Biomedical subjects

A Verdelho

Publications and source records attributed to A Verdelho.

4 recordsLinked to original sources

PubMed2004

Depressive symptoms after stroke and relationship with dementia: A three-year follow-up study.

OBJECTIVE: To determine frequency, determinants, and time course of poststroke depressive symptoms (DS) and their relationship with dementia. METHODS: Two hundred two consecutive stroke patients were prospectively evaluated for DS, followed up over a 3-year period. Patients with Montgomery and Asberg Depression Rating Scale (MADRS) scores of >/==" BORDER="0">7 were considered as having DS. The severity of the neurologic deficit, functional outcome, and dementia were quantified with the Orgogozo Scale, modified Rankin Scale, Informant Questionnaire on Cognitive Decline in the Elderly, and an extensive battery of neuropsychological tests. RESULTS: DS were present in 43% of survivors after 6 months, 36% after 12 months, 24% after 24 months, and 18% after 36 months. The severity of the neurologic deficit at admission was the only independent predictor of DS at month 6. DS at month 6 were more frequent in patients with previous depression, dementia, and right superficial lesions. Younger age and right superficial lesions were the two variables independently associated with the presence of DS at month 36. The time course of the various DS differed, sadness remaining frequent 3 years after stroke (50%), whereas slowness, psychic slowness, lack of energy, and concentration difficulties remained frequent at month 36 in patients with dementia. CONCLUSION: DS are frequent after stroke. Their time course varies and depends on the cognitive status; this variation contributes to differences among previous studies on poststroke depression.

Adult↗

PubMedDate not supplied

[Multiple vertebro-basilar infarcts and cardio-embolism].

INTRODUCTION: Stroke characteristics do not inform much about its etiology, even if they can suggest a specific mechanism. We thought that multiple vertebrobasilar infarcts could be related with embolism, namely cardioembolism. PATIENTS AND METHODS: From a hospital prospective registry of stroke we retrieved 73 cases of acute non-lacunar vertebrobasilar infarcts, without previous episodes of stroke in any territory or vertebrobasilar transient ischemic accidents (TIA). Two groups were compared: patients with single cerebral posterior artery infarct (49) and patients with multiple vertebrobasilar infarcts (24), in respect to conventional risk factors for cerebrovascular disease, ancillary procedures performed, and associated pathologic conditions, as possible infarct pathogenesis. RESULTS: Proportions of risk factors and ancillary procedures performed were similar in both groups, except for hypercholesterolemia, which was more frequent in multiple infarcts, and for transcranial Doppler, which was performed more frequently in multiple infarcts. In multiple infarct group, cardioemboligenic pathology was more frequent, as were medium-high emboligenic risk cardiac diseases and atrial fibrillation, although the difference did not reach statistical significance. CONCLUSIONS: Our results support the hypothesis that multiple non-lacunar vertebrobasilar infarcts, from a first ever stroke event, suggest cardioembolic etiology, and recommend performing an exhaustive cardiac investigation.

Aged↗

PubMedDate not supplied

[Two myopathy cases].

INTRODUCTION: Early diagnosis and therapeutic measures of frequent pathologies like hyperthyroidism made their neurological complications less frequent. In spite of well known, these neurological complications are some times forgotten. CLINICAL CASES: We describe two myopathy cases, which presentation was namely fatigue. The inespecificity of this complaint create aetiology and syndromatic diagnosis difficulties, and therapeutic decision. In first case, the symptoms were very gradual, what is usual in older patients, and became extremely incapacitate, depending on others for every daily activity. In the second case, a young patient with diplopia suggested myasthenia. Both cases were diagnosed with hyperthyroidism and a quick improvement occurred with proper medication. Based in these cases, a thyrotoxic myopathy brief comment is made, as in spite of being frequent, these cases presented diagnosis difficulties.

Adolescent↗

PubMedDate not supplied

[Cerebral venous thrombosis and familial prothrombin gene G20210a mutation].

INTRODUCTION: The prothrombin gene variant G20210A was first described as a risk factor for deep vein thrombosis, and recently for cerebral venous thrombosis, although reported cases had other concomitant risk factors. CLINICAL CASES: A 33 years old woman, with no previous vascular nor thrombotic risk factors, was admitted with thrombosis of superior longitudinal, lateral and sigmoid right sinus. The father had deep venous thrombosis 3 years before. One year later, the 29 year old sister of the proband, developed massive deep venous thrombosis, when she was 8 months pregnant. Laboratory investigations showed elevated anticardiolipin antibodies titer in the proband. Prothrombin activity was in the normal range in the 3 patients. Prothrombin gene mutation G 20210A was detected in the 3 patients. CONCLUSION: As the presence of more than one thrombophilic factor (in the reported case, prothrombin G20210A mutation and anticardiolipin antibodies) increases the likehood of a thrombotic event, it is useful to screen for thrombotic genetic conditions, even when other vascular risks are present, and vice versa.

Adult↗