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1622 Marantic thrombosis of the cerebral venous sinus associated to disseminated cerebral vasculitis — case report
Friday, November 11, 2005
Poster Abstracts
1620 Sunet - case report Gomes, S2, Campanella, CAD, Luna, Pizzato, R, Valle, ELR, Dantas, TN, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Germ Exdreito de Sdo Paulo - HGESP, Brazil
Introduction: Sunct is a pathology described as predominant in male gender which algic symptoms in the trigeminal territory may be triggered by several stimuli. Objective: To describe case of female patient. Method: DJOC, 50 years old, female, caucasian, with episode of extrenre pain on left eye intertral corner and left perinasal, with brief duration though very frequent, and progressive worsening. Patient informs having more titan 20 fits per day, associated with lacrimation. Results: TAC + RMN + EEG + Liquor + Angiography + normal laboratory examinations. Treatment: Little response obtained with Carbamazepin, difenilhidantoine, CZP, tricyclics and indometacine. Conclusion: the oxygen use presented a clinical improvement. We need more experience and better evaluation to gain knowledge of the syndrome.
$511
infectious processes. The latter are caused by bacterial pyogenic production, subsequent inflammatory cells migration and plaque ag~tfination factors. Case Report: T. T. F., 15 years old, male, caucasian, single, student, bortt in Franca SP. Clinical Scenario: Confusion, holocranial cephalea of high intensity, paralysis of the IV bilateral cranial nerve and incomplete paralysis of the III cranial nerve on the left. Personal Record: Surgical drainage of the mmxillary sinus on the left, due to chronic sinusitis, 53 days prior to admission. Liquor Exaufinalion: 1,114 cells, 86% neutrophils, 10% lymphocytes, 3% monocytes, proteins 256 mg/dl, glucose 10 mg/dl. Encephalon magnetic nuclear resonance and angioresonance: marantic thrombosis of all the visualized cerebral venous sinuses, presence of pyogerfic material in leptometfinges and cisterns of the basis. Digital Cerebral Arteriograpby: Suggestive images of disseminated arterial vasculitis, mainly in the left cerebral hemisphere. Conehision: The clinical signs and examinations are compatible with the marantic thrombosis of the cerebral venous sinus associated to disseminated cerebral vasculitis, according to the investigated worldwide literature. 1623 Cerebral Vasculitis
1621 Cerebral Trypanosomiasis and Aids
Gomes, S2, Campanella, CAD, Luna, Pizzato, R, Valle, ELK, Dantas, TN, Rodrigues, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benemdrita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Germ Exdreito de Sdo Paulo - HGESP, Brazil
Male, 40 years old, caucasian, is admitted in the mmficipal enrergency room with complaint of intense holocratfial cephalea with 20-day evolution. Vomit, nausea, drowsiness and mnemonic fluctuation were assodated. Patient companion informed important weight loss and denied temperature. Smoking, alcoholism, illidt endovenous drug use and sexual promiscuity record. Neurological examination: right homonymous hemianopsia, without papilledenra, left hemiparesis, profound diffuse hyperreflexia, motion slowliness. TAC without expanding process evidence, with gyro and sulcus obliteration. LCR: initial pressure 310, leukocytes 20 (mononuclear), glucose 20mg/dl, proteins 41 mg/dl and presence of parasites with trypanosome aspect and test for HIV reactant. Started treatment with benzomidazol, clinical scenario improvement. Respiratory complications occurred and lead to death in three weeks. Tire infection by the Trypanossoma cruzi in the SNC is a low frequency incident, however with an increasing number within AIDS carriers. The diagnosis via direct examination of the liquor is unusual, the most frequent per histopathological examination. Highly lethal disease even with adequate behavior. The case presentation has in view to make another differential diagnosis possible in inmmnosuppressed patients. 1622 Marantie Thrombosis of the Cerebral Venous Sinus Associated to Dissenfinated Cerebral Vaseulifis Case Report
