[Cerebrovascular accidents and pregnancy]

Although cerebrovascular accidents [CVA] during pregnancy and post-partum period constitute a major cause of maternal death, yet it is still not well known. It affect pregnant women essentially in the 2nd and 3rd trimesters and in the post-partum period. We reported here certain clinical, aetiological and therapeutical aspects of CVA in cases of pregnancy and post-partum period. It concerns 8 pregnant or post-partum cases [1.2%] presented with CVA hospitalized in the neurology department [B] between 1998 and 2004. The average age was 33,7 years. Risk factor were represented by oral contraception's [6 cases], multiparity [3 cases] and arterial hypertension [2 cases]. Carotid region affection was found in 75% of cases. The dominent aetiological factor was secondary cerebral thrombophlebitis in one case and one to deficient in protein S in the other. CVA risk does not seem higher than that found in general population. The treatment of CVA during pregnancy and in post-partum period is the same recommended in non pregnant CVA cases

syndrome of Tolosa Hunt

The Syndrome of Tolosa Hunt [STH] is a curiosity whose pathogenesis is completely unknown. It is a diagnosis of elimination, obliging to review the list of the painful ophthamloplegias. We report five original observations by their mode of presentation. Our study relates five patients hospitalized for assessment unilateral of orbital and retro-orbital pains, with an attack of the occulomotricity, enroled between 1993 and 2004. The average age of our patients was 43,6 years. The cerebral scanner was performed in all cases and MRI in two cases only. The attack of the cranial nerves observed in our series was in four cases for the common oculomotor nerve, three cases for the external oculomotor nerve, three cases for the optic nerve, the attack of the ophthalmic branch VI was found in two cases. The advent of the scanner and the MRI simplified discussion of the differential diagnosis. The corticotherapy has a spectacular effect on the favorable evolution of the disease