RESUMO
OBJECTIVE: To describe published cases of cerebral mansoni schistosomiasis and three others and discuss the diagnosis and treatment of cerebral pseudotumoral schistosomiasis. CASE DESCRIPTIONS: In case 1, a 20-year-old man presented with occipital headache, intense dizziness, visual alterations, nausea, decreased appetite, and asthenia. Cranial computed tomography (CT) revealed an expansive cerebellar lesion in the right hemisphere with no contrast enhancement. The patient had complete resection of the lesion. Anatomicopathological examination revealed a schistosomal granuloma. In case 2, a 22-year-old man presented with generalized tonic-clonic seizure. Cranial CT and magnetic resonance imaging (MRI) revealed an expansive bilateral middle frontal lesion, with contrast uptake close to the cingulate gyrus and corpus callosum. The patient underwent left frontal craniotomy, and an interhemispheric approach was used to resect part of the lesion. In case 3, a 32-year-old man presented with generalized tonic-clonic seizures. Cranial CT showed a hyperdense intense intracranial expansive lesion that presented contrast uptake in the left temporal region. The patient had complete resection of the lesion. CONCLUSIONS: A surgical approach with lesion resection or stereotaxic biopsy is warranted to determine the diagnosis definitively. Antiparasitic drugs must be administered to complete treatment.
Assuntos
Pseudotumor Cerebral/cirurgia , Esquistossomose mansoni/cirurgia , Adulto , Anticonvulsivantes/uso terapêutico , Encéfalo/diagnóstico por imagem , Encéfalo/parasitologia , Cerebelo/diagnóstico por imagem , Cerebelo/cirurgia , Craniotomia , Epilepsia Tônico-Clônica/etiologia , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Granuloma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos , Praziquantel/uso terapêutico , Pseudotumor Cerebral/diagnóstico por imagem , Pseudotumor Cerebral/parasitologia , Esquistossomose mansoni/diagnóstico por imagem , Esquistossomose mansoni/parasitologia , Esquistossomicidas/uso terapêutico , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
A doença de Huntington (DH) é um distúrbio hereditário autossômico dominante, que está relacionado à expansão das repetições de CAG (citosina-adenina-guanina) no braço curto do cromossomo 4, o que leva à formação de uma proteína mutante associada, principalmente, à destruição neuronal do estriado. Manifesta-se por transtornos motores, cognitivos e neuropsicológicos, evoluindo progressivamente para estado demencial grave. A patogênese da doença ainda apresenta pontos obscuros. No entanto, recentes investigações têm possibilitado maior entendimento de sua origem e evolução, assim como de outras doenças neurodegenerativas
Huntington's disease is a hereditary autosomal dominant disorder which occurs due to the expansion of the repetitions CAG on the short arm of chromosome 4, which leads to the formation of a mutant protein itself associated principally to the destruction of neuronal of the striated tissue. It manifests through motor, cognitive and neuropsychological disorders where it evolves progressively to a serious demential state. The pathogenesis of this disease still presents obscure points although recent investigations made it possible to understand it better in its origin and evolution, the same as with other neurodegenerative diseases