Sphenoid sinus bleeding during generalized seizure: a rare SISCOM (subtraction ictal SPECT coregistered with MRI) finding mimicking skull base tumor.
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Adult↗
Biomedical subjects
Antonio Carlos Santos
Publications and source records attributed to Antonio Carlos Santos.
Cavum septum pellucidum and adhesio interthalamica in schizophrenia: an MRI study.
Several studies have independently suggested that patients with schizophrenia are more likely to have an enlarged cavum septum pellucidum (CSP) and an absent adhesio interthalamica (AI), respectively. However, neither finding has been consistently replicated and it is unclear whether there is an association between these two midline brain abnormalities. Thus, we compared the prevalence of absent AI and the prevalence, size and volume of CSP in 38 patients with schizophrenia and 38 healthy controls using magnetic resonance imaging (MRI). There were no between group differences in the presence or volume of CSP; however, an enlarged CSP was commoner among patients than controls. There was also a positive correlation between CSP ratings and volumes. No differences in the presence or absence of the AI were found between patients and controls; however, an absent AI was commoner in male patients with schizophrenia than females. There was absolutely no overlap between the presence of a large CSP and an absence of AI. In conclusion, our findings are in line with several case series and other MRI investigations that have shown a higher incidence of putatively developmental brain abnormalities in patients with schizophrenia, particularly in males, and support the neurodevelopmental model of this disorder.
Adult↗
Quantitative aspects of brain perfusion dynamic induced by BOLD fMRI.
The increase of relative cerebral blood flow (rCBF) may contribute for a change in blood oxygenation level dependent signal (BOLD). The main purpose of this study is to investigate some aspects of perfusional alterations in the human brain in response to a uniform stimulation: hypercapnia induced by breath holding. It was observed that the BOLD signal increased globally during hypercapnia and that it is correlated with the time of breath holding. This signal increase shows a clear distinction between gray and white matter, being greater in the grey matter.
Blood Flow Velocity↗
Posture control in Pusher syndrome: influence of lateral semicircular canals.
UNLABELLED: Pusher syndrome is an interesting disorder of balance in patients with encephalic lesions characterized by the peculiar behavior of actively pushing away from the non-hemiparetic side and resisting against passive correction, with a tendency to fall toward the paralyzed side. The role of vestibular system on the pushing behavior is not clear. AIM: To evaluate horizontal semicircular canal function in patients with Pusher syndrome, using caloric and rotation tests. STUDY DESIGN: Observational prospective. MATERIAL AND METHOD: We evaluated 9 inpatients with stroke and Pusher syndrome at the neurological unit of HCFMRP-USP. We applied neurological and neuropsychological exams, NIHSS, Scale for contraversive pushing (SCP), caloric and rotation tests. RESULTS: We evaluated 9 patients (5 men) with mean age of 71.8 +/- 5.9 and mean NIHSS of 18.33. Three patients presented contralateral directional preponderance on caloric test and we found four patients with directional preponderance on analysis of the slow phase velocity of rotation test response. CONCLUSION: Our findings indicate that a dysfunction of semicircular canals does not seem to be relevant for the clinical manifestations of the Pusher syndrome.
Aged↗
The use of neoadjuvant chemotherapy to achieve complete surgical resection in recurring supratentorial anaplastic ependymoma.
INTRODUCTION: Ependymoma is a central nervous system neoplasm that is often managed with surgery and radiotherapy. The benefits of chemotherapy in treating this tumor remain poorly defined. CASE REPORT: The use of a platinum-based chemotherapy as a neoadjuvant treatment to permit complete surgical resection of a supratentorial anaplastic ependymoma recurring for the third time is described. DISCUSSION: This paper also discusses the possible use of chemotherapy as a strategy that may allow tumor shrinkage and ease tumor resection in giant recurring ependymomas.
Child↗
The relationship between diffuse axonal damage and fatigue in multiple sclerosis.
BACKGROUND: Fatigue is a common and distressing symptom for patients with multiple sclerosis (MS). There is growing evidence that fatigue in MS has a central nervous system component. We hypothesized that diffuse cerebral axonal damage could be associated with fatigue and used proton magnetic resonance spectroscopy to noninvasively measure axonal damage or loss in the brains of patients with MS. OBJECTIVE: To assess the strength of the relationship between central brain N-acetylaspartate and fatigue. DESIGN: Data from 73 patients who had undergone proton magnetic resonance spectroscopy imaging and completed the Fatigue Severity Scale questionnaire were analyzed. RESULTS: The N-acetylaspartate-creatine ratio (NAA/Cr) was significantly lower in the high-fatigue group than the low-fatigue group (mean +/- SD, 2.69 +/- 0.29 and 2.99 +/- 0.33, respectively. P =.003). Independent of the Kurtzke Expanded Disability Status Scale, T2 lesion volume, age, and disease duration, NAA/Cr was significantly lower in the high-fatigue group as compared with the low-fatigue group. There was a statistically significant linear correlation between the Fatigue Severity Scale scores and NAA/Cr (Spearman rank rho = -0.361, P =.02). CONCLUSIONS: The results of this study, combined with those of others, suggest that widespread axonal dysfunction is associated with fatigue in MS. Increased recruitment of cortical areas and pathways in response to brain injury may be responsible for the patient's sense that the effort required to perform actions is disproportionately high.
Adult↗
Surgical treatment for mesial temporal lobe epilepsy in the presence of massive calcified neurocysticercosis.
BACKGROUND: Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system and a major health problem for most developing countries. The most common clinical manifestations of NCC are epileptic seizures. Whenever epilepsy and NCC coexist in the same patient, an uncertainty may rise about a causal relationship between them. OBSERVATION: We described a female patient with disseminated calcified NCC lesions and intractable epilepsy. Her medical history included cysticercotic meningoencephalitis and status epilepticus caused by active NCC. Fundoscopy showed the ocular presence of parasite; computed tomography of the brain showed evidence of cystic lesions with the scolex and calcified lesions; enzyme-linked immunosorbent assay of the cerebrospinal fluid was positive for cysticercosis. Epileptic seizures started after an 8-year silent period. Magnetic resonance imaging showed left hippocampal sclerosis. Plain x-ray film showed calcifications in muscles and subcutaneous tissue. Video-electroencephalography and ictal and interictal single-photon emission computed tomography disclosed left mesial temporal lobe epilepsy. The patient underwent left temporal lobectomy and has been seizure free since surgery, for a follow-up of 4 years. CONCLUSION: This case report highlights and supports surgical therapy in patients with epileptic seizures and calcified NCC, even when there are several calcifications, provided that clear localization of epilepsy has been determined by means of a presurgical workup.
Adult↗
Sotos syndrome (cerebral gigantism): analysis of 8 cases.
Sotos syndrome or cerebral gigantism is characterized by macrocephaly, overgrowth, mental retardation and central nervous system abnormalities. Congenital heart defects may be present. We report 8 patients with this syndrome and relate their clinical features, neuroimaging and echocardiographic findings.
Abnormalities, Multiple↗