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[PMID]:29244920
[Au] Autor:Shakova FM; Kalinina TI; Gulyaev MV; Cheremnykh AM; Yurin VL; Romanova GA
[Ti] Título:Neuroprotective and antiamnestic effects of mutant molecules of erythropoietin on model of photochemical thrombosis of rat brain prefrontal cortex.
[So] Source:Patol Fiziol Eksp Ter;60(4):34-8, 2016 Oct-Dec.
[Is] ISSN:0031-2991
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Mutant EPO molecules, deprived of erythropoietic activity, but possessing cytoprotective action, were created by the method of genetic engineering. The assessment of the therapeutic effectiveness of the received mutant proteins was carried out by the retention of the conditioned reflex of passive avoidance (PA), developed before the ischemic injury of rat brain prefrontal cortex, and by the MRI-analysis of ischemic damage volume. Antiamnestic and neuroprotective action of mutant molecules - MERO-Fc and MEPO-TR is investigated on model of photothrombosis of rat brain prefrontal cortex at single intranasal introduction in 1 h after cortex ischemic damage. The neuroprotective (MRI) and antiamnestic (PA) effects of mutant molecules of erythropoietin derivatives are shown.
[Mh] Termos MeSH primário: Eritropoetina
Trombose Intracraniana
Mutação
Fármacos Neuroprotetores/farmacologia
Córtex Pré-Frontal
[Mh] Termos MeSH secundário: Animais
Modelos Animais de Doenças
Eritropoetina/genética
Eritropoetina/farmacologia
Trombose Intracraniana/induzido quimicamente
Trombose Intracraniana/tratamento farmacológico
Trombose Intracraniana/fisiopatologia
Masculino
Córtex Pré-Frontal/metabolismo
Córtex Pré-Frontal/fisiopatologia
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Neuroprotective Agents); 11096-26-7 (Erythropoietin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29202678
[Au] Autor:Riva N; Ageno W
[Ad] Endereço:1 Department of Pathology, University of Malta, Msida, Malta.
[Ti] Título:Approach to thrombosis at unusual sites: Splanchnic and cerebral vein thrombosis.
[So] Source:Vasc Med;22(6):529-540, 2017 12.
[Is] ISSN:1477-0377
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Splanchnic vein thrombosis (SVT) and cerebral vein thrombosis (CVT) are two manifestations of unusual site venous thromboembolism (VTE). SVT includes thrombosis in the portal, mesenteric or splenic veins, and the Budd-Chiari syndrome. CVT encompasses thrombosis of the dural venous sinuses and thrombosis of the cerebral veins. Unusual site VTE often represents a diagnostic and therapeutic challenge because of the heterogeneity in clinical presentation, the limited evidence available in the literature on the acute and long-term prognosis of these diseases, and the lack of large randomized controlled trials evaluating different treatment options. This narrative review describes the approach to patients with SVT or CVT by examining the diagnostic process, the assessment of potential risk factors and the appropriate anticoagulant treatment.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Síndrome de Budd-Chiari/tratamento farmacológico
Veias Cerebrais/fisiopatologia
Trombose Intracraniana/tratamento farmacológico
Oclusão Vascular Mesentérica/tratamento farmacológico
Tromboembolia Venosa/tratamento farmacológico
[Mh] Termos MeSH secundário: Anticoagulantes/efeitos adversos
Síndrome de Budd-Chiari/diagnóstico por imagem
Síndrome de Budd-Chiari/fisiopatologia
Circulação Cerebrovascular
Hemorragia/induzido quimicamente
Seres Humanos
Trombose Intracraniana/diagnóstico por imagem
Trombose Intracraniana/fisiopatologia
Oclusão Vascular Mesentérica/diagnóstico por imagem
Oclusão Vascular Mesentérica/fisiopatologia
Fatores de Risco
Circulação Esplâncnica
Resultado do Tratamento
Tromboembolia Venosa/diagnóstico por imagem
Tromboembolia Venosa/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1177/1358863X17734057


