{"id":339576,"date":"2017-07-23T02:00:00","date_gmt":"2017-07-23T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/padroes-tipicos-de-manifestacao-das-sindromes-atipicas-de-parkinson\/"},"modified":"2017-07-23T02:00:00","modified_gmt":"2017-07-23T00:00:00","slug":"padroes-tipicos-de-manifestacao-das-sindromes-atipicas-de-parkinson","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/pt-pt\/padroes-tipicos-de-manifestacao-das-sindromes-atipicas-de-parkinson\/","title":{"rendered":"Padr\u00f5es t\u00edpicos de manifesta\u00e7\u00e3o das s\u00edndromes at\u00edpicas de Parkinson"},"content":{"rendered":"<p><strong>Nas s\u00edndromes at\u00edpicas de Parkinson, as imagens mostram frequentemente padr\u00f5es cartogr\u00e1ficos que permitem a atribui\u00e7\u00e3o diganostica. Estes padr\u00f5es de infesta\u00e7\u00e3o t\u00eam frequentemente nomes cativantes.<\/strong><\/p>\n<p><!--more--><\/p>\n<p><strong>Introdu\u00e7\u00e3o:<\/strong> Nas chamadas &#8220;s\u00edndromes at\u00edpicas de Parkinson&#8221; (tamb\u00e9m: Parkinson plus), outros sistemas cerebrais s\u00e3o afectados desde cedo, para al\u00e9m dos neur\u00f3nios dopamin\u00e9rgicos da substantia nigra. Embora estas doen\u00e7as geralmente permitam diagn\u00f3sticos cl\u00ednicos claros em fases posteriores, a diferencia\u00e7\u00e3o da DP idiop\u00e1tica \u00e9 por vezes dif\u00edcil em fases iniciais ou com um curso at\u00edpico. Devido \u00e0 atrofia avan\u00e7ada das \u00e1reas circunscritas do SNC, os padr\u00f5es caracter\u00edsticos aparecem frequentemente na imagem, o que permite uma atribui\u00e7\u00e3o de diagn\u00f3stico exacta. A designa\u00e7\u00e3o destes padr\u00f5es de infesta\u00e7\u00e3o \u00e9 muito descritiva e memor\u00e1vel.<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\" size-full wp-image-8927\" alt=\"\" src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/kolibri_broetchen.jpg\" style=\"height:438px; width:200px\" width=\"592\" height=\"1296\"><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Descri\u00e7\u00e3o do caso: <\/strong>Ambos os pacientes aqui apresentados eram suspeitos de ter s\u00edndrome de Parkinson at\u00edpica com tremor e instabilidade de marcha. A atrofia multissist\u00e9mica (MSA) \u00e9 uma doen\u00e7a neurodegenerativa espor\u00e1dica com sintomas de Parkinson (MSA-P), ataxia cerebelar (MSA-C) ou d\u00e9fices auton\u00f3micos (MSA-A). A subclassifica\u00e7\u00e3o depende da sintomatologia dominante.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8928 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/617;height:337px; width:600px\" width=\"1100\" height=\"617\" data-srcset=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0.jpg 1100w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-800x449.jpg 800w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-120x67.jpg 120w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-90x50.jpg 90w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-320x179.jpg 320w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-560x314.jpg 560w\" data-sizes=\"(max-width: 1100px) 100vw, 1100px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>MSA-C em particular mostra uma imagem caracter\u00edstica com atrofia exclusivamente infractorial das pons e do cerebelo. As imagens sagitais mostram uma atrofia clara dos pons (setas em  <strong>Fig.&nbsp;1b)<\/strong>  e do cerebelo com fissura prima dilatada (seta estreita em  <strong>Figura&nbsp;1a).  <\/strong>A perda selectiva de fibras transversais de pontina com trajectos corticocerebelares conservados simultaneamente mostra um padr\u00e3o caracter\u00edstico em forma de cruz nas sequ\u00eancias transversais ponderadas em T2 e de flair  <strong>(Fig. 2). <\/strong>Este faz lembrar os rolos ingleses de Sexta-feira Santa  <strong>(Fig. 2b),<\/strong>  e \u00e9 por isso que a literatura fala do chamado &#8220;Sinal de P\u00e3o Quente-Cruz&#8221;.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8929 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb2_np4_s21.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/625;height:341px; width:600px\" width=\"1100\" height=\"625\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\"><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Discuss\u00e3o: <\/strong>Paralisia supranuclear progressiva (PSP) \u00e9 uma patologia tau com extensa atrofia supra e infratentorial <strong>(Fig. 3)<\/strong>. As imagens mostram a atrofia caracter\u00edstica do c\u00e9rebro m\u00e9dio mesmo nas fases iniciais. Nas imagens de m\u00e9dia dimens\u00e3o, o contorno superior do tectum \u00e9 c\u00f4ncavo (ponta de seta em  <strong>Fig. 3a)<\/strong>  que faz lembrar a imagem de um beija-flor voador. Nas sequ\u00eancias axiais, existe uma diverg\u00eancia do crura cerebri, que por si s\u00f3 n\u00e3o est\u00e3o significativamente atrofiadas, o chamado &#8220;sinal do rato Mickey&#8221; <strong>(Fig. 3)<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8930 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb3_np4_s21.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/660;height:360px; width:600px\" width=\"1100\" height=\"660\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\"><\/p>\n<p>&nbsp;<\/p>\n<p>Embora os sinais acima mencionados fossem originalmente considerados patognom\u00f3nicos para MSA-C ou PSP, presume-se agora que existe uma clara sobreposi\u00e7\u00e3o de sintomas. No entanto, o diagn\u00f3stico por imagem pode fornecer uma importante pista para o diagn\u00f3stico diferencial.<\/p>\n<p>&nbsp;<\/p>\n<p><em>InFo NEUROLOGIA &amp; PSYCHIATRY 2017; 15(4): 20-21<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nas s\u00edndromes at\u00edpicas de Parkinson, as imagens mostram frequentemente padr\u00f5es cartogr\u00e1ficos que permitem a atribui\u00e7\u00e3o diganostica. Estes padr\u00f5es de infesta\u00e7\u00e3o t\u00eam frequentemente nomes cativantes.<\/p>\n","protected":false},"author":7,"featured_media":68655,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Rolos e beija-flores de Sexta-feira Santa","footnotes":""},"category":[11536,11339,11374,11551],"tags":[37718,37726,37722,11755,37717],"powerkit_post_featured":[],"class_list":["post-339576","post","type-post","status-publish","format-standard","has-post-thumbnail","category-casos-pt-pt","category-conteudo-do-parceiro","category-neurologia-pt-pt","category-rx-pt","tag-as-sindromes-atipicas-de-parkinson","tag-cerebelar-ataxia","tag-paresia-do-olhar-supranuclear","tag-parkinson-pt-pt","tag-parkinson-plus-pt-pt","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-06 17:23:24","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"pt_PT","wpml_translations":{"es_ES":{"locale":"es_ES","id":339580,"slug":"patrones-de-manifestacion-tipicos-de-los-sindromes-de-parkinson-atipicos","post_title":"Patrones de manifestaci\u00f3n t\u00edpicos de los s\u00edndromes de Parkinson at\u00edpicos","href":"https:\/\/medizinonline.com\/es\/patrones-de-manifestacion-tipicos-de-los-sindromes-de-parkinson-atipicos\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/posts\/339576","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/comments?post=339576"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/posts\/339576\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/media\/68655"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/media?parent=339576"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/category?post=339576"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/tags?post=339576"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/pt-pt\/wp-json\/wp\/v2\/powerkit_post_featured?post=339576"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}