerco foram sempre do tipo inflamatorio cronico e fibrosante. Neste estudo ficou demonstrada a importância do metodo de impregnacao pela prata (Grocott) na identificacao do esqueleto do cisticerco no interior de lesoes fibrosantes e/ou calcificadas.
14 citations
TL;DR: A study was made of immunoglobulins in the CSF of 50 individuals who suffered from chronic migraine but showed normal results for the physical and neurological examinations; electroencephalograph, CSF tests (sub-occipital puncture) and proteinogram of the serum also fell within the limits of normalcy in all of the 50 cases.
Abstract: Sao revistos os principais metodos e resultados encontrados na literatura para as imunoglobulinas do liquido cefalorraqueano normal. Foram estudadas as imunoglobulinas do LCR de 50 pessoas com cefaleia cronica apresentando exame fisico e neurologico normais bem como eletrencefalograma, exame do LCR por puncao sub-occipital e proteinograma do soro dentro dos limites da normalidade. O estudo das imunoglobulinas foi realizzado pelo metodo de imunodifusao radial. Os resultados obtidos quanto as imunoglobulinas do LCR variaram entre 1,55 e 3,97 mg/100 ml ou 0,17 e 0,44 UI para a IGG; para IGA os valores encontravam-se entre 0 e 0,62 mg/100 ml ou 0 e 0,37 UI. Em todos os casos nao foi detectada a presenca de IGM no LCR. Na analise dos resultados foi concluido que para o LCR da cisterna magna em pessoas normais a imuno-glubulina IGG e encontrada sempre com concentracao media de 2,37 mg/100 ml e desvio padrao de 0,59. A imunoglobulina IGA e encontrada na maioria das ocasioes com concentracao media de 0,34 mg/100 ml e desvio padrao de 0,17. A imunoglobulina IGM nao e demonstrada em condicoes normais pelo metodo utilizado.
9 citations
TL;DR: It seems that there is another factor also responsible for the occurrence of cerebral atrophy in Chagas disease, since from the clinical and hemodynamic point of view both cardiopathies have many similarities.
Abstract: The pathological findings in the brain of patients who died with idiopathic cardiomegaly are reported. The major findings in the 38 studied cases were cerebral infarcts (10,5%) and cerebral atrophy (7,9%) besides the nonspecific histological changes represented by neuronal ischemic alteration, satellitosis of nerve cells and swollen and hyperplasia of endothelial cells in capilaries of the cerebral cortex. These findings were considered a consequence of the venous stasis of the congestive heart failure. These data were compared to those seen in the brain of patients with heart failure in the course of chronic Chagas disease. The morphological findings were similar. The frequence of infarcts and atrophy was higher in the cases of Chagas disease and the cerebral atrophy was seen in an younger group of patients compared to the cases of idiopathic cardiomegaly. It seems that there is another factor also responsible for the occurrence of cerebral atrophy in Chagas disease, since from the clinical and hemodynamic point of view both cardiopathies have many similarities.
7 citations
TL;DR: Side effects varied from case to case in the patients submitted to amphotericin-B and 5-fluorocytosine treatment, and its intravenous and its intrathecal administration did not provoke remarkable side effects.
Abstract: Results obtained in the treatment of cryptococcosis of the central nervous system with amphotericin-B, 5-fluorocytosine and miconazole are evaluated. The evaluation is based upon 18 cases. Emphasis is given to data pertinent to aspects proper to 7 of them, submitted to chronic immunossupressive treatment due to previous kidney transplantation. Side effects varied from case to case in the patients submitted to amphotericin-B and 5-fluorocytosine treatment. The intrathecal and the intraventricular administration of amphotericin-B was followed by complications of several types. Miconazole was used in one case. Its intravenous and its intrathecal administration did not provoke remarkable side effects.
7 citations
TL;DR: The authors propose a method to obtain a computer model of the anterior cerebral artery, based on a combined system of stereotaxic coordinates and a specially developed computer program, which is projected on a model atlas brain.
Abstract: This article is a corrollary of a previously published anatomical study of the anterior cerebral artery. The authors propose a method to obtain a computer model of the anterior cerebral artery, based on a combined system of stereotaxic coordinates and a specially developed computer program. The graphic analysis, thus obtained, is projected on a model atlas brain and an ideal diagram of this anatomical structure is obtained. Forty anatomical specimens were used for this study.
