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
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- Reduced Diffusion in Neurocysticercosis: Circumstances of Appearance and Possible Natural History Implications(2013) SANTOS, G. T.; LEITE, C. C.; MACHADO, L. R.; MCKINNEY, A. M.; LUCATO, L. T.BACKGROUND AND PURPOSE: Few studies discuss DWI findings in patients with NCC, and their conclusions are variable and contradictory. The aim of our study was to describe DWI findings of a cohort of patients with NCC, emphasizing the frequency of reduced diffusion. MATERIALS AND METHODS: This retrospective study included 48 patients with NCC. Two neuroradiologists analyzed MR images regarding location, number, and stage of NCC lesions. On the basis of visual analysis, they defined, by consensus, the presence of high signal within NCC lesions on DWI and measured their ADC values when feasible. RESULTS: The total number of lesions was 342: parenchymal (263), subarachnoid (65), and intraventricular (14); 83 were DWI hyperintense. The first pattern was a small eccentric hyperintense dot/curvilinear structure on DWI (representing the scolex) noted in intraparenchymal lesions in vesicular (41 lesions, 29%) and colloidal vesicular (18 lesions, 19%) stages, in 14 (22%) subarachnoid lesions, and 2 (14%) intraventricular lesions; rADC calculations were hampered by the intrinsic small dimensions of this finding. The second pattern was the presence of total/subtotal DWI hyperintensity in intraparenchymal lesions, 5 in the colloidal vesicular stage (5%) and 1 in the granular nodular phase (3%). Two subarachnoid lesions also showed the same presentation; in this second pattern, reduced diffusion was present in different degrees, measured by rADC calculations. CONCLUSIONS: DWI may identify the scolex, increasing diagnostic confidence for NCC. Total/subtotal DWI hyperintensity, related to the stage of the lesion, though uncommon, allows including NCC as a consideration in the differential diagnosis of lesions with reduced diffusion and ring enhancement.
conferenceObject Clinical Course of LETM Associated with Neuroschistosomiasis(2013) APOSTOLOS-PEREIRA, Samira; MARCHIORI, Paulo; MACHADO, Luis; LIVRAMENTO, Jose; GOMES, Helio; LUCATO, Leandro; CALLEGARO, Dagoberto- 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, histological and imaging aspects of pleomorphic xanthoastrocytomas: the key is in the name(2013) LUCATO, Leandro Tavares
- SMART syndrome: a late reversible complication of radiotherapy(2013) DINIZ, Fabio de Vilhena; LOPES, Laura Cardia Gomes; CASTRO, Luiz Henrique Martins; NITRINI, Ricardo; LEITE, Claudia da Costa; LUCATO, Leandro Tavares
conferenceObject Differential Diagnosis of Longitudinally Extensive Transverse Myelitis(2013) APOSTOLOS-PEREIRA, Samira; MARCHIORI, Paulo; DELLAVANCE, Alessandra; LUCATO, Leandro; JORGE, Frederico; SIMM, Renata; SATO, Douglas; CALLEGARO, Dagoberto- Prefrontal damage in childhood and changes in the development of personality: A case report(2013) BAHIA, Valéria Santoro; TAKADA, Leonel Tadao; CAIXETA, Leonardo; LUCATO, Leandro Tavares; PORTO, Claudia Sellitto; NITRINI, RicardoABSTRACT Frontal lobe lesions are associated with behavioral abnormalities and executive dysfunction. When these lesions occur early in life, the symptoms are even more severe as the anatomical and functional substrates underlying personality and behavior are damaged, distorting normal modulation by interaction with the psychosocial environment. We present a case of a 40-year-old man who suffered a frontal lobe lesion at the age of nine years and developed impulsivity, disinhibition and inappropriate behaviors while showing some preservation of insight. Brain MRI revealed lesions to bilateral orbitofrontal cortex, ventromedial prefrontal cortex, anterior cingulate gyri and genu of the corpus callosum , which were more extensive on the right side. The right prefrontal dorsolateral cortex was severely damaged, whereas the right ventrolateral prefrontal cortex was spared. We will discuss the correlation of the damaged pre frontal regions with the symptoms presented by the patient.
- Alexander Disease: A Novel Mutation in the Glial Fibrillary Acidic Protein Gene With Initial Uncommon Clinical and Magnetic Resonance Imaging Findings(2013) PEREIRA, Conceicao Campanario da Silva; GATTAS, Gabriel Scarabotolo; LUCATO, Leandro TavaresAlexander disease (AxD) is a rare neurodegenerative disorder related to mutations in the glial fibrillary acidic protein gene. We report the case of a child with disease onset at the age of 3 months and a novel mutation in the glial fibrillary acidic protein gene. Peculiar aspects were initially atypical clinical and magnetic resonance imaging (MRI) findings, which became typical during follow-up. The child was born after an uneventful pregnancy, presented initially only as a failure to thrive. The first MRI examination demonstrated obstructive hydrocephalus and cerebral white matter abnormalities (which were more prominent posteriorly). During follow-up, her clinical picture became typical of AxD with macrocephaly and neurodevelopmental delay. Sequential MRI examinations showed frontal white matter involvement, together with exuberant forniceal lesions and areas of contrast enhancement.
- Changes in normal appearing spinal cord in multiple sclerosis: another brick in the wall(2013) LUCATO, Leandro Tavares
- Cognitive impairment and magnetic resonance imaging correlations in Wilson's disease(2013) FROTA, N. A. F.; BARBOSA, E. R.; PORTO, C. S.; LUCATO, L. T.; ONO, C. R.; BUCHPIGUEL, C. A.; CARAMELLI, P.Objectives To evaluate the cognitive performance of a group of patients with Wilson's disease (WD) and to correlate the cognitive findings with changes in magnetic resonance imaging (MRI). Methods All patients with WD consecutively attended in a Movement Disorders Clinic between September 2006 and October 2007 were invited to participate in the study, together with a group of matched healthy controls. Patients and controls were submitted to comprehensive neuropsychological assessment. MRI was performed in all patients, and abnormalities (high-intensity signal, low-intensity signal and atrophy) were semi-quantitatively rated. Performance of patients and controls in each cognitive test was compared, and correlations between cognitive scores and MRI changes were investigated within the patients' group. Results Twenty patients with WD (11 men) and 20 controls (nine men) were evaluated. Mean age in the WD and control groups was 30.05 +/- 7.25 and 32.15 +/- 5.37years, respectively. Mean schooling years were 11.15 +/- 3.73 among WD cases and 10.08 +/- 2.62 among controls. Patients with WD performed significantly worse than controls in the Mini-Mental State Examination, Dementia Rating Scale, phonemic verbal fluency (FAS), verb generation, digit span forward, Stroop test, Frontal Assessment Battery and in the Brief Cognitive Screening Battery. A significant correlation emerged between global cognitive impairment and MRI scale (r=0.535), being higher for high-intensity signal plus atrophy (r=0.718). Conclusion Patients with WD presented cognitive impairment, especially in executive functions, with good correlation between cognitive abnormalities and MRI changes.