scholarly journals Paraneoplastic Vasculitis in a Patient with Astrocytoma of the Brain

2021 ◽  
Vol 11 (1) ◽  
pp. 67-71
Author(s):  
A. V. Yagoda ◽  
A. V. Rybas ◽  
E. N. Danilova ◽  
Yu. V. Gromova

Clinical case of paraneoplastic vasculitis аssociated a brain tumor was presented. Paraneoplastic vasculitis is a rare type of paraneoplastic syndrome. The frequency of detection of paraneoplastic vasculitis in cancer patients is 0.01-5%. In 70% of cases, the manifestation of vasculitis is observed long before the clinical manifestations of the tumor. Most studies report so-called leukocytoclastic vasculitis (allergic) or allergic angiitis. Vasculitis is usually accompanied by slowly progressing tumors such as breast and prostate cancer. It also develops with of stomach cancer, lung cancer, kidney adenocarcinoma, epithelioma, sarcoma, cholangiocarcinoma, other solid tumors, multiple myeloma, non-Hodgkin’s lymphoma. The nosological forms of paraneoplastic vasculitis include called polyarteritis nodosa, hemorrhagic vasculitis, Wegener’s granulomatosis, non-specific aortoarteritis, idiopathic pulmonary hypertension syndrome, thrombovasculitis, allergic hemorrhagic vasculitis, cutaneous vasculitis, systemic necrotizing vasculitis with increased ANCA titer. The patient suffered from paraneoplastic vasculitis with the development of amyloidosis of vascular tissues and arterial hypertension. The progression of the vascular process led to damage of the arteries of the brain and heart, the development of ischemic stroke and hemodynamically significant stenosis of the coronary arteries, the development of acute myocardial infarction complicated by acute heart failure, which caused death. The clinical significance of the case lies in the fact that paraneoplastic vasculitis, which was developed due to a brain astrocytoma with the formation of amyloidosis was firstly described.

Author(s):  
А.В. Серёжкина ◽  
И.Г. Хмелевская ◽  
Н.С. Разинькова ◽  
Т.А. Миненкова ◽  
И.И. Жизневская ◽  
...  

Поскольку непосредственные этиологические факторы аномалии развития не известны, в работе выделены основные группы причин, способствующих формированию пороков развития головного мозга. Большое значение отводится ранней диагностике пороков развития, которая позволяет своевременно решить вопрос о возможности пролонгирования беременности, что определяется видом порока, совместимостью с жизнью и прогнозом в отношении постнатального развития. В исследовании рассматриваемого порока развития большую роль играют такие современные методы, как пренатальная ультразвуковая диагностика, нейросонография, рентгеновская компьютерная и магнитно-резонансная томография головного мозга, имеющие достаточно высокую информативность. Указаны сроки гестации, позволяющие выявить структурные дефекты головного мозга. Медико-генетическое консультирование помогает выявить риск появления больного потомства. Проведена дифференциальная диагностика семилобарной с другими формами голопрозэнцефалии. Также отмечены возможные клинические проявления рассматриваемой нозологии. В данной статье представлен клинический случай семилобарной голопрозэнцефалии, диагностированной у мальчика в возрасте 1 месяц. При поступлении мать предъявляла жалобы на срыгивания и периодическое беспокойство сына. Объем и результаты обследования ребенка изложены ниже. Выявлена сопутствующая патология в виде пупочной грыжи, врожденной аномалии развития мочевой системы: подковообразная почка; водянки яичек и головчатой формы гипоспадии. После проведения курса поддерживающей терапии пациент был выписан в стабильном состоянии. В настоящее время специфическое лечение голопрозэнцефалии отсутствует. Оперативные вмешательства на головном мозге проводятся редко ввиду тяжести состояния больных, в связи с чем лечение данной патологии возможно только с помощью хирургической коррекции симптомов. Длительная дыхательная и кардиоваскулярная дисфункция предопределяет летальный исход заболевания. Since the direct etiological factors of developmental abnormalities are not known, the main groups of causes contributing to the formation of brain malformations are identified in the work. Great importance is given to the early diagnosis of malformations, which allows us to timely resolve the issue of the possibility of prolonging pregnancy, which is determined by the type of defect, compatibility with life and the prognosis for postnatal development. In the study of the considered malformation, such modern methods as prenatal ultrasound diagnostics, neurosonography, X-ray computer and magnetic resonance imaging of the brain, which have a sufficiently high informative value, play an important role. The terms of gestation are indicated, which make it possible to identify structural defects of the brain. Medical and genetic counseling helps to identify the risk of the appearance of sick offspring. The differential diagnosis of semilobar with other forms of holoprosencephaly was carried out. Possible clinical manifestations of the nosology under consideration are also noted. This article presents a clinical case of semilobar holoprosencephaly diagnosed in a boy at the age of 1 month. Upon admission, the mother complained of regurgitation and periodic anxiety of her son. The scope and results of the child's examination are set out below. Concomitant pathology was revealed in the form of an umbilical hernia, a congenital abnormality of the development of the urinary system: a horseshoe kidney; dropsy of the testicles and a cephalic form of hypospadias. After a course of maintenance therapy, the patient was discharged in a stable condition. Currently, there is no specific treatment for holoprosencephaly. Surgical interventions on the brain are rarely performed due to the severity of the patients ' condition, and therefore, the treatment of this pathology is possible only with the help of surgical correction of symptoms. Prolonged respiratory and cardiovascular dysfunction determines the fatal outcome of the disease.