7 citations
TL;DR: In this paper, anormalidades of the axonios of the brain have been found to be predominant on axonio, provocando degeneracao axonal distal, a fenomeno de "dying back".
Abstract: E relatado o estudo de nervo sural e musculos em 10 pacientes com intoxicacoes cronicas por inseticidas organoclorados e organofosforados, sendo utilizadas tecnicas de microdisseccao de nervos e histoquimica de musculos. Foram estudados os nervos surais de 9 pacientes por microdisseccao, tendo sido encontrado anormalidades em todos, predominando a presenca de fibras dos tipos C, D e grande quantidade de fibras G, conforme a classificacao de Dyck; o nervo do decimo paciente apresentava-se totalmente desmielinizado. Em 8 casos foram estudados musculos com inclusao em parafina e por histoquimica, sendo encontrada denervacao em seis; os restantes eram musculos normais. Os autores concluem que o processo atua predominantemente nos axonios, provocando degeneracao axonal distal, com fenomeno de "dying back".
6 citations
TL;DR: Rabies viruses were found in peripheral nerves compatible with axonal degeneration with secondary demyelination but the rabies viruses were not found in the axoplasm, myelin sheet, Schwann cell cytoplasm, endoneural or in the epineural structures.
Abstract: Alteracoes ultraestruturais bastante significativas foram encontrados em nervos perifericos de ratos inoculados com virus da raiva. Tais achados se caracterizam por degeneracao axonal com desmielinizacao secundaria. Os achados sao precedidos em cerca de 24 horas por sinais clinicos correspondentes. Contudo, os nervos examinados nao apresentaram particulas com as caracteristicas das do virus da raiva. E possivel que apos a inoculacao os virus percam suas capsulas e as molesculas de ARN que os constituem se confundam com o conteudo axoplasmatico, tornando-se indistinguiveis pela microscopia eletronica. So dessa forma poder-se-ia explicar a acao deleteria das particulas virais nos axonios e consequente tramitacao centripeta em direcao a medula e partes mais altas do sistema nervoso central, sem serem detectados pela microscopia eletronica. A degeneracao axonal encontrada, com consequente quadro de polineurite, mostra que os sinais perifericos nao sao exclusivamente de uma mielite ascendente. Ambos os processos podem estar envolvidos.
6 citations
TL;DR: It was found that the best index to appraise the behavior of IGG is: ( CSF IGG/S IGG) / (CSF PRE ALBUMIN-f ALBumIN/S ALbUMIN) that shows an average of 0.56 and a standard deviation of 0 .32 in the material studied.
Abstract: Relations and quocientes of cerebrospinal fluid (CSF) immunoglobulins G (IGG) and serum (S) IGG were studied in 50 patients with chronic headache, normal neurological examination and normal electroencephalogram. CSF was normal as to: pressure, cytology, total proteins, protein fractions and immunoglobulins (IGG, IGA and IGM) contents. In all cases the CSF sample studied was collected from cisterna magna. The relations and quocients studied were: CSF IGG/CSF TOTAL PROTEIN, CSF IGG/CSF ALBUMIN, CSF IGG/CSF PRE ALBUMIN+ALBU-MIN, (CSF IGG/S IGG) / (CSF ALBUMIN/S ALBUMIN) and (CSF IGG/S IGG) / (CSF PRE ALBUMIN+ALBUMIN) / (S ALBUMIN). It was found that the best index to appraise the behavior of IGG is: (CSF IGG/S IGG) / (CSF PRE ALBUMIN-f ALBUMIN/S ALBUMIN) that shows an average of 0.56 and a standard deviation of 0.32 in the material studied.
5 citations
TL;DR: Sao relatados dois casos de metastases cerebrais de melanoma maligno cuja manifestacao clinica foi de hemorragia cerebro-meningea, enfatizando-se a importância da inclusao das metastases no diagnostico diferencial das hemorragias cerebra is e da realizacao de biopsia da parede de hematomas intra-cerebrais
Abstract: Sao relatados dois casos de metastases cerebrais de melanoma maligno cuja manifestacao clinica foi de hemorragia cerebro-meningea. E feita a revisao da literatura pertinente, enfatizando-se a importância da inclusao das metastases no diagnostico diferencial das hemorragias cerebrais e da realizacao de biopsia da parede de hematomas intra-cerebrais espontâneos.
