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Browsing HB - NRAD - Artigos by Author "Beleza, P"
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- From juvenile parkinsonism to encephalitis lethargica, a new phenotype of post-streptococcal disorders: case report.Publication . Beleza, P; Soares-Fernandes, J; Jordão, MJ; Almeida, FWe report the case of a 16-year-old boy presented with a mild akinetic-rigid parkinsonism shortly after a post-streptococcal infection. After stopping corticoids, he had a rapid neurological deterioration to a fatal encephalitis lethargica-like syndrome. Serum analysis demonstrated consistently elevated anti-streptolysin-O. This case illustrates a new severe phenotype in the spectrum of the post-streptococcal disorders. This etiology should be considered in the differential diagnosis of a movement disorder with a rapid detrimental evolution.
- Giant cell glioblastoma: review of the literature and illustrated casePublication . Valle-Folgueral, JM; Mascarenhas, L; Costa, JA; Vieira, F; Soares-Fernandes, J; Beleza, P; Alegria, CGiant cell glioblastoma is an infrequent variety of glioblastoma (5% of the cases). It has deserved a separate category in the World Health Organization classification of grade IV tumors. The clinical, imaging, histological and immunohistochemical characteristics, and the genetic alterations are reviewed. Treatment and prognosis are discussed and updated. The case of a patient that survived 19 months and died of spinal leptomeningeal metastases is illustrated.
- Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitisPublication . Beleza, P; Ribeiro, M; Pereira, J; Jordão, MJ; Almeida, FWe report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI features were compatible with acute disseminated encephalomyelitis (ADEM), although a differential diagnosis included cerebritis or vasculitis, secondary to bacterial meningitis. The patient was treated with high-dose steroids which resulted in a gradual improvement followed by complete clinical recovery. We propose a diagnosis of ADEM was the best diagnosis because of the radiological features and response to steroids. The occurrence of ADEM associated with acute meningitis, however rare, represents an important diagnostic challenge for the clinician.
- Reverse crossed cerebellar diaschisisPublication . Ribeiro, M; Beleza, P; Fernandes, J; Almeida, F; Rocha, JCerebral Magnetic Resonance imaging in acute postictal period is performed to exclude structural processes that can be responsible for the epileptic activity. Sometimes, the findings are the result of the epileptic activity, and not the cause reflecting the pathophysiologic changes during epileptic activity. In this paper we describe a patient with status epilepticus who has developed hemicerebellar involvement contralateral to a frontal epileptogenic focus. This phenomenon of Reverse Crossed Cerebellar Diaschisis is rare and has been describe only in Single Photon Emission Computed Tomography (SPECT).
- Simultaneous supratentorial and brainstem abscesses due to Listeria monocytogenes.Publication . Soares-Fernandes, JP; Beleza, P; Cerqueira, JJ; Ribeiro, M; Maré, R; Lourenço, E; Rocha, JFMultiple supratentorial abscesses caused by Listeria monocytogenes are rare. We report the simultaneous occurrence of multiple supratentorial and brainstem abscesses due to Listeria, in a patient under corticotherapy for an exacerbation of ulcerative colitis. MR imaging features before and after successful conservative treatments are depicted. In immunocompromised patients with supratentorial listerial abscesses, the coexistence of brainstem abscedation is exceptional. Despite high mortality associated with listerial abscesses, this case illustrates the possibility of a good clinical outcome, if the appropriate antibiotic regimen is instituted and the immunosuppressant agent is discontinued.
- Transient ischemic attacks in a child with post-varicella arteriopathy and MTHFR homozigotic mutation C677TPublication . Beleza, P; Fernandes, J; Afonso, A; Silva, H; Jordão, MJ
- Wallerian degeneration after stroke: a new prognostic factor?Publication . Soares-Fernandes, J; Beleza, P; Ribeiro, M; Maré, R; Almeida, F; Rocha, JWallerian degeneration (WD) after ischemic stroke has been associated to persistent motor impairment, but signal intensity changes on conventional magnetic resonance imaging (MRI) are generally not detected until four weeks after the event. We report a 54 year old male patient, referred to our hospital for sudden-onset left hemiparesis. Cerebral CT showed right fronto-parietal infarct (middle cerebral artery stroke). We performed two CT control, which revealed no haemorrhagic transformation. MRI, obtained 13 days after the onset, demonstrated the infarct, mainly subcortical, extending throughout fronto-temporo-parietal areas and restricted diffusion in the ipsilateral corticospinal tract. In conclusion, WD is apparent on diffusion-weighted imaging within two weeks of stroke, allowing a better prognostic evaluation of recovery. The abnormal signal should not be misinterpreted as new ischaemic lesions.