Anemia falciforme alterações angiográficas cerebrais

Alarcon-Adorno, J. O.; Ferreira, Adelmo; Muszkat, M.

doi:10.1590/S0004-282X1991000100013

Resumos

São descritos dois casos de pacientes com anemia falciforme (AF) que desenvolveram complicações neurológicas. Os estudos angiográficos mostraram alterações semelhantes àquelas encontradas na doença moyamoya. Estes achados ocorrem também em outras patologias e são resultado de mecanismo de compensação a oclusão das artérias da base do cérebro. São comentados os riscos e as precauções para a realização da angiografia cerebral.

Two cases of sickle cell disease with neurological complications are described. Cerebral angiograms were performed and a characteristic moyamoya-like angiographic pattern was demonstrated. This pattern results from a compensatory vascularization which may follow occlusion of the arteries at the base of the brain in several diseases. The risks of angiography and appropriate precautions are emphasized.

CONTENTS CONTEÚDO

J. O. Alarcon-Adorno^I; Adelmo Ferreira^II; M. Muszkat^III

^IDoutor em Neurocirurgia pela Escola, Paulista de Medicina (EPM), Neurocirurgião do HIMJ - Hospital Infantil Menino Jesus (HIMJ), São Paulo

^IIPós-graduando em Neurocirurgia da EPM, Neurocirurgião do Hospital Municipal A.R. Saboya - Hospital Infantil Menino Jesus (HIMJ), São Paulo

^IIIMédico do HIMJ - Hospital Infantil Menino Jesus (HIMJ), São Paulo

RESUMO

São descritos dois casos de pacientes com anemia falciforme (AF) que desenvolveram complicações neurológicas. Os estudos angiográficos mostraram alterações semelhantes àquelas encontradas na doença moyamoya. Estes achados ocorrem também em outras patologias e são resultado de mecanismo de compensação a oclusão das artérias da base do cérebro. São comentados os riscos e as precauções para a realização da angiografia cerebral.

SUMMARY

Two cases of sickle cell disease with neurological complications are described. Cerebral angiograms were performed and a characteristic moyamoya-like angiographic pattern was demonstrated. This pattern results from a compensatory vascularization which may follow occlusion of the arteries at the base of the brain in several diseases. The risks of angiography and appropriate precautions are emphasized.

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Full text available only in PDF format.

Dr. Juana Oscar Alarcón Adorno - Rua Coronel Lisboa 454 - 04020 São Paulo SP - Brasil.

