Headache and Behçet disease: The hidden enemy

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Hurtado-García, C. Trasancos Escura, J.I. Massa Navarrete" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Hurtado-García" "email" => array:1 [ 0 => "robelx2@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Trasancos Escura" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.I." "apellidos" => "Massa Navarrete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Vega Baja, Orihuela, Alicante, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Vega Baja, Orihuela, Alicante, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cefalea y enfermedad de Behçet: el enemigo oculto" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1200 "Tamanyo" => 139793 ] ] ] ] "textoCompleto" => "A 35-year-old man, with a history of recurrent oral and genital aphthous and pseudofolliculitis undergoing treatment with colchicine, consulted for sudden-onset, oppressive, left hemicranial headaches that started a week ago, worsened with changes in posture and did not cease with the use of anti-inflammatory nonsteroidal drugs.Laboratory tests showed a C-reactive protein level of 6.40mg/dL and an erythrocyte sedimentation rate of 77mm/h. Cranial tomography showed no acute intracranial hemorrhagic or ischemic lesions. A lumbar puncture showed normal glucose and proteins, with slight lymphocytic pleocytosis. The results of the microbiological study of the cerebrospinal fluid were negative. The ophthalmological examination, which included the eye fundus, was normal.Magnetic resonance imaging with angiography showed thrombosis with a contrast filling defect in the left sigmoid and transverse sinuses, next to the proximal region of the internal jugular vein (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There were no other significant abnormalities in the brain parenchyma.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Treatment was initiated with an intravenous bolus of cyclophosphamide+250-mg methylprednisolone in a fortnightly regimen. The headaches disappeared within 72h, and the acute phase parameters improved.Clinical impairment in neuro-Behçet's disease typically presents as acute meningoencephalitis by parenchymal disease due to inflammatory perivasculitis. In other cases, the condition can start with headaches and papilledema associated with dural venous sinus thrombosis. In more uncommon cases, neuro-Behçet's disease can progress with focal neurological defects such as impairment of the pyramidal pathway.Brain magnetic resonance imaging has a fundamental role in the diagnosis and is the gold standard, enabling the differential diagnosis with other autoimmune diseases." "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-05-17" "fechaAceptado" => "2018-06-05" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Hurtado-García R, Trasancos Escura C, Massa Navarrete JI. Cefalea y enfermedad de Behçet: el enemigo oculto. Rev Clin Esp. 2019;219:98–99." ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1200 "Tamanyo" => 139793 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000002/v1_201902270625/S2254887418301310/v1_201902270625/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000002/v1_201902270625/S2254887418301310/v1_201902270625/en/main.pdf?idApp=WRCEE&text.app=https://www.revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301310?idApp=WRCEE"]

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