Publications by authors named "Luiz Carlos Porcello Marrone"

20 Publications

  • Page 1 of 1

Neuroanatomical Correlates of Macrolinguistic Aspects in Narrative Discourse in Unilateral Left and Right Hemisphere Stroke: A Voxel-Based Morphometry Study.

J Speech Lang Hear Res 2021 Apr 12:1-16. Epub 2021 Apr 12.

Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Background A growing body of literature has demonstrated the importance of discourse assessment in patients who suffered from brain injury, both in the left and right hemispheres, as discourse represents a key component of functional communication. However, little is known about the relationship between gray matter density and macrolinguistic processing. Purpose This study aimed to investigate this relationship in a group of participants with middle-low to low socioeconomic status. Method Twenty adults with unilateral left hemisphere ( = 10) or right hemisphere ( = 10) chronic ischemic stroke and 10 matched (age, education, and socioeconomic status) healthy controls produced three oral narratives based on sequential scenes. Voxel-based morphometry analysis was conducted using structural magnetic resonance imaging. Results Compared to healthy controls, the left hemisphere group showed cohesion impairments, whereas the right hemisphere group showed impairments in coherence and in producing macropropositions. Cohesion positively correlated with gray matter density in the right primary sensory area (PSA)/precentral gyrus and the pars opercularis. Coherence, narrativity, and index of lexical informativeness were positively associated with the left PSA/insula and the superior temporal gyrus. Macropropositions were mostly related to the left PSA/insula and superior temporal gyrus, left cingulate, and right primary motor area/insula. Discussion Overall, the present results suggest that both hemispheres are implicated in macrolinguistic processes in narrative discourse. Further studies including larger samples and with various socioeconomic status should be conducted. Supplemental Material https://doi.org/10.23641/asha.14347550.
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http://dx.doi.org/10.1044/2020_JSLHR-20-00500DOI Listing
April 2021

Posterior reversible encephalopathy syndrome (PRES): Is DWI a prognosis factor?

J Clin Neurosci 2020 Feb 24;72:357-359. Epub 2019 Dec 24.

Hospital São Lucas-PUCRS and Brain Institute (BraIns), Avenida Ipiranga, 6690 sala 220, Porto Alegre, Brazil.

Introduction: Posterior reversible encephalopathy syndrome is a clinicoradiologic entity with typical MR imaging showing a white matter vasogenic edema predominantly affecting the occipital and parietal lobes of the brain. The aim of this article is evaluated the importance of DWI as a prognosis factor in patients with PRES.

Materials And Methods: We reviewed data from 70 patients with PRES (35 with restricted DWI and 35 with no DWI abnormalities), that were admitted to Hospital São Lucas-PUCRS. These two groups were evaluated in age, sex, previous diseases and past medical history, use of medications, the neurologic manifestations, the highest blood pressure during the neurologic presentation and the highest creatinine during the period of observation.

Results: Evaluating 70 patients with PRES with a mean age of 25.4 years old (range from 2 to 74 years old; 55 female and 15 male) we identified 35 cases were brain MRI presents with restricted DWI. Restricted DWI was associated with higher mortality in 90 days (14.2% vs 0.0%; p: 0.027).

Conclusions: Few articles present new data that will help clinicians in therapeutic decisions or that modify the knowledge of this syndrome. We suggested that restricted DWI is associated with a worst prognosis in PRES.
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http://dx.doi.org/10.1016/j.jocn.2019.12.023DOI Listing
February 2020

Reversible hemianopsia in postpartum due to posterior reversible encephalopathy syndrome in pregnant with late eclampsia.

J Bras Nefrol 2016 Jun;38(2):265-8

Pontifícia Universidade Católica do Rio Grande do Sul, Brazil.

Objectives: To describe a case of Posterior Reversible Encephalopathy Syndrome diagnosed in pregnant women with late-eclampsia, as well as its clinical management.

