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2.
Neurochirurgie ; 59(1): 47-9, 2013 Feb.
Article in French | MEDLINE | ID: mdl-23395187

ABSTRACT

The fungus Cryptococcus neoformans can cause common opportunistic infection in acquired immune deficiency syndrome (AIDS) patients. But other conditions can be associated with sarcoidosis. Meningoencephalitis is the most common manifestation of this disease. One of the most important neurological complications is the development of intracranial hypertension (ICH), which may result in high morbidity and mortality. We report the case of a patient harboring a ventriculoperitoneal shunt, and having contracted a cryptococcal meningitis as a risk factor for pulmonary sarcoidosis. Brain MRI showed arachnoiditis, with a mass in contact with the right frontal horn. Indian ink staining of the cerebrospinal fluid (CSF) showed positivity that was confirmed by the identification of Cryptococcus neoformans after culture. The evolution was favorable under medical treatment with removal of material. The relationship between sarcoidosis and cryptococcosis, described in the literature is not coincidental but is a rare complication of sarcoidosis of potential severity (40% of mortality). Sarcoidosis is a common systemic disease that may increase host susceptibility to CNS cryptococcal infection without any other signs or symptoms of host immunosuppression. The diagnosis of cryptococcosis should be evoked as a differential diagnosis of neuro-sarcoidosis.


Subject(s)
Arachnoiditis/etiology , Meningitis, Cryptococcal/etiology , Prosthesis-Related Infections/etiology , Sarcoidosis, Pulmonary/complications , Ventriculoperitoneal Shunt/adverse effects , Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Arachnoiditis/cerebrospinal fluid , Arachnoiditis/diagnosis , Arachnoiditis/drug therapy , Arachnoiditis/microbiology , Carbon , Cerebrospinal Fluid/microbiology , Coloring Agents , Confusion/etiology , Cryptococcus neoformans/isolation & purification , Disease Susceptibility , Drug Therapy, Combination , Flucytosine/administration & dosage , Flucytosine/therapeutic use , Humans , Magnetic Resonance Imaging , Male , Meningitis, Cryptococcal/cerebrospinal fluid , Meningitis, Cryptococcal/diagnosis , Meningitis, Cryptococcal/drug therapy , Middle Aged , Prosthesis-Related Infections/cerebrospinal fluid , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/drug therapy , Psychomotor Agitation/etiology , Staining and Labeling
3.
Rev Med Interne ; 33(8): 433-8, 2012 Aug.
Article in French | MEDLINE | ID: mdl-22658530

ABSTRACT

Tuberous sclerosis is a phacomatosis resulting from an autosomal dominant inheritance. It is characterized by the presence of multiple hamartomas in various organs, especially the brain, the skin, the kidneys and the heart. The diagnosis of tuberous sclerosis is based on imaging and clinical examination, where magnetic resonance imaging constitutes the key investigation showing characteristic brain lesions. Neuro-encephalic manifestations may be particularly severe, and may even be life threatening. The authors report personal cases series and review the literature highlighting epidemiology, clinical features and imaging of neuro-encephalic tuberous sclerosis.


Subject(s)
Brain/pathology , Neurons/pathology , Tuberous Sclerosis/pathology , Tuberous Sclerosis/physiopathology , Brain/diagnostic imaging , Brain/physiopathology , Diagnosis, Differential , Humans , Mental Disorders/diagnosis , Mental Disorders/etiology , Mental Disorders/pathology , Nervous System Diseases/diagnosis , Nervous System Diseases/etiology , Nervous System Diseases/pathology , Neuroimaging/methods , Neurons/diagnostic imaging , Neurons/physiology , Radiography , Tuberous Sclerosis/complications , Tuberous Sclerosis/diagnosis
4.
Neurochirurgie ; 58(1): 44-6, 2012 Feb.
Article in French | MEDLINE | ID: mdl-22030167

ABSTRACT

Thalamo-mesencephalic neuroepithelial cysts are rare lesions of the central nervous system. They are thought to arise from neuroectoderm and are also referred to as ependymal cysts due to their origin. It can remain asymptomatic throughout life or rarely can cause symptoms. We describe a 42-year-old woman who presented with thalamic syndrome due to a neuroepithelial cyst of the thalamo-midbrain. Differential diagnosis is made with other cystic lesions in the brain. However a good analysis of imaging feature led to diagnosis. When the lesion is symptomatic, mini-invasive procedure is indicated.


Subject(s)
Central Nervous System Cysts/diagnosis , Central Nervous System Cysts/pathology , Neoplasms, Neuroepithelial/diagnosis , Neoplasms, Neuroepithelial/pathology , Thalamic Diseases/diagnosis , Adult , Central Nervous System Cysts/surgery , Diagnosis, Differential , Female , Humans , Mesencephalon/pathology , Neoplasms, Neuroepithelial/surgery , Neurosurgical Procedures
6.
Ann Urol (Paris) ; 37(4): 173-6, 2003 Aug.
Article in French | MEDLINE | ID: mdl-12951707

ABSTRACT

The authors report the case of a 35-years-women with a thoracic disc herniation, who presented with seven years history of episodic acute ureteric colic. An early diagnosis of a spinal disc herniation was made difficult by the absence of neurological findings. Imaging studies showed no lesion in the genito-urinary tract. Magnetic resonance imaging demonstrated a postero-lateral disc herniation at T10-T11 level. The pain disappeared immediately after surgery decompression. A literature search showed that acute ureteric colic associated with a lower thoracic disc herniation has not been previously reported.


