Etude Anatomique du Système Artériel Carotidien de l’Aulacode (Thryonomysswinderianus, Temminck 1827)

The Cane rat (Thryonomysswinderianus) is an African rodent described in 1827 by Temminck. In order to make of it a model animal of laboratory, it is subjected to research in many domains for few years. Objective: The aim of this work was to describe the anatomy of the carotid Artery System of the cane rate.Materials and methods: It was about a prospective experimental study carried out on a series of eight adult sacrificed and put at death cane rats. After realizing a previous thoracic shutter, a vascular washing was performed by cardiac path followed by two injections of latex colored differently. The first one in red color and the second in blue are respectively carried out on the left and right heart. The Craniospinal blocks carrying the heart and the supra cardiac vessels were removed and immersed in a solution of formaldehyde at 10% during 72 hours. The anatomy of carotid artery was studied after dissection of the blocks. Results: With their origin, the two common arteries carotid were born by a common trunk at the convexity level of the aortic arch. They had an ascending way along the trachea and were divided then into two branches under the solid massif of the mandible: An external branch for the bodies of the face and an internal branch which moves towards the cerebral trunk. Conclusion: This study enables us to show that the two arteries common carotids are born by a joint base from the aortic arc and that the internal artery carotid does not take part in the constitution of the arterial circle of the base

Microanatomy of the Supracavernous Internal Carotid - Anterior Cerebral Arterial Complex

Résumé  L\'anastomose carotide-artère cérébrale antérieure est une variante rare de la partie antérieure du cercle artériel de la base du crâne. L\'artère cérébrale antérieure naît de l\'artère carotide interne supracaverneuse au même niveau que l\'artère ophtalmique. Elle décrit un trajet infraoptique ipsilateral puis interoptique et préchiasmatique avant de donner deux artères péricalleuses droite et gauche. Cette variété anatomique est souvent associées à des anévrismes artériels et d\'autres anomalies vasculaires. La découverte d\'un cas et la revue de la littérature nous permettent d\'évoquer quelques hypothèses embryologiques.   Carotid-anterior cerebral artery anastomosis is a rare variety of the anterior part of skull base arterial circle. The anterior cerebral artery arises from the supracavernous internal carotid artery at the same level like the ophthalmic artery. It passes underneath the ipsilateral optic nerve, between optic nerves and ventrally to the chiasm, before giving rise to two pericallosal arteries right and left. This anatomic variety is often associated with aneurysms and other vascular anomalies. The discovery of a case and the review of the literature allow us to evoke some embryological hypotheses. Keywords: Anterior cerebral artery, Internal carotid artery, Optic nerve, Aneuryom, Artère cérébrale antérieure, Artère carotide interne, Nerf optique, Anévrismes artériels Af J Neuro Sci: 2001 20(1

Carotide interne supracaverneuse - artere cerebrale anterieure

MICROANATOMY OF THE SUPRACAVERNOUS INTERNAL CAROTID -ANTERIOR CEREBRAL ARTERIAL COMPLEX Carotid-anterior cerebral artery anastomosis is a rare variety of the anterior part of skull base arterial circle. The anterior cerebral artery arises from the supracavernous internal carotid artery at the same level like the ophthalmic artery. It passes underneath the ipsilateral optic nerve, between optic nerves and ventrally to the chiasm, before giving rise to two pericallosal arteries right and left. This anatomic variety is often associated with aneurysms and other vascular anomalies. The discovery of a case and the review of the literature allow us to evoke some embryological hypotheses

Carotide interne supracaverneuse - artere cerebrale anterieure

MICROANATOMY OF THE SUPRACAVERNOUS INTERNAL CAROTID -ANTERIOR CEREBRAL ARTERIAL COMPLEX Carotid-anterior cerebral artery anastomosis is a rare variety of the anterior part of skull base arterial circle. The anterior cerebral artery arises from the supracavernous internal carotid artery at the same level like the ophthalmic artery. It passes underneath the ipsilateral optic nerve, between optic nerves and ventrally to the chiasm, before giving rise to two pericallosal arteries right and left. This anatomic variety is often associated with aneurysms and other vascular anomalies. The discovery of a case and the review of the literature allow us to evoke some embryological hypotheses

Bêta-thalassémie intermédiaire compliquée d'une compression médullaire: Etude de trois observations et méta-analyse

