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- Ischemic stroke and subarachnoid hemorrhage following Epstein-Barr virus infectionPublication . Rios, Jonathan; Félix, Catarina; Proença, Paula; Malaia, Luís; Nzwalo, HipólitoThe epidemiological link between inflammation, infection, and acute ischemic stroke (AIS) is well known.1 Transient prothrombotic status and vasculitis are possible explanatory factors.1 Aneurysm formation in association with central nervous system infections is occasionally reported.2 Ischemic or hemorrhagic complication in relation to neurotropic virus infections, including Epstein-Barr Virus (EBV) are rarely reported in adults. Thus, we report here an extremely rare case of ischemic and hemorrhagic cerebrovascular complications in the context of EBV neuroinfection.
- On the pathways of an imperfect chameleon: posterior reversible encephalopathy syndromePublication . Félix, Catarina; Nunes, Nádia; Florêncio, André; Grande, Pablo; Gozabez, Beatriz; Milheiro, Miguel; Soleiro, Luis; Shamasha, Motassen; Nzwalo, HipólitoPosterior reversible encephalopathy (PRES) is a rare clinicoradiological syndrome characterized by a variety of neurological manifestations such as acute encephalopathy, headache, seizures, visual loss, and focal neurologic signs in association with a reversible and predominantly posterior leukoencephalopathy [1,2]. Although precipitated by severe hypertension in most cases, other conditions such as eclampsia, autoimmune disorders, renal failure, and drugs, for example, are now recognized to cause PRES [3]. The number of publications of PRES in the last years reflects the increasing recognition of the syndrome and also the availability of brain magnetic resonance (brain MRI) for urgent or emergency situations. However, because of its pleotropic clinical and radiological manifestations, the possibility of misdiagnosis should be considered [4]. Therefore, we decided to review and discuss our clinical experience in the diagnosis and management of this rare entity.
- Incidence and case-fatality from spontaneous intracerebral hemorrhage in a southern region of PortugalPublication . Nzwalo, Hipólito; Nogueira, Jerina; Félix, Catarina; Guilherme, Patrícia; Baptista, Alexandre; Figueiredo, Teresa; Ferreira, Fatima; Marreiros, Ana; Thomassen, Lars; Logallo, NicolaBackground: There is scarce information on incidence and case fatality of spontaneous intracerebral hemorrhage (SICH) in certain regions of the world, including in Europe. There is no community-based data on SICH in Southern Portugal. Aim: To determine the incidence and early case-fatality from SICH in Algarve, the southernmost region of Portugal. Methods: The recommended criteria for stroke incidence studies was used to identify cases of incident first-ever SICH from January 1st to December 31st 2015 in a subregion with 280,081 inhabitants. Crude incidence rates per age group and gender; standardized rates to the European population; and age adjusted case fatality rates were calculated. Results: Eighty-two first-ever cases of SICH (64.6% men) occurred. The mean age was 72.3 years (SD +/- 12.1); women were 3 years older than men on average and had more frequently lobar SICH. The crude annual incidence rate was 29.2/100,000 (95% CI 23.4- 38.6; p < 0.001); higher in men (39.7/100,000) than women (19.8/100,000). The standardized to the European population incidence was 15.1/100,000 (95% CI 3.6-18.9; p < 0.05); 26.9 and 10.9/100,000 for men and women respectively. The 30-day case-fatality was 40 % (95% CI 29-51) and increased steeply with age Conclusion: The incidence of SICH in Southern Portugal was high, but within the figures found in some parts of Europe. However, a marked predominance of males was found and the case-fatality rate was amongst the highest reported in western countries. (C) 2017 Elsevier B.V. All rights reserved.
- On the plausibility of late neuropsychiatric manifestations associated with the COVID-19 pandemicPublication . S. André, Ana; Félix, Catarina; Corvacho, Mafalda; Nzwalo, HipólitoRecognition of the association between acute and subacute different neuropsychiatric manifestations with the infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic, is progressively being recognized.
- Should we mind for late neurologic manifestations from novel coronavirus?Publication . S. André, Ana; Félix, Catarina; Nzwalo, HipólitoWe read with great interest the article published by Montalvan et al. [1] reviewing the neurological manifestations of COVID-19 and other coronavirus infections. The review was focused on the acute complications described in humans and in animal models of coronavirus infection.