LEANDRO TAVARES LUCATO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Radiologic and histologic findings in Sjogren's sensory neuronopathy(2019) GRATIVVOL, Ronnyson Susano; CAVALCANTE, Wagner Cid Palmeira; VENTURA, Lais Maria Gomes de Brito; CALDAS, Vitor Marques; LUCATO, Leandro Tavares; LOURENCO, Silvia Vanessa; HEISE, Carlos Otto; NITRINI, Ricardo
- Human immunodeficiency virus-associated vasculopathy with CNS compartmentalization of HIV-1(2015) GUEDES, Bruno Fukelmann; GOMES, Helio Rodrigues; LUCATO, Leadro Tavares; PUGLIA JR., Paulo; NITRINI, Ricardo; CASTRO, Luiz Henrique Martins
- Leukoencephalopathy resolution after atypical mycobacterial treatment: a case report(2015) OLIVEIRA, Marcos C. B.; SATO, Douglas Kazutoshi; SOARES-NETO, Herval R.; LUCATO, Leandro T.; CALLEGARO, Dagoberto; NITRINI, Ricardo; MEDEIROS, Raphael S. S.; MISU, Tatsuro; FUJIHARA, Kazuo; CASTRO, Luiz H.Background: Association of leukoencephalopathy and atypical mycobacteriosis has been rarely reported. We present a case that is relevant for its unusual presentation and because it may shed further light on the pathogenic mechanisms underlying reversible encephalopathies. Case report: We report the case of a Hispanic 64-year-old woman with cognitive decline and extensive leukoencephalopathy. Magnetic resonance imaging revealed white-matter lesions with increased water diffusivity, without blood-brain-barrier disruption. Brain biopsy showed tissue rarefaction with vacuolation, mild inflammation, few reactive astrocytes and decreased aquaporin water-channel expression in the lesions. Six months later, she was diagnosed with atypical mycobacterial pulmonary infection. Brain lesions resolved after antimycobacterial treatment. Conclusion: We hypothesize leukoencephalopathic changes and vasogenic edema were associated with decreased aquaporin expression. Further studies should clarify if reversible leukoencephalopathy has a causal relationship with decreased aquaporin expression and atypical mycobacterial infection, and mechanisms underlying leukoencephalopathy resolution after antimycobacterial treatment. This article may contribute to the understanding of pathogenic mechanisms underlying magnetic resonance imaging subcortical lesions and edema, which remain incompletely understood.
- Paraneoplastic limbic encephalitis with prominent neuropsychiatric apathy(2014) PORTO, Fabio Hernique de Gobbi; COUTINHO, Artur Martins Novaes; LUCATO, Leandro Tavares; SPINDOLA, Livia; ONO, Carla Rachel; BRUCKI, Sonia Maria Dozzi; BUCHPIGUEL, Carlos Alberto; NITRINI, RicardoThe spectrum of paraneoplastic neurologic syndromes has increased with the description of encephalitis associated with antibodies against cell surface and synaptic proteins. Subacute cognitive impairment, movement disorders, late onset epilepsy and neuropsychiatric syndromes were recently linked to paraneoplastic encephalitis. Despite that, probably some syndromes and antibodies are yet to be reported. Herein we reported the clinical and neuroimaging pictures of a patient with late onset medial temporal lobe epilepsy, subtle cognitive impairment, psychosis and severe apathy diagnosed with antibody-negative paraneoplastic encephalitis due to colonic adenocarcinoma. The apathy markedly improved after removal of the tumor, without concomitant immunotherapy (steroids, intravenous immunoglobulins, immunosuppressants, plasmapheresis, etc). Our report highlights the importance of a full clinical and neurologic investigation in cases of atypical neuropsychiatric presentations, particularly in the elderly and with the concomitance of epilepsy and cognitive decline. Even chronic presentations must be considered. Neuroimaging is an important tool to demonstrate structural and functional brain dysfunction in these cases. Colonic adenocarcinoma should be searched for in cases in which a typical tumor related to paraneoplastic neurologic syndromes is not found.
- Adult-onset subacute sclerosing panencephalitis manifesting as slowly progressive dementia(2015) STUDART NETO, Adalberto; NOBREGA, Paulo Ribeiro; DUARTE, Maria Irma Seixas; LUCATO, Leandro Tavares; CASTRO, Luiz Henrique Martins; NITRINI, Ricardo
- Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature(2020) LOPES, Cesar Castello Branco; BRUCKI, Sonia Maria Dozzi; PASSOS NETO, Carlos Eduardo Borges; CORAZZA, Luiza Alves; BAIMA, Jose Pedro Soares; FIORENTINO, Matheus Dalben; TATSCH, Joao Fellipe Santos; MARTIN, Maria da Graca Morais; LUCATO, Leandro Tavares; GOMES, Helio Rodrigues; ROCHA, Maria Sheila Guimaraes; FORTINI, Ida; NITRINI, Ricardo; CASTRO, Luiz H.Background: Neurological manifestations of COVID-19 are still incompletely understood. Neurological manifestations may be due to direct viral effect on neurons and glial cells, to an immune-mediated response to the virus, or to a hypercoagulable state and associated endothelial damage, as well as to severe systemic disease with prolonged intensive care unit stay. Objective: To describe two patients with severe SARS-CoV-2 infection and delayed recovery of consciousness after sedation withdrawal, in whom MRI disclosed multifocal white matter brain lesions, compatible with the diagnosis of acute disseminated encephalomyelitis. Methods: Observational report of two cases of severe COVID-19 infection in patients from two tertiary hospitals in Sao Paulo, Brazil. Results: These patients underwent neurologic and systemic evaluation for delayed awakening after sedation withdrawal. MRI displayed multifocal centrum semiovale lesions, suggestive of demyelinating inflammation. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for SARS-CoV-2 was negative in both cases. Conclusion: A recurrent pattern of multifocal white matter lesions can occur in COVID-19 patients, possibly associated with delayed awakening. Additional studies are necessary to elucidate the role of the viral infection and of inflammatory and immune-mediated associated changes in neurological manifestations of COVID-19.
