most cases reported a clinical picture consistent with acute Zika virus disease, which preceded the occurrence of neurological symptoms.

RESUMO -Para determinar a magnitude da associação entre defeitos de septo atrial (DSA) e migrânea avaliamos 101 indivíduos submetidos ao ecocardiograma transesofágico (ETE). Eles foram questionados sobre a presença de cefaléia. Migrânea foi diagnosticada segundo os critérios da Sociedade Internacional para Estudo das Cefaléias segunda edição. Pareamos 1:1 em port a d o res de DSA (casos) e indivíduos com septo atrial n o rmal (controles). Calculamos frequência de migrânea e de aura e a ocorrência de mais de três crises no último mês. Analisamos as diferenças pelo teste do qui-quadrado. Pareamos 34 casos e controles. Média etária 38,7(±11,2) e 38,9(±11,17) sendo 82,4% mulheres. Migrânea ocorreu em 79,4% dos casos e 55,9% dos contro l e s (or= 4,3 ic 95% = 1,048 -8,89) (p= 0,038). Aura ocorreu em 65,1%(casos) e 40%(controles). Em 76,7% casos e 60% dos controles ocorreram mais de três crises no último mês. DSA se constituiu fator de risco para migrânea com aura na amostra estudada. DSA parece aumentar a freqüência de crises de migrânea.PALAVRAS-CHAVE: defeitos de septo atrial, fator de risco, migrânea com aura.Atrial septal defects as a risk factor for migraine: a case-control study ABSTRACT -To determine the magnitude of the association between atrial septal defect (ASD) and migraine. We evaluated 101 subjects submitted to transeophageal echocardiography (TEE). They have been asked about headache. Migraine diagnosis was established according the criteria of the International Headache Society (IHS). The subjects were match in cases (ASD carrier) and controls (without ASD). We analyzed the occurre n c e of migraine, of aura and the frequency of crises in the last month by chi-square test. We matched 34 cases and controls: 82.4% female, the mean age, in years was 38.7(±11.24) and 38.9 (±11.17)). Migraine occurre d in 79.4% of the cases and in 55.9% of the controls (OR= 4.3) CI = 95% (1.04 -8.8), (p= 0.038). Aura occurre d in 65.1 %( cases) and 40% (controls). It was observed more than three migraine crises in the last month in 76.7% of the cases and 60 % of the controls (OR= 1.56 (p= 0.2) (95% CI, 0.6 to 7.6). ASD is a risk factor to migraine with aura in the sample studied. ASD apparently increase the frequency of migraine crises.KEY WORDS: atrial septal defect, risk factor, migraine with aura.Migrânea parece ser uma doença geneticamente adquirida e suas manifestações sofrem influên-cias de vários fatores externos, como ingestão de c e rtos alimentos ou alcool, privação de sono, jejum p rolongado, dentre outros. Vários autores têm demonstrado a associação entre defeitos de septo atrial (DSA) e migrânea. Muitos deles apontam os DSA, em particular o forame oval patente (FOP), como mais um dos fatores desencadeantes de crises de migrânea 1 , 2 . FOP e comunicação inter atrial (CIA) são defeitos de septo atrial frequentes na população adulta, chegando a uma ocorrência d e 15 a 27% 3 , 4 . A aura da migrânea é definida c o m o um conjunto de sintomas neurológicos focais que se manifestam de forma gradual em 5 a 20 mi...

Chagas disease (CD) is an important cause of cardiomyopathy and stroke in Brazil. Brain infarcts and atrophy seem to occur independently of cardiomyopathy severity and cognitive impairment is understudied.ObjectiveCompare the prevalence of brain magnetic resonance imaging abnormalities between patients with or without CD; determine if inflammatory biomarkers are increased in CD; and determine the efficacy of aspirin in reducing the rate of microembolization in these patients.Methods500 consecutive patients with heart failure will undergo a structured cognitive evaluation, biomarker collection and search for microembolic signals on transcranial Doppler. The first 90 patients are described, evaluated with cognitive tests and brain magnetic resonance imaging to measure N-acetyl aspartate (NAA), choline (Cho), myo-inositol (MI) and creatine (Cr).ResultsMean age was 55±11 years, 51% female, 38 (42%) with CD. Mean NAA/Cr ratio was lower in patients with CD as compared to other cardiomyopathies. Long-term memory and clock-drawing test were also significantly worse in CD patients. In the multivariable analysis correcting for ejection fraction, age, sex and educational level, reduced NAA/Cr (p=0.006) and cognitive dysfunction (long-term memory, p=0.023; clock-drawing test, p=0.015) remained associated with CD.ConclusionIn this preliminary sample, CD was associated with cognitive impairment and decreased NAA/Cr independently of cardiac function or educational level.

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