LEUCOARAIOSE GRAVE EM PACIENTE DE 19 ANOS: RELATO DE CASO

Abstract

Introduction: The term Leukoaraiosis (leuko, white, and araiosis, rarefaction) was introduced in 1987 by Hachinski to define areas appearing white matter Hypodense computed tomography (CT), later identified as hyperintense areas in Magnetic Resonance Imaging (MRI) in T2 sequence, called white matter lesions related to age, diabetes mellitus (DM) and hypertension. Clinical symptoms are usually associated with neuropsychiatric conditions, motor deficits, headache, urinary disturbances and cognitive impairment. Its prevalence varies between 24 and 33% in individuals over 65 years of age and rarely occurs below. Case report: MAS, 19, male, black, diagnosed with type 1 DM since childhood, illegal drug use, alcohol use since 12 years and without adequate nutritional follow-up starts at 16 intense daily headache frame, holocranial, pulsatile without drug improves and evolves with generalized tonic-clonic seizures (TCG) six months after the onset. Passes the course with repeated admissions for acute episodes of misunderstood speech, headache and unmotivated laughter, with progressive motor impairment in left hemisphere, cognitive impairment and urinary incontinence, always being released without diagnosis. Presented then seizure TCG, evolving to eat for a month. In diagnostic research, MRI showed areas of encephalomalacia in both brain hemispheres, suggesting chronic ischemic insult. At biopsy, suggesting necrotizing encephalitis glioma or pseudotumoral toxoplasmosis. For immunohistochemistry, the absence of evidence neuoplásica and negative for toxoplasmosis. Discussion: considering the evolution, chronic ischemia visualized on MRI, diagnostic differential exclusion and underlying disease decompensated as strong risk factor, the patient was diagnosed with microangiopathic leukoencephalopathy. The lack of appropriate treatment of MD and diagnostic investigation led to the delay in diagnosis and worsening the patient's prognosis.