Kyste neurentérique intra dural extra médullaire: à propos d’un cas

Le kyste neurentérique (KNE) est une malformation congénitale rare du système nerveux central (SNC) entrant dans le cadre des notochordodysraphies. Nous rapportons un nouveau cas de KNE de localisation intra durale extra médullaire chez un patient de 16 ans, admis dans un tableau de compression médullaire cervicale haut évoluant depuis 4 mois. L’imagerie a objectivé une lésion kystique pré médullaire en regardde C1-C2-C3. Le patient a bénéficié d’une évacuation kystique et l’histologie avait conclu à un kyste neurentérique. L’évolution était marquée par le décès du patient par des complications neurovégétatives graves. Malgré sa bénignité histologique, le kyste neurentérique de localisation cervicale haute peut se compliquer de troubles neurovégétatifs parfois imprévisibles pouvant aboutir à une évolution dramatique

Traitement peu invasif d’une breche osteo meningee associee a une hypertension intracranienne benigne

Description L’hypertension intracrânienne bénigne (HTICB) est une augmentation anormale de la pression intracrânienne non associée à un processus occupant de l’espace intracrânien, une thrombose des veinescérébrales ou une hydrocéphalie. Caractérisée par des céphalées invalidantes, des acouphènes pulsatiles, elle peut avoir une évolution péjorative et irréversible entraînant une cécité. La survenue d’une rhinorrhée spontanée dans un contexte d’HTICB a été décrite dans la littérature mais demeure peu fréquente. Objectif et cas cliniqueNous rapportons le cas d’une femme obèse âgée de 40 ans, qui a été admise pour rhinorrhée droite spontanée. Les explorations neuroradiologiques ont permis d’évoquer une hypertension intracrânienne bénigne sur une brèche ethmoïdale antérieure. Le monitoring de la pression a confirmé le diagnostic. Elle abénéficié d’une dérivation ventriculo péritonéale. L’évolution est favorable (disparition des symptômes) avec un delai de recul de 16 mois . Conclusion L’HTICB est une pathologie avec des conséquences irréversibles si le traitement n’est pas adéquat et rapide. En cas de rhinorrhée isolée dans le cadre de l’hypertension intracrânienne bénigne la dérivation ventriculo péritonéale est une attitude thérapeutique simple mais efficace

Classification of large-scale environments that drive the formation of mesoscale convective systems over southern West Africa

Mesoscale convective systems (MCSs) are frequently observed over southern West Africa (SWA) throughout most of the year. These MCS events are the dominant rain-bearing systems, contributing over 50 % of annual rainfall over SWA. However, it has not yet been identified what variations in typical large-scale environments of the seasonal cycle of the West African monsoon may favour MCS occurrence in this region. Here, nine distinct synoptic states are identified and are further associated with being a synoptic-circulation type of either a dry, transition, or monsoon season using self-organizing maps (SOMs) with inputs from reanalysis data. We identified a pronounced annual cycle of MCS numbers with frequency peaks in April and October that can be associated with the start of rainfall during the major rainy season and the maximum rainfall for the minor rainy season across SWA, respectively. Comparing daily MCS frequencies, MCSs are most likely to develop during transition conditions featuring a northward-displaced moisture anomaly (2.8 MCSs per day), which can be linked to strengthened low-level westerlies. Considering that these transition conditions occur predominantly during the pre- and post-monsoon period, these patterns may in some cases be representative of monsoon onset conditions or a delayed monsoon retreat. On the other hand, under monsoon conditions, we observe weakened low-level south-westerlies during MCS days, which reduce moisture content over the Sahel but introduce more moisture over the coast. Finally, we find a majority of MCS-day synoptic states exhibiting positive zonal wind shear anomalies. Seasons with the strongest zonal wind shear anomalies are associated with the strongest low-level temperature anomalies to the north of SWA, highlighting that a warmer Sahel can promote MCS-favourable conditions in SWA. Overall, the SOM-identified synoptic states converge towards high-moisture and high-shear conditions on MCS days in SWA, where the frequency at which these conditions occur depends on the synoptic state.</p