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[PMID]:29310406
[Au] Autor:Li C; Sun L; Zhao X; Zhu M; Zhang Y
[Ad] Endereço:Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China.
[Ti] Título:Cerebral venous thrombosis originating from internal jugular vein outflow impairment: A case report.
[So] Source:Medicine (Baltimore);96(48):e8975, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Cerebral venous thrombosis (CVT) comprises a group of cerebral vascular diseases resulting from cerebral venous outflow obstruction caused by various etiologies. The etiology of CVT is complex, including infectious and noninfectious factors. The diagnosis is difficult. As a result, many patients are misdiagnosed or never diagnosed. This patient was diagnosed with CVT due to unilateral internal jugular vein compression. PATIENT CONCERNS: In this report, we present a case of acute onset CVT in a 15-year-old female patient who presented with a headache, nausea, and vomiting as the main clinical manifestations. INTERVENTIONS: This patient was administered with conventional anticoagulants and treated for dehydration, but the effect of conventional therapy was not obvious. OUTCOMES: We recommended that this patient undergo left local decompression of the internal jugular vein to inhibit the thrombosis. But regretfully, due to economic reasons and surgical risk, the patient and her mother refused operation. LESSONS: This case report demonstrates the importance of considering jugular vein lesions as an etiology of CVT. Furthermore, computed tomography venography of the jugular vein and jugular vein ultrasound were instrumental in detecting the abnormal structure of the jugular vein and hemodynamic changes.
[Mh] Termos MeSH primário: Trombose Intracraniana/tratamento farmacológico
Trombose Intracraniana/etiologia
Veias Jugulares
Trombose Venosa/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Anticoagulantes/uso terapêutico
Feminino
Seres Humanos
Trombose Intracraniana/diagnóstico por imagem
Veias Jugulares/diagnóstico por imagem
Trombose Venosa/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008975


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[PMID]:29213030
[Au] Autor:Alabri H; Lewis WD; Manjila S; Alkhachroum AM; De Georgia MA
[Ad] Endereço:Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
[Ti] Título:Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases.
[So] Source:Am J Case Rep;18:1302-1308, 2017 Dec 07.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome. CASE REPORT Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke. CONCLUSIONS VBD is a complex arterial disease with a variety of clinical manifestation, with bilateral ophthalmoplegia being a rare presentation. Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient.
[Mh] Termos MeSH primário: Infarto Encefálico/etiologia
Trombose Intracraniana/etiologia
Oftalmoplegia/etiologia
Insuficiência Vertebrobasilar/complicações
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Infarto Encefálico/diagnóstico por imagem
Doenças dos Nervos Cranianos/etiologia
Feminino
Seres Humanos
Trombose Intracraniana/diagnóstico por imagem
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


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[PMID]:29019892
[Au] Autor:Kang JH; Yun TJ; Yoo RE; Yoon BW; Lee AL; Kang KM; Choi SH; Kim JH; Sohn CH; Han MH
[Ad] Endereço:aInstitute of Radiation Medicine, Seoul National University Medical Research Center bDepartment of Radiology cClinical Research Center for Stroke, Clinical Research Institute dDepartment of Neurology, Seoul National University Hospital, Seoul eDepartment of Radiology, Soonchunhyang University Bucheon Hospital, Gyunggi-do, Republic of Korea.
[Ti] Título:Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis.
[So] Source:Medicine (Baltimore);96(41):e8244, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cerebral venous thrombosis is a potentially lethal disease. Early diagnosis is essential to improve its prognosis. However, its early diagnosis based on conventional imaging modalities remains a challenge in clinical settings. The purpose of this study was to evaluate whether bright sinus appearance on arterial spin-labeling perfusion-weighted image (ASL-PWI) could help identify cerebral venous thrombosis.ASL-PWI of 13 patients who were confirmed as cerebral venous thrombosis based on neurologic symptoms and computed tomography (CT) or magnetic resonance (MR) venography (with/without cerebral angiography) were retrospectively analyzed for the presence or absence of the following: bright signal in dural sinus termed "bright sinus appearance"; and hypoperfusion in brain parenchyma drained by thrombosed sinus. In addition, conventional MR findings, including susceptibility vessel sign, empty delta sign, and atypical distribution against arterial territory, were also analyzed.Bright sinus appearance on ASL-PWI was found in all (100%) 13 patients. In addition, 10 (77%) patients showed hypoperfusion in the brain parenchyma drained by thrombosed sinus on ASL-PWI. Susceptibility vessel sign and empty delta sign were revealed in 11 (85%) and 7 (54%) patients, respectively. Atypical distribution against arterial territory was seen in 5 (50%) of the 10 patients with parenchymal abnormality on conventional MR sequences. Therefore, the bright sinus appearance had higher sensitivities for identifying cerebral venous thrombosis than the susceptibility vessel sign, empty delta sign, and atypical distribution against arterial territory (with differences of 15%; P = .500, 46%; P = .031, and 50%; P = .031, respectively).Bright sinus appearance on ASL-PWI can provide important diagnostic clue for identifying cerebral venous thrombosis. Therefore, this technique may have the potential to be used as a noninvasive diagnostic tool to identify the cerebral venous thrombosis.
[Mh] Termos MeSH primário: Arteriopatias Oclusivas/diagnóstico
Artérias Cerebrais/diagnóstico por imagem
Veias Cerebrais
Trombose Intracraniana
Imagem por Ressonância Magnética/métodos
Trombose Venosa/diagnóstico
[Mh] Termos MeSH secundário: Angiografia Cerebral/métodos
Veias Cerebrais/diagnóstico por imagem
Veias Cerebrais/patologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Trombose Intracraniana/diagnóstico por imagem
Trombose Intracraniana/patologia
Masculino
Meia-Idade
Reprodutibilidade dos Testes
República da Coreia
Estudos Retrospectivos
Marcadores de Spin
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Spin Labels)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008244


