Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.

Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features.

[Aneurysmal cyst of ethmoid bone: a case report]. / Le kyste osseux anévrismal de l'ethmoïde : à propos d'un cas.

AIM: To report on the value of imaging in the diagnosis and assessment of aneurysmal cyst of the ethmoid bone. CASE: A 12-year-old girl with a stuffy nose, revealing an aneurysmal bone cyst of the ethmoid, explored by CT, MRI, who had a preoperative arteriography with embolization. CONCLUSION: Aneurysmal bone cyst is a benign bone lesion which rarely involves the facial bones. Imaging plays an important role in the diagnostic approach, the assessment of the lesions, and the treatment using the techniques of interventional radiology.

[Atypical metastatic sites for adenocarcinoma of the lung]. / Localisations métastatiques inhabituelles d'adénocarcinome pulmonaire.

Lung carcinomas have a high propensity to metastasize to the liver, adrenal, bone or brain. However, certain atypical intracranial sites may occur. We report two cases of adenocarcinoma of the lung discovered by peculiar brain metastases. The first patient presented with an orbital apex syndrome due to a metastasis to the cavernous sinus with intraorbital extension. The second patient presented with headache and visual loss due to metastasis to the pituitary. Intrasellar and parasellar metastases are rare sequelae of pulmonary neoplasms. Etiological diagnosis is based on imaging and sampling or biopsy. They are often associated with a poor prognosis. The differential diagnosis of an intracranial process in the area of the sella should include metastasis even in the absence of a known primary cancer.

[Epidermoid cyst of the cisterna magna and the fourth ventricle: Report of four cases]. / Kystes épidermoïdes de la grande citerne et du quatrième ventricule : à propos de quatre cas.

INTRODUCTION: Epidermoid cyst is a congenital and benign tumor, developed from ectodermal inclusion. These cysts occur very rarely in the cisterna magna and the fourth ventricle. OBJECTIVE: To report four cases of epidermoid cyst of the cisterna magna and the fourth ventricle in the light of the data of literature. PATIENTS AND METHODS: We report a retrospective study of four cases of epidermoid cysts of the cisterna magna and the fourth ventricle. The data was collected from January 2000 to December 2006 from to series of 18 cases of epidermoid cysts of posterior cranial fossa (14 cases were localised at the cerebellopontine angle). All the patients had a physical examination and a complete neuroradiological imagery. The treatment was surgical. The follow-up was at least 9 months. RESULTS: There were two men and two women. The mean age was 47.75 years. All patients presented with cerebellar syndrome. Three patients had intracranial hypertension. Neuroradiological explorations showed a cystic lesion developed in the cisterna magna in two cases, in the fourth ventricle in one case and in the two locations in one case. Two patients had hydrocephalus. All patients had surgery with a posterior approach and one patient had first ventriculoperitoneal shunt. The diagnosis was confirmed by histological examination. Postoperatory outcome was favourable in all cases. One patient developed bilateral chronic subdural hematoma, which was surgically removed. A long time follow-up was good in all cases. CONCLUSION: Epidermoid cysts are characterized by a long evolution. The diagnosis is relatively characteristic in the imagery. The prognosis was favourable with a complete surgical resection.

[Intramedullary neuroglial cyst: a case report]. / Kyste neuroglial intramédullaire : à propos d'un cas.

BACKGROUND AND PURPOSE: Neuroglial cysts are uncommon congenital lesion with own wall, which can be confined into or outside the central nervous system. In the central nervous system the cyst is located commonly in the brain. Spinal intramedullary neuroglial cyst are exceptional. Our objective is to present a case of intramedullary neuroglial cyst, to discuss the differentiels diagnosis and to show difficulties of its medical taking care. CASE REPORT: A 60 year-old man, without past history, was admitted to the hospital with a compression of conus medullaris since one year. The clinical examination revealed paraparesis and genito-sphincterian disorders. MRI of the spine revealed intramedullary cyst at T12-L1 level. The patient underwent cystic evacuation, a large marsupialization of the cavity and a wall biopsy. Histopathological examination confirmed the diagnosis of neuroglial cyst. The postoperative outcome was favourable with a partial improvement of motor weakness. Postoperative MRI showed a persistent residual cavity. CONCLUSION: Neuroglial intramedullary cyst is uncommon. It is a benign lesion. Complete surgical resection is very difficult seen the absence of defined plan cleavage.

A rare localization of meningioma: meningioma of the foramen of Monro.

Intraventricular meningiomas (IVM) are rare tumors, constituting only 0.5 to 2% of all intracranial meningiomas, and meningiomas localized within the foramen of Monro are exceptional, with only a very few cases reported in the literature. We report the case of a 41-year-old man, admitted to our department for headaches. MRI found a mass tissular well enhanced after gadolinium injection, arising in the region of the foramens of Monro, and extended to the lateral and the third ventricles. Histological examination revealed a meningioma.