5 citations
TL;DR: The authors believe that, in their case, such a demyelinative mechanism was responsible for the clinical picture, although a necroscopic examination was not allowed.
Abstract: A case of transverse myelopathy in systemic lupus erythematosus with subacute onset and fatal course is reported. A review of the literature is done and clinical, laboratorial, therapeutics and pathological aspects are discussed. The authors call attention to the poor results of therapy and discuss the participation of immunological factors leaving to demyelination which are, aside the classical vascular involvement, the probable mechanisms in the neurological manifestations of systemic lupus erythematosus. The authors believe that, in their case, such a demyelinative mechanism was responsible for the clinical picture, although a necroscopic examination was not allowed.
TL;DR: The authors relatado o caso de uma paciente de 48 anos that apresentou um quadro de paraparesia crural espastica muito acentuada com evolucao de dois meses, acompanhada de disturbios da sensibilidade e disturbios esfincterianos.
Abstract: E relatado o caso de uma paciente de 48 anos que apresentou um quadro de paraparesia crural espastica muito acentuada com evolucao de dois meses, acompanhada de disturbios da sensibilidade e disturbios esfincterianos. As mielografias ascendente e descendente revelaram processo expansivo intra-raquideo ao nivel de T3. A laminectomia de T2-T4 e o exame histopatologico mostraram tratar-se de uma goma sifilitica justaposta a medula. As evolucoes clinica e dos exames complementares sao comentadas a luz de algumas observacoes encontradas na literatura.
TL;DR: Prophylactic broad-spectrum antibiotics were of no value in preventing post-operative infections in neurosurgical patients and those who received no antibiotics had a significantly lower rate of infections.
Abstract: The post-operative infection-rate in neurosurgical patients who received prophylactic antibiotics was compared to the infection-rate of patients who received no antibiotics. None of the 73 studied patients had pre-operative infection. Infections occured in 26,4% of the patients in the first group and in none of the second group (p less than 0,2); 27,5% of the patients with intracranial lesions and 9% of the patients with spinal lesions in the frist group had post-operative infections, and none in the second group (p less than 0,05 and 0.05 less than p less than 0.1). 67% of all the patients had severe neurological lesions; 27% of these had post-operative infections; only 4% of the patients with mild lesions had infections (p less than 0.05). Post-operative infections were severe and fatal in most of these cases. Prophylactic broad-spectrum antibiotics were of no value in preventing post-operative infections in these neurosurgical patients and those who received no antibiotics had a significantly lower rate of infections.
TL;DR: The authors believe that, in their case, such a demyelinative mechanism was responsable for the clinical picture, although a necroscopic examination was not allowed.
Abstract: Os autores apresentam caso de mielopatia transversa no curso de lupus eritematoso sistemico de evolucao sub-aguda e exito letal. E feita revisao da literatura e sao abordados aspectos clinicos, laboratoriais, terapeuticos e anatomo-patologicos. Sao ressaltados a precariedade dos resultados terapeuticos e a provavel participacao de fatores auto-imunes, levando a processos de desmielinizacao e que se constituiram, ao lado do classico comprometimento vascular, nos substratos anatomo-patologicos das manifestacoes neurologicas do lupus eritematoso sistemico. Os autores acreditam, fundamentados em dados evolutivos, na existencia de processo desmielinizante no caso relatado, embora a necropsia nao tenha sido autorizada.
TL;DR: When dealing with subarachoid haemorrhages, one should think of brain secondaries and a biopsy should always be performed whenever a spontaneous intra-cerebral hematoma is found.
Abstract: Two cases of intra-cerebral haemorrhage secondary to malignant melanoma metastasis are reported. When dealing with subarachoid haemorrhages, one should think of brain secondaries and a biopsy should always be performed whenever a spontaneous intra-cerebral hematoma is found.
TL;DR: The histochemical and ultrastructural demonstration of large amounts of lipopigments allows a presumptive classification of the case as NCL, however, the presence of involuntary movements, the absence of visual disturbances and the unusual ultrastructureural features place the patient into a small heterogeneous group within the NCL.
