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Vitorino M. Santos, Vitorino M.
Catholic University of Brasilia, Brasilia-DF, Brazil
Medicine & Pharmacology

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A Young Male with Spontaneous Ruptured Cerebral Arteriovenous Malformation (Case Report) Santos, Vitorino M.; Flores, Leandro P.; Barros, Isabella A.; Faria, Priscilla S.; Lamounier, Carolina P.; Casasanta, Renata A.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Cerebral arteriovenous malformation (AVM) is considered a congenital condition characterized by arterial-venous connections in the absence of intermediate capillaries with circulatory and functional changes, inclusive on the cerebrospinal fluid (CSF) dynamics. Case: A previously healthy young man with abrupt onset of intense headache followed by incoercible vomiting and generalized tonic-clonic seizures. On admission, he was in Glasgow scale IV with respiratory gasping, signs of decerebration and anisocoric mydriasis, and right paresis. Computed tomography showed left intraparenchymal hematoma and intraventricular blood. The abnormal vessels and blood clots were removed by neurosurgery. In early postoperative phase a large cerebrospinal fluid leak developed, and was aspirated and further controlled. The patient had respiratory complications, including pulmonary infection by Pseudomonas. Conclusions: After longstanding hospitalization, he was referred to other medical institution and home care.
Giant ovarian cyst Santos, Vitorino M.; Santos, Lister A. M.; Modesto, Fabiana R. D.
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

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We read the exceedingly rare case study recently described by Hota et al. about giant ovarian cyst in term pregnancy1. The patient was a 25-year-old woman undergoing therapy for hypothyroidism, with history of three previous deliveries (P1L1A1). USG of abdomen and pelvis was normal with respect to gestational age in the second trimester, and ovarian cyst was not seen. However, the USG of control done on the third trimester revealed a left ovarian cyst (21x18 cm), with normal obstetric features. The weight of removed cyst of 29x20 cm was 4.9 kg, and the histopathology diagnosis was ovarian mucinous cystadenoma1. The authors emphasized the rarity of concomitat pregnancy and ovarian cyst, and 15% of these mucinous cysts are malignant1. Huge ovarian cysts are more often benign, and less frequently they are diagnosed in association with normal pregnancies1. Major concerns in this setting should be the early diagnosis, close follow-up of the cyst growing, and appropriate intervention1. Interestingly, in the case herein commented the ovarian cyst was not detected by USG in the first two trimesters of pregnancy.
Brain Metastasis as Initial Manifestation of Melanoma (A Case Report) Santos, Vitorino M.; Silva, Renata F.; Passini, Viviane V.; Duarte, Mayza L.; Flores, Leandro P.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Melanoma is a malignancy derived from the neural crest, constituted of melanocytes found in the basal layer of epidermis, with the main function of melanin production. Case: A 64-yearold woman was admitted with headache and dyslalia and reported some episodes of vertigo and falls in the last six months. A superficial red and dark skin discoloration in the scalp and a node in the right parotid gland were observed. Computed tomography of the brain showed nodular lesions in the left parietal and right temporal and occipital lobes with hemorrhagic features, in addition to mass effect. Furthermore, PET-CT images were suggestive of brain, lung, and adrenal metastasis. The patient evolved with intracranial hypertension and a neurosurgery was performed. Histopathological and immunohistochemistry studies revealed metastatic melanoma. Conclusions: She underwent schedules of radiation therapy and chemotherapy, but developed uncontrolled sepsis and died in spite of clinical management and intensive care support. Cutaneous primary site of this malignancy in the scalp was previously neglected; therefore, neurological disturbances were the initial manifestations of melanoma. Immunohistochemistry findings allowed ruling out the main differential hypotheses.
Co-Authors Carolina P. Lamounier, Carolina P. Fabiana R. D. Modesto, Fabiana R. D. Isabella A. Barros, Isabella A. Leandro P. Flores, Leandro P. Lister A. M. Santos, Lister A. M. Mayza L. Duarte, Mayza L. Priscilla S. Faria, Priscilla S. Renata A. Casasanta, Renata A. Renata F. Silva, Renata F. Viviane V. Passini, Viviane V.