Gomes, Sz, Valle, ELR, Dantas, TN, Canrpanella, CAD, Luna, Pizzato, R, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benerndrita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Geral ExJrcito de Sffo Paulo HGESP, Brazil
The thrombosis of veins and venous cerebral sinus may be idiopathic, follow hematological disturbances or result from local or contiguous
Gomes, S2, Valle, ELR, Dantas, TN, Campanella, CAD,
Luna, Pizzato, R, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Sociedade Portuguesa de Beneficigncia HRBSPB; :Faculdade de Medicina da Universidade de Sdo Paulo F M U S P , Sao Paulo, Brazil," 3Hospital Germ Exdreito de S~.o Paulo - HGESP, Brazil
Vasculitis constitute a group o f diseases characterized by inflammatory reactions in blood vessels that result in lesions o f their walls. Tile process generally compromises the light of the vessel, with consequent ischemic disturbance of the tissue nourished by the involved vessel. The inflammatory vascular disturbance may be either the predominant scenario (iJrimary vasculitis) or one of the manifestations of another disease (secondary vasculitis). Thus, the torose polyarthritis, the Takayasu arthritis, and the Wegener granulomatosis are examples of primary vasculitis and the vasculitis that accomp any the other neoplasic diseases and the diffuse diseases of the comtective tissue, are secondary. Case Report: V. L. S. M., 39 years old, female, negroid, born in the Baixada Santista - SP. Clinical Scenario: Patient presents dysarthria scenario, sudden weight loss of approximately 10kg within 15 days, right facial paralysis (central type) and henfiparesis on the right, with onset 10 days ago. Personal Record: Defiles other diseases, deifies use of oral contraceptive, denies alcoholism, nullipara, long term smoking, approximately one packet per day. Physical Examination: VII nerve on the central right, dysarthria, dysmetria, in upper right limb, hemiparesis on the right, strength grade IV. LCR Exanrnation: No disturbance. Laboratory Exanrnafions: Evidentiated VHS of 22, positive FAN, microscopic hematuria, C protein reactant of 18 and other examinations with no disturbance. Encephalon TC: evidentiated multiple cerebral ischemia areas, counting two of larger volunre in the profound white substance on the left cerebral hemisphere and on the right fi'ontal area. Contusion: The clinical signs and the exanrinations performed, are compatible with cerebral vasculitis according to the investigated worldwide literature. 1624 Eating disorders intertering with Neuropba~nacologieal therapy COncepts - an interdisciplinary, observational compliance/adherence study
Poster Abstracts
1620 Sunet - case report Gomes, S2, Campanella, CAD, Luna, Pizzato, R, Valle, ELR, Dantas, TN, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Germ Exdreito de Sdo Paulo - HGESP, Brazil
Introduction: Sunct is a pathology described as predominant in male gender which algic symptoms in the trigeminal territory may be triggered by several stimuli. Objective: To describe case of female patient. Method: DJOC, 50 years old, female, caucasian, with episode of extrenre pain on left eye intertral corner and left perinasal, with brief duration though very frequent, and progressive worsening. Patient informs having more titan 20 fits per day, associated with lacrimation. Results: TAC + RMN + EEG + Liquor + Angiography + normal laboratory examinations. Treatment: Little response obtained with Carbamazepin, difenilhidantoine, CZP, tricyclics and indometacine. Conclusion: the oxygen use presented a clinical improvement. We need more experience and better evaluation to gain knowledge of the syndrome.
