Multiple meningiomatosis

Multiple meningiomas or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations. Early classification of Cushing and Eisenhardt claimed that a diagnosis of multiple meningioma can only be made if the patient does not suffer neurofibromatosis type I (NF1 is associated with neurofibromin, ras pathway). Majority of multiple meningiomas associate with neurofibromatosis type-II, multiple meningiomatosis refers to the association of at least 2 tumors in two different sites, in a patient who has no evidence of neurofibromatosis. The incidence of this condition varies between series between 1 and 3%, reaching a frequency of 8% with the onset of magnetic resonance imaging (MRI). This entity combines benign tumors of a different histological nature in 30% of cases. A 39-year-old woman patient, with no significant pathological history, who consulted for heaviness in both lower limbs having progressed for 6 months with paresthesias without genitosphincteric disorders, the examination found a spastic paraparesis rated at 3/5. The patient underwent a medullary MRI which revealed 4 lesions, the radiological semiology of which was suggestive of spinal meningiomas, the most compressive projecting in relation to T2. A cerebral computed tomography (CT) was systematically performed and objectified two intra cranial meningiomas, which until then were asymptomatic. Although its incidence is only 1 to 3%, the discovery of multiple meningiomatosis justifies morphological exploration (MRI) of the entire neurax, in which case any symptomatic location should suggest surgical management

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

Cystic Trigeminal Schwannoma: Case presentation

Trigeminal schwannoma is the second commonest intracranial schwannoma; they remain rare. A minority exhibit cystic changes, with even fewer an intracystic fluid level. We report a case of a 45-year-old man, presented with a progressive hearing loss, worsening right-sided facial spasms and facial numbness in the region of the right trigeminal nerve. Neurological examination revealed hypoesthesia in the right facial region and intermittent rights sided hemi-facial spasms, without signs of raised intracranial pressure or achieve the mixed nerves or neurological deficit. A Magnetic resonance imaging of the brain revealed a cystic mass in the right cerebello-pontine angle with extension forward towards the cavum meckel. The patient was operated by retro sigmoid approach, with a total resection of the tumor. Intracranial cystic schwannomas constitute an uncommon subset of tumors with a distinct clinico-biological behavior. The presence of fluid–fluid levels within the tumors, although rare, confirms the cystic nature of the neoplasms. Cystic areas are usually secondary to the coalescence of mucinous or microcystic regions in Antoni B tissues. The treatment is surgical in the majority of cases and stereotactic radiosurgery has a clear role for adjuvant treatment of post-surgical recurrence of the tumor or residue

Une cause rare de recidive de lombosciatalgie

Le terme de textile est un terme non médical qui désigne un objet synthétique oublié dans le foyer opératoire ainsi que la réaction inflammatoire qui l’entoure. Cette complication bien qu’elle soit connue est rarement publiée à cause implications médico-légale. Les manifestations cliniques peuvent êtres frustes et l’imagerie permet parfois d’avoir un diagnostic de certitude. Dans ce travail, nous présentons le cas d’un textilome retrouvé au niveau de l’espace épidural après cure d’une hernie discale réalisée deux ans auparavant et qui s’est révélé par des lombosciatalgies, ainsi que les facteurs humains et techniques impliqués dans cet événement indésirable

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

Rola dynamicznej tomografii komputerowej złącza szczytowo-potylicznego przy ustalaniu postępowania w przypadkach stwierdzenia os odontoideum

Abstract Os odontoideum is an uncommon abnormality of the craniovertebral junction (CVJ) that exists as a separate ossicle apart from a hypoplastic dens. Its genesis and natural history have been debated, and its proper treatment remains uncertain. A 48-year-old woman complained of persistent upper neck pain and paraesthesia of her left side. Magnetic resonance imaging of the CVJ demonstrated an os odontoideum. Dynamic computed tomography scan of the CVJ showed a reduction of the space available for the spinal cord to 50% from extended to flexed position. The patient underwent posterior spinal fusion of C1–C2 using a sublaminar titanium hook and rods fixed in moderate extension. We discuss the usefulness of the dynamic computed tomography (CT) scan in the evaluation of atlantoaxial motion and the management of this pathology.Streszczenie Os odontoideum jest rzadko spotykaną nieprawidłowością złącza szczytowo-potylicznego, w której słabo wykształcony ząb obrotnika tworzy dodatkową kość. Sposób jej powstawania i historia naturalna są przedmiotem dyskusji; istnieje również niepewność co do właściwego postępowania. Czterdziestoośmioletnia kobieta zgłosiła się z powodu utrzymującego się bólu górnej części szyi oraz lewostronnych parestezji. W badaniu złącza szczytowo-potylicznego za pomocą rezonansu magnetycznego uwidoczniono os odontoideum. Dynamiczna tomografia komputerowa tej okolicy wykazała zmniejszanie się przestrzeni dostępnej dla rdzenia kręgowego o 50% podczas zgięcia w porównaniu z prostowaniem szyi. U chorej wykonano tylne zespolenie kręgów C1–C2 za pomocą tytanowego haka i prętów, uzyskując stabilizację szyjnego odcinka kręgosłupa w umiarkowanym wyproście. Autorzy omawiają przydatność dynamicznej tomografii komputerowej (TK) w ocenie ruchomości stawu szczytowo-obrotowego i w leczeniu wspomnianej patologii

Downstaging hepatocellular carcinoma: A systematic review and pooled analysis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113108/1/lt24169.pd