Masson's tumor revealed by an intracerebral hematoma. Case report and a review of the literature.

We report the case of a 56-year-old woman who underwent total resection of a Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH), which was discovered due to a left temporal intracerebral hematoma revealed by aphasia. IPEH is more often localized on cutaneous and subcutaneous locations, intracranial IPEH are rare and only approximately twenty cases have been published to date. These tumors are a benign vascular lesion composed of papillary intravascular proliferation of epithelial cellular associated thrombosis with fibrin deposits responsible for vascular lumen obliteration. Differential diagnoses of neurological locations of IPEH are more often an angiosarcoma, or meningioma, and metastasis. Magnetic Resonance imaging (MRI) and CT-scan are not specific. On CT-scan the lesion is hypodense without calcification with a peripheral enhancement and on MRI a hyposignal T1 with homogeneous enhancement and a hypersignal T2. Arteriography may reveal a tumoral blush and arterio-venous shunt or arterial pedicles which can be embolized. The age of discovery is between 12 and 70 with a female predominance. IPEH are often localized close to the venous sinus or can be developed in a vascular malformation, thrombus or aneurysm. The curative treatment is total resection but recurrence has been reported, long-term follow-up with MRI is recommended.

[Study of the junction between the cortical bridging veins and basal cranial venous sinus]. / Etude anatomique du drainage des veines corticales inférieures dans le sinus transverse.

INTRODUCTION: The cerebral venous system is poorly known and is best appreciated based on macroscopic anatomical considerations. We present an anatomical and immunohistochemical study to better define the morphological characteristics of the junction between the inferior cortical veins and the transversal sinuses. MATERIAL AND METHODS: Sixteen cadaveric specimens from the anatomy laboratory of the University Victor-Segalen of Bordeaux were studied. The venous junctions with the transversal sinuses were observed under the operating microscope. Thirty vein-sinus junctions were immunohistochemically stained with smooth muscle actin. Ten venous junctions were observed under the electronic microscope. RESULTS: The inferior cortical veins drain into the transverse sinus either directly or through a tentorial sinus. The venous orifices in the transverse sinuses share the same characteristics. They are oval with semicircular superior dural reinforcement and follow an orientation opposite venous flow in the transversal sinus. The histologic study showed that the walls of the cortical veins contained smooth muscle cells as well as the dural reinforcement of the transversal sinuses. CONCLUSION: The venous orifices of the inferior cortical veins have the anatomical features of true sphincters. Their function in the regulation of the cerebral blood flow needs further exploration.

[Functional neuronavigation. Fusion of functional MRI data in a neuronavigation system]. / Neuronavigation fonctionnelle. Fusion des données de l'IRM fonctionnelle dans un système de neuronavigation.

Neuronavigation systems integrating functional magnetic resonance imaging data have been reported recently, but generally without many details about methodology. We propose an easy method to perform functional neuronavigation by integrating functional MRI data analyzed with the Statistical Parametric Mapping 99 reference software, in the Stealth Station which is the most common neuronavigation system. Users of this new and promising technique, which requires further validation, must be aware of its limitations. Functional MRI data seem to be the major source of imprecision. As a result we do not yet recommend the use of functional neuronavigation without the control of direct cortical stimulations.