$511
infectious processes. The latter are caused by bacterial pyogenic production, subsequent inflammatory cells migration and plaque ag~tfination factors. Case Report: T. T. F., 15 years old, male, caucasian, single, student, bortt in Franca SP. Clinical Scenario: Confusion, holocranial cephalea of high intensity, paralysis of the IV bilateral cranial nerve and incomplete paralysis of the III cranial nerve on the left. Personal Record: Surgical drainage of the mmxillary sinus on the left, due to chronic sinusitis, 53 days prior to admission. Liquor Exaufinalion: 1,114 cells, 86% neutrophils, 10% lymphocytes, 3% monocytes, proteins 256 mg/dl, glucose 10 mg/dl. Encephalon magnetic nuclear resonance and angioresonance: marantic thrombosis of all the visualized cerebral venous sinuses, presence of pyogerfic material in leptometfinges and cisterns of the basis. Digital Cerebral Arteriograpby: Suggestive images of disseminated arterial vasculitis, mainly in the left cerebral hemisphere. Conehision: The clinical signs and examinations are compatible with the marantic thrombosis of the cerebral venous sinus associated to disseminated cerebral vasculitis, according to the investigated worldwide literature. 1623 Cerebral Vasculitis
1621 Cerebral Trypanosomiasis and Aids
Gomes, S2, Campanella, CAD, Luna, Pizzato, R, Valle, ELK, Dantas, TN, Rodrigues, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benemdrita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Germ Exdreito de Sdo Paulo - HGESP, Brazil
Male, 40 years old, caucasian, is admitted in the mmficipal enrergency room with complaint of intense holocratfial cephalea with 20-day evolution. Vomit, nausea, drowsiness and mnemonic fluctuation were assodated. Patient companion informed important weight loss and denied temperature. Smoking, alcoholism, illidt endovenous drug use and sexual promiscuity record. Neurological examination: right homonymous hemianopsia, without papilledenra, left hemiparesis, profound diffuse hyperreflexia, motion slowliness. TAC without expanding process evidence, with gyro and sulcus obliteration. LCR: initial pressure 310, leukocytes 20 (mononuclear), glucose 20mg/dl, proteins 41 mg/dl and presence of parasites with trypanosome aspect and test for HIV reactant. Started treatment with benzomidazol, clinical scenario improvement. Respiratory complications occurred and lead to death in three weeks. Tire infection by the Trypanossoma cruzi in the SNC is a low frequency incident, however with an increasing number within AIDS carriers. The diagnosis via direct examination of the liquor is unusual, the most frequent per histopathological examination. Highly lethal disease even with adequate behavior. The case presentation has in view to make another differential diagnosis possible in inmmnosuppressed patients. 1622 Marantie Thrombosis of the Cerebral Venous Sinus Associated to Dissenfinated Cerebral Vaseulifis Case Report
Gomes, Sz, Valle, ELR, Dantas, TN, Canrpanella, CAD, Luna, Pizzato, R, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benerndrita Soeiedade Portuguesa de Benefieidneia - H R B S P B ; 2Faeuldade de Medieina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Geral ExJrcito de Sffo Paulo HGESP, Brazil
The thrombosis of veins and venous cerebral sinus may be idiopathic, follow hematological disturbances or result from local or contiguous
Gomes, S2, Valle, ELR, Dantas, TN, Campanella, CAD,
Luna, Pizzato, R, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Sociedade Portuguesa de Beneficigncia HRBSPB; :Faculdade de Medicina da Universidade de Sdo Paulo F M U S P , Sao Paulo, Brazil," 3Hospital Germ Exdreito de S~.o Paulo - HGESP, Brazil
Vasculitis constitute a group o f diseases characterized by inflammatory reactions in blood vessels that result in lesions o f their walls. Tile process generally compromises the light of the vessel, with consequent ischemic disturbance of the tissue nourished by the involved vessel. The inflammatory vascular disturbance may be either the predominant scenario (iJrimary vasculitis) or one of the manifestations of another disease (secondary vasculitis). Thus, the torose polyarthritis, the Takayasu arthritis, and the Wegener granulomatosis are examples of primary vasculitis and the vasculitis that accomp any the other neoplasic diseases and the diffuse diseases of the comtective tissue, are secondary. Case Report: V. L. S. M., 39 years old, female, negroid, born in the Baixada Santista - SP. Clinical Scenario: Patient presents dysarthria scenario, sudden weight loss of approximately 10kg within 15 days, right facial paralysis (central type) and henfiparesis on the right, with onset 10 days ago. Personal Record: Defiles other diseases, deifies use of oral contraceptive, denies alcoholism, nullipara, long term smoking, approximately one packet per day. Physical Examination: VII nerve on the central right, dysarthria, dysmetria, in upper right limb, hemiparesis on the right, strength grade IV. LCR Exanrnation: No disturbance. Laboratory Exanrnafions: Evidentiated VHS of 22, positive FAN, microscopic hematuria, C protein reactant of 18 and other examinations with no disturbance. Encephalon TC: evidentiated multiple cerebral ischemia areas, counting two of larger volunre in the profound white substance on the left cerebral hemisphere and on the right fi'ontal area. Contusion: The clinical signs and the exanrinations performed, are compatible with cerebral vasculitis according to the investigated worldwide literature. 1624 Eating disorders intertering with Neuropba~nacologieal therapy COncepts - an interdisciplinary, observational compliance/adherence study