Real-life study of the use of oto-acoustic emissions in the diagnosis of intracranial hypotension.

BACKGROUND: The diagnosis of spontaneous or post-traumatic intracranial hypotension (IH) mainly relies on clinical features and neuro-imaging. However, the results of brain and spine magnetic resonance imaging are not always contributive. There is an interest for other non-invasive procedures, able to confirm or refute the diagnosis. The use of oto-acoustic emissions (OAE) was previously reported on isolated cases of IH associated with endolymphatic hydrops (ELH). The aim of this study was to assess the real-life utilization of this electrophysiological method in a larger population of suspected IH. METHODS: A retro-prospective cohort study was conducted from November 2013 to July 2022 in patients with a suspected or doubtful diagnosis of IH. They were assessed for ELH by recording bilateral distortion product of oto-acoustic emissions (DPOAE) in sitting then in supine position. RESULTS: Among the 32 patients assessed, the diagnostic of IH was confirmed in 18 patients. An ELH was shown in 15 of them (83%), but also in seven other patients. They had several differential diagnoses: chronic migraine, Chiari malformation, rebound intracranial hypertension and perilymph fistula. CONCLUSIONS: This procedure seems to be insufficient to exclude differential diagnosis when intracranial hypotension is suspected.

Evaluation of magnetic resonance imaging for the detection of sacroiliitis in patients with early seronegative spondylarthropathy.

A prospective study was conducted in 23 patients to evaluate magnetic resonance imaging versus computed tomography and plain film radiography for the early detection of sacroiliitis in patients with spondylarthropathy and an Amor score of less than 6. Computed tomography was significantly better than the other two techniques despite some false-positive results, particularly in patients older than 40 years. Magnetic resonance imaging lacked sensitivity for detecting elementary lesions, particularly of the cartilage, but demonstrated clearly that the earliest abnormality was edema of the subchondral bone.

[Pulmonary hemosiderosis. Hemodynamic or idiopathic origin? Diagnostic contribution of imaging and review of the literature]. / Hémosidérose pulmonaire. Origine hémodynamique ou idiopathique? Contribution diagnostique de l'imagerie et revue de la littérature.

We report two cases of Pulmonary Hemosiderosis. The first patient (adult male) had an angiosarcoma of the left auricle and developed pulmonary arterial hypertension, was treated by surgery and chemotherapy. The other patient (adult female) suffered from Idiopathic Pulmonary Hemosiderosis (IPH) and had been treated by corticosteroids for fifteen years, with one acute episode during this period. We discuss the etiological diagnosis and the contribution of chest radiographs, CT-scan and MR Imaging in this rare illness according to literature. IPH occurs mostly in childhood with acute and fatal issue, whereas presents as a chronic form in adults. Assessment of IPH requires large investigations to eliminate hemodynamic, hemato-, immuno-, carcinological disorders, and infectious agents as well. Review.

[Extent of idiopathic necrosis of the femoral head. Assessment using computerized tomography. Anatomo-radiologic correlation]. / Etendue de la nécrose idiopathique de la tête fémorale. Appréciation par la tomodensitométrie numérisée. Corrélation anatomo radiologique.

The indications for treatment of idiopathic necrosis of the hip depend on the stage of development of the lesion, its extent and the site of the necrotic area. Digital computerised tomography with horizontal sections at five millimetre intervals from the upper to the lower pole of the femoral head is of value in the determination of these three features. For this purpose, fifteen femoral heads removed in the course of total hip arthroplasty were subjected to histological sections in parallel to those of the CT scan. This study showed that digital computerised tomography indicates the extent and topography of the necrosis and provides true histo-radiological sections.

[Surgical excision of meningioma of the posterior fossa in a dog after detection by x-ray computed tomography]. / Exérèse chirurgicale d'un méningiome de la fosse postérieure chez un chien après détection par un examen tomodensitométrique.

Following the progressive occurrence of a central vestibular syndrome in a 9 year old female dog, the diagnosis of a compressive lesion was confirmed by cerebrospinal fluid analysis (C.S.F.) and by computerized axial tomography (C.T.). The C.T.Scan revealed a large tumor occupying two thirds of the posterior fossa on the right side. A direct surgical approach to the right side of the posterior fossa revealed a large, friable mass, consistent with a meningioma, underneath the cerebellum, over the brain stem. Microscopic surgical dissection permitted the removal of the major part of the tumor. The nature of the intracranial neoplasm was confirmed histopathologically as a meningioma. No post operative complication arose and the dog returned to normal. Three months later, clinical signs reappeared and a control C.T.Scan showed recurrence of the tumor. The dog was euthanized four months postsurgically. Intracranial tumors are common in the dog, but rarely diagnosed and operated. However, a direct surgical approach to the posterior fossa for a tentative curative removal of an intracranial tumor has never been described in a dog. The localization and description of the lesions demonstrate the utility of C.T.Scans in the canine species. Recurrence of the tumor following surgery confirms the importance of complete excision of intracranial meningiomas when possible.

[Thrombosed carotid aneurysm and CT scan. Report on three cases]. / Anévrysme thrombosé carotidien et TDM. A propos de 3 cas.

Thrombosed intracranial aneurysms are always large aneurysms with a diameter superior to 25 mm. They are easily detected by computed tomography, but their diagnosis when they are located in the sphenoidosellar region may cause problems. Three cases of giant aneurysms have been discovered by CT scan over a period of 27 months.

[Atypical osteodystrophy of visceral origin (author's transl)]. / Ostéodystrophie atypique d'origine viscérale.

The authors report a case of atypical osteodystrophy of visceral origin (uretero-sigmoid by-pass for bladder exstrophy) which was characterized by the association of osteocondensation and looser-Milkman lines. They emphasize the rareness of osteodystrophy after uro-digestive by-pass and the exceptional character of the osteocondensation.