2018 ◽  
Vol 17 (4) ◽  
pp. 333-340
Author(s):  
Svetlana A. Hmilevskaya ◽  
Galina N. Masljakowa ◽  
Nikolai I. Zryachkin ◽  
Olga A. Makarowa ◽  
Mikhail M. Bazalitsky ◽  
...  

Background. The prevalence of congenital malformations of the vessels or angiodysplasia ranges from 1:50,000 to 1:5,000,000. Congenital angiodysplasia is a consequence of impaired formation and development of the vascular system in embryogenesis. The aetiology of angiodysplasia remains poorly studied, and the diagnosis involves significant difficulties in some cases. Clinical Case Description. The observation of a rare case of a combined malformation of vessels and thymic aplasia in a female infant is presented. Angiodysplasia included the syndrome of congenital generalised phlebectasia (synonym: congenital telangiectatic marbled skin) combined with multiple vascular malformations with predominant vascular lesions of the brain, lungs, heart, kidneys, and mesentery. Clinically, the disease was characterised by a generalised change in the skin in the form of livedo reticularis accompanied by the development of severe pneumonia, persistent urinary syndrome, neurological symptoms (convulsive seizures, motor disorders), and progressive heart failure. The diagnosis was confirmed in the course of a pathological study. Conclusion. The presented case allows expanding the notion of the variety of clinical manifestations of congenital angiodysplasia, as well as its possible combinations with other malformations.


Author(s):  
Sergii Stadnik ◽  
Oleksii Saiko

The most severe and disabling among various types of cerebrovascular accidents are hemorrhages. High mortality in hemorrhagic stroke is due to the possible development of a generalized convulsive syndrome, accompanied by respiratory failure; a cascade of irreversible biological reactions (dislocation syndrome with wedging, ventricular system hemotamponade with the formation of acute obstructive hydrocephalus); the development of complications associated with forced immobilization of the patient or connecting to a ventilator. The diagnosis of cerebral stem strokes is highly relevant due to the increase in their prevalence in the structure of cerebrovascular diseases. With stem strokes, the prognosis of the disease is worse than with strokes of any other localization, which is explained by the location of many vital centers in these structures. The paper highlights the classification and clinical manifestations of hemorrhages in the brain stem, substantiates the feasibility of rehabilitation measures at all periods of the disease. The use of early individual rehabilitation complex treatment can improve the results of therapy of deeply located hematomas, reducing disability and mortality of patients. The article presents the clinical case of a patient with a stem hemorrhagic stroke, in which, against the background of drug therapy and rehabilitation measures developed according to an individual program, self-care skills and working capacity were fully restored. Key words: hemorrhagic stroke (hemorrhage), stem stroke, hemorrhage in pons, rehabilitation


2017 ◽  
Vol 8 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Valentina I Guzeva ◽  
Inna V Ochrim ◽  
Nadezhda E Maksimova ◽  
Oksana V Guzeva ◽  
Victoria V Guzeva ◽  
...  