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[PMID]:28987433
[Au] Autor:Long B; Koyfman A; Runyon MS
[Ad] Endereço:Department of Emergency Medicine, San Antonio Military Medical Center, 3841 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. Electronic address: Brit.long@yahoo.com.
[Ti] Título:Cerebral Venous Thrombosis: A Challenging Neurologic Diagnosis.
[So] Source:Emerg Med Clin North Am;35(4):869-878, 2017 Nov.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy. Diagnosis requires imaging. Treatment includes stabilization, management of complications, and anticoagulation.
[Mh] Termos MeSH primário: Trombose Intracraniana/diagnóstico
Neuroimagem/métodos
Trombose Venosa/diagnóstico
[Mh] Termos MeSH secundário: Angiografia por Tomografia Computadorizada
Seres Humanos
Angiografia por Ressonância Magnética
Flebografia/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171009
[St] Status:MEDLINE


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[PMID]:28974635
[Au] Autor:Aguiar de Sousa D; Canhão P; Crassard I; Coutinho J; Arauz A; Conforto A; Béjot Y; Giroud M; Ferro JM; ISCVT-2-PREGNANCY Investigators
[Ad] Endereço:From the Department of Neurology, Hospital de Santa Maria, University of Lisbon, Portugal (D.A.d.S., P.C., J.M.F.); Instituto de Medicina Molecular, Lisbon, Portugal (D.A.d.S., P.C., J.M.F.); Department of Neurology, Hôpital Lariboisière, Paris, France (I.C.); Department of Neurology, Academic Medic
[Ti] Título:Safety of Pregnancy After Cerebral Venous Thrombosis: Results of the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis)-2 PREGNANCY Study.
[So] Source:Stroke;48(11):3130-3133, 2017 Nov.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Pregnancy is associated with increased risk of venous thrombotic events, including cerebral venous thrombosis. We aimed to study the complications and outcome of subsequent pregnancies in women with previous cerebral venous thrombosis. METHODS: Follow-up study of women with acute cerebral venous thrombosis at childbearing age included in a previously described cohort (International Study of Cerebral Vein and Dural Sinus Thrombosis). Patients were interviewed by local neurologists to assess rate of venous thrombotic events, pregnancy outcomes, and antithrombotic prophylaxis during subsequent pregnancies. RESULTS: A total of 119 women were included, with a median follow-up of 14 years. Eighty-two new pregnancies occurred in 47 women. In 83% (68 of 82), some form of antithrombotic prophylaxis was given during at least 1 trimester of pregnancy or puerperium. Venous thrombotic events occurred in 3 pregnancies, including 1 recurrent cerebral venous thrombosis. Two of the 3 women were on prophylactic low-molecular-weight heparin at the time of the event. Outcomes of pregnancies were 51 full-term newborns, 9 preterm births, 2 stillbirths, and 20 abortions (14 spontaneous). CONCLUSIONS: In women with prior cerebral venous thrombosis, recurrent venous thrombotic events during subsequent pregnancies are infrequent.
[Mh] Termos MeSH primário: Veias Cerebrais
Fibrinolíticos/administração & dosagem
Heparina de Baixo Peso Molecular/administração & dosagem
Trombose Intracraniana/prevenção & controle
Complicações Cardiovasculares na Gravidez/prevenção & controle
Resultado da Gravidez
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Trombose Intracraniana/epidemiologia
Trombose Intracraniana/fisiopatologia
Gravidez
Complicações Cardiovasculares na Gravidez/epidemiologia
Complicações Cardiovasculares na Gravidez/fisiopatologia
Recidiva
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Fibrinolytic Agents); 0 (Heparin, Low-Molecular-Weight)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.018829


