Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 |
Resumo: | Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function. |
id |
RCAP_1165bc2126ae4c52dacb9b8b9a6a9b8d |
---|---|
oai_identifier_str |
oai:ojs.www.actamedicaportuguesa.com:article/7523 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical InterventionAlteração do Comportamento e Instabilidade da Marcha: O Valor da Avaliação Neuroimagiológica e da Intervenção Neurocirúrgica PrecocesCognition DisordersGait DisordersNeurologicHemangiomaCavernousMagnetic Resonance ImagingNeurosurgical ProceduresTomographyX-Ray ComputedVentriculostomyHemagnioma CavernosoPerturbações da CogniçãoPerturbações Neurológicas da MarchaProcedimentos NeurocirúrgicosRessonância MagnéticaTomografia ComputorizadaVentriculostomiaCavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function.Os angiomas cavernosos são malformações do sistema nervoso central cujas manifestações mais comuns são crises epiléticas e défices neurológicos agudos. Apresentamos o caso clínico de um doente de 71 anos com uma história com dois meses de evolução de alteração do comportamento, défice de atenção e apatia, sucedidas por marcada instabilidade da marcha. A avaliação neuropsicológica revelava alterações cognitivas e disfunção executiva marcadas. Na Tomografia Computorizada Cerebral observava-se hidrocefalia supraventricular enquanto na Ressonância Magnética cerebral era possível observar uma pequena hemorragia que obstruía o aqueduto de Sylvius localizada contiguamente a um angioma cavernoso mesencefálico. Quatro meses após o tratamento com ventriculocisternostomia endoscópica, o doente apresentava melhoria significativa na avaliação neuropsicológica tendo voltado a adquirir a autonomia prévia. A apresentação de um angioma cavernoso parenquimatoso como uma obstrução do aqueduto de Sylvius secundária a hemorragia é invulgar. Rara é também a sua apresentação como alterações do comportamento e do estado mental subagudas. Uma avaliação neuroimagiológica e uma intervenção neurocirúrgica precoces foram essenciais para a melhoria cognitiva observada.Ordem dos Médicos2017-01-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegimage/jpegapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523oai:ojs.www.actamedicaportuguesa.com:article/7523Acta Médica Portuguesa; Vol. 30 No. 1 (2017): January; 77-79Acta Médica Portuguesa; Vol. 30 N.º 1 (2017): Janeiro; 77-791646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/4897https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8300https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8630https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8631https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8744Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessCosta, AndreiaMarques-Matos, CláudiaReis, CarinaCarvalho, MartaPinto, Madalena2022-12-20T11:05:15Zoai:ojs.www.actamedicaportuguesa.com:article/7523Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:28.189861Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention Alteração do Comportamento e Instabilidade da Marcha: O Valor da Avaliação Neuroimagiológica e da Intervenção Neurocirúrgica Precoces |
title |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
spellingShingle |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention Costa, Andreia Cognition Disorders Gait Disorders Neurologic Hemangioma Cavernous Magnetic Resonance Imaging Neurosurgical Procedures Tomography X-Ray Computed Ventriculostomy Hemagnioma Cavernoso Perturbações da Cognição Perturbações Neurológicas da Marcha Procedimentos Neurocirúrgicos Ressonância Magnética Tomografia Computorizada Ventriculostomia |
title_short |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
title_full |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
title_fullStr |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
title_full_unstemmed |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
title_sort |
Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
author |
Costa, Andreia |
author_facet |
Costa, Andreia Marques-Matos, Cláudia Reis, Carina Carvalho, Marta Pinto, Madalena |
author_role |
author |
author2 |
Marques-Matos, Cláudia Reis, Carina Carvalho, Marta Pinto, Madalena |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Costa, Andreia Marques-Matos, Cláudia Reis, Carina Carvalho, Marta Pinto, Madalena |
dc.subject.por.fl_str_mv |
Cognition Disorders Gait Disorders Neurologic Hemangioma Cavernous Magnetic Resonance Imaging Neurosurgical Procedures Tomography X-Ray Computed Ventriculostomy Hemagnioma Cavernoso Perturbações da Cognição Perturbações Neurológicas da Marcha Procedimentos Neurocirúrgicos Ressonância Magnética Tomografia Computorizada Ventriculostomia |
topic |
Cognition Disorders Gait Disorders Neurologic Hemangioma Cavernous Magnetic Resonance Imaging Neurosurgical Procedures Tomography X-Ray Computed Ventriculostomy Hemagnioma Cavernoso Perturbações da Cognição Perturbações Neurológicas da Marcha Procedimentos Neurocirúrgicos Ressonância Magnética Tomografia Computorizada Ventriculostomia |
description |
Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 oai:ojs.www.actamedicaportuguesa.com:article/7523 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/7523 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/4897 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8300 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8630 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8631 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7523/8744 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2017 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2017 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf image/jpeg image/jpeg image/jpeg application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 30 No. 1 (2017): January; 77-79 Acta Médica Portuguesa; Vol. 30 N.º 1 (2017): Janeiro; 77-79 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799130645730951168 |