Revista de neurologia
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Revista de neurologia · Jul 1997
Case Reports[Subarachnoid hemorrhage associated to subhyaloid hemorrhage: "Terson syndrome"].
The combination of subarachnoid hemorrhage (SAH) and subhyaloid hemorrhage is known as 'Terson syndrome'. Retinal hemorrhage is commonly observed clinically in the optic fundi of patients with SAH, however, subhyaloid hemorrhage of the globe in the setting of SAH has been rarely on CT of the brain. Several mechanisms of subhyaloid hemorrhage have been proposed: a. A sudden increase in intracranial pressure (ICP) forces blood from the subarachnoid space directly into the preretinal space. b. A sudden rise in ICP is thought to decrease venous return to the cavernous sinus from the veins draining the globe. The increased retinal venous pressure results in stasis followed by vessel rupture. c. A sudden rise in ICP obstructs both the retinochoroidal anastomoses and the central retinal vein due to a rapid effusion of CSF through the communication of the subarachnoid space with the optic nerve sheat. This produces an acute decrease in venous drainage from the retina and results in stasis and hemorrhage. ⋯ We report a case of Terson syndrome demonstrated by CT. This CT allow see the blood from the subarachnoid space erupt directly into the preretinal space through optic nerve sheath, confirming one the proposed mechanism for this syndrome.
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Revista de neurologia · Jun 1997
Case Reports[Myopathy caused by inhibitors of hydroxymethylglutaryl-coenzyme A reductase].
Hydroxymethylglutaryl-Coenzyme A (HMG-CoA) Reductase inhibitors are a group of drugs widely used for hypercholesterolemia. They are known to originate side-effects on muscles but with a very low incidence of myopathy. ⋯ Usage of this group of drugs is wide. Their side effects are rare but it is important to remember their capacity to induce a myopathy, usually reversible upon withdrawal of the drug.
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Coma is differentiated from sleep by the absence of a normal arousal response and from death by the presence of heart beats and the absence of brain death criteria. Most causes of coma are readily diagnosed and treated. Others require a test whose results are not immediately available, transportation or a risky procedure and empirical treatment has to be considered. In addition to treating the cause of coma, treatment of the systemic and neurological causes of secondary brain damage is paramount.
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Revista de neurologia · Feb 1997
Case Reports[Transitory episode of laughter as the initial symptom of an ischemic stroke].
Pathological laughter occurs in pseudobulbar paralysis, in psychiatric disorders and as a sign of convulsions (gelastic crisis). An extremely rare form is the "fou rire prodromique' a pathological episode of laughter preceding a stroke. The pathogenesis is unknown and classically differentiated from gelastic crises. "Fou rire prodromique' has been described in subcortical ischaemic or haemorrhagic strokes, not in cortical strokes. ⋯ We suggest that in the case described it is impossible to differentiate between the "fou rire prodromique' and a gelastic crisis as a first sign of an embolic cerebrovascular accident.