[Osteoarticular lesions in Whipple's disease. Apropos of a destructive form and review of the literature]. / Lésions ostéo-articulaires de la maladie de Whipple. A propos d'une forme destructrice et revue de la littérature.

A patient with Whipple's disease was considered as cured after treatment for two years, but relapse occurred as the neurological form. Radiographic imaging showed destructive osteoarticular lesions, with few or no symptoms, affecting the peripheral skeleton but also the sacroiliac joints. The published literature is reviewed and the different osteoarticular radiologic forms of the affection described.

[Pseudo-tumoral form of delayed radionecrosis of the brain]. / Forme pseudo-tumorale de radionécrose retardée de l'encéphale.

A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. gamma EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

[Limited paralysis of the hand caused by metastasis in the motor cortex]. / Paralysie limitée de la main due a une métastase du cortex moteur.

A 66-year old man presented a progressive motor deficit of the left hand mimicking radial and ulnar paralysis. Clinical examination, laboratory investigations, and post mortem findings, demonstrated a single metastasis in the contralateral motor cortex. The interest of this case lies in the discrepancy between the extent of the motor deficit and the size of the lesion. This finding could help to interpret current theories concerning the somatotopic representation on the motor cortex in man.

[Brown-Séquard syndrome caused by a spinal cord infarction]. / Syndrome de Brown-Séquard dû a un infarctus spinal.

A 77-year old woman presented a Brown-Séquard syndrome of sudden onset at level C4, and a few days later a tetraplegia. Postmortem findings demonstrated, at C3-C4, a left spinal cord infarct accounting for the Brown-Séquard syndrome, and a second C5-C6 bilateral infarct responsible for the tetraplegia. Alternating distribution of sulcal arteries explains the limitation of the first lesion to one half of the spinal cord.