Navegando por Palavras-chave "neuroimage"

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    Clinical variables related to the diagnostic stability of demential syndromes
    (Cambridge Univ Press, 2017) de Moraes, Fabiano Moulin [UNIFESP]; Ferreira Bertolucci, Paulo Henrique [UNIFESP]
    Background: Assigning a diagnosis to a patient with dementia is important for the present treatment of the patient and caregivers, and scientific research. Nowadays, the dementia diagnostic criteria are based on clinical information regarding medical, history, physical examination, neuropsychological tests, and supplementary exams and, therefore, subject to variability through time. Methods: A retrospective observational study to evaluate variables related to clinical diagnostic stability in dementia syndromes in at least one year follow up. From a sample of 432 patients, from a single university center, data were collected regarding sociodemographic aspects, Clinical Dementia Rating, physical examination, neuropsychological tests, and supplementary exams including a depression triage scale. Results: From this sample, 113 (26.6%) patients have their diagnosis changed, most of them adding a vascular component to initial diagnosis or depression as comorbidity or main disease. Our findings show that many factors influence the diagnostic stability including the presence of symmetric Parkinsonism, initial diagnosis of vascular dementia, presence of diabetes and hypertension, the presence of long term memory deficit in the neuropsychological evaluation, and normal neuroimaging. We discuss our findings with previous findings in the literature. Conclusion: Every step of the clinical diagnosis including history, vascular comorbidities and depression, physical examination, neuropsychological battery, and neuroimaging were relevant to diagnosis accuracy.
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    Hematoma extradural estudo radiológico comparativo entre pacientes em coma e não comatosos
    (Academia Brasileira de Neurologia - ABNEURO, 1992-09-01) Mello, Luis Renato; Ferraz, Fernando A. P. [UNIFESP]; Braga, Fernando M. [UNIFESP]; Hospital Santa Isabel; Universidade Federal de São Paulo (UNIFESP)
    A series of 129 patients harbouring extradural hematomas was analysed considering the neurological state immediately before operation as the most consistent variable. Seventy eight patients were considered to be comatous (Group I) and 51 were noncomatous. Among the comatous group, 30 were investigated with computerized tomography (23.3% mortality, 50% good results), 31 were submitted to angiography (48.3% mortality, 38.7% good results), and 17 were operated based on the neurological examination and skull radiography (47% mortality, 35.2% good results). The presence or absence of skull fracture and the density of hematoma did not change the final outcome. Associated intracranial lesions increased the mortality and lowered the good results in both groups. Frontal hematomas (10 cases) in the comatous group were associated with high mortality (52.6%) due to bad neurological state (Glasgow 3-5) and to isolated or multiple intracranial associated lesions (6 patients).
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    Hippocampal volume and CDR-SB can predict conversion to dementia in MCI patients
    (Academia Brasileira de Neurologia - ABNEURO, 2012-11-01) Borgio, João Guilherme Fiorani [UNIFESP]; Baldaçara, Leonardo [UNIFESP]; Moraes, Walter dos Santos [UNIFESP]; Lacerda, Acioly Luiz Tavares de [UNIFESP]; Montaño, Maria Beatriz Marcondes Macedo [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Tufik, Sergio [UNIFESP]; Ramos, Luiz Roberto [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the combination of two factors: clinical dementia rating sum of boxes scores (CDR-SB) and hippocampal volume (HV) as predictors of conversion from mild cognitive impairment (MCI) to dementia. METHODS: Twenty-eight individuals (9 normal and 19 with MCI) were classified according to their CDR sum of boxes scores into 3 groups. RESULTS: The hippocampal volume was significantly lower in the high-risk group and in those who developed dementia after two years. The rate of conversion was crescent among the three groups. CONCLUSION: We were proposed an additional measurement of the hippocampal volume which may be helpful in the prognosis. However, we noted that the CDR-SB is a method as efficient as neuroimaging to predict dementia with the advantage of being a procedure for low cost and easy implementation, more consistent with public policy.