Encephalopathy, recurrent occlusion of retinal arteries and hearing loss comprise the clinical pi... more Encephalopathy, recurrent occlusion of retinal arteries and hearing loss comprise the clinical picture of Susac’s syndrome. The correct diagnosis is frequently missed because of incomplete clinical signs or negligence of previous symptoms. Early diagnosis and treatment can halt the progression and prevent permanent disability. Methods: Here, we describe a Hungarian case and review the clinical characteristics, diagnostic procedures and current concepts of therapy. Results: A 30-year-old female was admitted to our neurology department because of change in her personality, apathy, and difficulty in concentration. Brain MRI indicated multiple hyperintense T2-weighted lesions including cerebellum and corpus callosum. Protein content of the CSF was markedly elevated. The recurrent bilateral loss of vision and hearing along with migraine in her previous 2,5-year-long medical history suggested Susac’s syndrome. Fundoscopy and flurescein angiography indicated multiple occlusions of the retinal arteries, audiography revealed bilateral hearing loss. Systemic autoimmune and connective tissue diseases and thrombophilia were excluded. The markedly elevated protein in the cerebrospinal fluid supported Susac’s syndrome. Chronic treatment with methylprednisolone resulted in remission of clinical signs. Discussion: Consideration of multiple clinical signs is an important key to the diagnosis of rare clinical entities like Susac’s syndrome.
... Monika Szots Arpad Szomor Ferenc Kover Laszlo Pajor Samuel Komoly Endre Kalman Eva Gomori Zso... more ... Monika Szots Arpad Szomor Ferenc Kover Laszlo Pajor Samuel Komoly Endre Kalman Eva Gomori Zsolt Illes ... Hematologica 92:486492 3. Ponzoni M, Ferreri AJ, Campo E, Facchetti F, Mazzucchelli L, Yoshino T, Murase T, Pileri SA, Doglioni C, Zucca E, Cavalli F, Nakamura S ...
Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk... more Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk of stent occlusion and restenosis might be increased by abnormal rheological conditions amplified platelet aggregation and free radical production during the operation. The aim of this study was to assess the changes of the rheologic parameters, platelet aggregation, and oxidative stress after endovascular treatment of carotid stenosis. 18 patients (11 men, ages 68 +/- 9 years and 7 women, ages 62 +/- 8 years) suffering from significant carotid stenosis and treated with carotid endovascular intervention were examined. Alteration in hemorrheological parameters as well as epinephrine-, ADP-, and collagen-induced platelet aggregation were evaluated. Oxidative stress was characterized by the determination of catalase activity. The measurements were carried out directly before and after the procedure and 1, 2, 5 days and 1 month following the intervention. Preceding the operation the patients were administered a maximum dose (300 mg) of clopidogrel. The hematocrit, the plasma fibrinogen concentration (Pfc) and whole blood-, and plasma viscosity (Wbv and Pv) decreased significantly immediately after stenting ( p < 0.001). By the fifth day following the intervention the Pfc, Wdv, Pv, red blood cell (Rbc) aggregation and ADP-induced platelet aggregation increased significantly ( p < 0.0001) compared to values measured after the procedure. At 1 month follow-up these parameters, excepting Wbv, decreased significantly compared to measurements made on the 5th day. On the other hand, catalase activity showed significant elevation by the end of the first month. Hemorrheological parameters and platelet aggregation showed specific changes following carotid stenting. Abnormal changes of the rheological conditions and increasing platelet activation are the most pronounced in the first week following stenting, which may lead to the stent's early occlusion. Oxidative stress production returned to baseline levels only by the end of the first month.
Encephalopathy, recurrent occlusion of retinal arteries and hearing loss comprise the clinical pi... more Encephalopathy, recurrent occlusion of retinal arteries and hearing loss comprise the clinical picture of Susac’s syndrome. The correct diagnosis is frequently missed because of incomplete clinical signs or negligence of previous symptoms. Early diagnosis and treatment can halt the progression and prevent permanent disability. Methods: Here, we describe a Hungarian case and review the clinical characteristics, diagnostic procedures and current concepts of therapy. Results: A 30-year-old female was admitted to our neurology department because of change in her personality, apathy, and difficulty in concentration. Brain MRI indicated multiple hyperintense T2-weighted lesions including cerebellum and corpus callosum. Protein content of the CSF was markedly elevated. The recurrent bilateral loss of vision and hearing along with migraine in her previous 2,5-year-long medical history suggested Susac’s syndrome. Fundoscopy and flurescein angiography indicated multiple occlusions of the retinal arteries, audiography revealed bilateral hearing loss. Systemic autoimmune and connective tissue diseases and thrombophilia were excluded. The markedly elevated protein in the cerebrospinal fluid supported Susac’s syndrome. Chronic treatment with methylprednisolone resulted in remission of clinical signs. Discussion: Consideration of multiple clinical signs is an important key to the diagnosis of rare clinical entities like Susac’s syndrome.
... Monika Szots Arpad Szomor Ferenc Kover Laszlo Pajor Samuel Komoly Endre Kalman Eva Gomori Zso... more ... Monika Szots Arpad Szomor Ferenc Kover Laszlo Pajor Samuel Komoly Endre Kalman Eva Gomori Zsolt Illes ... Hematologica 92:486492 3. Ponzoni M, Ferreri AJ, Campo E, Facchetti F, Mazzucchelli L, Yoshino T, Murase T, Pileri SA, Doglioni C, Zucca E, Cavalli F, Nakamura S ...
Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk... more Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk of stent occlusion and restenosis might be increased by abnormal rheological conditions amplified platelet aggregation and free radical production during the operation. The aim of this study was to assess the changes of the rheologic parameters, platelet aggregation, and oxidative stress after endovascular treatment of carotid stenosis. 18 patients (11 men, ages 68 +/- 9 years and 7 women, ages 62 +/- 8 years) suffering from significant carotid stenosis and treated with carotid endovascular intervention were examined. Alteration in hemorrheological parameters as well as epinephrine-, ADP-, and collagen-induced platelet aggregation were evaluated. Oxidative stress was characterized by the determination of catalase activity. The measurements were carried out directly before and after the procedure and 1, 2, 5 days and 1 month following the intervention. Preceding the operation the patients were administered a maximum dose (300 mg) of clopidogrel. The hematocrit, the plasma fibrinogen concentration (Pfc) and whole blood-, and plasma viscosity (Wbv and Pv) decreased significantly immediately after stenting ( p < 0.001). By the fifth day following the intervention the Pfc, Wdv, Pv, red blood cell (Rbc) aggregation and ADP-induced platelet aggregation increased significantly ( p < 0.0001) compared to values measured after the procedure. At 1 month follow-up these parameters, excepting Wbv, decreased significantly compared to measurements made on the 5th day. On the other hand, catalase activity showed significant elevation by the end of the first month. Hemorrheological parameters and platelet aggregation showed specific changes following carotid stenting. Abnormal changes of the rheological conditions and increasing platelet activation are the most pronounced in the first week following stenting, which may lead to the stent's early occlusion. Oxidative stress production returned to baseline levels only by the end of the first month.
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