Extramedullary hematopoiesis is common in patients who suffer from beta-thalassemia. Extramedullary hematopoiesis is a compensatory mechanism of chronic anemia. Although the diagnosis is relatively easy, management is still the subject of considerable controversy. The aim of the present paper is to report three cases of spinal cord compression due to beta-thalassemia followed by a meta-analysis. In one of the three cases reported, spinal compression revealed beta-thalassemia. Forty-three cases have been reported in the last 10 years, i.e. four cases per year. The diagnosis was made by CT and myelography and confirmed by histology after surgical treatment. Two patients were followed in the hematology department. Young patients accounted for 95.45% of cases. The time to diagnosis was 3.33 months (3 days to 12 months). The most sensitive exam for diagnosis is magnetic resonance imaging before surgery. The MR image shows a hypointense lesion on T1-weighted sequences in 30.43% of cases or isointense on T2-weighted sequences in 34.78% of cases, and hypointense on T1-weighted sequences enhanced with gadolinium in 42.85% of cases. When MRI is absent, as in our patients, myelography can provide the diagnosis. The vertebrae are enlarged and translucent in 85.71% of cases with a hypodense lesion compressing the spinal cord. Laboratory tests show chronic microcytosis hemolytic anemia in 97.17% of cases. The diagnosis was established by histology performed after surgical removal. The patients recovered 97.5% of their neurologic deficiency after specific treatment. The mean follow-up was 2 years (4 weeks to 15 years).Case ReportsEnglish AbstractJournal Articleinfo:eu-repo/semantics/publishe

Les adénomes hypophysaires cliniquement non-fonctionnels: Peuvent-ils être diagnotiqués plus tôt?

(fr) Introduction Les adénomes pituitaires « silencieux » n’entraînent pas de tableau en rapport avec une hypersécrétion hormonale. Ils posent un problème de diagnostic tardif au stade des complications comprimant les voies visuelles. Le but de ce travail est de permettre un diagnostic précoce en dégageant un profil clinique et biologique de ces adenomes.Matériels et méthodes 44 dossiers de malades opérés entre 1994 et 2005, tous des macroadénomes de plusieurs types histochimiques, ont été analysés au plan clinique :Le sexe, le status gynéco-obstétrique, l’âge, le délai diagnostic, les circonstances de découverte, le tableau clinique ont été notés. Le dosage de base des gonadotrophines ainsi que les tests dynamiques aux GnRH et TRH ont ete etudies separement chez les hommes, les femmes menopausees, et celles en periode d’activite genitale. L’anatomopathologie et l’immunohistochimie ont ete realisees. La loi des moyennes a été utiliséeRésultats 28 hommes (63,6%) et 16 femmes (36,4%) dont 10 ménopausées. L’âge moyen était de 58 ans et demi, le délai diagnostic moyen était de 9 mois et demi. Le syndrome tumoral était au premier plan (86,4%) avec des troubles visuels dans tous les cas (100%), dominés par les anomalies campimétriques. Les signes cliniques d’hypopituitarisme (41%) qui sont en rapport avec la compression/destruction de l’hypophyse saine par la tumeur predominaient sur ceux d’hypersécrétion de gonadotrophines (9,1%) vus essentiellement dans les adénomes gonadotropes. Le bilan hypophysaire montrait des insuffisances antehypophysaires (IAH) chez plus de 60% des patients, surtout gonadotropes, dans tous les groupes. L’hyperprolactinemie variait de 41 a 89% mais toujours inferieure a 150 ng/ml. A l’immunohistochimie les adenomes gonadotropes etaient les plus nombreux (81,8%) suivis des non-secretants vrais (11%), des corticotropes (4,5%) et d’un plurisecretant (2,3%)Conclusion Le tableau clinique évocateur est exceptionnel ;il faut donc, par une analyse plus fine, retrouver ces signes au début, qui sont pourtant perçus à posteriori à l’interrogatoire, par un examen rigoureux et faire ainsi realiser un bilan hypophysaire qui montrerait une IAH gonadotrope et une hyperprolactinemie moderee. Le dosage des sous-unites α et β devra etre realise. Les tests dynamiques et de freinage devront etre faits exceptionellement en cas de doute, voire supprimes. L’interprétation reste cependant difficile chez la femme ménopausée.(en) Introduction Clinically silent pituitary adenomas are not diagnosed because of hormonal hypersecretion. They are detected late when the optic pathway is compressed. The objective of this work is to define clinical and biological profile which will allow an early diagnosis.Material and methods 44 files of patients operated on between 1994 and 2005 were analyzed. They all had macroadenomas of different histochemical types. Sex, gynecological and obstetrical history, age, delay before diagnosis, circumstances of diagnosis and clinical data were obtained in each case. Basic gonadotrophins level, GnRH and TRH dynamical tests were separately performed in men, sexually active women and women in menopause. Histopathology and immunohistochemistry studies were performed.Results the series comprised 28 men(63.6%) and 16 women (36.4%) (10 of them were in menopause). Mean age was 58.5 years and diagnostic delay was 9.5 months. Tumoral syndrome was present in 86.4 % of cases, all the patients had visual impairment, mainly visual’s field amputation or restriction. Hypopituitarism syndrome was present (41 %) according to the degree of compression or destruction of the normal pituitary gland by the tumor, except for gonadotrophic hypersecretion signs (9.1%). Hormonal dosage showed more than 60% of pituitary gland insufficiency in all three groups, particularly the gonadotrophic one. Moderate prolactin hypersecretion was found in 41 to 89% of cases, but the absolute value was always less than 150 ng/ml At histoimmunochemistry, gonadotroph cell adenomas predominate (81.8%), followed by the real non-secreting one(11%), then corticotroph (4.5%) and lastly the multi-secreting adenomas (2.3%)Conclusion The clinical syndrome of non secretory pituitary adenoma is not clearly defined. Practitionners need to identify early these symptoms, which were actually present from the beginning of the clinical history, by a meticulous examination. If patient presents cephalalgia and visual impairment, cerebral CT scan or MRI explorations are mandatory to explore the presence of a pituitary tumor. In case of non-functioning pituitary adenoma, basic endocrine exploration should find a hypopituitarism, mainly gonadotropic, with a moderate prolactin hypersecretion. The dosage of α and β subunits must be done. Dynamic tests should be performed only in case of difficulty. Analysis is difficult in menopausal women.info:eu-repo/semantics/publishe

