Navegando por Autor "Fraiman, Pedro Henrique Almeida"
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Artigo Acute hemicerebellitis in a young adult: a potential pitfall(SciELO, 2021-06-03) Godeiro Junior, Clecio de Oliveira; Moreira Neto, Manuel; Fraiman, Pedro Henrique Almeida; 0000-0002-4312-1633A 20-year-old man presented with a new headache for 21 days. His neurological examination showed mild right-side ataxia while walking in tandem. Brain MRI revealed extensive hyperintensities in the right cerebellar hemisphere in FLAIR/T2WI and moderate choline peak and low NAA.Artigo Amyotrophic Lateral Sclerosis and Palatal Myoclonus: An Uncommon Association(Movement Disorders Clinical Practice, 2020-10-18) Godeiro Junior, Clécio de Oliveira; Fraiman, Pedro Henrique Almeida; Dourado, Mario Emilio; 0000-0002-4312-1633We read the article by Rebello et al.1 with great interest. It is an interesting case because it aligns with the modern perspective that amyotrophic lateral sclerosis (ALS) neurodegeneration not only affects the motor neurons. However, we have few considerations related to major points for the uncommon association presented in the case.Artigo "Clock dial pattern", a radiologic clue to neuro-chikungunya diagnosis: a case series(Georg Thieme Verlag KG, 2024-01) Fraiman, Pedro Henrique Almeida; Freire, Mariana; Fernandes, Bruno; Mangueira, Felipe Palitot Alves; Mota, Nathalia Louise Gomes do Rosario Alves da; Sequerra, Eduardo Bouth; Santos, Glauco Igor Viana dos; Dourado Junior, Mario Emilio Teixeira; Godeiro Júnior, Clécio de Oliveira; Moreira-Neto, ManuelBackground: Chikungunya is a mosquito-borne disease caused by the chikungunya virus (CHIKV) and can lead to neurological complications in severe cases. Objective: This study examined neuroimaging patterns in chikungunya cases during two outbreaks in Brazil to identify specific patterns for diagnosis and treatment of neuro-chikungunya. Methods: Eight patients with confirmed chikungunya and neurological involvement were included. Clinical examinations and MRI scans were performed, and findings were analyzed by neuroradiologists. Data on age, sex, neurological symptoms, diagnostic tests, MRI findings, and clinical outcomes were recorded. Results: Patients showed different neuroimaging patterns. Six patients exhibited a "clock dial pattern" with hyperintense dotted lesions in the spinal cord periphery. One patient had thickening and enhancement of anterior nerve roots. Brain MRI revealed multiple hyperintense lesions in the white matter, particularly in the medulla oblongata, in six patients. One patient had a normal brain MRI. Conclusion: The "clock dial pattern" observed in spinal cord MRI may be indicative of chikungunya-related nervous system lesions. Isolated involvement of spinal cord white matter in chikungunya can help differentiate it from other viral infections. Additionally, distinct brainstem involvement in chikungunya-associated encephalitis, particularly in the rostral region, sets it apart from other arboviral infections. Recognizing these neuroimaging patterns can contribute to early diagnosis and appropriate management of neuro-chikungunyaArtigo COVID-19 and cerebrovascular diseases: a systematic review and perspectives for stroke management(Frontiers in Neurology, 2020-11) Godeiro Junior, Clécio de Oliveira; Fraiman, Pedro Henrique Almeida; Cavallieri, Francesco; Moro, Elena; Zedde, Marialuisa; 0000-0002-4312-1633Importance: Reported cerebrovascular events in patients with COVID-19 are mainly ischemic, but hemorrhagic strokes and cerebral venous sinus thrombosis (CSVT), especially in critically ill patients, have also been described. To date, it is still not clear whether cerebrovascular manifestations are caused by direct viral action or indirect action mediated by inflammatory hyperactivation, and in some cases, the association may be casual rather than causal. Objective: To conduct a systematic review on the cerebrovascular events in COVID-19 infection. Evidence review: A comprehensive literature search on PubMed was performed including articles published from January 1, 2020, to July 23, 2020, using a suitable keyword strategy. Additional sources were added by the authors by reviewing related references. The systematic review was conducted in accordance with the PRISMA guidelines. Only articles reporting individual data on stroke mechanism and etiology, sex, age, past cardiovascular risk factors, COVID symptoms, admission NIHSS, D-dimer