Navegando por Autor "Figueiredo, Marcelo Marinho de"
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Artigo Acute foot drop syndrome mimicking peroneal nerve injury: an atypical presentation of ischemic stroke(Elsevier, 2014) Figueiredo, Marcelo Marinho de; Ricarte, Irapuá Ferreira; Fukuda, Thiago Gonçalves; Pedroso, José Luiz; Silva, Gisele SampaioFoot drop syndrome is a frequent neurologic condition usually caused by peroneal nerve damage. On rare occasions, foot drop may present as the single neurologic manifestation of intracranial lesions. We presented a 43-year-old man admitted to our hospital with acute weakness in the dorsiflexion of his right foot that appeared 3 days before admission. Brain magnetic resonance imaging diffusion-weighted sequence revealed a small area of restricted diffusion in the left frontal cortex. Three months later, his motor deficit had completely improved (modified Rankin scale score 5 0). To our knowledge, this is the second report of sudden isolated foot drop caused by a cortical infarction.Artigo Ataxia and progressive myoclonic epilepsy associated with reduced ceramide synthase 1 (CERS1)(Journal Of The Neurological Sciences, 2015-10) Afonso, C.O.M.; Campos, M.L.S.; Mendes, V.L.; Campêlo, C.L.C.; Camilo, A.F.C.; Correia, Carlos Eduardo Rocha; Figueiredo, Marcelo Marinho de; Kok, F.; G. Junior, C.O.Background: Ceramides and their sphingolipid have a wide range of biological functions. Ceramide synthase 1 (CERS1) catalyzes the synthesis of C18 ceramide and is mainly expressed in the brain. Alterations of sphingolipid metabolism are involved in the patho genesis of many neurodegenerative disorders. Objective: Report a case of myoclonic epilepsy and ataxia associated with homozygous variant in the gene CERS1, described in only one family previously). Patients and methods: male, 22 years old with history of appendic ular ataxia since 01 years old, followed by slight myoclonic jerks that progressively worsened despite treatment instituted and delayed psychomotor development. He had a previous episode of generalized tonic-clinic seizures (CTCSs). The electroencephalography (EEG) showed bursts of generalized polyspikes and slow wave discharges and Magnetic Ressonance imaging of the brain showed signs of pontine atrophy, cerebellum and cerebellar peduncle medium and higher, associated with the pontine cross sign. Genomix exonme’s analysis demonstrated a homozygous variant of CERS1. Results: It was found a homozygous variant of CERS1 gene in a patient with epilepsy, ataxia and progressive myoclonic epilepsy, a rare condition currently described as myoclonic epilepsy type 8. Conclusion: Our case demonstrates that reduced levels of CERS1 could be associated with progressive myoclonic epilepsy and must be considered as a differential diagnosis, supporting that impairment of ceramide biosynthesis underlies neurodegeneration in humans. Futher studies may help to define the phenotypes more appropriately.Artigo Fluid-attenuated inversion recovery vascular hyperintensities in patients with transient ischemic attack(Elsevier, 2017) Figueiredo, Marcelo Marinho de; Amaro Júnior, Edson; Alves, Maramélia Araújo de Miranda; Vazzoler, Marcela; Miranda, Renata Carolina Acre Nunes; SilvaFluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs) are common in patients with acute ischemic stroke, possibly representing impaired hemodynamics in the ischemic territory due to intracranial stenoocclusive disease. There are few reports on FVHs in patients with transient ischemic attack (TIA). Aims: We investigated the prevalence of FVHs and its clinical correlations in patients with TIA. Methods: We evaluated consecutive patients admitted with TIA from February 2009 to June 2012 who had undergone magnetic resonance imaging within 30 hours of symptoms onset and intracranial and extracranial vascular imaging. Two independent neuroradiologists determined the presence of FVHs. We assessed the relationship between FVHs, clinical presentation, vascular risk factors, neuroimaging characteristics, and the presence of large artery stenosis or occlusion. Results: Seventy-two patients with TIA were evaluated. FVHs were present in 12 (16.7%) patients. The overall agreement between examiners was good (κ = .67). There were no differences in the frequency of intracranial or cervical arterial stenosis in patients with and without FVH. In a multivariate logistic regression analysis including atrial fibrillation (AF), congestive heart failure, and diabetes, only AF remained in the final model. Conclusions: FVH signals on FLAIR images occur in patients with TIA and might correlate with clinical variables like AF and not only with large vessel occlusion. The presence of FVH