Browsing by Author "Ferreira, C"
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- Acidente Vascular Cerebral em Doente com Anemia de Células FalciformesPublication . Caridade, S; Machado, A; Ferreira, CStroke in patients with sickle cell anemia is multifactorial but occurs mainly by 2 mechanisms: occlusive arteriopathy and obliteration of small vessels with plugs of sickle cells. The high individual risk can be assessed by simple and well-defined strategies such as ultrasounds with transcranial and cervical Doppler Ultrasonography. The authors report the clinical case of a 25 year-old black female patient with sickle cell anemia, who was admitted with right hemiparesis. Cerebral MRI showed small recent fronto-temporo-parietal cortical-subcortical infarcts and several, older, posterior periventricular lacunae of left preponderance. A brief discussion is made, with particular emphasis on the proper treatment and prevention of its cerebrovascular complications.
- Alcohol abuse and acute behavioural disturbances in a 24-year-old patient. Diagnosis: Marchiafava-Bignami disease (MBD)Publication . Machado, A; Soares-Fernandes, J; Ribeiro, M; Rodrigues, M; Cerqueira, J; Ferreira, C
- Angioplastia CarotídeaPublication . Ribeiro, M; Xavier, J; Ferreira, C; Fernandes, J; Magalhães, Z; Rocha, J
- Cerebral venous thrombosis in a patient with localised sclerodermaPublication . Rocha, J; Pinho, J; Fernandes, J; Ferreira, C; Macedo, C; Fontes, JR; Perdigão, S
- Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndromePublication . Pereira, PR; Pinho, J; Rodrigues, M; Rocha, J; Sousa, F; Amorim, J; Ribeiro, M; Rocha, J; Ferreira, CObjective Analyze the cases of posterior reversible encephalopathy syndrome (PRES) admitted in a Neurology Department during an 8-year period. Method Retrospective observational study in a central hospital in the north of Portugal. Results 14 patients were identified, mean age 52.3 years. Precipitating factors included: eclampsia, isolated arterial hypertension, spinal trauma and autonomic dysreflexia, Guillain-Barré syndrome, sepsis, sarcoidosis and pulmonary cryptococcosis and drugs. Most patients presented posterior-predominant vasogenic edema lesions, however 64.2% presented frontal lesions and in 42.8% cerebellum was involved. Four patients also had acute ischemic lesions and 1 had hemorrhagic lesions. During follow-up 10 patients recovered fully, 2 recovered partially, 1 suffered a recurrence and 2 died in hospital. Conclusion PRES has many etiological factors. The terms posterior and reversible should be revised because PRES frequently involves other brain regions and it is not always reversible. PRES patients may develop life-threatening complications and mortality is not negligible.
- De encefalopatia e orelhas duras ao síndrome de Sheehan: caso clínicoPublication . Machado, A; Ferreira, C; Lopes, M; Pereira, T; Pardal, F
- Declínio Cognitivo de Etiologia MedicamentosaPublication . Caldeira, L; Varanda, S; Machado, A; Ferreira, C; Carneiro, GIn the elderly there is a high risk of inappropriate medication and adverse effects of polypharmacy. A 68 year-old female patient resorted to the Emergency Room for suspected stroke. According to the husband, in the six months prior to admission, she became progressively disorientated and dependent. She had resorted to various appointments from different specialties and was polymedicated. It was impossible to clarify the exact dosage. On neurological examination she presented disturbance in attention and memory, disorientation, constructional apraxia, myoclonus and gait imbalance. After the suspension of all chronic medication, she showed gradual improvement. By the time of discharge, her neurological examination was completely normal. Iatrogenic effect of drugs as a cause of reversible dementia should be considered. All patients, particularly the elderly and their caregivers, should be suitably informed about the drugs that are prescribed and the dosages used. Using the biopsychosocial model could prevent inappropriate polypharmacy and iatrogeny.
- Deep cerebral venous thrombosis: a challenging diagnosisPublication . Pires, A; Rocha, S; Rodrigues, M; Machado, A; Lourenço, E; Ferreira, C
- Deep cerebral venous thrombosis: a challenging diagnosis.Publication . Pires, A; Rocha, S; Rodrigues, M; Machado, A; Lourenço, E; Ferreira, C
- Diversity in anti-N-methyl-D-aspartate receptor encephalitis: case-based evidencePublication . Pinho, J; Rocha, J; Rodrigues, M; Pereira, J; Maré, R; Ferreira, C; Lourenço, E; Beleza, PAntibodies against N-methyl-D-aspartate receptor (NMDAR) are identified in the form of immune-mediated encephalitis in which typical manifestations include neuropsychiatric symptoms, seizures, abnormal movements, dysautonomia and hypoventilation. The authors report two cases of anti-NMDAR encephalitis with different presentations and patterns of progression. The first patient presented with status epilepticus and later developed psychosis, pyramidal signs and diffuse encephalopathy. The second patient presented with acute psychosis followed a week later by seizures, dystonia, rigidity, oromandibular dyskinesias and dysautonomia. Possible mechanisms responsible for the clinical manifestations of this disease are discussed in light of recently described additional clinical and laboratory findings.