A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project

Abstract Background Because residents of the southeastern United States experience disproportionally high rates of cardiovascular disease (CVD), it is important to develop effective lifestyle interventions for this population. Methods The primary objective was to develop and evaluate a dietary, physical activity (PA) and weight loss intervention for residents of the southeastern US. The intervention, given in eastern North Carolina, was evaluated in a 2 year prospective cohort study with an embedded randomized controlled trial (RCT) of a weight loss maintenance intervention. The intervention included: Phase I (months 1–6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI ≥ 25 kg/m2 offered in 2 formats (16 weekly group sessions or 5 group sessions and 10 phone calls) or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance RCT for those losing ≥ 8 lb with all other participants receiving a lifestyle maintenance intervention. Change in diet and PA behaviors, CVD risk factors, and weight were assessed at 6, 12, and 24 month follow-up. Results Baseline characteristics (N = 339) were: 260 (77 %) females, 219 (65 %) African Americans, mean age 56 years, and mean body mass index 36 kg/m2. In Phase I, among 251 (74 %) that returned for 6 month follow-up, there were substantial improvements in diet score (4.3 units [95 % CI 3.7 to 5.0]), walking (64 min/week [19 to 109]), and systolic blood pressure (−6.4 mmHg [−8.7 to −4.1]) that were generally maintained through 24 month follow-up. In Phase II, 138 (57 group only, 81 group/phone) chose the weight loss intervention and at 12 months, weight change was: −3.1 kg (−4.9 to −1.3) for group (N = 50) and −2.1 kg (−3.2 to −1.0) for group/phone combination (N = 75). In Phase III, 27 participants took part in the RCT. At 24 months, weight loss was −2.1 kg (−4.3 to 0.0) for group (N = 51) and −1.1 kg (−2.7 to 0.4) for combination (N = 72). Outcomes for African American and whites were similar. Conclusions The intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest. Trial registration clinicaltrials.gov Identifier: NCT0143348

A Rare Case of Adult Medulloblastoma with Spinal Metastasis

Medulloblastoma is a relatively common malignant brain tumor of childhood and relatively rare in adulthood, with a propensity for neuraxial spread via cerebrospinal fluid pathways. Osseous extraneural metastasis is uncommon and when it happens, radiologic findings are of sclerotic (60%), lytic (35%), and mixed patterns (5%) (Algra et al. (1992)). In this paper, we present a case of medulloblastoma metastiaszing to the lumbar spine and describe the magnetic resonance appearance, with emphasis on the image findings mimicking spondylodiscitis

The Grand Popo experiment, Benin

International audienceThe first large nearshore field experiment in the G ulf of Guinea was conducted at Grand Popo Beach, Be nin, in February 2013, on an open wave-dominated micro- to meso-tidal coast, located mid-way between Cotonou and Lome harbours. The overall project aims at understanding at multi-scale (from event to interannual) the causes of the dramatic erosion observed throughout the Bight of Benin, and caused by the interaction of a large littoral drift with human engineering works. Grand Popo 2013 experiment was designed to measure the processes over the short term and to test the ability of an installed video system to monitor the evolution of this stretch of coast over the longer term. The beach, characterized by a low-tide terrace and a high tide reflective part, experiences a long swell (Hs=1.6m, Tp=16 s, oblique incidence ~15-20°). Topographic surveys showed a double beach cusp system interaction and repeated surf-zone drifter runs revealed high flash and swash rip activity driven by wave dissipation over the terrace and energetic swash dynamics at the upper reflective beach. Swash was measured over a cusp system at two locations using video poles. Wave reanalyses (ERAInterim) were used to determine the wave climate and its variability, and to quantify sediment transport. This robust methodology is thought to be replicated elsewhere in different coastal environments in West Africa, in particular with the objective to monitor various sites within the framework of the new West African Coastal Observatory

The Grand Popo beach 2013 experiment, Benin, West Africa: from short timescale processes to their integrated impact over long-term coastal evolution

The first large nearshore field experiment in the Gulf of Guinea was conducted at Grand Popo Beach, Benin, in February 2013, on an open wave-dominated micro- to meso-tidal coast, located mid-way between Cotonou and Lome harbours. The overall project aims at understanding at multi-scale (from event to interannual) the causes of the dramatic erosion observed throughout the Bight of Benin, and caused by the interaction of a large littoral drift with human engineering works. Grand Popo 2013 experiment was designed to measure the processes over the short term and to test the ability of an installed video system to monitor the evolution of this stretch of coast over the longer tenn. The beach, characterized by a low-tide terrace and a high tide reflective part, experiences a long swell (Hs=1.6 m, Tp=16 s, oblique incidence similar to 15-20 degrees). Topographic surveys showed a double beach cusp system interaction and repeated surf-zone drifter runs revealed high flash and swash rip activity driven by wave dissipation over the terrace and energetic swash dynamics at the upper reflective beach. Swash was measured over a cusp system at two locations using video poles. Wave reanalyses (ERAInterim) were used to determine the wave climate and its variability, and to quantify sediment transport. This robust methodology is thought to be replicated elsewhere in different coastal environments in West Africa, in particular with the objective to monitor various sites within the framework of the new West African Coastal Observatory