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- Proposta de classificação dos quadros parkinsónicosPublication . Cunha, L; Freire-Gonçalves, A; Dinis, MA; Oliveira, CR; Ferro, MA; Amaral, R; Januário, C
- Encefalite do tronco e mielite por listeria num jovem adulto previamente saudávelPublication . Bento, C; Januário, C; Silva, S; Oliveira, CR
- Eficácia da plasmoferese e da imunoglobulina humana no síndrme de Guillain-BarréPublication . Negrão, L; Santos, JM; Camões, F; Barbosa, J; Cunha, L
- Apolipoprotein E epsilon4 allele is a risk factor for Alzheimer's disease: the central region of portugal (Coimbra) as a case studyPublication . Fernandes, MA; Oliveira, CR; Oliveira, LM; Nogueira, AJ; Santiago, B; Santana, I
- 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.
- Choroid plexus tumours: a surgically treated seriesPublication . Barbosa, MD; Rebelo, O; Barbosa, P; Lacerda, A; Fernandes, RChoroid plexus tumours-carcinomas and papillomas are rare, especially in adults, and they pose some problems in their diagnosis and management. We have reviewed a series of nine cases from our institution surgically treated during the last 18 years. Their clinical charts, neuroradiological examinations, surgical technique, neuropathology and follow-up were analysed. In only one case total removal proved to be impossible, but even in cases of total removal recurrence appeared in two cases (one carcinoma and one papilloma). Morbility is especially associated with posterior fossa tumours. These rare tumours are managed surgically. They are usually associated with hydrocephalus, and it is difficult to forecast whether or not permanent CSF drainage will be required. A long-term follow-up is needed in patients with this type of tumour.
- Papel de la hipertensión arterial en la comorbilidad de la cefalea crónicaPublication . Grebe, HP; Nunes da Silva, J; Diogo-Sousa, LMINTRODUCTION: The literature concerning the association between headache and arterial hypertension is very scarce, mostly prior to the actual IHS classification and based on very diverse methods, being therefore difficult to interpret. OBJECTIVES: To analyse the association between arterial hypertension and two types of chronic headache and to determine, if and how arterial hypertension may affect the outcome of prophylactic therapy for chronic headaches. PATIENTS AND METHODS: Sixty four files of our headache outpatient clinic, chosen randomly among patients suffering from migraine or tensional type headache (TTH), were analysed retrospectively. Patients were considered hypertensive, if blood pressure was higher than normal several times without an acute crisis present. Resistance to treatment was defined as lack of benefit concerning number and/or intensity of crisis. RESULTS: Age varied between 18 and 80 years, the mean age being 42,9 (SD 13,86) years. Eighty six percent were females. Twenty nine patients suffered from TTH and 35 from migraine. Prevalence of hypertension was 35,9% among all patients, 28,5% among migraine patients, 44,8% among patients with TTH. The prevalence of resistance to treatment was 39,8%, 34,3% and 41,3%, respectively. Of the patients resistant to treatment 60% were hypertensive and 62,5% of the hypertensive patients showed resistance to therapy. CONCLUSIONS: Arterial hypertension was more prevalent in the study sample than would be expected in an equivalent sample of the general population. Hypertension was significantly more prevalent among patients resistant to therapy, as was resistance to treatment among hypertensive patients. We therefore conclude that there is a relevant comorbidity between chronic headache and hypertension and that arterial hypertension complicates the control of chronic headaches.
- Cystic intraventricular schwannoma: case report and review of the literaturePublication . Barbosa, MD; Rebelo, O; Barbosa, P; Gonçalves, J; Fernandes, RIntraventricular schwannoma is an exceedingly rare tumour with only 6 cases described in the literature. One case of a cystic intraventricular schwannoma operated on at our Institution is analyzed and the other cases reported in the literature are reviewed. Complete removal was achieved and no recurrence was noted after a follow-up period of 10 years. Intraventricular schwannomas are rare tumours that are amenable to complete surgical removal, having a good prognosis without the need of adjuvant therapy.
- Results of a multicenter SPECT study with [123I]-Iodolisuride in extrapyramidal syndromes.Publication . Ribeiro, MJ; Januário, C; Prunier, C; Chossat, F; Santos, AC; Mauclaire, L; Bekhechi, D; Marchand, J; Catela, L; Cunha, L; Pedroso de Lima, JJ; Baulieu, JLThe main objective of the present multicenter study was to evaluate -Iodolisuride (-ILIS) as a radioligand for dopamine receptors in patients (pts) with extrapyramidal diseases when using g-cameras of different types. 45 pts (28M, 17F) were studied in 2 centers (23+22 pts) and were divided in 2 groups: group I (n=28 age=66.8±3.5 years): idiopathic Parkinson’s disease; group II (n=17, age=57.5±7.1 years): other extrapyramidal syndromes. -ILIS (1.7 to 2.8 MBq/kg) was injected after informed consent. Single photon emission computed tomography (SPECT) studies were performed with a single head -camera (-camera A, GE 400AC*, 24 studies 1 hr p.i.), a dual head -camera (-camera B, Helix Elscint*, 15 studies 1hr to 2.5hr p.i.), a triple head -camera (-camera C, Neurocam GE*, 12 studies 45min to 2hr p.i.) and a brain dedicated annular detector (-camera -camera D, Ceraspect DSI*, 17 studies 1 to 3.5hr p.i.). Patients showed no undesirable reactions. All SPECT images obtained with different -cameras contained sufficient information for clinical interpretation and were qualitatively interpreted according to the visualization of basal ganglia (or striata) alone (type 1), visualization of cerebral cortex alone (type 2) and visualization of both basal ganglia and cerebral cortex (type 3) on the transversal slices. Striatal/frontal cortex ratios (S/FC) were calculated from standardized geometrical regions of interest. In group I, 45/45 SPECT images were classified as type 1 or type 3. In group II, 18/23 SPECT were classified as type 2 or 3. With any -camera, S/FC values were significantly higher in group I than in group II: -camera A: S/FC=1.48±0.20 vs. 1.26±0.25 (p=0,036), -camera B: S/FC=2.32±0.27 vs. 1.75±0.70 (p=0.025), -camera C: S/FC=1.55±0.22 vs. 1.34±0.15 (p=0.033), -camera D: S/FC=3.07±1.30 vs. 2.11±0.66 (p=0.039). We conclude that -ILIS imaging with any -camera provides functional information on striatal dopaminergic synapses in patients with extrapyramidal degenerative disease and could be useful in the differential diagnosis between Parkinson’s disease and other extrapyramidal syndromes. However, clinical use of -ILIS will require normalization and standardization of imaging and data processing procedures.
- 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.