Mature posterior fossa teratoma mimicking infratentorial meningioma: a case report.

Intracranial teratomas are congenital neoplasms mostly diagnosed in the pediatric hood and usually involve supratentorial midline structures. These teratomas, especially those involving the posterior fossa are an uncommon and representing less than 0.5% of all intracranial tumors. We report a case of mature posterior fossa teratoma in an adult patient diagnosed in the 4th decade of life. This lesion was taken for a huge infratentorial meningioma.

[Primary hydatid cyst of the parotid gland]. / Kyste hydatique parotidien primitif.

INTRODUCTION: The hydatid cyst is an anthropozoonosis due to the development of the Echinococcus granulosus tapeworm larva in humans. Its intraparotid localization is extremely rare. CLINICAL CASE: A 10-year-old-male patient was admitted for an isolated renitent swelling of the left parotid region having grown for several months. Cervical ultrasonography revealed a left parotid cystic mass, characterized by a double wall, and a small daughter cyst. The CT-scan typically showed the absence of enhancement after iodine contrast medium injection. The imaging-based diagnosis of a hydatid cyst was supported by positive hydatid serology, and confirmed by histological analysis of the cyst. No other hydatid location was found (chest and abdominal). DISCUSSION: In spite of its rarity, hydatid cyst can be a diagnosis in case of parotid cystic masses. Ultrasonography is the first examination to be performed; it must be completed by CT-scan or even better by MRI. Once the diagnosis of hydatid cyst is confirmed, a chest radiograph and an abdominal ultrasonography should be performed, to screen for other localizations. Surgical resection is the gold standard treatment.

[Neuromarketing: When marketing meet neurosciences]. / Neuromarketing : lorsque neurosciences et marketing se rejoignent.

INTRODUCTION: The emergence of brain imaging in recent years has been accompanied by an alliance between neuroscientists and marketers. This collaboration gave birth to "neuromarketing", a new field that uses imaging techniques with the aim of resolving marketing issues. STATE OF THE ART: Several studies have shown that pleasure felt at the sight of a product or after its consumption, is activated by a reward system involving ventral striatum. Since then, marketers seeking exploit this data and have found that some marketing actions can generate added satisfaction in a placebo-like manner. However, neuromarketing suffer from many limits that are a barrier to its development and its scope is restricted. PERSPECTIVES: Through this article, we attempt to give an overview on neuromarketing and its neural correlates while provide a perspective toward the use of field for less commercial purposes. CONCLUSION: The neuromarketing is a new field which efficiency is not proven. Its results must be interpreted with caution.

[Primitive aspergillosis of the posterior cerebral fossa in immunocompetent patient]. / Aspergillose primitive de la fosse cérébrale postérieure chez un patient immunocompétent.

Cerebral aspergillosis arises in the great majority of cases during an invasive aspergillosis with hematogene scattering from the lung hurts. The cerebral, not rare location is one of the worse criteria forecast during the invasive aspergillosis. We report the case of patient who was hospitalized in the neurosurgery department for syndrome of increased intracranial pressure, hemiparesis and cerebellar syndrome in febrile context. The radiological exploration objectified a collection of the posterior fossa. A stereotactic biopsy was performed. It collected fragments biopsy and pus. The pathological and microbiological analysis allowed the identification of Aspergillus fumigatus. The originality of this observation comes from the rare location in the posterior fossa of aspergillosis and because the patient is immunocompetent and no primary location is found. The patient presents however a viral hepatitis B of fortuitous discovery. He is put under treatment by amphotericin B. The evolution is marked by meningitis comment-diversion. Antibiotics are prescribed, and then the patient is operated for total ablation of the tumor. He dies following an osmolar coma associated with thrombopenia and a secondary renal insufficiency due to his treatment by the amphotericin B.

Primary laryngeal tuberculosis mimicking laryngeal carcinoma: CT scan features.

Laryngeal tuberculosis is a rare disease. It is almost always associated with pulmonary tuberculosis. It occurs generally in adults without BCG vaccination or in cases of the acquired immune deficiency syndrome. On laryngoscopy and imaging, it often simulates laryngeal carcinoma, and confirmation is always histological. We report the case of a 36-year-old man who presented to our hospital with dysphonia and dysphagia. Laryngoscopy revealed a lesion of the left vocal cord and the ventricular strip. CT scan found focal, regular thickening of the left vocal cord, associated with irregular thickening of the posterior laryngeal wall. A biopsy confirmed the diagnosis of tuberculosis.