[Imaging of rhinocerebral mucormycosis]. / L'imagerie dans la mucormycose rhinocérébrale.

PURPOSE: Rhinocerebal mucormycosis is a rare life threatening fungal infection observed in immunocompromised patients. We report six cases of patients with rhinocerebral mucormycosis confirmed histologically. Our study confirms the necessity of early diagnosis when clinical and CT findings are suggestive. MATERIALS AND METHODS: This is a retrospective study including 6 diabetic patients (3 women and 3 men) aged from 28 and 63 years. Five patients had ethmoiditis evolving for a few days (3 to 5 days), and one patient was in an ketoacidotic coma and had a severe infectious syndrome with purulent rhinorrhea evolving for 4 days. All of our patients underwent computed tomography (CT) scan of the paranasal sinuses. MRI was performed in two patients with neurological findings. RESULTS: Unilateral ethmoido-maxillary sinusitis was noted in 5 cases. Only one case of pansinusitis was found. All patients presented orbital involvement. Cerebral involvement was noted in 4 cases (cerebral venous thrombosis: 2 cases; abscess: 2 cases; cerebral ischemia: 2 cases). The diagnosis of mucormycosis was based on endonasal biopsy. When available, MRI allowed a more precise evaluation of the orbital and cerebral extension. CONCLUSION: Mucormycosis is an opportunist mycosis due to mucoralis fungus. It is very invasive with a highly aggressive potential in diabetic or immunocompromised patients. Imaging study particularly CT scan, plays an important role in diagnosis especially to evaluate cerebral extension.

[Percutaneous treatment of a gas containing epidural pseudocyst: an uncommon cause of sciatica]. / Traitement percutané d'un pseudo-kyste gazeux épidural: cause rare de sciatique.

Gas containing epidural pseudocyst is a rare cause of lumbar radicular compression. We present the case of a 42 year old woman presenting with right L5 radicular pain. CT showed vacuum phenomenon and a gas containing epidural pseudocyst compressing the right L5 root. Resolution of radicular pain occurred following CT guided aspiration and steroid injection. The patient remained asymptomatic at one year follow-up.

[MRI of cerebral cortical dysgenesis]. / IRM des dysgénésies corticales.

PURPOSE: Cortical cerebral dysgenesis is a heterogeneous disorder of cortical development and organization. It is well known by neuropathologists and is becoming more important in the clinical setting, mainly due to MRI. Our purpose is to report the MRI features of cortical dysplasia in 30 patients and to propose a simple classification with review of the literature. PATIENTS AND METHODS: It is a retrospective study of the MRI features of 30 cases of cortical dysgenesis. All patients were evaluated by electroencephalography and brain MRI using T1 and T2 weighted, inversion recovery T1 weighted, FLAIR and MPR 3D sequences with multiplanar reformations. RESULTS: Twenty-nine patients were referred to the neurology department because of refractory epilepsy and one patient for mental retardation. Our patients were distributed in 4 groups: diffuse forms represented by agyria-pachygyria (4 cases), polymicrogyria (one case), and nodular heterotopias (5 cases), local bilateral forms represented by bilateral polymicrogyria (11 cases), unilateral forms represented by hemi-megalencephaly (one case), and focal cortical forms found in eight cases. CONCLUSION: Neuroblast migration disorders are better known, mainly due to high resolution MRI techniques that by the quality of multiplanar study and a better differentiation between gray and white matter, allow a more precise diagnosis.