HB - Neurorradiologia
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- Hemangioma intracranianoPublication . Rocha, J; Marques, C; Adams, A; Rodrigues, JA case of intracranial hemangioma in a neonate is described by the authors. The rarity of the condition raised differential diagnosis problems.
- Wallerian degeneration after stroke: a new prognostic factor?Publication . Soares-Fernandes, J; Beleza, P; Ribeiro, M; Maré, R; Almeida, F; Rocha, JWallerian degeneration (WD) after ischemic stroke has been associated to persistent motor impairment, but signal intensity changes on conventional magnetic resonance imaging (MRI) are generally not detected until four weeks after the event. We report a 54 year old male patient, referred to our hospital for sudden-onset left hemiparesis. Cerebral CT showed right fronto-parietal infarct (middle cerebral artery stroke). We performed two CT control, which revealed no haemorrhagic transformation. MRI, obtained 13 days after the onset, demonstrated the infarct, mainly subcortical, extending throughout fronto-temporo-parietal areas and restricted diffusion in the ipsilateral corticospinal tract. In conclusion, WD is apparent on diffusion-weighted imaging within two weeks of stroke, allowing a better prognostic evaluation of recovery. The abnormal signal should not be misinterpreted as new ischaemic lesions.
- Reverse crossed cerebellar diaschisisPublication . Ribeiro, M; Beleza, P; Fernandes, J; Almeida, F; Rocha, JCerebral Magnetic Resonance imaging in acute postictal period is performed to exclude structural processes that can be responsible for the epileptic activity. Sometimes, the findings are the result of the epileptic activity, and not the cause reflecting the pathophysiologic changes during epileptic activity. In this paper we describe a patient with status epilepticus who has developed hemicerebellar involvement contralateral to a frontal epileptogenic focus. This phenomenon of Reverse Crossed Cerebellar Diaschisis is rare and has been describe only in Single Photon Emission Computed Tomography (SPECT).
- Isolated velopalatine paralysis associated with parvovirus B19 infectionPublication . Soares-Fernandes, JP; Maré, RA case of isolated velopalatine paralysis in an 8-year-old boy is presented. The symptoms were sudden-onset of nasal speech, regurgitation of liquids into the nose and dysphagia. Brain MRI and cerebrospinal fluid examination were normal. Infectious serologies disclosed an antibody arrangement towards parvovirus B19 that was typical of recent infection. In the absence of other positive data, the possibility of a correlation between the tenth nerve palsy and parvovirus infection is discussed.
- Deficiência de desidrogenase do piruvato: achados em ressonância magnética neonatalPublication . Fernandes, JS; Gomes, R; Cruz, R; Ribeiro, M; Magalhães, Z; Rocha, J
- Abcesso isolado do clivus achados em ressonância magnética convencional: estudo de difusãoPublication . Fernandes, JS; Valle, JM; Morais, N; Ribeiro, M; Magalhães, Z; Moreira da Costa, JA; Rocha, J
- Neurological picture. The sonographic pitfall of carotid collateralisation via the vasa vasorumPublication . Soares-Fernandes, JP; Ribeiro, M; Magalhães, Z; Rocha, JF
- Angioplastia CarotídeaPublication . Ribeiro, M; Xavier, J; Ferreira, C; Fernandes, J; Magalhães, Z; Rocha, J
- Primary angiitis of the central nervous system: an infrequent form of presentationPublication . Jordão, MJ; Almeida, F; Moreira da Costa, JA; Rocha, JINTRODUCTION: Primary angiitis of the central nervous system (CNS) is a rare disease. Clinical signs and symptoms include headache and cognitive disorders associated to multifocal neurological deficits. A definitive diagnosis can only be achieved by means of a cerebromeningeal biopsy. CASE REPORT: We describe the case of a 15-year-old male who first reported lower back pain and progressive paresis of the right lower limb, later followed by laterocollis on the right side. Magnetic resonance (MR) scanning of the brain and spinal cord revealed a pseudotumoral lesion in the right cerebellum and two lesions in the spinal cord. Dexamethasone was administered and surgical resection of the cerebellar lesion was performed. Following surgery, the patient received corticoid treatment with progressive withdrawal. Full clinical recovery of the patient was achieved. A year later, the same patient was admitted to hospital again because of headaches and diplopia. A new MR brain scan showed a right frontotemporal lesion. Dexamethasone was administered and the patient recovered. Thirteen months later, he reported dysarthria and right-side hemiparesis. An MR brain scan revealed the presence of a number of bilateral lesions in the white matter. Results of a lumbar puncture showed lymphocytic pleocytosis and raised protein levels in cerebrospinal fluid. The laminae from the cerebromeningeal biopsy were reviewed and the results confirmed the hypothetical diagnosis of angiitis of the CNS. Treatment was established with intravenous cyclophosphamide in association with oral prednisone. CONCLUSIONS: Primary angiitis of the CNS is an infrequent disease and its pathogenesis remains unknown. The definitive diagnosis of these patients is histological. It courses spontaneously and generally has a fatal outcome. Treatment, which consists in an association of cyclophosphamide and prednisone, must be started as early as possible.
- Multiple cerebral cystic lesions with calcified borders: an atypical presentation of pulmonary adenocarcinomaPublication . Machado, A; Soares-Fernandes, J; Ferreira, C; Rocha, J