The clinical picture of traumatic brain injury (TBI) in children is characterized by pronounced polymorphism. To clarify the severity of TBI and the localization of the pathological process, use computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. The aim of the work was to justify the need for neuroimaging to all children with hemophilia with TBI and to determine the correlation between the severity of clinical manifestations and neuroimaging data. The article describes the clinical case of a favorable outcome of an TBI in a toddler child with hemophilia A. The case is of interest to physicians of various specialties and demonstrates the features of the clinical course of acute TBI with hemophilia. The diagnostic process for TBI was based on complaints, clinical and neuroimaging data. Complaints and the circumstances of the injury are known from the mother's words in connection with the early age of the child and the absence of a formed speech. Methods of investigation: collection of complaints and anamnesis of the disease, neurological examinations, laboratory and instrumental data, including neuroimaging data. It is known that the boy fell off the couch, hit the back of the head, did not lose consciousness, there was no vomiting. A day after receiving the injury, there was an increase in cerebral neurological symptoms. Clinically, hematoma is suspected. On the CT of the brain, epidural hematoma was determined. Thus, the presented clinical case illustrates that even a minor head injury in patients with hemophilia can lead to severe consequences. Neuroimaging of the brain with TBI is indicated for all children with hemophilia, regardless of the severity of clinical manifestations.


2021 ◽  
Vol 6 (6) ◽  
pp. 152-157
Author(s):  
I. O. Filiuk ◽  
◽  
O. I. Kalbus ◽  
N. P. Shastun ◽  
D. I. Andreichenko ◽  
...  

COVID-19 is an urgent problem all over the world that affects not only the respiratory system, but also causes many neurological disorders. In connection with the clinical manifestations of COVID-19, further detailed study of neurological complications is required, such as ischemic and hemorrhagic strokes, damage to the peripheral nervous system, and inflammatory diseases of the brain. Some neurological symptoms after an illness may persist for several weeks or even months. Hemorrhagic encephalitis is one such complication of COVID-19. Taking into account the growth of COVID-19 and frequent neurological complications after a previous illness, more and more often patients will seek medical help from a specialist, such as a neurologist, psychologist, psychiatrist. The only protection against COVID-19, which causes serious complications, is vaccination. The purpose of the study was to highlight a rare case of hemorrhagic encephalitis, which developed against the background of the previous COVID-19 disease. Materials and methods. The work is based on a description of a clinical case of hemorrhagic encephalitis in a patient who has undergone COVID-19. The modern literature data on the clinical and diagnostic features and therapeutic possibilities of hemorrhagic encephalitis are presented. Results and discussion. The article examines data on the clinical manifestations of COVID-19, which can occur in both mild and severe forms, reflects the diagnostic criteria of this disease, highlights treatment approaches, discusses in detail and provides data on the main aspects of the pathogenetic mechanisms underlying development of the disease. Complications of COVID-19 have been described, not only from the central and peripheral nervous system, but also from other systems. The second part of the article is presented in the form of a clinical case of hemorrhagic encephalitis against the background of the undergone COVID-19, which was recorded in our hospital. This part of the article describes in detail the patient's complaints and anamnestic data, the data of the somatic and neurological examination at the time of admission to the hospital and in dynamics, and describes the treatment tactics. Attention is especially focused on the cognitive functions of this patient, which will become the reason for seeing a psychiatrist in the future. Conclusion. Neurological complications of COVID-19 are increasingly registered, requiring close attention from neurologists. Hemorrhagic encephalitis can be one of these complications


2013 ◽  
Vol 12 (5) ◽  
pp. 133-138
Author(s):  
V. M. Alifirova ◽  
T. A. Valikova ◽  
T. N. Nikolaeva ◽  
N. V. Pugachenko ◽  
S. V. Vtorushin

Schilder’s leukoencephalitis was described by American neurologist and psychiatrist P.F. Schilder (1886– 1940). At present the pathology is regarded as acute diffuse form of multiple sclerosis, and it is characterized by demyelination of the brain. Clinical manifestations of pathological process varied. The disease is a rare, usually in children and adolescents. In patients older than 40 years of death can occur in a period of 6 months to 3 years from the onset of the first symptoms. Considering the rarity of the disease, we present a clinical case with autopsy data from our practice. 


