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Biomedical subjects

J Masjuan Vallejo

Publications and source records attributed to J Masjuan Vallejo.

5 recordsLinked to original sources

[Thrombolytic treatment in acute ischemic stroke in a center without previous experience. Development of internal organization and first results].

BACKGROUND AND OBJECTIVE: Treatment of acute ischemic stroke within three hours with intravenous tissue-type plasminogen activator (t-PA) has been recently approved by the European Drug Agency. We present the development of an internal organization system that has permitted thrombolytic treatment in our center without previous experience as well as the results of the first year. PATIENTS AND METHOD: Development of the thrombolysis educational program for the staff informed, of the internal organization system, and combined care protocols among the participating services. Prospective registry of patients treated with t-PA within the period 1/2004-2/2006. We collected demographic data, stroke assessment scales score (NIHSS), time to treatment, seven day and three months mortality, symptomatic hemorrhagic transformation, systemic bleedings, functional independency at three months, early significant improvement and significant deterioration. RESULTS: Fifty-three patients were treated. Mean age: 65 +/- 13 years; 56% women. Mean NIHSS pre-treatment: 14 +/- 4.7. Mean time to hospital arrival: 62 +/- 40 minutes; door-to-treatment: 68 +/- 22 minutes, and mean time from stroke onset to treatment: 130 +/- 31 minutes. Symptomatic hemorrhagic transformation: 5.8%. Systemic bleeding: 3.8%. Seven day mortality: 5.6%; three months mortality: 15.1%. Early significant improvement: 51%. Significant neurological deterioration: 7.5%. Functional independency at three months: 51%. CONCLUSIONS: Treatment of acute ischemic stroke within three hours with intravenous t-PA is safe and is associated with a favourable outcome when it is applied by neurologists specifically trained in acute stroke management.

Aged↗

[Pseudotumor cerebri and systemic lupus erythematosus].

Pseudotumor cerebri (PC) is a syndrome characterized by intracranial hypertension in the absence of any space-occupying lesion, hydrocephalus, cerebral sinus thrombosis and biochemical or cytological abnormalities in the CSF. PC has ben associated with several factors such as systemic conditions or drugs. We report here the case of a patient who presented with headache, vomiting and blurred vision accompanied by bilateral papilledema and had been diagnosed with systemic lupus erythematosus (SLE) seven years before. Treatment was started with high-dose corticosteroids with rapid resolution of the clinical symptoms and papilledema of the patient.

Adult↗

[POEMS Syndrome with central and peripheric nervous system demyelination].

POEMS syndrome is characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin changes. This polyneuropathy belongs to the chronic inflammatory demyelinating polyradiculoneuropathies (CIDP) group. Sporadic reports have emphasized the clinical association between CIDP and central nervous system (CNS) demyelination, but as far as we know not in the context of POEMS syndrome. We report the case of a 67 years old patient who developed POEMS syndrome associated to Castleman's disease, characterized by demyelinating polyradiculoneuropathy, hepatosplenomegaly, mediastinal and supraclavicular adenopathies and monoclonal IgG lambda gammapathy. Cranial magnetic resonance imaging disclosed diffuse alteration of the cerebral white matter highly suggestive of demyelination. CNS demyelination can be another feature of POEMS syndrome. Cranial MRI should be performed in patients with POEMS syndrome in order to verify this new feature.

Aged↗

[Progressive amyotrophy of a limb as the presenting symptom of anchored spinal cord syndrome with spinal lipoma].

OBJECTIVE: We present a case of progressive amyotrophy of a limb as the presenting symptom of the anchored spinal cord syndrome and review the principal clinical features of the syndrome, diagnostic tests which are useful in differentiating it from other conditions and its treatment. CLINICAL CASE: We describe a case of a young woman in whom the spinal cord was anchored by a spinal lipoma. At the onset of the disorder she complained of progressive muscular atrophy of the right leg and difficulty in dorsi-flexion of her right foot. Plain X-ray of the pelvis showed partial agenesis of the right lower hemisacrum and partial sacralization of L5. Lumbosacral CT and MR showed a lipoma to be present within the spinal canal and the thickened filum terminale anchored within the lipoma. During the next five months after diagnosis, the clinical picture worsened with paresia of flexo-extension of the right knee and of flexion of the right foot. Surgical treatment was therefore indicated. CONCLUSIONS: The anchored spinal cord syndrome should be considered in the differential diagnosis of spinal cord disorders presenting in adults, when there are other malformations such as agenesis of the sacrum. Surgical treatment is always indicated when there is evidence of worsening clinical condition.

Adolescent↗