Une Baisse Visuelle Révélant Une Pachyméningite Hypertrophique Idiopathique

Idiopathic hypertrophic pachymeningitis is a rare fibrosing inflammatory disorder that causes thickening of the dura matter of the base of skull. We report a case of a 27 year-old man presented with this pathological form causing a visual decrease. The diagnosing is a dural matter biopsy and the main treatment is steroid and immunosuppressive therapy. Idiopathic hypertrophic pachymeningitis is a differential diagnosis of optic neuropathy

Transient mutism after anterior transcallosal approach

Postoperative mutism is an infrequent complication of brain surgery. We report a third ventricular astrocytoma in a 16-year-old boy. The tumor was totally removed via anterior transcallosal approach. The operation was uneventful. On the second postoperative day he became mute. He could follow verbal commands, and write and read. Histopathological examination revealed a pilocystic astrocytoma. Four days postoperatively, he began to say simple words, and two weeks later he could talk normally. The possible cause and pathophysiological mechanism of mutism in the lesions of this region are discussed in this paperKey words: Mutism; Third ventricle; Corpus callosum; Transcallosal approac

Les metastases meningees solitaires prevalentes

Objectif Intérêt d’avoir une confirmation histologique, en présence d’un processus leptoméningée solitaire dont le diagnostic de méningiome bénin est souvent évoqué en premier. Introduction Les métastases méningées sont observées de plus en plus fréquemment chez les patients connus porteur d’une néoplasie, du fait de l’allongement de la survie des patients et l’amélioration des moyens diagnostiques ; elles représentent environ 8 % des métastases du système nerveux central.Observation Nous rapportons deux observations originales de patients sans histoire néoplasique, opérés pour un processus leptomeningé solitaire dont le diagnostic préopératoire était celui d’un méningiome. L’étude histologique révélait la nature néoplasique métastatique de la lésion, alors que le bilan radiologique a permis de détecter la localisation primitive méconnue. Conclusion et discussion La découverte à l’occasion d’une imagerie cérébrale (TDM et/ou IRM) chez un patient, sans histoire néoplasique, d’une ou plusieurs lésions leptoméningées, pose un problème diagnostique. Lorsque lalocalisation est unique, le diagnostic de méningiome est évoqué en premier ; alors que les lésions inflammatoires et secondaires des hémopathies malignes représentent un diagnostic différentiel lorsque les lésions sont diffuses. Seront discutées à lumière de ces observations et d’une revue de la littérature, les aspects physiopathologiques, cliniques, paracliniques, thérapeutiques et évolutifs de cette pathologie

Advancing nursing practice : the emergence of the role of Advanced Practice Nurse in Saudi Arabia

Background: The roots of advanced practice nursing can be traced back to the 1890s, but the Nurse Practitioner (NP) emerged in Western countries during the 1960s in response to the unmet health care needs of populations in rural areas. These early NPs utilized the medical model of care to assess, diagnose and treat. Nursing has since grown as a profession, with its own unique and distinguishable, holistic, science-based knowledge, which is complementary within the multidisciplinary team. Today Advanced Practice Nurses (APNs) demonstrate nursing expertise in clinical practice, education, research and leadership, and are no longer perceived as “physician replacements” or assistants. Saudi Arabia has yet to define, legislate or regulate Advanced Practice Nursing. Aims: This article aims to disseminate information from a Saudi Advanced Practice Nurse thought leadership meeting, to chronicle the history of Advanced Practice Nursing within the Kingdom of Saudi Arabia, while identifying strategies for moving forward. Conclusion: It is important to build an APN model based on Saudi health care culture and patient population needs, while recognizing global historical underpinnings. Ensuring that nursing continues to distinguish itself from other health care professions, while securing a seat at the multidisciplinary health care table will be instrumental in advancing the practice of nursing