Case Description: A 34 years old patient in her third pregnancy had started with high blood pressure levels during labor; after eleven days postpartum, she presented a decreased right visual acuity; subsequently one episode of seizure followed by partial loss of vision in the right eye. After conducting tests and ruled out stroke, the patient was diagnosed as Posterior Reversible Encephalopathy Syndrome (PRES). Established the clinical management of seizures and hypertensive crisis, there was complete remission of symptoms and reversal of the initial clinical picture.

Conclusion: Once properly diagnosed and treated, the Posterior Reversible Encephalopathy Syndrome can present satisfactory progress, especially when associated with an acutely triggered factor, as eclampsia.
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http://dx.doi.org/10.5935/0101-2800.20160037DOI Listing
June 2016

Hypertrophic olivary degeneration: unveiling the triangle of Guillain-Mollaret.

Arq Neuropsiquiatr 2016 May;74(5):426-7

Departamento de Neurologia, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil.

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http://dx.doi.org/10.1590/0004-282X20160049DOI Listing
May 2016

Posterior Reversible Encephalopathy Syndrome: Clinical Differences in Patients with Exclusive Involvement of Posterior Circulation Compared to Anterior or Global Involvement.

J Stroke Cerebrovasc Dis 2016 Jul 18;25(7):1776-1780. Epub 2016 Apr 18.

Neurology Department of Hospital São Lucas and Instituto do Cérebro (Inscer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.

Introduction: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiologic syndrome not yet fully understood and characterized by transient neurologic symptoms in addition to typical radiological findings. There are only a few articles that describe the clinical differences between patients with PRES that involve carotid and vertebrobasilar circulations. Our study aims to further evaluate the differences between predominantly anterior and posterior circulation PRES.

Methods: We review 54 patients who had received the diagnosis of PRES from 2009 to 2015. The patients were divided into 2 groups: (1) exclusively in posterior zones; and (2) anterior plus posterior zones or exclusively anterior zones. Several clinical characteristics were evaluated, including the following: age, sex, previous diseases, the neurologic manifestations, the highest blood pressure in the first 48 hours of presentation, highest creatinine level during symptoms, and the neuroimaging alterations in brain magnetic resonance imaging.

Results: Mean age at diagnosis was 28.5 years old (9 men and 45 women) and mean systolic blood pressure among patients with lesions only in posterior zones was 162.1 mmHg compared to 179.2 mmHg in the anterior circulation. The most common symptoms in the 2 groups were headache and visual disturbances.

Discussion: PRES may have several radiological features. A higher blood pressure seems to be 1 of the factors responsible for developing widespread PRES, with involvement of carotid vascular territory. This clinical-radiological difference probably occurs because of the larger number of autonomic receptors in the carotid artery in comparison to the vertebral-basilar system.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.03.042DOI Listing
July 2016

Holmes' tremor as a delayed complication of thalamic stroke.

J Clin Neurosci 2016 Apr 19;26:158-9. Epub 2015 Nov 19.

Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, CEP: 90610-000, Brazil; Internal Medicine, Division of Neurology, Faculty of Medicine, PUCRS, Porto Alegre, Brazil.

Movement disorders are not commonly associated with stroke. Accordingly, thalamic strokes have rarely been associated with tremor, pseudo-athetosis and dystonic postures. We present a 75-year-old man who developed a disabling tremor 1 year after a posterolateral thalamic stroke. This tremor had low frequency (3-4 Hz), did not disappear on focus and was exacerbated by maintaining a static posture and on target pursuit, which made it very difficult to perform basic functions. MRI demonstrated an old ischemic lesion at the left posterolateral thalamus. Treatment with levodopa led to symptom control. Lesions in the midbrain, cerebellum and thalamus may cause Holmes' tremor. Delayed onset of symptoms is usually seen, sometimes appearing 2 years after the original injury. This may be due to maturation of a complex neuronal network, leading to slow dopaminergic denervation. Further studies are needed to improve our understanding of this unique disconnection syndrome.
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http://dx.doi.org/10.1016/j.jocn.2015.09.014DOI Listing
April 2016

Malignant Posterior Reversible Encephalopathy Syndrome: A Case of Posterior Irreversible Encephalopathy Syndrome.

