[Abnormalities of the interatrial septum associated with cerebral ischemia in young adults: Contribution of trans-oesophageal echocardiography]

About 40% of the mechanism of ischaemic stroke in young adults remains unclear. A paradoxical embolism associated with persistence of a patent foramen ovale and/or the presence of an atrial septal aneurysm are significantly more frequent in patients examined for ischaemic stroke of unknown cause than in control subjects. Was to evaluate the contribution of trans-oesophageal echocardiography to the diagnosis of abnormalities of the interatrial septum and to identify the role played by this condition in unexplained ischemic stroke. In 30 consecutive patients, trans-oesophageal echocardiography recording were made during a saline contrast study. Abnormalities of the interatrial septum was diagnosed in 23.3% cases. The proportion of patent foramen ovale was 10% [3 patients]; atrial septal aneurysm was detected in 6.6%[2 patients]. The prevalence of patent foramen ovale associated with atrial septal aneurysm was 6.6% [2 patients]. Transesophageal echocardiography with contrast appears to be an effective exam in diagnosis of abnormalities of the interatrial septum and our study was suggestive of their embolic nature

Encephalopathie posterieure reversible

Posterior reversible encephalopathy [PRE] is a recent syndrome characterized by headache, vomiting, seizures, visual loss, altered mental status with or without motor or sensitive deficit. Neuroimaging demonstrates symmetrical posterior cortical and subcortical lesions. The aetiology remains uncertain but vascular hypotheses is the most retained. We report a case of a 21 year old man with posterior cerebral encephalopathy; the toxic hypothesis remains the most probable

Neurofibromatose de type 1 et epilepsie

Epilepsy has been rarely reported with type 1 neurofibromatosis [Reckling Hausen disease]. It may occur in 3 to 6% of cases. We report in this study three cases of patients with type I neurofibromatosis associated with epilepsy. The patients were respectively 23, 30 and 35 years old. Epilepsy was focal and complex in one patient, generalized in one case and simply focal in another one. Cerebral MRI showed sphenoidal dysplasia and temporal lobe ectopy compressing orbital structures in one patient and normal in the other cases. We discuss through these three cases the relationship between Reckling Hausen disease and epilepsy