Publicação
Síndrome demencial reversível : caso clínico
| Resumo: | Inflammatory AAC is a clinical, radio and histopathological syndrome characterized by rapidly progressive cognitive decline, asymmetric and extensive white matter lesions , hyperintense on T2 , cortical and subcortical microhemorrhages , and typical vascular amyloid deposits associated with perivascular inflammation, visible CE-MRI . Case Report: 80 year old man with a history of dyslipidemia and dementia for about seven years was admitted to the emergency department with generalized tonic-clonic and self-limited seizure. The observation found himself waking, restless and uncooperative. Disoriented in space and time, not doing simple orders. Physical examination is not sensed focal neurological abnormalities, highlighting only high BP, which was maintained during hospitalization. Laboratory tests were normal. The CE-CT revealed lesions consistent with metastases, which led to hospitalization of the patient for further research, particularly for performing CE-MRI. He was treated with 4mg of dexamethasone 6/6h (EV), but kept the initial state. In CE-RM was observed pattern suggestive of reversible posterior leukoencephalopathy. For lack of control of hypertension, increased to therapeutic dose of Captopril and CE-MRI was repeated to confirm regression of the lesions. In MRI lesions remained. It is therefore hypothesized inflammatory AAC, the patient having been treated with 1 g methylprednisolone daily for 3 days , improved clinically and radiologically , thus confirming the diagnosis. |
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| Autores principais: | Araújo, Graça Maria Jardim |
| Assunto: | Angiopatia amilóide cerebral |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Inflammatory AAC is a clinical, radio and histopathological syndrome characterized by rapidly progressive cognitive decline, asymmetric and extensive white matter lesions , hyperintense on T2 , cortical and subcortical microhemorrhages , and typical vascular amyloid deposits associated with perivascular inflammation, visible CE-MRI . Case Report: 80 year old man with a history of dyslipidemia and dementia for about seven years was admitted to the emergency department with generalized tonic-clonic and self-limited seizure. The observation found himself waking, restless and uncooperative. Disoriented in space and time, not doing simple orders. Physical examination is not sensed focal neurological abnormalities, highlighting only high BP, which was maintained during hospitalization. Laboratory tests were normal. The CE-CT revealed lesions consistent with metastases, which led to hospitalization of the patient for further research, particularly for performing CE-MRI. He was treated with 4mg of dexamethasone 6/6h (EV), but kept the initial state. In CE-RM was observed pattern suggestive of reversible posterior leukoencephalopathy. For lack of control of hypertension, increased to therapeutic dose of Captopril and CE-MRI was repeated to confirm regression of the lesions. In MRI lesions remained. It is therefore hypothesized inflammatory AAC, the patient having been treated with 1 g methylprednisolone daily for 3 days , improved clinically and radiologically , thus confirming the diagnosis. |
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