Acidentes isquêmicos transitórios em criança com arteriopatia pós-varicela e mutação MTHFR C677T homozigótica
| Autor: | Pedro Beleza, João Fernandes, Maria José Jordão, Ana Sofia Afonso, Helena Silva |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
Criança Electroencephalography Serology Chickenpox medicine Humans Metilenotetrahidrofolato Redutase Stroke Methylenetetrahydrofolate Reductase (NADPH2) Mutação Past medical history medicine.diagnostic_test biology business.industry Homozygote Infarction Middle Cerebral Artery Heparin medicine.disease Hemiparesis Neurology Ischemic Attack Transient Child Preschool Acidente Isquémico Transitório Anesthesia Methylenetetrahydrofolate reductase Mutation Angiography biology.protein Neurology (clinical) Varicela/complicações medicine.symptom business medicine.drug |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| ISSN: | 0004-282X |
| Popis: | A three year-old boy was admitted to the emergency room (ER) with sudden onset of transient motor deficit of both left limbs. The neurological and general examination was normal. His past medical history was remarkable for primary varicella infec-tion occurring five months before. In the ER he underwent blood tests, brain CT and EEG which displayed normal results. While performing EEG, he presented another deficit episode lasting for five minutes and similar to the one previously described. In the light of multiple TIA’s, anticoagulation with heparin was initiat-ed. However, he had three more TIA’s in the same territory, and at the fifth day after admission had sudden onset of a left pyra-midal syndrome with discrete hemiparesis. The heart evaluation including electrocardiogram and echo-cardiogram was normal. Noteworthy, concearning the analyti-cal work-up, we underscore the serologic evidence of a non-re-cent VVZ infection (IgG+, IgM–) and the presence of a MTHFR homozigotic mutation C677T with normal homocystein and folic acid. All the remaining study was normal or negative and includ-ed hemogram, biochemistry, immunologic study, metabolic, pro-trombotic and CSF (cytochemistry, serologic, microbiologic and virus PCR including VVZ). The MRI with Angio-MRI performed at the second day after admission showed a recent stroke in the territory of right lenticulostriate arteries and a decreased flow on the M1-M2 transition of right MCA (Fig 1). A brain conven-tional angiography was performed to better study all the brain vascular system including the distal vessels. The intracranial es |
| Databáze: | OpenAIRE |
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