Abstract: A case of neuronal ceroid-lipofuscinosis (NCL) is reported in a 11-year-old girl, whose main symptoms were progressive dementia since the age of 4 years and choreic movements since age 10. Seizures, myoclonus and visual deterioration were absent and optic fundi were normal. A cerebral biopsy disclosed two basic types of stored substance in the cytoplasm of neurons: a) severely balloned nerve cells in cortical layers HI and V contained a non-autofluorescent material, which stained with PAS and Sudan Black B in frozen, but not in paraffin sections; ultrastructurally, these neurons showed abundant corpuscles similar to the membranous cytoplasmic bodies of Tay-Sachs disease and, in smaller amounts, also zebra bodies; b) slightly distended or non-distended neurons in all layers contained lipopigment granules, which were autofluorescent, PAS-positive and sudanophil in both frozen and paraffin sections; their ultrastructure was closely comparable to that of lipofuscin. Similar bodies were found in the swollen segments of axons and in a few astrocytes and endothelial cells. The histochemical and ultrastructural demonstration of large amounts of lipopigments allows a presumptive classification of the case as NCL. However, the presence of involuntary movements, the absence of visual disturbances and the unusual ultrastructural features place the patient into a small heterogeneous group within the NCL. A better classification of such unique instances of the disease must await elucidation of the basic enzymatic defects.
TL;DR: A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances, and surgical exploration showed a syphilitic gumma attached to the spinal cord.
Abstract: A case of an syphilitic intraspinal gumma is reported. A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances. Myelography revealed an intraspinal tumor at T3 level. Surgical exploration by dorsal laminectomy showed a syphilitic gumma attached to the spinal cord. Clinical observations and laboratory studies are discussed. Revision and comments on previous reports are presented.
TL;DR: Os autores concluem that o nervo peroneiro e o que melhores condicoes fornece para o seguimento e avaliacao clinica dos pacientes com uremia, apresentando tendencia para diminuir a conducao nervosa, quando existe piora da sintomatologia.
Abstract: Neste estudo foram avaliados 33 pacientes com polineuropatia e insuficiencia renal cronica. A idade dos pacientes variou entre 18 e 58 anos, sendo 26 do sexo masculino e 9 do feminino. Todos os pacientes apresentavam niveis de ureia acima de 100 mg/dl e creatinina acima de 5,0 mg/dl. 10 pacientes foram mantidos com hemodialise cronica, 13 com dialise peritoneal semanal e 10 com tratamento clinico conservador (controles). Foram realizadas medidas da conducao nervosa motora nos nervos mediano, ulnar e peroneiro em todos os pacientes, concomitante com a avaliacao clinica. Os pacientes foram divididos em grupos, conforme a intensidade da neuropatia presente. Os sintomas mais frequentes foram diminuicao do senso de vibracao, câimbras e hipoestesia distai para tacto. O nervo mais afetado foi o peroneiro (97,82%), seguido do mediano e ulnar. O procedimento dialitico alterou pouco a conducao nervosa, quando as afericoes eram realizadas antes e depois da mesma dialise. Nao houve nenhuma diferenca estatisticamente significante entre os grupos de hemodialise e dialise peritoneal na avaliacao clinica ou eletroneurografica. Em 7 pacientes seguidos por varios anos, a conducao nervosa manteve-se estavel em dois, aumentou em dois e baixou em tres, acompanhando a evolucao dos sintomas. Nos tres que pioraram, houve desenvolvimento paralelo de hiper-paratireoidismo secundario. Os autores concluem que o nervo peroneiro e o que melhores condicoes fornece para o seguimento e avaliacao clinica dos pacientes com uremia, apresentando tendencia para diminuir a conducao nervosa, quando existe piora da sintomatologia, sem relacao com o tipo de dialise empregado.
TL;DR: The projective test revealed that the pathology of the psychotic patients was qualitatively different in that they use negation and selfblocking defense mechanisms at a self-destructive level.