J Clin Neurol 2016 Apr 4;12(2):236-7. Epub 2015 Nov 4.

Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

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http://dx.doi.org/10.3988/jcn.2016.12.2.236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828572PMC
April 2016

New Era for Stroke Therapy: Is This a Global Perspective?

Cerebrovasc Dis 2015 29;40(5-6):307. Epub 2015 Oct 29.

Hospital São Lucas\Instituto do Cérebro-PUCRS, Neurology, Porto Alegre, Brazil.

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http://dx.doi.org/10.1159/000441363DOI Listing
September 2016

Ocular myositis: insights into recurrence and semiological presentation.

Int J Neurosci 2015 26;125(9):711-5. Epub 2014 Nov 26.

1Service of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).

Ocular myositis (OM) is a rare clinical entity characterized by idiopathic, nonspecific inflammation of primarily or exclusively extraocular muscles (EOM). Presentation usually encompasses painful diplopia, exacerbated by eye movement. We report two cases of idiopathic OM with unique characteristics. The first presented with pseudo-sixth nerve palsy due to medial nucleus inflammation and the second presented with recurrent OM, subsequently affecting both eyes. Knowledge of different patterns of presentation and recurrence are important to manage this rare inflammatory syndrome.
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http://dx.doi.org/10.3109/00207454.2014.983228DOI Listing
May 2016

Cardioembolic sources in stroke patients in South of Brazil.

Thrombosis 2014 2;2014:753780. Epub 2014 Oct 2.

Hospital São Lucas, Instituto do Cérebro, Pontifícia Universidade Católica do Rio Grande do Sul, Avenida Ipiranga 6690, Room 220, 90610-000 Porto Alegre, RS, Brazil.

Background. Stroke is a leading cause of mortality and disability in Brazil and around the world. Cardioembolism is responsible for nearly 30% of the origins of ischemic stroke. Methods. We analyzed data of 256 patients with cardioembolic ischemic stroke (according to TOAST classification) who were admitted into the Hospital São Lucas-PUCRS from October 2011 to January 2014. The cardioembolic subtype was divided into six subgroups: arrhythmias, valvular heart disease, coronary artery disease, cardiomyopathy, septal abnormalities, and intracardiac injuries. The prevalence of the most important cardiovascular risk factors and medications in use for prevention of systemic embolism by the time of hospital admission was analyzed in each patient. Results. Among 256 patients aged 60.2 +/- 6.9 years, 132 males, arrhythmias were the most common cause of cardioembolism corresponding to 50.7%, followed by valvular heart disease (17.5%) and coronary artery disease (16%). Hypertension (61.7%) and dyslipidemia (43.7%) were the most common risk factors. Less than 50% of patients with arrhythmias were using oral anticoagulants. Conclusions. Identifying the prevalence of cardioembolic stroke sources subgroups has become an increasingly important role since the introduction of new oral anticoagulants. In this study, arrhythmias (especially atrial fibrillation) were the main cause of cardioembolism.
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http://dx.doi.org/10.1155/2014/753780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198824PMC
October 2014

Blood-brain barrier breakdown in reduced uterine perfusion pressure: a possible model of posterior reversible encephalopathy syndrome.

J Stroke Cerebrovasc Dis 2014 Sep 10;23(8):2075-2079. Epub 2014 Aug 10.

Neurology Service, Hospital São Lucas and Instituto do Cérebro do Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).

Background: Posterior reversible encephalopathy syndrome (PRES) is a clinical entity characterized by headaches, altered mental status, seizures, and visual disturbances and is associated with white matter vasogenic edema. There are no experimental models to study PRES brain changes.

