Pacient (56 rokov), s arteriálnou hypertenziou, vyhľadal lekársku pomoc pre náhle vzniknutý jednostranný opuch jazyka a pocit,,ráčkovania“. ORL vyšetrenie odhalilo léziu nervus hypoglossus vľavo, ostatný neurologický nález bol negatívny, vrátane zobrazovacích vyšetrení mozgu. MR krku suponovalo a angiografia potvrdila aneuryzmu extrakraniálneho úseku a. carotis interna vľavo s útlakom n. hypoglossus. Aneuryzmatický úsek bol ošetrený flowdiverterom, ktorý presmeroval tok krvi, výduť postupne trombotizovala a zvraštila sa, s vymiznutím mass efektu a úpravou funkcie n. hypoglossus ad integrum.
A 56-year-old male with arterial hypertension sought for medical help for a sudden unilateral swelling of the oral tongue and changed quality of speech. An ENT examination revealed a lesion of the left hypoglossal nerve. Neurological examinations including brain imaging showed negative results. The MRI of the neck only suggested, the angiography confirmed internal carotid aneurysm in the extracranial portion causing pressure on the hypoglossal nerve. The aneurysm was treated with a flow diverter, which reroutes the blood flow and thus embolises the aneurysm. The aneurysm shrunk, its mass effect disappeared and the function of the nerve fully recovered.
- MeSH
- aneurysma * diagnóza terapie MeSH
- arteria carotis interna patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci podjazykového nervu * etiologie MeSH
- nervus hypoglossus patologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Autonomic nervous system (ANS) disorders are common in multiple sclerosis (MS). Previous studies showed differences in insulin resistance (IR) and lipoprotein levels in MS subjects compared to controls. Lipolysis caused by increased sympathetic activity could be one of the possible linking mechanisms leading to dyslipidemia in MS. Our study aimed to evaluate ANS activity in the context of glucose and lipid metabolism in people with MS. We prospectively measured short-term heart rate variability (HRV), fasting lipoprotein concentrations, and calculated IR indices based on plasma glucose and insulin levels during oral glucose tolerance test (oGTT) in 32 patients with MS and 29 healthy controls matched for age, sex and body mass index in our study. There was no significant difference in HRV parameters and lipoprotein levels between MS and controls. A significant positive correlation was found between low/high-frequency power ratio (LF/HF) and triglycerides (r=0.413, p=0.021) in MS subjects but not in controls. A significantly lower whole-body insulin sensitivity index (ISIMat) was found in patients with MS compared to the control group (7.3±3.7 vs. 9.8±5.6, p=0.041). No significant correlations were found between LF/HF and IR parameters. In MS subjects, the positive correlation of LF/HF with triglycerides could reflect the effects of sympathetic activity on lipolysis. Positive correlations of sympathetic activity with increased lipoprotein levels could rather reflect processes associated with immune system activation/inflammation, than processes involved in glucose homeostasis maintenance.
- MeSH
- autonomní nervový systém patofyziologie MeSH
- dospělí MeSH
- inzulinová rezistence * MeSH
- lidé MeSH
- lipidy krev MeSH
- lipolýza * MeSH
- mladý dospělý MeSH
- prospektivní studie MeSH
- roztroušená skleróza krev patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
