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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
- Assessing Executive Dysfunction in Neurodegenerative Disorders: A Critical Review of Brief Neuropsychological ToolsPublication . Moreira, HS; Costa, AS; Castro, SL; Lima, CF; Vicente, SGExecutive function (EF) has been defined as a multifaceted construct that involves a variety of high-level cognitive abilities such as planning, working memory, mental flexibility, and inhibition. Being able to identify deficits in EF is important for the diagnosis and monitoring of several neurodegenerative disorders, and thus their assessment is a topic of much debate. In particular, there has been a growing interest in the development of neuropsychological screening tools that can potentially provide a reliable quick measure of EF. In this review, we critically discuss the four screening tools of EF currently available in the literature: Executive Interview-25 (EXIT 25), Frontal Assessment Battery (FAB), INECO Frontal Screening (IFS), and FRONTIER Executive Screen (FES). We first describe their features, and then evaluate their psychometric properties, the existing evidence on their neural correlates, and the empirical work that has been conducted in clinical populations. We conclude that the four screening tools generally present appropriate psychometric properties, and are sensitive to impairments in EF in several neurodegenerative conditions. However, more research will be needed mostly with respect to normative data and neural correlates, and to determine the extent to which these tools add specific information to the one provided by global cognition screening tests. More research directly comparing the available tools with each other will also be important to establish in which conditions each of them can be most useful.
- Caracterização dos antecedentes psiquiátricos nos doentes com demência: relação da depressão com a demênciaPublication . Fonseca, L; Machado, A; Duarte, JDepression has been reported as the most frequent neuropsychiatric diagnostic on the clinical background of demented patients, mainly with Alzheimer dementia (AD). Several studies have showed that this relation is not occasional. In this work we present the results of the statistical analysis made on the characterization of the psychiatric background of demented patients from the memory consultation of the Braga Hospital.
- A case of pediatric paraparesis secondary to an idiopathic acute transverse myelitisPublication . Teixeira, J; Carvalho, S; Martins, S; Pontes, T; Machado, A; Antunes, HIntroduction: Acute transverse myelitis (ATM) refers to a frequently idiopathic, segmental spinal cord inflammation. It is a rare condition, in particular in children, and not previously reported in a family retinitis pigmentosa (RP) clinical setting. Case Report: An 11-year-old previously healthy girl, with a family history of RP, presented with a subacute flaccid paraparesis, with bilateral, up to the fourth dorsal level, mixed sensory hypoesthesia and autonomic dysfunction. Brain and spinal cord magnetic resonance imaging (MRI) showed an extensive, T2-hyperintense, non-contrast enhancing lesion from the second to fifth dorsal levels. Cerebrospinal fluid (CSF) and lab studies were normal, as the ophthalmologic observation. Treated with high-dose corticosteroids and intensive physical therapy,a significant recovery could be seen. Conclusion:Early pharmacological and physical treatment is fundamental and may indeed change the prognosis of this disease ATM. The family history of RP, although probably incidental, brings nevertheless the issue of a possible etiological contribution, or pathologic common pathways.
- Uma causa rara de paralisia facial periférica recorrentePublication . Pinho, J; Rocha, S; Machado, A; Lourenço, ERecurrent peripheral facial palsy (PFP) is not uncommon and it is reported in 3 to 15% of idiopathic PFPs. Other etiologies include intracranial compressive tumors, parotid gland tumors or inflammation, recurrent otitis media, head trauma, multiple sclerosis, sarcoidosis, tuberculosis, Lyme disease, HIV, and the rare Melkersson-Rosenthal Syndrome (MRS). The MRS is a non-necrotizing granulomatous disease characterized by PFP, lingua plicata and orofacial edema, even though the classic triad is reported in only from 20 to 30% of the patients1. We describe a patient with recurrent alternating PFP with MRS.
- Cerebral venous thrombosis in a patient with localised sclerodermaPublication . Rocha, J; Pinho, J; Fernandes, J; Ferreira, C; Macedo, C; Fontes, JR; Perdigão, S
- Ciproterone Effect on Compulsive Masturbation in a Frontotemporal Dementia PatientPublication . Fonseca, L; Simões, S; Ferreira, P; Mesquita, J; Machado, A
- 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.