Abstract: 86 cronic alcoholics, hospitalized in three psychiatric clinics, were studied through a questionnaire and the Szondi Projective Test. Dividing the sample into two groups, "social" and psychotic alcoholics brought several significant differences to light. The mean age of the psychotic patients was lower than of the "social" alcoholics, suggesting that the pathology of the former had begun sooner. Furthermore, the projective test revealed that the pathology of the psychotic patients was qualitatively different in that they use negation and selfblocking defense mechanisms at a self-destructive level. This hinders individualization and fixates the patient, without internal consistency, at a level of pre-genital regression which is manifested in their social marginality.
TL;DR: Six cases of meningeal melanomatosis are reported and emphasis is given to morphological characteristics of the tumor cells and specially to the melanin dark brown pigment, observed in all cases.
Abstract: Six cases of meningeal melanomatosis are reported. The cytomorphological analysis of cerebrospinal fluid lead to diagnosis in all of them. Emphasis is given to morphological characteristics of the tumor cells and specially to the melanin dark brown pigment, observed in all cases here reported.
TL;DR: A case of precocious puberty and diabetes insipidus in a 7 years old boy due to a malignant teratoma in the IVth ventricle is reported.
Abstract: A case of precocious puberty and diabetes insipidus in a 7 years old boy due to a malignant teratoma in the IVth ventricle is reported. The tumor had grown into the Illrd and lateral ventricles as found on the necropsy. The original site of the tumor and the possible physiopathological mechanisms for the precocious puberty are discussed.
TL;DR: Muscles from human foetuses of nine weeks to nine months development were examined by electron microscopy for the first time and vessels having the features of veins and of arteries can be identified between the muscle cells.
Abstract: Foram examinados por ultramicroscopia vasos sanguineos provenientes da biopsia muscular de 27 fetos humanos de 9 semanas a 9 meses de desenvolvimento intra-uterino. Na nona semana de vida embrionaria os vasos sanguineos intramusculares tem a aparencia de capilares cujas celulas endoteliais sao envoltas por membrana basal e abaixo desta muitas vezes sao identificados pericitos. Tais capilares sao do tipo continuo. Nas areas de contato entre as celulas endoteliais ocorrem desmossomas. Veias e arterias bem formadas sao vistas a partir da decima sexta semana Nas arterias sao observadas amplas zonas de contato entre a camada endotelial e a camada seguinte formada pelas celulas musculares lisas. Tais zonas de contato interrompem periodicamente a lâmina elastica interna e sao originarias, na verdade, de celulas claras que situadas entre as celulas endoteliais mantem com estas uma intima relacao atraves de numerosos desmossomas. Nao foi possivel identificar os nucleos de tais celulas cuja funcao parece ser a de fixar a intima na camada media.
TL;DR: In this article, a study of 103 amostras de LCR de pacientes portadores de doenca neurologica ou sistemica mas com possivel repercussao no sistema nervoso central (SNC) was conducted.
Abstract: A conceituacao atual do sistema LCR e de uma entidade dinâmica, com papel ativo na homeostase do sistema nervoso central (SNC). Diversas afeccoes do sistema nervoso apresentam desde o inicio, ou a partir de determinado tempo de evolucao, citologia do LCR quantitativamente normal. Foram estudadas 103 amostras de LCR de pacientes portadores de doenca neurologica ou sistemica mas com possivel repercussao no sistema nervoso. Paralelamente, 30 amostras de LCR de pacientes com cefaleia cronica foram analisadas e consideradas como grupo controle. Sao analisados e discutidos os resultados de cada grupo, levando em conta os criterios de ativacao celular bem como os varios tipos celulares observados. Foi verificado ocorrer sinalizacao do sistema celular que habitualmente integra a citomorfologia classe 1 em ambos os grupos. No grupo dos 103 pacientes do grupo 1, a essas celulas, aduziam-se aquelas proprias a classe II em 71 casos.
TL;DR: Los autores resumen la evolucion que ha conducido al nacimiento de la neuropsicolinguistica actual cuyo panorama revisan en forma sumaria y propo-niendo una definicion general de Ias afasias desde this nuevo plano.
Abstract: The authors summed up the evolution of the current neuropsicolinguistics and of its origins. They proposed a general definition of the aphasic disorders in relation to the psycholinguists capacities involved. The paper finish with a brief reference to the variety of types of the aphasics disorders according with its fluent or non-fluent caracter.
