[Anterior spinal artery infarct: amyotrophic lateral sclerosis-like]

Psychiatric disorders accompanying infection with human immunodeficiency virus are frequent and varied. They canthe medullary infarct is a rare injury, with a difficult diagnosis. Usually, it is due to an aortic disease or to iatrgenic cause. We relate the observation of a patient presenting an anterior spinal infarct simulating an amyotrophic lateral sclerosis. Through this observation, we discuss the particular semiology of this medullar pathology. A 15-year-old girl, who developed sudden tetraparesis, tetrapyramidal syndrome and amyotrophy of the hands. The medullary MRI showed an extended hypersignal from C3 to C6 [compatible with an infarct in the anterior spinal artery territory]. The etiologic investigations were unremarkable. The clinical presentation of our patient and MRI results confirm the diagnosis of medullar infarct but absence of any objective sensory disorder suggest an ALS-like syndrome. The anterior horn cell region is in the most distally perfused part of the anterior spinal artery territory and is vulnerable to hypoperfusion. It can explain the clinical picture. The diagnosis of spinal cord infact must be suspected in case of atypical ALS syndrome with sudden onset

[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