2020 ◽  
Vol 75 (3) ◽  
pp. 138-144
Author(s):  
T.N. Buchkova ◽  
◽  
N.I. Zriachkin ◽  
G.I. Chebotareva ◽  
O.V. Tihnenko ◽  
...  

The relevance of the topic is due to insufficient awareness of doctors about neurofibromatosis, which leads to a delay in diagnosis and the development of complications. The diagnostic criteria characteristic of this disease, features of the clinical course, possible complications, methods of treatment, features of dispensary observation are described. A clinical case of neurofibromatosis type I with astrocytoma of the brain is described. The diagnosis of neurofibromatosis type I (NFI) was established in a patient aged 4 years 3 months. The peculiarity of the manifestations of this clinical case is the absence of family history; the combination of cutaneous manifestations, multiple lesions of the nervous system, complicated by chronic subdural hematoma, endocrine disorders and extra-cutaneous manifestations (eye symptoms, hearing and speech disorders); the absence of significant positive dynamics despite repeated surgical treatment and long-term polyochemotherapy. Despite the stabilization of clinical manifestations of the disease, this patient has an unfavorable prognosis with possible progression of the pathological process. For early clinical detection of patients with NFI, using for this purpose diagnostic criteria recommended by the International Committee of experts on neurofibromatosis, continuity of management and adequate measures of primary and secondary prevention of complications of NFI is important knowledge of this pathology by primary health care physicians, including pediatricians, district and family doctors, neurologists, dermatologists, ophthalmologists and surgeons.


2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (7) ◽  
pp. 523-529 ◽  
Author(s):  
Palmiero Monteleone ◽  
Antonio DiLieto ◽  
Eloisa Castaldo ◽  
Mario Maj

AbstractLeptin is an adipocyte-derived hormone, which is involved predominantly in the long-term regulation of body weight and energy balance by acting as a hunger suppressant signal to the brain. Leptin is also involved in the modulation of reproduction, immune function, physical activity, and some endogenous endocrine axes. Since anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by abnormal eating behaviors, dysregulation of endogenous endocrine axes, alterations of reproductive and immune functions, and increased physical activity, extensive research has been carried out in the last decade in order to ascertain a role of this hormone in the pathophysiology of these syndromes. In this article, we review the available data on leptin physiology in patients with eating disorders. These data support the idea that leptin is not directly involved in the etiology of AN or BN. However, malnutrition-induced alterations in its physiology may contribute to the genesis and/or the maintenance of some clinical manifestations of AN and BN and may have an impact on the prognosis of AN.


Author(s):  
Sergey Armakov

Sensorineural hearing loss is a disorder associated with the damage to the inner ear structures: the cochlea (cortical organ), dysfunctioning of the vestibule-cochlear nerve or the central part of the auditory analyser (brain stem and cortical representation of the cortical temporal lobe). In recent years, there has been a steady increase in ensorineural hearing loss patients; they account for ca. 70% among the total patients with impaired hearing. The disease has numerous causes and a complex pathogenesis. Among the main factors contributing to hearing loss are genetic predisposition, perinatal pathology, including hypoxia at childbirth, exposure to infectious and toxic agents and metabolic disorders, injuries (mechanical, acoustic and altitude trauma). Vascular-rheological disorders in the vertebro-basilar system play an important part because blood is supplied to the inner ear from the anterior inferior cerebellar artery. There are sudden, acute and chronic sensorineural hearing loss. The ensorineural hearing loss isdiagnosed by examinations that allow to verify the diagnosis and to determine the sound analyser damage level. This complex includes audiometric examinations, including the tuning fork examination, speech audiometry, and acoustic impedancemetry. If necessary, ultrasound Doppler imaging of the main blood vessels of the brain, computed tomography of the temporal bones, and MRI of the brain are prescribed. The pattern of comprehensive treatment should include, first of all, the elimination of the disease cause and anti-hypoxic drugs, anti-oxidants and a number of physiotherapy procedures.


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