Browsing by Author "Diogo, M"
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- Cognitive Impairment and Magnetic Resonance Imaging Correlates in Primary Progressive Multiple SclerosisPublication . Gouveia, A; Dias, S; Santos, T; Rocha, H; Coelho, C; Ruano, L; Galego, O; Diogo, M; Seixas, D; Sá, MJ; Batista, SObjectives: To characterize cognitive impairment in primary progressive multiple sclerosis (PPMS) and to correlate the pattern of cognitive deficits with brain magnetic resonance imaging (MRI) volumetric data. Materials and methods: In a multicenter cross-sectional study, we recruited consecutive patients with PPMS as well as age, sex, and education level-matched healthy controls (HC). All participants underwent neuropsychological (NP) assessment, and brain MRI was performed in patients with PPMS for analysis of lesion load, subcortical GM volumes, and regional cortical volumes. Results: We recruited 55 patients with PPMS and 36 HC. Thirty-six patients were included in the MRI analysis. Patients with PPMS performed significantly worse than HC in all NP tests. Subcortical GM volume was significantly correlated with all NP tests, except for Stroop Test, with the largest effect for the thalamus (r=-.516 [BVMT-R DR, P=.016 FDR-corrected] to r=.664 [SDMT, P<.001 FDR-corrected]). In the stepwise linear regression model, thalamic volume was the only predictor of performance in all NP tests. Conclusion: Cognitive impairment is common in PPMS and affects all evaluated cognitive domains. Subcortical GM volume, particularly of the thalamus, is a strong predictor of cognitive performance, suggesting it has a central role in the pathophysiology of PPMS-related cognitive dysfunction.
- Extensive Inner Ear and Facial Canal Lipoma - a Case ReportPublication . Diogo, M; Sagarribay, A; Conceição, CInner ear lipomas are rare benign congenital lesions, most frequently presenting at the internal auditory canal and labirynth. Lipomas of the facial nerve are even less frequent. We present a case of a lipoma involving all internal ear structures and VII nerve canal and extending intracranially and extracranially, presenting with facial palsy and ipsilateral hearing loss. To our knowledge this is the most extensive case of inner ear lipoma described.
- Hematoma Subdural Fatal in-Utero, Secundário a Terapêutica com AcenocoumarolPublication . Diogo, M; Rijo, C; Cohen, A; Conceição, CApresentamos o caso de um hematoma subdural atraumático num feto de 35 semanas de gestação, cuja mãe se encontrava sob terapêutica anticoagulante com acenocumarol, devido a prótese mitral mecânica. A ecografia, realizada às 35 semanas de gestação por redução dos movimentos fetais, revelou aumento do espaço incracraniano extracerebral e provável malformação cortical. RM fetal efetuada no dia seguinte revelou extenso hematoma subdural hemisférico bilateral, com sinais de atividade e significativo efeito de massa. Ecografia de controlo detetou ausência de batimentos cardíacos fetais e autópsia confimou o diagnóstico. Tanto quanto nos foi possível averiguar, este é o mais extenso caso de HSD fetal relacionado com a toma de acenocoumarol descrito em RM fetal e um exelente exemplo da utilidade dets técnica no diagnóstico pré-natal de lesões hemorrágicas.
- Low Prevalence of Fetal-Type Posterior Cerebral Artery in Patients with Basilar Tip AneurysmsPublication . Diogo, M; Fragata, I; Dias, SP; Nunes, J; Pamplona, J; Reis, JBACKGROUND: Basilar tip aneurysms (BTA) are multifactorial in origin, with luminal forces playing a major role in their formation. Considering the reduced hemodynamic stress on the basilar apex in the fetal-type posterior cerebral artery (fPCA), we hypothesize that BTA should be less common in patients with this variant. OBJECTIVE: To investigate, in a retrospective case-control study, the frequency of fPCA in patients with and without BTA. MATERIALS AND METHODS: We collected clinical and imaging data from consecutive patients with BTA undergoing catheter angiography between July 2010 and July 2015, and from a randomly selected, age- and sex-matched non-BTA control population from our prospective database. Anatomical variants of the distal basilar artery region were assessed in the two groups and compared using parametric and non-parametric tests. RESULTS: Fifty-nine BTA cases and 337 controls were included. fPCA was present in 3% of patients with BTA and 23% in the control group (p<0.001; OR=0.11, 95% CI 0.03 to 0.48). Basilar tip disposition was cranial in 49% of BTA and 63% of non-BTA cases (p=0.04; OR=0.57, 95% CI 0.33 to 0.99); a caudal disposition was found in 24% and 6% of cases, respectively (p<0.001; OR=4.65, 95% CI 2.21 to 9.80). CONCLUSIONS: We found a statistically significant association between the absence of fPCA and BTA. Our findings underline the importance of hemodynamic stress in the formation of intracranial aneurysms, and suggest that fPCA is a protective variant for formation of BTA.