Browsing by Author "Carvalho, S"
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- Blue rubber-bleb nevus syndrome: report of a familial case with a dural arteriovenous fistulaPublication . Carvalho, S; Barbosa, V; Santos, N; Machado, EWe report a case of a 45-year-old woman known to have a familial form of blue rubber-bleb nevus syndrome (BRBNS). The patient developed severe occipital headaches and bilateral retroauricular bruits. Cerebral angiography showed a large dural arteriovenous fistula in the torcular region. Central nervous system involvement in BRBNS is not often reported, and most cases of BRBNS are sporadic.
- Brain activation of the defensive and appetitive survival systems in obsessive compulsive disorderPublication . Gonçalves, OF; Soares, JM; Carvalho, S; Leite, J; Ganho, A; Fernandes-Gonçalves, A; Frank, B; Pocinho, F; Relvas, J; Carracedo, A; Sampaio, ASeveral studies have shown that basic emotions are responsible for a significant enhancement of early visual processes and increased activation in visual processing brain regions. It may be possible that the cognitive uncertainty and repeated behavioral checking evident in Obsessive Compulsive Disorder (OCD) is due to the existence of abnormalities in basic survival circuits, particularly those associated with the visual processing of the physical characteristics of emotional-laden stimuli. The objective of the present study was to test if patients with OCD show evidence of altered basic survival circuits, particularly those associated with the visual processing of the physical characteristics of emotional stimuli. Fifteen patients with OCD and 12 healthy controls underwent functional magnetic resonance imaging acquisition while being exposed to emotional pictures, with different levels of arousal, intended to trigger the defensive and appetitive basic survival circuits. Overall, the present results seem to indicate dissociation in the activity of the defense and appetitive survival systems in OCD. Results suggest that the clinical group reacts to basic threat with a strong activation of the defensive system mobilizing widespread brain networks (i.e., frontal, temporal, occipital-parietal, and subcortical nucleus) and blocking the activation of the appetitive system when facing positive emotional triggers from the initial stages of visual processing (i.e., superior occipital gyrus).
- Fístulas da tenda do cerebelo: diagnóstico e tratamentoPublication . Machado, E; Santos, N; Carvalho, S; Freitas, P; Filho, T; Machado, C; Martins, FAmong the 17 intracranial dural fistulae treated in the Department of Neuroradiology of the University Hospital of Coimbra (17 patients, 28 embolizations) between 19/10/98 and 20/11/2000, 4 cases (23%) were located on the tentorium cerebelli. Three patients were men aged 45, 53 and 56 years old. The remaining patient was an 85-year-old woman. All 4 patients were treated by embolization. One underwent post embolization surgical interruption of the draining vein. The authors analyse clinical presentation, complementary tests, therapy and outcome.
- Hemorragia Subaracnoideia e Angiografia Cerebral por Tomografia ComputorizadaPublication . Santos, N; Machado, E; Carvalho, S; Barbosa, MD; Martins, FWe present a review of 57 cases of nontraumatic subarachnoid hemorrhagesubmitted to CT angiography of the cerebral vessels. The purpose of our study was to estimate the value of CT angiography in the detection of intracranial aneurysms. These findings were compared with those from selective angiography. The results showed that CT angiography is a rapid, low-risk technique with a low level of invasiveness and high specificity and sensitivity in the detection of cerebral aneurysms, allowing the planning of endovascular intervention and surgical approach.
- Malformações do desenvolvimento cortical em doentes com epilepsia: estudo neurorradiológico de 17 casosPublication . Carvalho, S; Brito, O; Machado, E; Santos, N; Melo Freitas, P; Bento, C; Santana, I; Sales, F; Martins, FThis article reviews Malformations of Cortical Development (MCD) diagnosed by Magnetic Resonance Imaging (MRI) in a series of patients with epilepsy. This study spans a five year period. The frequency of these malformations was 7.1%. Most of these were focal or multifocal and the most common ones were polymicrogyria (35.3% of the patients), heterotopia (29.4%), and focal cortical dysplasia (29.4%). The frontal lobes were the most frequently affected regions. The various MCD encountered reflect the wide spectrum of MCD leading to epilepsy.
- Neurorradiologia da síndroma de KallmannPublication . Melo Freitas, P; Carvalho, S; Ribeiro, F; Marnoto, D; Martins, FThe present study refers to the magnetic resonance characteristics observed in a group of three patients with clinical and laboratory evidence of Kallmann's Syndrome. This disease, also named olfactogenital dysplasia, affects the normal gonadal and olfactory development and is clinically characterized by the association of hypogonadotrophic hypogonadism and anosmia/hyposmia. The study protocol, which included the attainment of sagittal and coronal T1-weighted MPRAGE (Multiplanar Rapid Acquisition Gradient Echo) volumetric sequences, showed defective rhinocephalon development in all patients, expressed by the aplasia/hypoplasia of the olfactory bulbs/tracts and/or of the olfactory sulci. The changes observed corroborate the predictable imaging of this genetic disorder and have been mainly visible in the coronal slices obtained. The results shown are more clear evidence that magnetic resonance is an effective method to show the abnormalities in the olfactory region that are invariably found in this syndrome.
- Obsessive Compulsive Disorder as a functional interhemispheric imbalance at the thalamic levelPublication . Gonçalves, OF; Carvalho, S; Leite, J; Pocinho, F; Relvas, J; Fregni, FObsessive Compulsive Disorder (OCD) involves failures in two main inhibitory processes, namely cognitive (obsessions) and behavioral (compulsions). Recent research has supported two cortical-subcortical pathways on OCD pathogenesis: (a) the frontostriatal loop (dorsolateral-caudate-striatum-thalamus) responsible for impairments of behavioral inhibition; (b) the orbitofrontal loop (orbitofrontal, medial prefrontal and cingulate) responsible for impairments with cognitive inhibitory processes. These failures in both cognitive and motor inhibitory systems may mediate several neuropsychological deficits in these patients, namely memory, attention, planning and decision making. But are those deficits related to specific hemispheric effects, namely functional imbalance between hemispheres? In this article we hypothesize that: (1) OCD patients have an inter-hemispheric functional imbalance, probably due to inadequate filtering at the thalamic level; (2) the restoration of inter-hemispheric balance, will be correlative to symptomatic improvement.
- Preliminary results of an Acceptance and Commitment Therapy (ACT) brief group intervention for psychosis.Publication . Castilho, P; Pinto, AM; Viegas, R; Carvalho, S; Madeira, N; Martins, MJAcceptance and Commitment Therapy (ACT) is a contextual-behavioral therapy with promising results in various psychological disorders, including psychosis. This study aims to compare the potential benefits of a 4-session ACT group intervention with the interventions commonly offered in Portugal. ACT participants improved in a wider range of measures and 2 of the 3 patients improved significantly in both symptoms, cognitive processes and positive indicators of adjustment (without any deterioration). Future studies should explore the relationship between participants’ clinical profile and benefits from ACT interventions.