On the series of MR-tomogrammes of the brain, in 3 projections, middle structures are without dislocation . Lateral ventricles are flatted, not widened . III , IV brain ventricicles, basal cicternes are not changed in volume. The hiasmo-sllar cictern structure is inhomogeneity, with sign of the soldering process. Subarachnoidal furrows are smoothed , the shell space can't be differented. Brain shells are thickened in convexital areas . In latero-basal areas of the right temple part of the brain , a subarachnoidal cyst can be seen , which has 2,0 x 0,8 cm size. Conclusion : Hipertensious syndrome. Consequences of convexital- basal arachnoidit with presence of subarachnoidal cyst in basal areas of the right temple part
Moscow Endocrinological Clinic named by Sechenov Epicrise from the medical card no .9778 Shilo Vitaly ,were lying in the endocrinological clinic since 10.05 till 3.06.94
Diagnose: diffusive toxical goitre , II st , in the stage of compensation . Endocrinal ophtalmopathy . Consequences of closed brain trauma . Post-traumatic arachnoidit . Hypertensive syndrome.
Complaints when coming :weakness, strong periodical headaches, boneaches (arms ,feet) , appearance of red stripes on hips, buttocks, abdomen.
From anamnese: Headaches torture from childhood . In age of 11 and 13 had brain shakes with consciousness loses. In 1993 ,after the carried influenza , observed the appearance of tremor in hands and all the body , lost his weight, there appeared pains in large joints .Since August, 1993 observed the swelling of the left eye ,tearing pains and tearness. With a suspicion for a volumetric formation was hospitalized to the MMA professional sickness clinic, and then to the endocrinlogical clinic , where there was diagnosed diffusive toxic goitre of II st, endocrinal ophtalmopaty of II st. There was done MR-Tomography of the brain there was observed hypertension syndrome , consequences of carried arachnoidit with the presence of subarachnoidal cyst in the temple area. There has begun curing with mercasolyle (10 mg) . There has been gone the course of healing with prednysolone , beginning with 50mg/day with step-by-step ablatement till the full abrogation (ended in April ,1994). Accepting prednysolone , observed some betterment of the condition,but there were appeared red stripes on skin.
Hospitalization to the clinic for dynamic observation.
When coming: + Avizenna syndrome , more on the left
Laboratory tests: Common blood analyse : HB - 15,2 g% ; erytrocites - 5 mln./mm3, CP- 0.95 , leycocites -5000 , formula: stick-nuclear -1.5% , segmento-nuclear -58%, lymph. 27% , monoc. 4% ,eosonoph. 9.5% . trombocytes -166000/mm3
Biochemical test: alcaline phosphatasa -74 mg% ,direct bilirubine -0.3 mg%, common bilirubine -1.0 mg% , urinal acid - 5.4 mg%, glucose -64 mg% , cholesteryne -19 mg% , P-6.5 mg%, Ca -8.7 mg% , alb. 4.5g % , common alb.- 6.9 g%, creatinin -0.9 mg%, urinal nitrogen -18 mg% , K- 3, 2 mequv./l , serum iron -117 mkg/100 ml
TTG when coming -18.8 mme/ml (normal is 0.12-2.44). Serum albymines electrophores: albumines -58.9 rel.% , alpha1 -5.5, alpha2 -10.0 ,beta -10.3 ,gamma -15.3 rel.%
Coauglogarmme :conclusion- phybrinolisw abatement . AST -13ME, ALT -14 ME, gamma-GT -12ME , amilasa -14 mg/ml/hour , lipasa -27ME
Miocard changes in the up-frame area and the top of both areas . Goitre is enlarged due to both parts and isthmus (sagital size of the right part is 24mm, left is 19mm, isthmus is 5mm. Echostructure of the tissue is hypoechogenic , diffuse uncongeneric with islands of infiltration which is small size (from 3 to 5mm) in both parts, more in the right one. In compare with test from January'94 -enlargement of the goitre.
Ochylist : Venae are fool-blooded, left-side exophtalm.
Neuropatologyst : Hypertensive syndrome . Consequences of carried arachnoidit, subarachnoidal cyst of the right temple area. Periodical courses of dehydrative therapy are recommended.
1: Mercasolyle - 1g in the morning during 1.5 years, leycocite control once a two weeks
2. Levo-thyroxine 100mkg 1/4 of a pill ,morning
3. Isoptyne 80mg when heartbeatings
4. Diacarb 0.25 ,3 days a week , during 1 month, 2-3 times a year.
5. Riboxin 0.2 3 times a day, 1 month
Internal sleepy artheries : right - 1.4, left -2.2, CA -57.1
Spine artheries - right - 1.9 , left -1.8
Functional tests : when head turnings in PA-Basins-
signs of extravasal dependance on the right
Conclusion: in ISA basin - blood flowing assymetry. In SA basin pulse blood flowing is enough. The tone of peripherial areas of cerebrovascular net is enlarged.