Search PubMed⌕ Search

Biomedical subjects

H R Martinez

Publications and source records attributed to H R Martinez.

6 recordsLinked to original sources
PubMed1995

Medical and surgical treatment in neurocysticercosis a magnetic resonance study of 161 cases.

In a prospective non-controlled study we have treated 161 consecutive cases of Active Neurocysticercosis (NCC) diagnosed by Magnetic Resonance (MR). Active NCC was classified in: (1) brain parenchymal cysts (85 cases); (2) ventricular cysts (24 cases); (3) subarachnoid cysts (46 cases); and (4) cysticercus racemose (6 cases). All patients had MR follow up 1 month after treatment. Twenty five patients had MR with gadopentetate dimeglumine (Gd) contrast enhancement. Cine MR was performed in one patient. Medical treatment with albendazole (ABZ) or Praziquantel (PZQ) was applied in 136 cases. Drug efficacy, assessed by disappearance of the lesion on MR, was 92.5% with ABZ and 60% with PZQ. Thirty patients were treated by surgery. Five patients of group I were treated surgically due either to refractory seizures or persistent abnormalities on MR. Ventricular cysts were removed in 20 cases; 4 cases with cysticercus racemose and one with subarachnoid spinal cyst were also treated by surgery. Two patients with 4th ventricle cysts received ABZ and ventricular shunt only. Two cases with intraventricular cysts (lateral ventricles) and two with racemose cysts were successfully treated with ABZ. The Gd infusion showed enhancement in cysts with adjacent inflammatory reaction or edema and in cases with meningeal inflammation. Cine MR was useful in the differential diagnosis with congenital arachnoid cyst. We conclude that (1) MR is sensitive in the diagnosis of active NCC and may be useful in evaluating degenerative changes in the parasite; (2) ABZ is highly effective in the treatment of parenchymal and subarachnoidal NCC; (3) Parenchymal lesions which remain with abnormal appearance on MR (Degenerative cysticerci or gliosis) and refractory seizures should be treated by surgery; (4) Cysticercus racemose without intracranial hypertension may be treated with ABZ; (5) Ventricular cysts are treated by surgical removal, however, ABZ and ventricular peritoneal shunt may also be an alternative approach.

Adolescent↗
PubMed1993

Ischemic stroke due to deficiency of coagulation inhibitors. Report of 10 young adults.

BACKGROUND AND PURPOSE: Deficiencies in coagulant inhibitors protein C, protein S, and antithrombin III increase the risk of venous thrombosis. We describe 10 young adults with cerebral arterial thrombosis due to deficiencies in these factors. METHODS: Sixty patients younger than 45 years were hospitalized because of acute ischemic stroke diagnosed through computed tomography or magnetic resonance imaging. Cerebral angiography was performed in 54 cases. Hematologic and coagulation profiles, autoantibody screen, syphilis serology, and lupus anticoagulant were analyzed in all patients. Among the total cases, Holter monitoring was performed in 13 patients, echocardiography in 20, and cerebrospinal fluid studies for cysticercosis and tuberculosis in two. The quantitative analysis of protein C, protein S (by Laurell rocket immunoelectrophoresis), and antithrombin III (by radial immunodiffusion) was performed on admission and 3 months after stroke in all patients and in relatives of six patients. RESULTS: In 10 cases (17%) the stroke was attributed to deficiency of coagulation inhibitors: three men had protein C deficiency, two women had protein S deficiency, and five had antithrombin III deficiency (three men and two women). The cerebral infarction involved the carotid territory in these 10 patients. None had previous thromboembolic disease. Eight patients showed a complete recovery. An acquired disorder was presumed in one protein S-deficient and in two antithrombin III-deficient patients; the remainder were considered heterozygous. CONCLUSIONS: The cerebral vasculature may be primarily involved in the deficiency of these natural anticoagulants. Young adults seem to be the most often affected. A knowledge of these new clotting defects will enable the clinician to improve the prevention and treatment of this devastating neurological disease.

Adult↗
PubMedDate not supplied

MR imaging in neurocysticercosis: a study of 56 cases.

We reviewed the MR findings in 56 patients with neurocysticercosis (NCC). MR findings were correlated with other neuroradiologic findings in 40 cases, with histopathologic studies in 15 surgically treated patients, and with autopsy findings in one case. Active NCC was characterized by the presence of a cyst in the brain parenchyma (53%) or in an intraventricular subependymal (22%) or subarachnoid (10%) location. The cysticercus appeared as a vesicle with a high-intensity signal nodule that corresponded to the scolex. Cyst mobility was observed in two intraventricular cases. Periventricular edema and ependymitis appeared as high-intensity signal on T2 sequences. Inactive NCC (15%) was characterized by calcifications (signal void on T1 and T2 sequences), aqueductal stenosis, and tissue thickness in the basal meninges. Degenerative cysticercus appeared on MR as an irregular vesicle without a scolex. Active NCC was better detected with MR than with CT (85% vs 21%), whereas inactive forms were observed better with CT (23% vs 14%). We conclude that MR is sensitive in the diagnosis of active NCC and may be useful in evaluating the degenerative changes in the parasite that occur as a result of natural degeneration, host response, or medical therapy.

Adolescent↗