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[PMID]:28830976
[Au] Autor:Saber H; Yakoob MY; Shi P; Longstreth WT; Lemaitre RN; Siscovick D; Rexrode KM; Willett WC; Mozaffarian D
[Ad] Endereço:From the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Bosto
[Ti] Título:Omega-3 Fatty Acids and Incident Ischemic Stroke and Its Atherothrombotic and Cardioembolic Subtypes in 3 US Cohorts.
[So] Source:Stroke;48(10):2678-2685, 2017 Oct.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The associations of individual long-chain n-3 polyunsaturated fatty acids with incident ischemic stroke and its main subtypes are not well established. We aimed to investigate prospectively the relationship of circulating eicosapentaenoic acid, docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with risk of total ischemic, atherothrombotic, and cardioembolic stroke. METHODS: We measured circulating phospholipid fatty acids at baseline in 3 separate US cohorts: CHS (Cardiovascular Health Study), NHS (Nurses' Health Study), and HPFS (Health Professionals Follow-Up Study). Ischemic strokes were prospectively adjudicated and classified into atherothrombotic (large- and small-vessel infarctions) or cardioembolic by imaging studies and medical records. Risk according to fatty acid levels was assessed using Cox proportional hazards (CHS) or conditional logistic regression (NHS, HPFS) according to study design. Cohort findings were pooled using fixed-effects meta-analysis. RESULTS: A total of 953 incident ischemic strokes were identified (408 atherothrombotic, 256 cardioembolic, and 289 undetermined subtypes) during median follow-up of 11.2 years (CHS) and 8.3 years (pooled, NHS and HPFS). After multivariable adjustment, lower risk of total ischemic stroke was seen with higher DPA (highest versus lowest quartiles; pooled hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.58-0.92) and DHA (HR, 0.80; 95% CI, 0.64-1.00) but not eicosapentaenoic acid (HR, 0.94; 95% CI, 0.77-1.19). DHA was associated with lower risk of atherothrombotic stroke (HR, 0.53; 95% CI, 0.34-0.83) and DPA with lower risk of cardioembolic stroke (HR, 0.58; 95% CI, 0.37-0.92). Findings in each individual cohort were consistent with pooled results. CONCLUSIONS: In 3 large US cohorts, higher circulating levels of DHA were inversely associated with incident atherothrombotic stroke and DPA with cardioembolic stroke. These novel findings suggest differential pathways of benefit for DHA, DPA, and eicosapentaenoic acid.
[Mh] Termos MeSH primário: Isquemia Encefálica/sangue
Doenças Cardiovasculares/sangue
Ácidos Graxos Ômega-3/sangue
Embolia Intracraniana/sangue
Trombose Intracraniana/sangue
Acidente Vascular Cerebral/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Isquemia Encefálica/diagnóstico
Isquemia Encefálica/epidemiologia
Doenças Cardiovasculares/diagnóstico
Doenças Cardiovasculares/epidemiologia
Estudos de Casos e Controles
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Incidência
Arteriosclerose Intracraniana/sangue
Arteriosclerose Intracraniana/diagnóstico
Arteriosclerose Intracraniana/epidemiologia
Embolia Intracraniana/diagnóstico
Embolia Intracraniana/epidemiologia
Trombose Intracraniana/diagnóstico
Trombose Intracraniana/epidemiologia
Masculino
Meia-Idade
Estudos Prospectivos
Distribuição Aleatória
Fatores de Risco
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/epidemiologia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Fatty Acids, Omega-3)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.018235