Subject(s)
Back Pain/etiology , Colic/diagnosis , Diagnostic Errors , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/diagnosis , Kidney Diseases/diagnosis , Thoracic Vertebrae/pathology , Adult , Decompression, Surgical , Diagnosis, Differential , Female , Humans , Intervertebral Disc Displacement/pathology , Lumbosacral Region , Magnetic Resonance Imaging , Time Factors
7.
Neurochirurgie ; 49(1): 39-43, 2003 Mar.
Article in French | MEDLINE | ID: mdl-12736579

ABSTRACT

We report the case of a 50-year-old woman presenting a primitive adenoid cystic carcinoma of the middle part of skull base diagnosed by transphenoidal biopsy. She was treated by exclusive radiation therapy with cobalt 60 1.25 MeV and the dose received was 66 Gy in 33 fractions. Our patient remains alive 50 months after the completion of treatment. Adenoid cystic carcinoma is a slow growing malignant tumor with perineural invasion which arises more frequently from salivary glands. The occurrence of primary intracranial adenoid cystic carcinoma is exceptional. The best treatment is radical surgery followed by radiotherapy. Chemotherapy is rarely used. Prognosis is worse than for salivary glands.


Subject(s)
Carcinoma, Adenoid Cystic/surgery , Skull Base Neoplasms/surgery , Biopsy , Carcinoma, Adenoid Cystic/pathology , Carcinoma, Adenoid Cystic/radiotherapy , Combined Modality Therapy , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Neurosurgical Procedures , Prognosis , Skull Base Neoplasms/pathology , Skull Base Neoplasms/radiotherapy , Tomography, X-Ray Computed
8.
J Neuroradiol ; 29(3): 193-9, 2002 Sep.
Article in French | MEDLINE | ID: mdl-12447144

ABSTRACT

Intradiploic epidermoid cyst of the skull is a rare clinical entity that can exceptionally grow to a large size with intracranial extension. The authors report the case of a 38-year-old man with a giant epidermoid cyst of the parietal bone with extra and intracranial extension, presenting with focal neurological symptoms. The diagnosis was suggested at imaging (skull radiographs, CT and MRI), and confirmed at histology. Complete removal of the cyst and its capsule was performed followed by cranioplasty. Postoperatively, the patient was discharged free of symptoms. CT scan provides good evaluation of the bony lesion and may suggest intracranial extension. MRI is superior for evaluation of cerebral compression. The pathogenesis, clinical presentation, diagnostic evaluation and therapeutic management of these rare lesions are reviewed.


Subject(s)
Bone Diseases/diagnosis , Epidermal Cyst/diagnosis , Skull , Adult , Biopsy , Bone Diseases/complications , Bone Diseases/epidemiology , Bone Diseases/surgery , Diagnosis, Differential , Epidermal Cyst/complications , Epidermal Cyst/epidemiology , Epidermal Cyst/surgery , Headache/etiology , Humans , Magnetic Resonance Imaging , Male , Methylmethacrylate/therapeutic use , Prognosis , Tomography, X-Ray Computed
10.
Prog Urol ; 11(6): 1298-301, 2001 Dec.
Article in French | MEDLINE | ID: mdl-11859670

ABSTRACT

Central nervous system metastases from prostate cancer are exceptional secondary sites, reported in less than 4% of postmortem cases. The authors describe an unusual case of cerebral metastasis from prostate cancer in a 44-year-old man that temporarily regressed during endocrine therapy.


Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Androgen Antagonists/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Cyproterone Acetate/therapeutic use , Prostatic Neoplasms/drug therapy , Adult , Fatal Outcome , Humans , Male , Prostatic Neoplasms/pathology , Remission Induction
12.
J Mal Vasc ; 24(3): 225-8, 1999 Jun.
Article in French | MEDLINE | ID: mdl-10467534

ABSTRACT

Behçet disease is a rare condition in central Europe but more common in Morocco. A case of multiple intracranial arterial aneurysms occurring in a 44 year-old Moroccan patient with 2-years history of Behçet's disease is reported. CT-scan showed an infarction in the right middle cerebral artery territory. Panangiography showed sacciform aneurysms of the bifurcation of the right and left middle cerebral arteries. The draining veins and sinuses were normal. The two aneurysms were successfully clipped by two microsurgical frontotemporal approach in one surgical time. There have been only eight reports of intracranial arterial aneurysms associated to Behçet disease in the literature.


Subject(s)
Behcet Syndrome/complications , Intracranial Aneurysm/complications , Adult , Humans , Intracranial Aneurysm/surgery , Male , Morocco
14.
Rev Rhum Engl Ed ; 64(7-9): 492-4, 1997.
Article in English | MEDLINE | ID: mdl-9338931

ABSTRACT

A case of intradural extramedullary neurenteric cyst is reported. The embryogenesis and surgical treatment of this lesion are discussed.


Subject(s)
Mediastinal Cyst/complications , Mediastinal Cyst/diagnosis , Paraplegia/etiology , Spina Bifida Occulta/diagnosis , Diagnosis, Differential , Female , Humans , Mediastinal Cyst/surgery , Middle Aged , Myelography , Paraplegia/diagnosis , Paraplegia/surgery , Spinal Diseases/diagnosis , Spinal Diseases/etiology
15.
Rev Rhum Engl Ed ; 62(3): 212-4, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7788339

ABSTRACT

A case of intrasacral meningocele with low back pain and sciatica as the presenting manifestations in a 47-year-old male is reported. Magnetic resonance imaging established the diagnosis. Surgical treatment was successful.


Subject(s)
Meningocele/complications , Sacrum , Back Pain/etiology , Humans , Magnetic Resonance Imaging , Male , Meningocele/diagnosis , Meningocele/surgery , Middle Aged , Sacrum/diagnostic imaging , Sacrum/pathology , Sciatica/etiology , Tomography, X-Ray Computed
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