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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(03): 5
DOI: 10.1590/0004-282X20150186
Articles

Transient ischemic attack caused by cerebral ergotism

Ataque isquêmico transitório causado por ergotismo cerebral
Gustavo Andrés Gaye-Saavedra
Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Unidad AVC, Montevideo, Uruguay.
,
Federico Preve
Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Unidad AVC, Montevideo, Uruguay.
,
Silvana Albisu
Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Unidad AVC, Montevideo, Uruguay.
,
Mariana Legnani
Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Unidad AVC, Montevideo, Uruguay.
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Association of protease inhibitors and ergotamine causing systemic ergotism is well established[1],[2],[3]. Cerebral ergotism is poorly reported[4],[5]. We describe the case of an HIV positive 49 yo man under protease inhibitors (ritonavir) presenting with total reversible left hemiparesis after the intake of 3 g of ergotamine. After 20 minutes he was spontaneously asymptomatic. TIA was diagnosed. Parenchymal MRI was normal, cervical doppler ultrasound showed symmetric narrowing in both internal carotid arteries, causes of cardiac embolism were properly excluded. Angio Magnetic Resonance Imaging ([Figures 1] and [2]) was performed in acute stage and evolution, as well as cerebral angiography, leading to the diagnosis of cerebral ergotism. Between both MRI showed, only aspirin 325 mg and bed rest was indicated.

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Figure 1 Angio MRI showing progressive and symmetrical narrowing in both internal carotid arteries after the origin with minimum intracranial filling. T1 fat suppression secuence did not show a dissection pattern.
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Figure 2 Control MRI at 7 days: Normal filling of both internal carotid arteries is seen. Patient was asymptomatic just with aspirin 325 mg, ergotamine cessation and change of antiretroviral therapy.

Arquivos de Neuro-Psiquiatria. ahead of print Epub 24-Nov-2015.

Nome correto do autor:

Gustavo Andrés Gaye-Saavedra.




Publikationsverlauf

Eingereicht: 30. Juli 2015

Angenommen: 14. Oktober 2015

Artikel online veröffentlicht:
06. September 2023

© 2015. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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