1. Adams RJ, Aaslid R, Gammal TE, Nichols FT, McKie V. Detection of cerebral vas-culopathy in sickle cell disease using transcranial doppler ultrasonography and magnetic resonance imaging. Stroke 1988, 19:518-520.
2. Baird RL, Weiss DL, Ferguson AD, French JH, Scott RB. Studies in sickle cell anemia. Pediatrics 1964, 34:92-100.
3. Ballard HS, Bondar H. Spontaneous subarachnoid hemorrhage in sickle cell anemia. Neurology 1957, 7:443-444.
4. Bridgers WH. Cerebral vascular disease accompanying sickle cell anemia. Am J Pathol 1939, 15:353-361.
5. Cheatham ML, Brackett CE. Problems in management of subarachnoid hemorrhage in sickle cell anemia, J Neurosurg 1965, 23:488-493.
6. Close RA, Buchheit WA. The management of ruptured intracranial aneurysm in sickle cell anemia. J Neurosurg 1977, 47:761-765.
7. Clower BR, Sullivan DM, Smith RR. Intracranial vessels lack vasa vasorum. J Neurosurg 1984, 61:44-48.
8. Fadell EJ, Crone RI. Cerebral hemorrhage as a manifestation of the sickle-cell phenomenon. Am J Obst Gynec 1957, 73:212-214.
9. Gammal TE, Adams RJ, Nichols FT, McKie V, Milner P, McKie K, Brooks BS. MR and CT investigation of cerebrovascular disease in sickle cell patients. AJNR 1986, 7:1043-1049.
10. Garza-Mercado R. Pseudomoyamoya in sickle cell anemia. Surg Neurol 1982, 18:425-431.
11. Gerald B, Sebes JI, Langston JW. Cerebral infarction secondary to sickle cell disease : arteriographie findings. AJR 1980, 134:1209-1212.
12. Goldberg HI, Zimmerman RA. Central nervous system. Seminars Roentgenol 1987, 22:205-212.
13. Greer M, Schotland D. Abnormal hemoglobin as a cause of neurologic disease. Neurology 1962, 12:114-123.
14. Haut A, Wintrobe MM. The hemoglobinopathies and thalassemias. In Harrison's Principles of Internal Medicine. Ed 7. New York: McGraw-Hill, 1974, p 1614-1625.
15. Hebbel RP, Yamada O, Moldow CF, Jacob HS, White JG, Eaton JW. Abnormal adherence of sickle erythrocytes to cultured vascular endothelium. J Clin Invest 1980, 64:154-160.
16. Hebbel RP, Boogaerts MAB, Eaton JW, Steinberg MH. Erythrocyte adherence to endothelium in sickle-cell anemia. N Engl J Med 1980, 302-992.
17. Hilal SK, Solomon GE, Gold AP, Carter S. Primary cerebral arterial occlusive disease in children: part II. Radiology 1971, 99:87-94.
18. Hoff JV, Ritchey AK, Shaywitz BA. Intracranial hemorrhage in children with sickle cell disease. AJDC 1985, 139:1120-1123.
19. Hughes JG, Diggs LW, Gillespie CE. The involvement of the nervous system in sickle cell anemia. J Pediatr 1940, 17:166-184.
20. Love LC, Mickle JP, Sypert GW. Ruptured intracranial aneurysms in cases of sickle cell anemia. Neurosurgery 1985, 16:608-612.
21. Marinho HM, Pereira JM. Hemoglobinopatias. In Marinho HM (ed) : Hematologia. Sao Paulo: Sarvier, 1984, p 37-78.
22. Numaguchi Y, Balsys R, Marc JA, O'Brien MS. Some observations in progressive arterial occlusions in children and young adolescents (Moyamoya disease). Surg Neurol 1976, 6:293-300.
23. Pavlakis SG, Bello J, Prohovnik I, Sutton M, Ince C, Mohr JP, Piomelli S, Hilal S, De Vivo DC. Brain infarction in sickle cell anemia: magnetic resonance imaging correlates. Ann Neurol 1988, 23:125-130.
24. Poor G, Gács G. The so-called «Moyamoya disease». J Neurol Neurosurg Psychiatry 1974, 37:370-377.
25. Portnoy BA, Herion JC. Neurological manifestations in sickle-cell disease. Ann Intern Med 1972, 76:643-652.
26. Powars D, Wilson B, Imbus C, Pegelow C, Allen J. The natural history in sickle cell disease. Am J Med 1978, 65:461-471.
27. Richards D, Nulsen FE. Angiographic media and the sickling phenomenon. Surg Forum 1971, 22:403-404.
28. Rothman SM, Nelson JS. Spinal cord infarction in a patient with sickle cell anemia. Neurology 1980. 30:1072-1076.
29. Rothman SM, Fulling KH, Nelson JS. Sickle cell anemia and central nervous system infarction: a neuropathological study. Ann Neurol 1986, 20:684-690.
30. Russell MO, Goldberg HI, Hodson A, Kim HC, Halus J, Reivich M, Schwartz E. Effect of transfusion therapy on arteriography abnormalities and on recurrence of stroke in sickle cell disease. Blood 1984, 63:162-169.
31. Sampson I, Pratila M, Pratilas V. Anesthetic management of cerebral aneurysmectomy in a sickle cell anemia patient. Mt Sinai J Med 1982, 49:326-328.
32. Seeler RA, Royal JE, Powe L, Goldbarg HR. Moyamoya in children with sickle cell anemia and cerebrovascular occlusion. J Pediatr 1978, 93 : 808-810.
33. Solomon GE, Hilal SK, Gold AP, Carter S. Natural history of acute hemiplegia of childhood. Brain 1970, 93:107-120.
34. Stockman JA, Nigro MA, Mishkin MM, Oski FA. Occlusion of large cerebral vessels in sickle-cell anemia. N Engl J Med 1972, 287:846-849.
35. Zuzuki J, Takaku A. Cerebrovascular moyamoya disease. Arch Neurol 1969. 20:288-299.

Anemia falciforme alterações angiográficas cerebrais

Sickle cell anemia: angiographic abnormalities.

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Mar 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams RJ, Aaslid R, Gammal TE, Nichols FT, McKie V. Detection of cerebral vas-culopathy in sickle cell disease using transcranial doppler ultrasonography and magnetic resonance imaging. Stroke 1988, 19:518-520.

[2] 2. Baird RL, Weiss DL, Ferguson AD, French JH, Scott RB. Studies in sickle cell anemia. Pediatrics 1964, 34:92-100.

[3] 3. Ballard HS, Bondar H. Spontaneous subarachnoid hemorrhage in sickle cell anemia. Neurology 1957, 7:443-444.

[4] 4. Bridgers WH. Cerebral vascular disease accompanying sickle cell anemia. Am J Pathol 1939, 15:353-361.

[5] 5. Cheatham ML, Brackett CE. Problems in management of subarachnoid hemorrhage in sickle cell anemia, J Neurosurg 1965, 23:488-493.

[6] 6. Close RA, Buchheit WA. The management of ruptured intracranial aneurysm in sickle cell anemia. J Neurosurg 1977, 47:761-765.

[7] 7. Clower BR, Sullivan DM, Smith RR. Intracranial vessels lack vasa vasorum. J Neurosurg 1984, 61:44-48.

[8] 8. Fadell EJ, Crone RI. Cerebral hemorrhage as a manifestation of the sickle-cell phenomenon. Am J Obst Gynec 1957, 73:212-214.