Methods: Twenty-eight pregnant Wistar rats were divided into 4 groups of 7: (1) pregnant-control; (2) reduced uterine perfusion pressure (RUPP); (3) invasive blood pressure (IBP); and (4) reduced uterine perfusion pressure plus invasive blood pressure (RUPP-IBP). The RUPP and RUPP-IBP groups were submitted to a reduction of uterine perfusion pressure at pregnancy days 13 to 15. The invasive mean arterial pressure of the IBP and RUPP-IBP groups was measured on day 20. The blood-brain barriers (BBBs) of all groups were analyzed using 2% Evans Blue dye on day 21.

Results: RUPP rats had higher blood pressures and increased BBB permeability to Evans Blue dye compared with the control animals. Brain staining occurred in 11 of 14 RUPP rats and in none of the control groups (P < .0001).

Conclusions: The physiopathology of PRES remains unclear. Here, we described the use of RUPP rats as a potential model to better comprehend this syndrome.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.03.012DOI Listing
September 2014

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients.

Neurol Int 2014 Jan 24;6(1):5376. Epub 2014 Mar 24.

Service of Neurology, Instituto do Cérebro, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre, Brazil.

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiologic entity not yet understood, that presents with transient neurologic symptoms and particular radiological findings. Few papers show the differences between pregnant and non-pregnant patients. We review the cases of 38 women diagnosed with PRES, in order to find significant differences between pregnant (18) and non-pregnant (20) patients. We found differences among the age of patients (25.83 years old in pregnant and 29.31 years old in non pregnant; P=0.001); in the mean of highest systolic blood pressure, that was higher in non-pregnant group (185:162 mmHg; P=0.121); and in creatinine levels that was higher in non-pregnant group (3.47:1.04 mg/dL; P=0.001). To our knowledge, just a few papers analyzed whether PRES syndrome presented in the same way in pregnant and non-pregnant patients. The differences and the possible pathophisiology of this syndrome still remain enigmatic.
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http://dx.doi.org/10.4081/ni.2014.5376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980148PMC
January 2014

Posterior reversible encephalopathy syndrome following a scorpion sting.

J Neuroimaging 2013 Oct 3;23(4):535-6. Epub 2013 Apr 3.

Department of Neurology, Hospital São Lucas/Instituto do Cérebro - Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity not yet understood, that is present with transient neurologic symptoms and particular radiological findings. The most common imaging pattern in PRES is the presence of edema in the white matter of the posterior portions of both cerebral hemispheres. The cause of PRES is unclear. We report a case of 13-year-old male who was stung by a scorpion and developed a severe headache, visual disturbance, and seizures and had the diagnosis of PRES with a good outcome. Numerous factors can trigger this syndrome, most commonly: acute elevation of blood pressure, abnormal renal function, and immunosuppressive therapy. There are many cases described showing the relationship between PRES and eclampsia, transplantation, neoplasia and chemotherapy treatment, systemic infections, renal disease acute, or chronic. However, this is the first case of PRES following a scorpion sting.
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http://dx.doi.org/10.1111/jon.12017DOI Listing
October 2013

Posterior Reversible Encephalopathy Syndrome Associated with FOLFOX Chemotherapy.

Case Rep Oncol Med 2013 27;2013:306983. Epub 2013 Feb 27.

Hospital São Lucas/Instituto do Cérebro (Inscer), Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 90610-000 Porto Alegre, RS, Brazil.

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, visual loss, and characteristic imaging pattern in brain MRI. The cause of PRES is not yet understood. We report a case of a 27-year-old woman that developed PRES after the use of FOLFOX 5 (oxaliplatin/5-Fluoracil/Leucovorin) chemotherapy for a colorectal cancer.
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http://dx.doi.org/10.1155/2013/306983DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600224PMC
March 2013

Acute ischemic stroke and new anticoagulants -- how to act in the acute phase of stroke?.

Cerebrovasc Dis 2013 14;35(1):91. Epub 2013 Feb 14.

Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul/Instituto do Cérebro, Porto Alegre, Brazil. lcpmarrone @ gmail.com

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http://dx.doi.org/10.1159/000346079DOI Listing
August 2013

Posterior reversible encephalopathy syndrome.

Clin Adv Hematol Oncol 2012 Sep;10(9):614-5

Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, RS, Brazil.

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September 2012

Thrombolysis in an ischemic stroke patient on dabigatran anticoagulation: a case report.

Cerebrovasc Dis 2012 26;34(3):246-7. Epub 2012 Sep 26.

Hospital São Lucas-Pontificia Universidade Católica do Rio Grande do Sul/Instituto do Cérebro, Porto Alegre, Brazil.

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http://dx.doi.org/10.1159/000342307DOI Listing
March 2013

Risk factors among stroke subtypes in Brazil.

J Stroke Cerebrovasc Dis 2013 Jan 10;22(1):32-5. Epub 2011 Nov 10.

Neurology Department, Sao Lucas Hospital, Pontifíciae Universidade Católica do Rio Grande do Sul (PUCRS)/Instituto do Cérebro (INSCER).

Stroke is a leading cause of mortality and disability in Brazil. Among the risk factors for cerebrovascular disease, some have more influence than others in certain stroke subtypes. Little data are available in the literature on the prevalence of stroke subtypes in Latin America. We analyzed data from 688 patients with acute ischemic stroke (52.3% women; mean age, 65.7 years) who were enrolled in a stroke data bank. Standardized data assessment and stroke subtype classification were used. The most common stroke subtype was large-artery atherosclerosis (n = 223; 32.4%), followed by cardioembolism (n = 195; 28.3%), and microangiopathy (n = 127; 18.5%). Stroke risk factors differ among stroke subtypes. The population of South America is ethnically diverse, and few previous studies have describe the distribution of risk factors among stroke subtypes in this population. In this study, the most important risk factors were hypertension and dyslipidemia.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2011.05.022DOI Listing
January 2013

Gemcitabine monotherapy associated with posterior reversible encephalopathy syndrome.

Case Rep Oncol 2011 Feb 16;4(1):82-7. Epub 2011 Feb 16.

Instituto do Cérebro, Porto Alegre, Brazil.

Posterior reversible encephalopathy syndrome is a clinicoradiologic entity that may present with headaches, altered mental status, seizures and visual loss as well as specific neuroimaging findings. We report a case of a 74-year-old woman receiving adjuvant gemcitabine chemotherapy as monotherapy for a stage IIa pancreatic adenocarcinoma, who developed posterior reversible encephalopathy syndrome.
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http://dx.doi.org/10.1159/000324581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072184PMC
February 2011

Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection.

Am J Surg 2010 Nov 22;200(5):e64-6. Epub 2010 Sep 22.

Surgery Department, Medical University of Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Background: Historically, tertiary syphilis infection has been the most common cause of thoracic aortic aneurysm, resulting in 5% to 10% of cardiovascular deaths until the era of antibiotics.

Methods: A 49-year-old Caucasian man presented to our institution with progressive dysphagia, weight loss, incomplete bladder emptying, alcohol and tobacco consumption, systemic arterial hypertension, Argyll Robertson pupil, leg paresthesias, and mediastinal widening. He was admitted to investigate clinical alterations. Thoracic computed tomography revealed an aortic aneurysm complicated with chronic aortic dissection from the ascending aorta to the iliac vessels with 2 communicating lumens. Cerebrospinal fluid examination tested positive for neurosyphilis in a venereal disease research laboratory test (titre 1/32).

Results: Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection was diagnosed.

Conclusions: This is a unique presentation of a syphilitic infection. Syphilitic aortitis, the hallmark of cardiovascular syphilis, has become rare and is hardly considered by today's clinicians in their differential diagnosis.
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http://dx.doi.org/10.1016/j.amjsurg.2010.02.017DOI Listing
November 2010