[Clinical report of posterior leukoencephalopathy syndrome].

The article describes the case history of posterior leukoencephalopathy syndrome - a brain disorder that predominantly affects the cerebral white matter. Edematous lesions involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem and cerebellum. This rapidly evolving neurological condition is clinically characterized by headache, nausea and vomiting, seizures, visual disturbances and altered sensorial functions, and occasionally focal neurological deficit. Posterior leukoencephalopathy syndrome is often associated with an abrupt increase in blood pressure and is usually seen in patients with eclampsia, renal disease and hypertensive encephalopathy. It is also seen in the patients treated with cytotoxic and immunosuppressive drugs such as cyclosporine A, tacrolimus /FK-506, cisplatin, cytarabine, IVIg, erytrophoietin, and interferon alpha. The study demonstrated that lesions of posterior leukoencephalopathy syndrome are best visualized with magnetic resonance [MR] imaging. T2 weighted MR Images, at the height of symptoms, characteristically show diffuse hyper intensity selectively involving the parieto - occipital white matter. Occasionally the lesions also involve the grey matter. Computed tomography can also be used satisfactorily to detect hypodense lesions of posterior leukoencephalopathy. Early recognition of this condition is of paramount importance because prompt control of blood pressure, withdrawal of immunosuppressive agents will cause reversal of the syndrome. Delay in the diagnosis and treatment can result in permanent damage to affected brain tissues. The clinical data and radiological findings depicted in the study add to the investigation of the disorder.

[Intramedullary metastases of bronchogenic carcinoma. Two cases]. / Métastases intramédullaires d'un cancer bronchique. Deux observations.

Intramedullary metastases are uncommon. We report two cases in patients with small cell bronchogenic cancer. The clinical diagnosis was supported by T1 magnetic resonance imaging after gadolinium injection. A unique medullary metastasis associated with other metastatic localizations was observed in the first patient and multiple intramedullary metastases alone in the second. These secondary intramedullary localizations were highly sensitive to chemotherapy after the first monthly cure in the first patient and after the third in the second patient. We emphasize the importance of chemotherapy in such cases, usually associated with focal radiotherapy.