Arquivos de neuro-psiquiatria
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We report the cases of two women who presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. Both presented normal clinical and neurological examination and MRI compatible with microangiopathy. The first one related headache attacks for three years, occurring several times a day when she masticated or yawned. ⋯ The second one related she had daily headaches for six months that occurred from 20 to 40 times per day. At the first visit to the ambulatory, she related she was using carbamazepine (600 mg per day) and chlorpromazine (15 mg per day) having a partial response. Administration of gabapentin (1200 mg per day) led to complete resolution of the pain attacks, but the patient continue to have episodes of conjunctival injection.
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Comparative Study
Outcome of sleepiness and fatigue scores in obstructive sleep apnea syndrome patients with and without restless legs syndrome after nasal CPAP.
The association of obstructive sleep apnea syndrome (OSAS) and restless legs syndrome (RLS) has been reported in the literature for many years. Both conditions may be responsible for fatigue and somnolence complaints secondary to nocturnal sleep disruption. The primary concern of this study is to evaluate the outcome of fatigue and daytime sleepiness symptoms at baseline and after continuous positive air pressure (CPAP) treatment in OSAS patients with and without RLS. ⋯ Despite a favorable general response, n-CPAP seemed less effective in treating fatigue and sleepiness in the OSAS+RLS group.
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Case Reports
Traumatic subdural hygroma: five cases with changed density and spontaneous resolution.
Thirty-four consecutive adult patients with subdural traumatic hygroma were analysed for clinical evolution, serial computed tomography scan (CT), and magnetic resonance imaging (MRI) over a period of several months. Five of the patients presented CT scan and MRI evolution data showing increasing density over a period of 11 days to 6 months post trauma. ⋯ Descriptions in literature of evolving traumatic subdural hygroma have presented CT scan density modifications changing into chronic subdural hematoma. Our patients show another possibility, density transformation, which sometimes show as subdural hematoma in CT scan and MRI, but with final evolution where clinical condition and CT scan return to normal.
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The large ischemic cerebral infarction (LICI) is a blood supply loss of a large area in the brain, mainly on the middle cerebral artery. Is possible that evolutes a major edema, intracranial hypertension and death in about 80% of the cases. ⋯ The factors age over 50 years and male gender were associated with a high death risk. The level of consciousness at admission and bone flap area were nearer the values of statistic significance.
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Randomized Controlled Trial Comparative Study
[Comparison of intravenous dipyrone to intravenous metoclopramide in the treatment of acute crisis of migraine: randomized clinical trial].
Migraine is one of the commonest diseases of clinical practice. ⋯ There was no difference about the intensity of pain reduction neither about the development of collateral effects comparing dipyrone to metoclopramide.