Brain Intraventricular Tumors

(fr) Objectif: Rapporter notre expérience des tumeurs intraventriculaires encéphaliques.Methodes: Etude rétrospective descriptive et analytique portant sur une série de 19 patients traités de Janvier 1994 à décembre 2004. L’évaluation diagnostique s’est faite à l’aide de la tomodensitométrie crânio-encéphalique et de l’étude neuro-pathologique des pièces opératoires. Les tumeurs paraventriculaires prolabées dans les ventricules ont été exclus. Résultats: Il s’agissait de 12 patients de sexe masculin et 7 de sexe féminin (sex ratio: 1.71). L’âge moyen des patients a été de 19 ans variant entre 2 et 52 ans avec un pic de fréquence entre 20 et 29 ans. Le syndrome d’hypertension intracrânienne a été la circonstance diagnostique la plus fréquente (89.4%) et l’hydrocéphalie présente chez 78.95% des patients. La tomodensitométrie cranio-encéphalique a été réalisée dans tous les cas. Les ventricules latéraux ont été le site anatomique le plus touché (52.63%) suivi du troisième ventricule (26.32%) puis du quatrième ventricule (21.05%). L’évaluation de la qualité de l’exérèse tumorale a montré 61.11% d’exérèse complète contre 38.89% d’exérèse partielle. D’un point de vue neuropathologique l’Ependymome a été la tumeur la plus fréquente (21.05%) et la majorité des tumeurs était bénigne ou à faible potentiel évolutif. La mortalité globale liée aux tumeurs intraventriculaires a été de 21.04% (4 cas) avec une mortalité opératoire à 10.52% (2 cas).Conclusion: Ce travail portant sur les tumeurs intraventriculaires dans leur ensemble semble être le premier effectué en Afrique subsaharienne. Malgré leur siège ces tumeurs sont souvent curables lorsque le diagnostic est posé précocement. L’exérèse tumorale complète doit être tentée autant que possible(en) Aim: to report our experience about intraventricular tumors.Methods: Descriptive retrospective and analytic study directed on a sample of 19 subjects treated from january 1994 to december 2004. Diagnostic evaluation was made pby using CT- scan and the neuropathological study of the operative pieces. Paraventricular tumors were excluded.Results: We undertook a retrospective study of the 19 patients :12 males and 7 females (sex ratio 1.75). The average age was 19 years old ( 2 to 52 years old) with high frequency between 20 and 29 years old. The increase of intracranial pressure syndrom was the mostly frequent diagnostic circonstance (89.4%) and 78.4% of the patients carry hydrocephalus. The CT- scan was tested to all cases. Lateral ventricles were the mostly affected anatomic site (52.63%), follow by the third ventricle (26.32%) then the 4th ventricle (21.05%). The evaluation of tumoral resection quality shows 61.11% of complete resections versus 38.89% of partial resections. Ependymoma was the most frequent tumor (21.05%) and the majority of them were potentially benign. Global death mortality was 21.04% (4 cases) with a death rate during surgery of 10.52% (2 cases).Conclusion: Despite their localisation, intraventricular tumors can be cured if the diagnosis is made early. Complete resection should be done.info:eu-repo/semantics/publishe

A case of non traumatic cercical extradural hematoma

(fr) L’hématome extradural cervical spontané est une pathologie rare mais une sévère cause de compression médullaire. Il requiert un diagnostic et une prise en charge urgents. Nous en rapportons un cas chez une patiente de 20 ans sans antécédent pathologique, révélé par un syndrome de compression médullaire cervical sévère (grade A de Frankel). Une décompression neurochirurgicale est intervenue avec un délai de 48H avec comme corollaire de lourdes séquelles. Les auteurs insistent sur l’intérêt d’un diagnostic et d’une prise en charge précoces pour en minimiser les séquelles neurologiques.(en) Spontaneous cervical extradural hematoma is a rare pathology but a severe spinal cord compression cause.We report a case revealed by a severe spinal cord compression (Frankel rank A) in a 20 old female patient without past medical history. A neurosurgical decompression has been performed 48 hours later which result of important after-effects. The authors insist for the early diagnostic and treatment to minimize neurological deficits.info:eu-repo/semantics/publishe