-The aim of this study was to analyse distribution of meningoencefalitis caused by mumps viras in children related to sex, age and seasonal influences. Thirty seven children were evaluated, ages ranging from 2 to 14 years. They were seen at Emergency Unit of Faculdade de Medicina do Triângulo Mineiro and at Hospital da Criança, in Uberaba-MG, Brazil, from March 1st 1991 to February 1st 1993 and they were hospitalized for about 5 days. Through a protocol findings were studied during hospitalization and clinical course stressing epidemiology, symptomatology, cerebrospinal fluid studies, electroencephalogram and cortical function analysis. Only epidemiological data were considered in the present study. Data analysis revealed male predominance, at a range from 5 to 9 years and great number of occurrences at the last quarter of the year.KEY WORDS: mumps meningoencephalitis, neuroepidemiology, aseptic meningoencephalitis. Meningoencefalite pelo vírus da caxumba: abordagem epidemiológicaRESUMO -O presente trabalho tem por objetivo, estudar a distribuição quanto ao sexo, idade e sazonalidade, em crianças com meningencefalite pelo vírus da caxumba. Foram avaliadas 37 crianças, com idades variando de 2 a 14 anos, atendidas no Pronto-Socorro do Hospital Escola da FMTM e do Hospital da Criança, MG, no período de 1-março-1991 a 1-fevereiro-1993 e hospitalizadas por período médio de 5 dias. Através de protocolo pré-elaborado foram estudados os achados obtidos por ocasião da internação e evolução, enfatizando-se a epidemiologia, sintomatologia, líquido cefalorraqueano, eletrencefalograma e função cortical. São considerados apenas os dados epidemiológicos, no presente estudo. A análise das informações pertinentes revela predomínio no sexo masculino, na faixa etária dos 5 aos 9 anos e maior número de casos no último trimestre do ano, correspondente à estação da primavera.PALAVRAS-CHAVE: meningencefalite pelo vírus da caxumba, neuroepidemiologia, meningencefalite asséptica.Mumps virus is one of the most frequent agents causing aseptic meningoencephalitis in patients under 15 years old. Nevertheless, the real incidence is clinically difficult to establish because it occurs asymptomatically (36%) 3 or in the absence of parotiditis (29%) 26 . Cerebrospinal fluid (CSF) studies in patients with epidemic parotiditis show pleocytosis ranging from 34% (26/77) 4 to 63% (235/371) 3 . Mumps virus belongs to genus Paramyxovirus, family Paramyxoviridae, and possess one RNA molecule. Two surface glucoproteins (HN and F) were described, which are essential for Este estudo faz parte da Dissertação de Mestrado do primeiro autor, apresentada à
In this study we aimed to determine the levels of tumor necrosis factor beta (TNF-b), interleukin (IL) 1-beta (IL-1b), IL-5, IL-10, and interferon gamma (IFN-g ) in CSF from children during the onset of West syndrome (WS). We observed elevated levels of IL-1b and IFN-g correlated to clinical, EEG, therapeutic response, and follow-up suggesting the involvement of immune response in WS. These results suggest that inflammatory and immunologic mediators may play a role in the pathophysiologic mechanisms of infantile spasms. Our findings may explain the perfusion and cognitive disfunctions and actions of adrenocorticotropic hormone (ACTH), corticosteroids, and intravenous immunoglobulin (IVIg) observed in WS. In conclusion, WS results from association of neurophysiological mechanisms and structural abnormalities with participation of cytokines mainly in symptomatic group.
A. LEBOREIRO-FERNANDEZ \ LEE LEBOREIRO", M.V.L MOURA-RIBEIRO "*RESUMO -Os autores apresentam o estudo de quatro crianças que manifestaram hemiparesia desproporcionada de instalação súbita, sem perda da consciência. O diagnóstico de infarto estriatocapsular foi confirmado pela tomografia computadorizada do crânio (TCC) e ressonância magnética (RM). Discutem os achados clínico-neurológicos e de exames complementares. História familiar de migrânea foi relatada em dois dos pacientes. Constatou-se migrânea em dois, trauma craniano, miocardite e prolapso de válvula mitral em um. Hemiparesia esquerda, com predomínio bráquio-facial em três e braquial em um. A TCC demonstrou comprometimento do núcleo lenticular e da cápsula interna nos quatro casos; da cabeça do núcleo caudado em três e da substância branca em dois. A RM foi realizada em dois e confirmou os achados da TCC. O eletrencefalograma, obtido na fase aguda em três, se mostrou alterado nos quatro casos. PALAVRAS-CHAVE: infarto estriatocapsular, isquemia cerebral, hemiplegia aguda, infância. S t r i a t o c a p s u l a r i n f a r c t i o n i n c h i l d h o o d : r e p o r t o f f o u r casesSUMMARY -The authors present the study of four children that manifested asymmetric hemiparesis with sudden onset, without consciousness loss. The diagnosis of striatocapsular infarction was confirmed by computed tomography (CT) and magnetic resonance imaging (MRI). The clinical and neurological examination, and laboratorial results are discussed. Familial history of migraine was found in two of the patients. Migraine was diagnosed in two, mild head trauma, viral miocarditis and mitral valve prolapse in one. Left hemiparesis, with brachiofacial features in three, and brachial in one. CT showed lenticular nucleus and internal capsule lesions in all of them, head of caudate nucleus in three, and white substance in two. MRI was done in two and confirmed CT findings. Electroencephalogram, at the acute phase in three, showed abnormalities in all patients.KEY WORDS: striatocapsular infarction, cerebral ischemia, acute hemiplegia, childhood.Os acidentes vasculares isquémicos envolvendo as artérias cerebrais são raros na infância, apresentando incidência de 0,2 a 0,6/100000 / ano, a maioria detectada na região estriatocapsular 24,25 , com manifestações clínicas dependentes da localização e extensão 8,26 . Os infartos mais extensos ocorrem com certa frequência em crianças 16 , sendo difícil a visualização dos vasos comprometidos mesmo com a utilização das modernas técnicas de neuroimagem 28 e, em geral, são secundários ao envolvimento das artérias perfurantes, ramos dos grandes vasos encefálicos.A vascularização da região estriatocapsular é mantida pelas artérias: estriada interna, ramo da cerebral anterior, responsável pela irrigação do segmento anterior da cápsula interna; coroidea
Terson's syndrome is characterized by the presence of a subarachnoid hemorrhage accompanied by retinal and vitreous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage .
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