Síndrome de Parkes-Weber

Paciente feminina, 63 anos, branca, apresentando, desde a infância, edema e úlceras do membro inferior esquerdo e diferença de comprimento entre as extremidades. Submetida, aos 13 anos, a procedimento cirúrgico para correção de varizes. Úlcera venosa sangrante, após trauma, com sangramento abundante que não cessou à compressão elástica, necessitando de ligadura venosa

Síndrome de Parkes-Weber

Paciente feminina, 63 anos, branca, apresentando, desde a infância, edema e úlceras do membro inferior esquerdo e diferença de comprimento entre as extremidades. Submetida, aos 13 anos, a procedimento cirúrgico para correção de varizes. Úlcera venosa sangrante, após trauma, com sangramento abundante que não cessou à compressão elástica, necessitando de ligadura venosa

Síndrome de Parkes-Weber

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Mielite transversa secundária a estafilococcemia

Paciente de 32 anos, masculino, preto, foi recebido e internado na emergencia do HCPA com tetraplegia e insuficiência ventilatória. Familiares relatavam que o paciente referia febre, dores lombares e sensação de rigidez de nuca há dois dias e perda súbita dos movimentos em membros superiores e inferiores há um dia, e também referiam história de tratamento de lesão perfurocortante  no pé direito com antibioticos IM por 10 dias. Durante a internação o paciente necessitou de hemodiálise e  apresentou episódio de bradicardia extrema, necessitando de marca-passo. Quatro dias após internação não apresentava melhora do líquor ou sintomatologia neurológica. Realizada nova punção lombar com proteínas totais 1221 mg/dl e leucócitos 196/mm3. PCR para Herpes 1 e 2 Positivo. Associado Aciclovir à Vancomicina . Não apresentou nenhuma melhora neurológica.Realizou exame de Ressonância Magnética (RM) da coluna cervical em 24/02/2011, que foi compatível com mielite transversa. Paciente iniciou quadro de abdome agudo por úlcera perfurada, necessitando de intervenção cirúrgica e diversos episódios subsequentes de hemorragia digestiva, resistentes a terapêutica, tratados com embolização percutânea da artéria gastroduodenal. Realizou nova RM em 11/03/2011 que demonstrou abscessos intra e perimedulares. Evolui ao óbito. Diagnóstico final: Estafilococcemia, com meningoencefalite e abscessos

Stroke and stroke mimics: a case of high grade glioma

The clinical diagnosis of acute stroke is inaccurate approximately 10%-30% of the time, which can lead to unnecessary administration of thrombolytic therapy or delays in appropriate therapy. Rapid and accurate neuroimaging triage is essential to guide therapy and exclude mimics. Although many conditions that mimic stroke clinically have imaging appearances that can overlap acute stroke, these conditions can be differentiated in most cases by using a careful pattern-based approach. We describe a case of 67 yo male patient who had a clinic of wakeup stroke and at the first magnetic resonance image (MRI) it was found that was an acute stroke of middle cerebral artery.The patient did not improve and a second MRI  revelead a two times growth of the lesion, and the MRI findings were compatible with tumor. At the surgery they found a infiltrative lesion and the anatomopathological exam showed that it was a high grade glioma.The diagnosis of ischemic stroke is often straight forward; however, the clinical diagnosis of acute stroke is inaccurate in many cases. Furthermore, many of these conditions, such as encephalitis, mass lesions, seizures, hypoglycemia, transient global amnesia (TGA),demyelinating disease, drug toxicity, and metabolic disturbances, have imaging appearances that can mimic acute or subacute infarction; however, an accurate diagnosis can often be made by using a pattern-based approach.

Stroke and stroke mimics: a case of high grade glioma

The clinical diagnosis of acute stroke is inaccurate approximately 10%-30% of the time, which can lead to unnecessary administration of thrombolytic therapy or delays in appropriate therapy. Rapid and accurate neuroimaging triage is essential to guide therapy and exclude mimics. Although many conditions that mimic stroke clinically have imaging appearances that can overlap acute stroke, these conditions can be differentiated in most cases by using a careful pattern-based approach. We describe a case of 67 yo male patient who had a clinic of wakeup stroke and at the first magnetic resonance image (MRI) it was found that was an acute stroke of middle cerebral artery.The patient did not improve and a second MRI  revelead a two times growth of the lesion, and the MRI findings were compatible with tumor. At the surgery they found a infiltrative lesion and the anatomopathological exam showed that it was a high grade glioma.The diagnosis of ischemic stroke is often straight forward; however, the clinical diagnosis of acute stroke is inaccurate in many cases. Furthermore, many of these conditions, such as encephalitis, mass lesions, seizures, hypoglycemia, transient global amnesia (TGA),demyelinating disease, drug toxicity, and metabolic disturbances, have imaging appearances that can mimic acute or subacute infarction; however, an accurate diagnosis can often be made by using a pattern-based approach

Síndrome de Parkes-Weber

Paciente feminina, 63 anos, branca, apresentando, desde a infância, edema e úlceras do membro inferior esquerdo e diferença de comprimento entre as extremidades. Submetida, aos 13 anos, a procedimento cirúrgico para correção de varizes. Úlcera venosa sangrante, após trauma, com sangramento abundante que não cessou à compressão elástica, necessitando de ligadura venosa

Síndrome de Parkes-Weber

Resumo não disponíve