[9] 9. Gammal TE, Adams RJ, Nichols FT, McKie V, Milner P, McKie K, Brooks BS. MR and CT investigation of cerebrovascular disease in sickle cell patients. AJNR 1986, 7:1043-1049.

[10] 10. Garza-Mercado R. Pseudomoyamoya in sickle cell anemia. Surg Neurol 1982, 18:425-431.

[11] 11. Gerald B, Sebes JI, Langston JW. Cerebral infarction secondary to sickle cell disease : arteriographie findings. AJR 1980, 134:1209-1212.

[12] 12. Goldberg HI, Zimmerman RA. Central nervous system. Seminars Roentgenol 1987, 22:205-212.

[13] 13. Greer M, Schotland D. Abnormal hemoglobin as a cause of neurologic disease. Neurology 1962, 12:114-123.

[14] 14. Haut A, Wintrobe MM. The hemoglobinopathies and thalassemias. In Harrison's Principles of Internal Medicine. Ed 7. New York: McGraw-Hill, 1974, p 1614-1625.

[15] 15. Hebbel RP, Yamada O, Moldow CF, Jacob HS, White JG, Eaton JW. Abnormal adherence of sickle erythrocytes to cultured vascular endothelium. J Clin Invest 1980, 64:154-160.

[16] 16. Hebbel RP, Boogaerts MAB, Eaton JW, Steinberg MH. Erythrocyte adherence to endothelium in sickle-cell anemia. N Engl J Med 1980, 302-992.

[17] 17. Hilal SK, Solomon GE, Gold AP, Carter S. Primary cerebral arterial occlusive disease in children: part II. Radiology 1971, 99:87-94.

[18] 18. Hoff JV, Ritchey AK, Shaywitz BA. Intracranial hemorrhage in children with sickle cell disease. AJDC 1985, 139:1120-1123.

[19] 19. Hughes JG, Diggs LW, Gillespie CE. The involvement of the nervous system in sickle cell anemia. J Pediatr 1940, 17:166-184.

[20] 20. Love LC, Mickle JP, Sypert GW. Ruptured intracranial aneurysms in cases of sickle cell anemia. Neurosurgery 1985, 16:608-612.

[21] 21. Marinho HM, Pereira JM. Hemoglobinopatias. In Marinho HM (ed) : Hematologia. Sao Paulo: Sarvier, 1984, p 37-78.

[22] 22. Numaguchi Y, Balsys R, Marc JA, O'Brien MS. Some observations in progressive arterial occlusions in children and young adolescents (Moyamoya disease). Surg Neurol 1976, 6:293-300.

[23] 23. Pavlakis SG, Bello J, Prohovnik I, Sutton M, Ince C, Mohr JP, Piomelli S, Hilal S, De Vivo DC. Brain infarction in sickle cell anemia: magnetic resonance imaging correlates. Ann Neurol 1988, 23:125-130.

[24] 24. Poor G, Gács G. The so-called «Moyamoya disease». J Neurol Neurosurg Psychiatry 1974, 37:370-377.

[25] 25. Portnoy BA, Herion JC. Neurological manifestations in sickle-cell disease. Ann Intern Med 1972, 76:643-652.

[26] 26. Powars D, Wilson B, Imbus C, Pegelow C, Allen J. The natural history in sickle cell disease. Am J Med 1978, 65:461-471.

[27] 27. Richards D, Nulsen FE. Angiographic media and the sickling phenomenon. Surg Forum 1971, 22:403-404.

[28] 28. Rothman SM, Nelson JS. Spinal cord infarction in a patient with sickle cell anemia. Neurology 1980. 30:1072-1076.

[29] 29. Rothman SM, Fulling KH, Nelson JS. Sickle cell anemia and central nervous system infarction: a neuropathological study. Ann Neurol 1986, 20:684-690.

[30] 30. Russell MO, Goldberg HI, Hodson A, Kim HC, Halus J, Reivich M, Schwartz E. Effect of transfusion therapy on arteriography abnormalities and on recurrence of stroke in sickle cell disease. Blood 1984, 63:162-169.

[31] 31. Sampson I, Pratila M, Pratilas V. Anesthetic management of cerebral aneurysmectomy in a sickle cell anemia patient. Mt Sinai J Med 1982, 49:326-328.

[32] 32. Seeler RA, Royal JE, Powe L, Goldbarg HR. Moyamoya in children with sickle cell anemia and cerebrovascular occlusion. J Pediatr 1978, 93 : 808-810.

[33] 33. Solomon GE, Hilal SK, Gold AP, Carter S. Natural history of acute hemiplegia of childhood. Brain 1970, 93:107-120.

[34] 34. Stockman JA, Nigro MA, Mishkin MM, Oski FA. Occlusion of large cerebral vessels in sickle-cell anemia. N Engl J Med 1972, 287:846-849.

[35] 35. Zuzuki J, Takaku A. Cerebrovascular moyamoya disease. Arch Neurol 1969. 20:288-299.