TL;DR: The authors resumen la evolucion que ha conducido al nacimiento de la neuropsicolinguistica actual cuyo panorama revisan en forma sumaria, propo-niendo una definicion general de Ias afasias desde this nuevo plano, to finalizar haciendo un breve referencia a sus diversas formas.
Abstract: Los autores resumen la evolucion que ha conducido al nacimiento de la neuropsicolinguistica actual cuyo panorama revisan en forma sumaria, propo-niendo una definicion general de Ias afasias desde este nuevo plano, para finalizar haciendo una breve referencia a sus diversas formas.
TL;DR: Generalised post-operative cerebral vasospasm is a major factor in delineating poor operative results following direct ruptured intracranial aneurysms, and continuous monitoring of intrac cranial pressure seems to be particularly helpful on such occasions, and intrac Cranial compliance determination as well.
Abstract: Generalised post-operative cerebral vasospasm is a major factor in delineating poor operative results following direct ruptured intracranial aneurysms. Continuous monitoring of intracranial pressure seems to be particularly helpful on such occasions, and intracranial compliance determination as well. High intracranial compliance values suggest that even small intracranial volume increases may induce rapid intracranial pressure increase and situations likely to produce neurological deterioration.
TL;DR: The prognosis of the acute intermittent porphyria is worse if the patients have disautonomic symptoms; three patients died and two had neurological sequalae (motor tetraparesis); the cause of this problems is probably the involvment of the autonomic adrenergic system.
Abstract: The study of six patients with acute intermittent porphyria is reported. Clinical and biochemical studies have been performed during the long hospitalization of the patients. The main disautonomic aspects were the arterial hypertension and the tachycardia in four patients, cardiac arrest in three patients and respiratory arrest in five patients. The cause of this problems is probably the involvment of the autonomic adrenergic system. The authors observed also three patients with hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. The prognosis of the acute intermittent porphyria is worse if the patients have disautonomic symptoms; three patients died and two had neurological sequalae (motor tetraparesis).
TL;DR: A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances, and surgical exploration showed a syphilitic gumma attached to the spinal cord.
Abstract: A case of an syphilitic intraspinal gumma is reported. A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances. Myelography revealed an intraspinal tumor at T3 level. Surgical exploration by dorsal laminectomy showed a syphilitic gumma attached to the spinal cord. Clinical observations and laboratory studies are discussed. Revision and comments on previous reports are presented. Spinal cord compression by intraspinal syphilitic gumma: report of a case
TL;DR: In this article, a case of miopatia ocular tipo Kiloh-Nevin nao-familiar com importantes alteracoes histoquimicas e ultraestruturais was discussed.
Abstract: E relatado um caso de miopatia ocular tipo Kiloh-Nevin nao-familiar com importantes alteracoes histoquimicas e ultraestruturais. O paciente apresentava fenomenos de natureza miastenica e dores musculares, achados pouco comuns. Do ponto de vista histopatologico foram assinaladas a abundante quantidade de "fibras rasgadas" ("ragged-red fibres") e a predominante atrofia nas fibras musculares tipo I. Tambem o estudo ultraestrutural mostrou a importância das alteracoes mitocondriais, notadamente a abundância de inclusoes cristaloides na matriz mitocondrial. Os autores concluem tecendo consideracoes sobre a provavel alteracao a nivel da transmissao neuromuscular, atribuindo a algum fator enzi-matico geneticamente determinado a etiopatogenia da miopatia.
TL;DR: Este estudo mostra that a inteligencia, medida pelo teste nao-verbal de Leither, esta melhor preservada em alguns tipos oficiales de afasicos.
Abstract: Foram estudados 8 pacientes com quadro clinico de acidente vascular cerebral e afasia, internados logo apos o ictus. Foram avaliados os aspectos clinico, neuropsiquiatrico, eletrencefalografico e neuroradiologico. Os pacientes foram submetidos a avaliacao psicologica e fonoaudiologica. Este trabalho correlaciona a lesao neurologica as alteracoes estruturais da inteligencia, as alteracoes praxicas e estereognosicas e tambem aos disturbios da linguagem. Para a classificacao do nivel intelectual foram usados os criterios da Organizacao Mundial da Saude e a classificacao genetica de Jean Piaget. Este estudo mostra que a inteligencia, medida pelo teste nao-verbal de Leither, esta melhor preservada em alguns tipos de afasicos.