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[PMID]:28692549
[Au] Autor:Ciraci S; Ozcan A; Ozdemir MM; Chiang SCC; Tesi B; Ozdemir AM; Karakukcu M; Patiroglu T; Acipayam C; Doganay S; Gumus H; Unal E
[Ad] Endereço:Departments of *Radiology, Division of Pediatric Radiology †Pediatrics, Division of Pediatric Hematology Oncology ∥Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri §Department of Pediatrics, Division of Pediatric Hematology & Oncology, Sutcu Imam University, Kahramanmaras, Turkey ‡Department of Medicine, Karolinska Institutet, Center for Hematology and Regenerative Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
[Ti] Título:A Case of Familial Hemophagocytic Lymphohistiocytosis Type 4 With Involvement of the Central Nervous System Complicated With Infarct.
[So] Source:J Pediatr Hematol Oncol;39(6):e321-e324, 2017 Aug.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Familial hemophagocytic lymphohistiocytosis (HLH) is a fatal disease affecting infants and very young children. Central nervous system involvement of HLH can cause catastrophic results. METHOD: We present a case with cranial involvement of familial HLH type 4 who showed diffuse infiltration of white matter complicated with intracranial thrombosis. A 5-year-old girl from a consanguineous couple presented with fever and pancytopenia, and was referred to our hematology unit. Examination revealed fever, lymphadenopathy, and hepatosplenomegaly. Ultrasound examination revealed hepatosplenomegaly and free intra-abdominal fluid. HLH was revealed on bone marrow aspiration biopsy. Defective natural killer and T lymphocyte cytotoxicity using degranulation tests was determined. In the genetic analysis, syntaxin gene mutation was found. On T2-weighted and T2-fluid-attenuated inversion recovery magnetic resonance imaging (MRI), diffuse hyperintense signal changes of cerebral white matter, indicating white matter demyelination, were observed. A second brain MRI showed an acute infarct involving the left temporooccipital region. Immunosuppressive therapy according to the HLH 2004 protocol was started. The infarct resolved but white matter lesions were stable on the brain MRI that was performed 1 month later. Brain MRI taken 4 months after the first examination showed stable cerebral white matter lesions, but hyperintense signal changes appeared in the cerebellar white matter and were regarded as progression. The patient died because of infection despite immunosuppressive therapy. CONCLUSIONS: Physicians managing patients with HLH must be vigilant about the possibility of central nervous system involvement including stroke.
[Mh] Termos MeSH primário: Doenças do Sistema Nervoso Central/complicações
Infarto/etiologia
Linfo-Histiocitose Hemofagocítica/patologia
[Mh] Termos MeSH secundário: Pré-Escolar
Progressão da Doença
Evolução Fatal
Feminino
Seres Humanos
Trombose Intracraniana/etiologia
Leucoencefalopatias/etiologia
Leucoencefalopatias/patologia
Linfo-Histiocitose Hemofagocítica/complicações
Imagem por Ressonância Magnética/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000886


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[PMID]:28604189
[Au] Autor:Brinjikji W; Michalak G; Kadirvel R; Dai D; Gilvarry M; Duffy S; Kallmes DF; McCollough C; Leng S
[Ad] Endereço:1 Department of Radiology, Mayo Clinic, USA.
[Ti] Título:Utility of single-energy and dual-energy computed tomography in clot characterization: An in-vitro study.
[So] Source:Interv Neuroradiol;23(3):279-284, 2017 Jun.
[Is] ISSN:2385-2011
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background and purpose Because computed tomography (CT) is the most commonly used imaging modality for the evaluation of acute ischemic stroke patients, developing CT-based techniques for improving clot characterization could prove useful. The purpose of this in-vitro study was to determine which single-energy or dual-energy CT techniques provided optimum discrimination between red blood cell (RBC) and fibrin-rich clots. Materials and methods Seven clot types with varying fibrin and RBC densities were made (90% RBC, 99% RBC, 63% RBC, 36% RBC, 18% RBC and 0% RBC with high and low fibrin density) and their composition was verified histologically. Ten of each clot type were created and scanned with a second generation dual source scanner using three single (80 kV, 100 kV, 120 kV) and two dual-energy protocols (80/Sn 140 kV and 100/Sn 140 kV). A region of interest (ROI) was placed over each clot and mean attenuation was measured. Receiver operating characteristic curves were calculated at each energy level to determine the accuracy at differentiating RBC-rich clots from fibrin-rich clots. Results Clot attenuation increased with RBC content at all energy levels. Single-energy at 80 kV and 120 kV and dual-energy 80/Sn 140 kV protocols allowed for distinguishing between all clot types, with the exception of 36% RBC and 18% RBC. On receiver operating characteristic curve analysis, the 80/Sn 140 kV dual-energy protocol had the highest area under the curve for distinguishing between fibrin-rich and RBC-rich clots (area under the curve 0.99). Conclusions Dual-energy CT with 80/Sn 140 kV had the highest accuracy for differentiating RBC-rich and fibrin-rich in-vitro thrombi. Further studies are needed to study the utility of non-contrast dual-energy CT in thrombus characterization in acute ischemic stroke.
[Mh] Termos MeSH primário: Trombose Intracraniana/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Eritrócitos
Fibrina
Seres Humanos
Técnicas In Vitro
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9001-31-4 (Fibrin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1177/1591019917694479



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