in patients with TIA and AF might be a surrogate marker for a large vessel occlusion spontaneously recanalized or for impaired autoregulation in a previously ischemic vascular territory.Artigo Frequency of stroke types at an emergency hospital in Natal, Brazil(Arquivos de Neuro-Psiquiatria, 2007) Dourado Junior, Mário Emílio Teixeira; Martins Junior, Antonio N.N.; Figueiredo, Marcelo Marinho de; Rocha, Orlandil D.; Ferreira, Maria Angela Fernandes; Jeronimo, Selma Maria Bezerra; https://orcid.org/0000-0002-9462-2294Realizamos um estudo de prevalência para determinar a freqüência dos tipos de acidente vascular cerebral (AVC) num hospital de urgência de Natal. Estudaram-se todos os pacientes que foram admitidos no hospital de urgência com diagnóstico presuntivo de AVC. Dos 416 pacientes, 328 foram estudados, 88 foram excluídos por não cumprirem os critérios de inclusão, 74,7% (n= 245) tiveram AVC isquêmico, 17,7% (n=58) hemorragia intracerebral e 7,6% (n=25) hemorragia subaracnóidea. O gênero mais prevalente foi o masculino (52,7%). A média de idade foi 64,1 anos. A letalidade intra-hospitalar foi de 10,2%, 17,2% e 36% para o tipo isquêmico, hemorrágico e hemorragia subaracnóide, respectivamente. O principal fator de risco modificável foi a hipertensão arterial sistêmica (HAS) para AVC isquêmico (67,6%) e AVC hemorrágico (57,8%). A regressão logística identificou diabetes como fator de risco independente para AVC isquêmico (OR=3,70; IC=1,76-7,77). O AVC isquêmico foi o tipo mais comum. HAS e diabetes foram importantes fatores de riscoArtigo Opsoclonus-myoclonus syndrome associated with herpes simplex encephalitis(Journal Of The Neurological Sciences, 2015-10-15) Afonso, C.O.M.; Campos, M.L.S.; Maia, Ferdinand Gilbert Saraiva da Silva; Campêlo, C.L.C.; Camilo, A.F.C.; Correia, Carlos Eduardo Rocha; Fernandes, José Veríssimo; Figueiredo, Marcelo Marinho de; Silva, R.A.Background: Opsoclonus-myoclonus ataxia is a rare neurologic syn drome, often paraneoplastic in origin, but reported in association with various infections. Little is known about adult-onset opsoclonus myoclonus syndrome (OMS) outside of individual case reports Objective: Describe a case of herpes-simplex virus 1 encephalitis presenting as opsoclonus-myoclonus ataxia Patients and methods: A 35 year-old woman, with no known comorbidities, developed a headache with nausea and vomiting, without fever or nuchal rigidity. In the following 48-hours, she presented an altered mental status, opsoclonus and myoclonus and was admitted to hospital. Lumbar puncture: 40 cells (60% mononu clear), protein 140 mg/dL and a normal glucose. Gram stain and culture for bacteria and fungi were negative. A PCR for herpes simplex virus was positive. Brain MRI: normal. Chest, Abdomen and Pelvis CT: no signs of neoplasia. Results: The patient received intra-venous acyclovir for 21 days, with resolution of symptoms Conclusion: OMS is an uncommon presentation of infections of central nervous system. Its fame extends further to the fact that OMS can be a harbinger of occult malignancy. The Adult-onset presentation is rare. Paraneoplastic and parainfectious causes (particularly virus) are common; however, more often OMS in adults occurs after systemic infection. After this report, HSV1 infection should be considered in OMS cases. We described the first case of OMS secondary to Herpes-Simplex Virus 1 infection.Artigo The influence of patient’s knowledge about stroke in Brazil: a cross sectional study(Arquivos de Neuro-Psiquiatria, 2014) Figueiredo, Marcelo Marinho de; Panício, Maurício Isaac; Mateus, Lucas; Ricarte, Irapuá Ferreira; Fukuda, Thiago Gonçalves; Seixas, Jamile Cavalcanti; Ferraz, Maria Elizabeth; Silva, Gisele SampaioPouco se sabe sobre o conhecimento dos pacientes com acidente vascular cerebral (AVC) acerca dos sinais de alarme da doença e sua janela terapêutica no Brasil. Método: Foram entrevistados consecutivamente os pacientes com AVC agudo internados em um hospital público terciário no Brasil. Os dados coletados incluíram dados demográficos, o modo de chegada, escala de AVC do National Institute of Health (NIH) e conhecimento sobre a janela de tempo terapêutica e os sinais de alerta do AVC através de um questionário padronizado. Chegada precoce foi definida como aquela dentro de 4,5 horas do início dos sintomas. Resultados: Embora 66,2% dos pacientes sabiam os sinais de alerta do AVC , apenas 7,8% relataram saber que a doença tinha uma janela de tempo terapêutica limitada. A gravidade do AVC avaliada pela escala do NIH foi preditora de chegada precoce, mas conhecimento acerca dos sinais e sintomas do AVC não foram. Conclusão: O conhecimento acerca dos sintomas do AVC não foi preditivo de chegada precoce ao hospital.