[Symptomatic venous congestion of the brain stem after embolization for dural fistula of the cavernous sinus]. / Congestion veineuse symptomatique du tronc cérébral après embolisation d'une fistule durale du sinus caverneux.

We report the case of a 60-year old woman presenting, 3 days after arterial embolization of a dural arteriovenous fistula, with diplopia and gait disturbance in relation with right oculomotor nerve palsy and cerebellar dysfunction. On T2 weighted MR images, several hyperintense areas appeared in the pons and the midbrain. After one month, clinical symptoms and diffuse hyperintense areas resolved spontaneously, as the patient was treated by anti-vitamin K. This complication probably corresponds to reversible pontine venous congestion caused by poor venous drainage of the dural arteriovenous fistula.

Computed tomographic demonstration of the posterior pituitary.

From a series of 700 thin, axial, contrast-enhanced CT scans of the sellar region, the posterior lobe of the pituitary was studied. Empty sellae and pituitary lesions larger than 8 mm in diameter were excluded from the study. Of the 320 remaining axial contrast-enhanced CT scans, the posterior lobe of the pituitary was apparent in 124 (39%) as an oval lucency 3-4 mm thick, located medially or paramedially just in front of the dorsum sellae. Normally, the anterior limit of the posterior lobe is always regularly convex forward, but in the presence of a microadenoma of the anterior lobe it may be compressed. The lesser enhancement of the posterior lobe probably correlates with the different volumes of the interstitial spaces in the anterior and in the posterior lobes. The normal picture of the posterior lobe of the pituitary must not be confused with a posteriorly located microadenoma.

[Intracranial septic aneurysm in an infant. Apropos of a case and review of the literature]. / Anévrisme septique intra-crânien chez un nourrisson. A propos d'un cas et revue de la littérature.

This case report describes a four and a half month old infant with all meningitis symptoms and a sub arachnoidal hemorrhage at the lumbar puncture. Transfontanelle - ultrasonography and computed tomography enables us to diagnose a right intra-cerebral hematoma. Angiography visualises a mycotic aneurysm in a distal portion of the sylvian artery. A success is obtained both by neuro surgery and antibiotics treatment. Regarding this case of intra cranial septic aneurysm and the ones reviewed in the literature, aetiology, frequency, clinical features and management are discussed by the authors.

Dynamic computed tomography of the pituitary gland: the "tuft sign".

Diagnosis of an intrasellar pituitary microadenoma by CT may be difficult if the only finding is a small defect in enhancement. The diagnosis can be facilitated by dynamic CT of the pituitary gland in the coronal plane. This method permits visualization of the capillary bed of the pituitary, whose displacement ("tuft sign") could be an indication of the presence of a microadenoma.

[Eaton-Lambert syndrome associated with multiple myeloma: resolution of the neuromuscular block after chemotherapy]. / Syndrome de Lambert et Eaton associé à un myélome multiple: réversibilité du bloc neuromusculaire après chimiothérapie.

The Eaton Lambert syndrome is a myasthenic disorder often associated with small-cell carcinoma of the lung. In some instances, no neoplasm is demonstrated and the Eaton Lambert syndrome is isolated. This syndrome may also be associated with autoimmune diseases. The authors describe a case of Eaton Lambert syndrome in a patient with multiple myeloma that resolved after chemotherapy. The authors connect this case to evidence previously reported in the medical literature in favor of an autoimmune origin to the neuromuscular block. Considering this etiopathogenic hypothesis, immunosuppressive therapy should be attempted in these patients.

CT follow-up of microprolactinomas during bromocriptine-induced pregnancy.

In the last few years complete or partial regression of prolactinomas has been demonstrated in nonpregnant women treated by bromocriptine. Thus bromocriptine therapy appears as an attractive alternative to surgery for management of infertility related to hyperprolactinemia. However, numerous reports emphasized the possibility of an excessive growth of the pituitary adenoma with visual field defects during the last 3 months of pregnancy. To avoid these complications, the authors followed with serial CT scans the growth of microprolactinoma at the 5th or 6th month of pregnancy. Among six pregnant women, one patient presented a marked upward extension of the adenoma. Bromocriptine was then reintroduced and the effectiveness in reducing tumor growth was proved by CT scan at the 7th month. Regarding low risk of using intravenous iodinated contrast medium in pregnant women and of fetal radiation damage, the authors emphasize the value of CT in the follow-up of bromocriptine-induced pregnancies.

Ossification of the posterior longitudinal ligament after cervical irradiation.

A case of ossification of the posterior longitudinal ligament (PLL) at the cervical level one year after cervical irradiation is reported. This condition is rare in Caucasian people. The cause is unknown. The particular circumstances of ossification occurrence in the case reported allow us to propose a new etiological hypothesis.