Abstract
Context: The azygos anterior cerebral artery (azygos-ACA) is a rare variant that involves a common trunk in segment A2 (above the anterior communicating artery). Its prevalence is 0.3–2%. Case report: Male patient, 59 years old, diabetic, smoker, with congenital heart disease (long congenital QT) was admitted to the hospital on 01/07/2020 with traumatic brain injury followed by a seizure crisis (1st episode). Upon admission, he had Glasgow 13 and a cranial tomography showing small left frontal hemorrhage, then conservative treatment with phenytoin 100mg every 8 hours was initiated. The following day, there was a decrease in the level of consciousness (Glasgow 7), with orotracheal intubation being performed and a new skull tomography was performed revealing a slightly enlarged left frontal contusion area, right subdural hematoma, bifrontal hypodensity and left caudate nucleus. Mannitol (100ml / 6h) was indicated and phenytoin (100mg/ 8h) was maintained. On 16/07/2020, the cranial angiotomography showed hypoflow of the anterior cerebral artery and an anatomical variant showing that such artery emerged from a single trunk. The next day, he was still intubated, with Glasgow 6 and no interaction with an examiner. Conclusions: It is concluded that the patient had a bifrontal ischemic stroke (evidenced by the 2nd tomography) and this, occurred due to an obstruction of the azygos-ACA (rare variant), explaining its bilaterality. This situation led to traumatic brain injury, syncope and a severe decrease in the level of consciousness. Given the possible repercussions, the anatomical recognition of this variant becomes important.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
Objectives: The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
The analyses showed significantly higher frequency of the genotype VV in those who had depression, compared with the allele A
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Neuroinfections are pathologies that affect the CNS, for example, we have Murcomycosis, a progressive infection caused by opportunistic fungi of the order Mucorales, with high frequency in Immunodepressed patients, Diabetes Mellitus (DM) is the main underlying pathology associated with the development of Rhinocerebral Murcomycosis, which represents 50% of the cases, with a mortality rate of 70% (Sidrim, 2012, p.168). The COVID-19 pandemic has been alarming the world since its first outbreak in December 2019 In this scenario, the presence of aggravating factors such as the elevation of the D-dimer and the reduction of the angiotensin-converting enzyme 2 (ACE2) during the clinical course of the disease, collaborated in the appearance of thromboembolic events derived from inflammatory processes and extensive intravascular coagulation, contributing to the emergence of diseases such as Hemorrhagic Stroke (ICH), leading the patient to have a worse clinical prognosis and a consecutive worsening of their health. Despite being classically associated with this etiology, the finding may be present in other diseases, especially infiltrative ones
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