- Rapidly progressive dementia due to neurosarcoidosis(2013) FORTES, Gabriela Carneiro C.; OLIVEIRA, Marcos Castello B.; LOPES, Laura Cardia G.; TOMIKAWA, Camila S.; LUCATO, Leandro T.; CASTRO, Luiz Henrique M.; NITRINI, RicardoABSTRACT Rapidly progressive dementia (RPD) is typically defined as a cognitive decline progressing to severe impairment in less than 1-2 years, typically within weeks or months. Accurate and prompt diagnosis is important because many conditions causing RPD are treatable. Neurosarcoidosis is often cited as an unusual reversible cause of RPD. Methods: We report two cases of neurosarcoidosis presenting as RPD. Results: Case 1: A 61-year-old woman developed a RPD associated with visual loss. In seven months she was dependent for self-care. Magnetic resonance imaging (MRI) revealed temporal and suprasellar brain lesions. Treatment with high-dose intravenous prednisolone was associated with partial improvement. Case 2: A 43-year-old woman who was being treated for diabetes insipidus developed a severe episodic amnesia one year after onset of cognitive symptoms. Previous MRI had shown a hypothalamic lesion and she had been treated with oral prednisone and cyclophosphamide. There was reduction of the MRI findings but no improvement in the cognitive deficits. Brain biopsy disclosed noncaseous granulomas and granulomatous angiitis; treatment was changed to high-dose intravenous methylprednisolone, with poor symptomatic response. Conclusion: The diagnosis of RPD due to neurosarcoidosis can be challenging when the disease is restricted to the nervous system. In these cases, clinical presentation of RPD associated with neuroendocrine and visual dysfunction, imaging findings showing hypothalamic lesions and, in some cases, brain biopsy, are the key to a correct diagnosis. It is possible that earlier diagnoses and treatment could have led to a better outcome in these patients.
- Clinical, cerebrospinal fluid, and neuroimaging findings in COVID-19 encephalopathy: a case series(2021) TUMA, Raphael L.; GUEDES, Bruno F.; CARRA, Rafael; IEPSEN, Bruno; RODRIGUES, Julia; CAMELO-FILHO, Antonio Edvan; KUBOTA, Gabriel; FERRARI, Maira; STUDART-NETO, Adalberto; OKU, Mariana Hiromi; TERRIM, Sara; LOPES, Cesar C. B.; PASSOS NETO, Carlos E. B.; FIORENTINO, Matheus D.; SOUZA, Julia C. C.; BAIMA, Jose Pedro S.; SILVA, Tomas; PERISSINOTTI, Iago; MARTIN, Maria da Graca M.; GONCALVES, Marcia; FORTINI, Ida; SMID, Jerusa; ADONI, Tarso; LUCATO, Leandro; NITRINI, Ricardo; GOMES, Helio; CASTRO, Luiz H.Objective To describe the clinical, neurological, neuroimaging, and cerebrospinal fluid (CSF) findings associated with encephalopathy in patients admitted to a COVID-19 tertiary reference center. Methods We retrospectively reviewed records of consecutive patients with COVID-19 evaluated by a consulting neurology team from March 30, 2020 through May 15, 2020. Results Fifty-five patients with confirmed SARS-CoV-2 were included, 43 of whom showed encephalopathy, and were further divided into mild, moderate, and severe encephalopathy groups. Nineteen patients (44%) had undergone mechanical ventilation and received intravenous sedatives. Eleven (26%) patients were on dialysis. Laboratory markers of COVID-19 severity were very common in encephalopathy patients, but did not correlate with the severity of encephalopathy. Thirty-nine patients underwent neuroimaging studies, which showed mostly non-specific changes. One patient showed lesions possibly related to CNS demyelination. Four had suffered an acute stroke. SARS-CoV-2 was detected by RT-PCR in only one of 21 CSF samples. Two CSF samples showed elevated white blood cell count and all were negative for oligoclonal bands. In our case series, the severity of encephalopathy correlated with higher probability of death during hospitalization (OR = 5.5 for each increment in the degree of encephalopathy, from absent (0) to mild (1), moderate (2), or severe (3), p < 0.001). Conclusion In our consecutive series with 43 encephalopathy cases, neuroimaging and CSF analysis did not support the role of direct viral CNS invasion or CNS inflammation as the cause of encephalopathy.
- Teaching NeuroImages: Bilateral intracerebral hemorrhage in expanded dengue syndrome(2017) CAVALCANTE, Wagner Cid Palmeira; SOARES NETO, Herval Ribeiro; GRATIVVOL, Ronnyson Susano; SPERA, Raphael Ribeiro; FRASSETTO, Fernando Pereira; LUCATO, Leandro Tavares; NITRINI, Ricardo
- Imaging findings in faciobrachial dystonic seizures associated with LGI-1 antibodies(2016) GRATIVVOL, Ronnyson Susano; SIMABUKURO, Mateus Mistieri; SPERA, Raphael Ribeiro; CAVALCANTE, Wagner Cid Palmeira; ARAUJO, Hugo Henrique Soares; SAKUNO, Daniel; LUCATO, Leandro Tavares; PINTO, Lecio Figueira; CASTRO, Luiz Henrique Martins; NITRINI, Ricardo