Edema cerebral crônico na neurocisticercose
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Data
1998-09-01
Autores
AGAPEJEV, SVETLANA [UNESP]
YELA, DANIELA ANGERAME
GOMES, ANDRÉ EDUARDO
Título da Revista
ISSN da Revista
Título de Volume
Editor
Academia Brasileira de Neurologia (ABNEURO)
Resumo
Neste estudo retrospectivo, relatam-se as características clínicas do edema cerebral crônico (ECCr) em 34 pacientes com neurocisticercose (NCC), que apresentavam edema cerebral difuso, à tomografia computadorizada (TC), como característica comum. Todos foram tratados com dextroclorofeniramina e, 32 deles, com albendazol. O ECCr predominou no sexo feminino (73,5%) na faixa etária dos 11 - 40 anos (92,3%). A cefaléia ocorreu em 94,1% dos pacientes, náuseas/vômitos em 47,1%, crises epilépticas em 41,1% e distúrbios psíquicos em 38,2%. A hiperreflexia ocorreu em 82,3% e o papiledema em 58,8% e o exame neurológico normal em 11,8%. Na TC, o edema esteve associado a calcificações em 61,8% dos casos. As pressões liquóricas foram mais elevadas (p< 0,05) antes do tratamento. Atualmente, estão assintomáticos, ou com melhora clínica, 79,4% dos pacientes (57,1% deles sem medicação). Discute-se a possibilidade do ECCr, na NCC, ser uma manifestação antigênica, sem a presença concomitante de cistos parasitários, e poder representar mais uma condição clínica associada à hipertensão intracraniana benigna.
In a retrospective study, we report the clinical characteristics of chronic brain oedema (CBO) in 34 patients with neurocysticercosis (NCC) who presented diffuse brain oedema upon computed tomography (CT) as a common point. All patients received dextrochlorpheniramine, and, 94.1% of them also albendazole. A predominance of females (73.5%) aged 11-40 years (92.3%) was seen. Headache occurred in 94.1% of patients, nausea/vomiting in 47.1%, epileptic manifestations in 41.1% and psychiatric disorders in 38.2%. Hyperreflexia was obtained in 82.3% of patients, papilloedema in 58.8% and normal neurological examination in 11.8%. The CT scan of the brain showed an association of oedema with calcifications in 61.8% of cases. The cerebrospinal fluid (CSF) pressure was higher before than after treatment (p < 0.05). At the last visit, 79.4% of patients were currently asymptomatic (57.1% of them without medication). It is pointed out that CBO may be an antigenic manifestation in NCC without the concomitant presence of parasitic cysts and may represent an additional clinical condition associated with benign intracranial hypertension
In a retrospective study, we report the clinical characteristics of chronic brain oedema (CBO) in 34 patients with neurocysticercosis (NCC) who presented diffuse brain oedema upon computed tomography (CT) as a common point. All patients received dextrochlorpheniramine, and, 94.1% of them also albendazole. A predominance of females (73.5%) aged 11-40 years (92.3%) was seen. Headache occurred in 94.1% of patients, nausea/vomiting in 47.1%, epileptic manifestations in 41.1% and psychiatric disorders in 38.2%. Hyperreflexia was obtained in 82.3% of patients, papilloedema in 58.8% and normal neurological examination in 11.8%. The CT scan of the brain showed an association of oedema with calcifications in 61.8% of cases. The cerebrospinal fluid (CSF) pressure was higher before than after treatment (p < 0.05). At the last visit, 79.4% of patients were currently asymptomatic (57.1% of them without medication). It is pointed out that CBO may be an antigenic manifestation in NCC without the concomitant presence of parasitic cysts and may represent an additional clinical condition associated with benign intracranial hypertension
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Palavras-chave
neurocisticercose, edema cerebral crônico, hipertensão intracraniana benigna, tratamento, neurocysticercosis, brain oedema, benign intracranial hypertension, treatment
Como citar
Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 56, n. 3B, p. 569-576, 1998.