levels, and acute stroke treatment were selected for the review. Articles that did not report the clinical description of the cases were excluded. A descriptive statistical analysis of the data collected was performed. Finding: From a total of 1,210 articles published from January 1, 2020, to July 23, 2020, 80 articles (275 patients), which satisfied the abovementioned criteria, were included in this review. A total of 226 cases of ischemic stroke (IS), 35 cases of intracranial bleeding, and 14 cases of CVST were found. Among patients with IS, the mean age was 64.16 ±14.73 years (range 27–92 years) and 53.5% were male. The mean NIHSS score reported at the onset of stroke was 15.23 ±9.72 (range 0–40). Primary endovascular thrombectomy (EVT) was performed in 24/168 patients (14.29%), intravenous thrombolysis (IVT) was performed in 17/168 patients (10.12%), and combined IVT+EVT was performed in 11/168 patients (6.55%). According to the reported presence of large vessel occlusion (LVO) (105 patients), 31 patients (29.52%) underwent primary EVT or bridging. Acute intracranial bleeding was reported in 35 patients: 24 patients (68.57%) had intracerebral hemorrhage (ICH), 4 patients (11.43%) had non-traumatic subarachnoid hemorrhage (SAH), and the remaining 7 patients (20%) had the simultaneous presence of SAH and ICH. Fourteen cases of CVST were reported in the literature (50% males), mean age 42.8 years ±15.47 (range 23–72). Treatment was reported only in nine patients; seven were treated with anticoagulant therapy; one with acetazolamide, and one underwent venous mechanical thrombectomy. Conclusion: Cerebrovascular events are relatively common findings in COVID-19 infection, and they could have a multifactorial etiology. More accurate and prospective data are needed to better understand the impact of cerebrovascular events in COVID-19 infection.Artigo Hemorrhagic stroke and COVID-19 infection: coincidence or causality?(Elsevier, 2020-12) Godeiro Junior, Clécio de Oliveira; Freire, Mariana; Moreira Neto, Manuel; Fraiman, Pedro Henrique Almeida; 0000-0002-4312-1633Amyloid Protein Precursor gene duplication is a rare cause of early-onset Alzheimer's disease that can be associated with Cerebral Amyloid Angiopathy. This condition predisposes cerebrovascular events, specifically, intracerebral hemorrhagic stroke. This report describes a case of first-time intracerebral hemorrhage in a patient with APP gene duplication during SARS-CoV-2 infection, a typically pro-thrombotic and pro-inflammatory condition, as a possible trigger for this condition.Artigo Magnetic resonance imaging traits may help to differentiate Pelizaeus-Merzbacher and Pelizaeus-Merzbacher-like disease(SciELO, 2019-08) Godeiro Junior, Clécio de Oliveira; Castro, Matheus Augusto Araújo; Fraiman, Pedro Henrique Almeida; 0000-0002-4312-1633A six-year-old boy with nystagmus and developmental delay from six months of age, was born from healthy first-degree cousins. On neurological examination, he presented with spontaneous and multidirectional nystagmus, gait and upper limb ataxia, and lower limb hyperreflexia/spasticity.Artigo Rapidly progressive sporadic Creutzfeldt-Jakob disease: isolated Heidenhain variant or a combination with PRES?(SciElo, 2020-09-19) Godeiro Junior, Clecio de Oliveira; Fraiman, Pedro Henrique Almeida; Teixeira, Carolina Militão; Oliveira, Juliano César Dantas de; Sousa, Thadeu Alexandre Paulino de; Moreira Neto, Manuel; 0000-0002-4312-1633A 70-year-old man presented with rapidly progressive cognitive impairment with ataxia and myoclonus. Visual agnosia was noticed after blood pressure oscillations, during immunoglobulin therapy for suspected autoimmune encephalitis.Artigo Rucksack palsy after military boot camp(SciELO, 2022-06) Godeiro Junior, Clécio de Oliveira; Fraiman, Pedro Henrique Almeida; Papa, Igor Matheus Diniz; Fernandes, Bruno de Medeiros; Santos, Fernanda Thaysa Avelino dos; 0000-0002-4312-1633A 18-year-old soldier reported weakness on the abduction of right arm and mild right shoulder pain five days after wearing a rucksack during a 3-day boot camp training (Figure 1-A). After six weeks, he presented hypotrophy of shoulder girdle muscles and winged scapula (Figure 1-B). An electroneuromyography performed at this moment revealed signs of progressive subacute neurogenic motor unit potentials of right deltoid, biceps brachii and anterior serratus (Figure 1-C). Right brachial plexus, shoulder MRI and a viral serum panel were unremarkable.