Spontaneous resolution of an epidural haematoma complicating an intracranial arachnoid cyst

We report a case of a right temporal epidural hermatoma complicating a Sylvian arachnoid cyst in a 25-year-old man after head injury. The diagnosis of this association was .confirmed by MRI. Outcome is favourable with spontaneous resolution of the haematoma. Few cases of association epidural haematoma arachnoid cyst were reported in literature but our case is, to our knowledge, the first one with a conservative treatment and spontaneous favourable outcome

[Treatment of idiopathic varicocele: comparative study of three techniques about 128 cases]

Several modalities of varicocele treatment are available, however, no therapeutic technique showed its superiority with regard to the other one. To compare the results of three techniques of varicocelecomy. Retrospective Analytical and comparative study of 128 patients treated by of three techniques of varicocelectomy: the opensurgery by retro peritoneal way for 42 patients [GI], the varicocelectomie coelioscopique for 41 patients [GII] and the antegrade scrotal sclerotherapy done for 45 patients [GIII], between march 2001 and January 2009.The mean age was 28 years. The main motive for consultation was represented by the painful varicocele in 67% of the cases, followed by the hypofertility in 20.3% of the cases and the association both in 12,5% of the cases. The varicocele was in leftsider in 71.1% of the cases, to the right side in 5.4% of the cases and was bilateral in 23.43% of the cases. Varicocele was infra-clinical at 6 patients, grade 1 in 16 sides, grade 2 in 105 sides and grade 3 in 31 sides. The numeration, the mobility as well as the morphology of sperm cells were comparable between the three groups. The global rate success was 81.2%, with the highest rate found in the group III which was treated by ant‚grade scrotal sclerotherapy [84.4%]. The improvement of the parameters of the spermogramme was noted in the three groups, however a statistically significant difference was found only in patients treated by ant‚grade scrotal sclerotherapy; it mainly concerned numeration and the mobility of spermatozoides. The highest rate of pregnancy was recorded in patients treated by ant‚grade scrotal sclerotherapy [13.3%]. The main postoperative complications were hydrocele [16%] followed by testicular hypotrophy [3 patients]. Three techniques of varicocele treatment, offer either a similar succes rate, and improvement of parameters of the sperm cells. However, antegrade scrotal sclerotherpy seem to be the best treatment of first intention in proposed, regarding its efficiency, of the ease of its realization, its moderate cost and its feasibility in case of recurrence if varicocele was treated with open way'GIII]

[Atypical form of melorheostosis improved by pamidronate]

Melorheostosis is a rare chronic bone disease of unknown etiology that often affects a single limb. Report a new case of melorheostosis of the ribs improved by pamidronate infusions. A 36 year old man without any medical history was admitted for a history of one month painful tumefaction on the 7th left rib. The diagnosis of melorheostosis of the rib and the tibia was made. Patient was treated by pamidronate infusions with useful and satisfactory outcome

[Prevalence of axial manifestations among patients with inflammatory bowel disease: a prospective study about 50 cases]

Rheumatologic manifestations occurring during inflammatory bowel disease are the most frequent extra intestinal features. They are dominated by spondyloarthropathies, sacro-iliite and peripheral arthritis. To identify in a group of inflammatory bowel disease, the frequency of axial manifestations, to describe the clinical and the radiological features and to identify the risk factors of their occurrence and/or worseness We have established a transversal prospective study including 50 cases of inflammatory bowel disease seen in the department of the internal medicine in the interior forces security hospital during a period of 5 years between January 2001 and December 2006. The prevalence of axial involvement in the case of inflammatory bowel disease was 26%especially spondyloarhropathies which were diagnosed in 11 cases according to the criteria of European Spondyloarthropathy study Group [ESSG], 8 of them fulfilled the modified criteria of new york for the diagnosis of spondyloarhropathy. Isolated sacro-iliitis was found in 4%of cases. By univariate study, only the age under 35 years with a relative risk of 5, 8 and the colic involvement in chron's disease was significativelly associated with the presence of spondyloarthropathy. Systematic checking of spondyloarhtropathies in the course of inflammatory bowel disease through a clinical exam and systematic radiological should be recommended especially if we are in front of a man aged more than 35 years old with a crhon disease involving the colon. This screening offers an early management and avoid ankylosis

Rapid fatal thrombosis of giant fusiform basilar artery aneurysm

Thrombosed giant fusiform aneurysms are often revealed by progressive ischemic symptoms and are generally treated by anticoagulation therapy with long-term favourable outcome. We report a case of a 73-year-old man with past history of atherosclerotic and cardiovascular diseases, admitted to our hospital with symptoms of acute brainstem transient ischemic attacks. Neuroimaging showed a giant fusiform aneurysm of the basilar artery with recent posterior intra aneurysmatic thrombus. Anticoagulation therapy was initiated, but rapid deterioration occurred resulting in massive stroke and disturbance of consciousness. Computed tomography scan showed complete occlusion of the aneurysm with unilateral brainstem infarct. The patient died rapidly. It appears that anticoagulation therapy, used in the treatment of fusiform aneurysm revealed by ischemic symptoms, is not efficient and will not prevent further ischemic events and fatal outcome in some complex cases

[Imaging of neuro-behcet]

Behcet's disease is a vasculitis affecting predominantly the venous system. It's characterized by a classical triad of recurrent uveitis, oral and genital ulceration. Behcet's disease is more frequent in Japan. the Middle East and some Mediterranean countries. Its pathogenesis is still uncertain. Neurological manifestations in Behcet's disease are not rare and are associated with poor prognosis. These manifestations can be inaugural in 5% of cases and they are polymorphous. We report 15 new cases of neuro Behcet's disease explored by magnetic resonance imaging [MRI] and magnetic resonance angiography [MRA]

Syndrome de Lofgren revele par une tumeur palpebrale

The Lofgren syndrom is a particular variety of sarcoidose. The ocular attack is dominated in this syndrom by anterior uveitis. More rarely the eyelids and the orbitary structures ore attached. Purpose In this work, we report a lofgren syndrom case revealed by eyelid tumor. Observation It is about 42 year-oid patient who consults for a right inferior eye-lid tumefaction developped for 2 months. The diagnosis of Lofgren syndrome was evoqued because of the association of fever, arthritis, erythema nodosum, tuberculin anergia, hypercalcinuria and mediastinal adenopathy at thoracic scan-tomography. The diagnosis was then confirmed by biopsy of palpebral tumor which showed multiple epithe-lioid and gigantocellulor granuloma without caseous necrosis. Conclusion The Lofgren syndrome is a multivisceral chronic affection. The eye and its annexes constitute frequent cibles of this affection for which they react by a diverse and rich symptomalogy and which can be presented by eye-lid tumors with orbital extension

Spontaneous outcome of brainstem cavernoma

We report a case of 36-year-old man who presented acutely in 1995 with severe headache and right hemiparesis without loss of consciousness. Computed tomography scan showed intrapontine haemorrhage. Cerebral angiography was normal but cerebral magnetic resonance imaging [MRI] showed left deep anterior pontine cavernoma. Spontaneous progressive improvement in clinical condition was noticed. One month after onset of symptoms he was asymptomoatic and to date neurological examination is normal. Patient was not operated but controlled yearly by MRI, which showed an increase in the cavernoma size without clinical expression