Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention
Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unstead...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2017-01-01
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| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 |
| _version_ | 1818617463032512512 |
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| author | Andreia Costa Cláudia Marques-Matos Carina Reis Marta Carvalho Madalena Pinto |
| author_facet | Andreia Costa Cláudia Marques-Matos Carina Reis Marta Carvalho Madalena Pinto |
| author_sort | Andreia Costa |
| collection | DOAJ |
| description | Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function. |
| first_indexed | 2024-12-16T17:06:05Z |
| format | Article |
| id | doaj.art-9f363b427fba43f1a0b72b64fd51b12d |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-12-16T17:06:05Z |
| publishDate | 2017-01-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-9f363b427fba43f1a0b72b64fd51b12d2022-12-21T22:23:34ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582017-01-01301777910.20344/amp.75234428Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical InterventionAndreia Costa0Cláudia Marques-Matos1Carina Reis2Marta Carvalho3Madalena Pinto4Neurology Department. Centro Hospitalar São João. Porto. Portugal. Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. University of Porto. Porto. Portugal.Neurology Department. Centro Hospitalar São João. Porto. Portugal. Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. University of Porto. Porto. Portugal.Neuroradiology Department. Centro Hospitalar São João. Porto. Portugal.Neurology Department. Centro Hospitalar São João. Porto. Portugal. Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. University of Porto. Porto. Portugal.Neurology Department. Centro Hospitalar São João. Porto. Portugal.Cavernous angiomas are central nervous system malformations. Most common manifestations are seizures and acute focal neurological deficits. We present a case report of a seventy-one year-old man with a two-month history of behavior changes, attention deficit and indifference followed by gait unsteadiness. Neuropsychological evaluation showed severe cognitive impairment and executive dysfunction. Head computed tomography depicted a supraventricular hydrocephaly. Magnetic resonance imaging revealed a small hemorrhage, contiguous to a mesencephalic cavernous angioma, obstructing the Sylvius aqueduct, causing secondary hydrocephalus. Four months after endoscopic ventriculocisternostomy, neuropsychological evaluation showed improvement and the patient regained autonomy. Parenchyma cavernous angiomas causing direct hemorrhage and subsequent obstruction of the Sylvian aqueduct are uncommon. Sub-acute behavior and mental state abnormalities are rare first manifestations of cavernous angioma and requires high clinical suspicion for its correct diagnosis. Magnetic resonance imaging evaluation is crucial in the detection of such patients as prompt neurosurgical intervention may substantially improve cognitive function.http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7523Cognition DisordersGait Disorders, NeurologicHemangioma, CavernousMagnetic Resonance ImagingNeurosurgical ProceduresTomography, X-Ray ComputedVentriculostomy |
| spellingShingle | Andreia Costa Cláudia Marques-Matos Carina Reis Marta Carvalho Madalena Pinto Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention Acta Médica Portuguesa Cognition Disorders Gait Disorders, Neurologic Hemangioma, Cavernous Magnetic Resonance Imaging Neurosurgical Procedures Tomography, X-Ray Computed Ventriculostomy |
| title | Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
| title_full | Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
| title_fullStr | Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
| title_full_unstemmed | Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
| title_short | Behavior Changes and Gait Unsteadiness: The Value of Imaging and Prompt Neurosurgical Intervention |
| title_sort | behavior changes and gait unsteadiness the value of imaging and prompt neurosurgical intervention |
| topic | Cognition Disorders Gait Disorders, Neurologic Hemangioma, Cavernous Magnetic Resonance Imaging Neurosurgical Procedures Tomography, X-Ray Computed Ventriculostomy |
| url | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/7523 |
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