8 research outputs found
Pneumatocele espontĂąneo extracraniano: registro de um caso
à registrado um caso de pneumatocele espontùneo extracraniano, diagnosticado e operado com bom resultado. Os autores tecem comentårios sobre a fisiopatologia, enfatizando como causa principal as alteraçÔes de desenvolvimento da fissura petro-escamosa, que faz com que o ar indo desde a trompa de Euståquio e atingindo o ouvido médio, chegue até às células da mastóide que sofrerão pressão constante havendo, portanto, aumento das mesmas, seguido de ruptura e propagação do ar para o aspaço sub-aponeurótico. Foi feita revisão da literatura
Involuntary movements and AIDS: report op seven cases and review of the literature
We studied 1086 AIDS patients in the last six years. Of these 389 (35.82%) had neurological manifestation and 7 (1.8%) male patients had abnormal involuntary movements (parkinsonism in 3, hemichorea-hemiballism in 2, spinal myoclonus in 1 and rubral tremor in another). All patients were men, 5 white and 2 black. Four were homosexual, 2 drug-users and 1 bisexual. The mean age was 33.14 years. The time between AIDS diagnosis and the onset of movement disorders was 23.8 months in 5 patients and in 2 it was the first symptom. The parkinsonian patients did not show any opportunistic infection in conection with the neurological symptoms but in the remaining four cases this relationship was suggested. The data showed that not only the opportunistic infection but also the AIDS virus may play an important role on the development of involuntary movements
ComplicaçÔes neurolĂłgicas da sĂndrome de imunodeficiĂȘncia adquirida experiĂȘncia do HUCFF - UFRJ: experience at HUCFF-UFRJ.
A frequĂȘncia de manifestaçÔes neurolĂłgicas foi analisada em 653 pacientes so-ropositivos para o HIV, internados em um hospital universitĂĄrio na cidade do Rio de Janeiro, entre 1985 e 1989. Do total de pacientes, 172 (26%) apresentavam sintomas referentes ao sistema nervoso. Nesta população, foram estudados os diferentes fatores de risco e distribuição etĂĄria. Dentre as complicaçÔes observadas predominaram: toxoplasmose cerebral (80), neurocriptococose (57), encefalite subaguda (17) e meningite tuberculosa (8). Fez-se correlação entre os aspectos clĂnicos e tomogrĂĄficos. A maioria dos casos (60%) evoluiu para o Ăłbito no perĂodo estudado e 89% destes tiveram sobrevida inferior a 6 meses
Movement disorders in 28 HIV-infected patients DistĂșrbios do movimento em 28 pacientes infectados pelo HIV
From 1986 to 1999, 2460 HIV-positive inpatients were seen in our Hospital. Neurological abnormalities were detected in 1053 (42.8%) patients. In this group, 28 (2.7%) had involuntary movements, 14 (50%) with secondary parkinsonism, six (21.4%) with hemichorea/hemiballismus, four (14.2%) with myoclonus, two (7.2%) with painful legs and moving toes, one (3.6%) with hemidystonia and one (3.6%) with Holmes' tremor. The HIV itself (12 patients), toxoplasmosis of the midbrain (1) and metoclopramide-related symptoms (1) were the most probable causes for the parkinsonism. All patients with hemichorea/hemiballismus were men and in all of them toxoplasmosis of the basal ganglia, mostly on the right side, was the cause of the involuntary movements. Generalized myoclonus was seen in two patients and they were due to toxoplasmosis and HIV-encephalopathy respectively; two others presented with spinal myoclonus. The two patients with painful legs and moving toes had an axonal neuropathy. The patient with hemidystonia suffered from toxoplasmosis in the basal ganglia and the patient with Holmes' tremor had co-infection with tuberculosis and toxoplasmosis affecting the midbrain and cerebellum. We conclude that HIV-infected patients can present almost any movement disorder. They can be related to opportunistic infections, medications, mass lesions and possibly to a direct or indirect effect of the HIV itself.<br>De 1986 a 1999, 2460 pacientes HIV-positivos internados foram avaliados em nosso Hospital. AlteraçÔes neurolĂłgicas foram encontradas em 1053 (42,8%). Neste grupo, 28 (2,7%) exibiam movimentos involuntĂĄrios, 14 (50%) com parkinsonismo secundĂĄrio, seis (21,4%) com hemicorĂ©ia/hemiballismo, quatro (14,2%) com mioclonias, dois (7,2%) com painful legs and moving toes, um (3,6%) com hemidistonia e um (3,6%) com tremor de Holmes. No grupo com parkinsonismo, 12 eram, provavelmente, secundĂĄrios ao HIV; um Ă toxoplasmose mesencefĂĄlica e outro desencadeado pela metoclopramida. Todos com hemicorĂ©ia/hemiballismo eram homens e estavam relacionados com toxoplasmose nos gĂąnglios da base. Nos quatro pacientes com mioclonia, em dois era generalizada, relacionada, em um, com toxoplasmose e, em outro, com a encefalopatia pelo HIV; nos outros dois era de origem medular. Nos dois pacientes com painful legs and moving toes, ficou demonstrada a neuropatia axonal pela biĂłpsia do nervo perifĂ©rico. Toxoplasmose da gĂąnglia basal estava relacionada com hemidistonia contralateral. No paciente com tremor de Holmes havia lesĂ”es no mesencĂ©falo e no cerebelo, secundĂĄrias Ă co-infecção pelo bacilo da tuberculose e pelo Toxoplasma gondii. ConcluĂmos que diversos distĂșrbios do movimento podem ocorrer em pacientes infectados pelo HIV. Costumam estar relacionados Ă s infecçÔes oportunĂsticas, ao uso de certos medicamentos, Ă s lesĂ”es com efeito de massa e, possivelmente, Ă ação direta ou indireta do HIV