Asymptomatic Dandy-Walker syndrome in an adult

This 34 years old man presented with moderate and persistent headache occurring 48 hours following Benin head injury. There were no symptoms of increased intracranial pressure. Neurological examination was unremarkable without cerebellar ataxia or psychomotor retardation .the patient was submitted to CT scan and magnetic resonance imaging (MRI) of the brain that revealed agenesis of cerebellar vermis and large posterior fossa cyst communicating with the enlarged fourth ventricle suggestive of Dandy-Walker malformation without hydrocephalus. He was managed conservatively and he is doing well following 2 years ago. The Dandy-Walker syndrome (DWS) is a rare posterior fossa malformation and more rarely observed in adults. This case is unique in that the patient has been entirely asymptomatic with this abnormality since birth. The preserved cortical cytoarchitecture and the rarity of additional neurodevelopmental changes in DWS adults may explain the mild or absence of clinical expression, compared with DWS infants

Intracerebral hemorrhage complicating viral hepatitis A

The 11-year old girl presented a diagnosis of viral hepatitis A confirmed by anti-HVA IgM. Eight 8 weeks after, she developed hemorrhagic syndrome coupled with fever associated and persistent jaundice. The blood count showed aregenerative pancytopenia secondary to aplastic anemia confirmed by bone marrow biopsy. During conditioning for allogenic bone marrow grafts, the patient developed generalized seizures revealing disseminated intracerebral hemorrhage (pictures). There was a favorable outcome after blood transfusions and resuscitation. Hematological complications in hepatitis A are rare. Although intracerebral hemorrhage resulting from Hep A has never been reported in the literature; its occurrence is directly correlated with the degree of thrombocytopenia due to aplastic anemia. The prevalence of aplastic anemia in viral hepatitis is estimated at 0.1%. This complication implies systematic hematological evaluation in cases of viral hepatitis A; especially in severe forms or those associated with involving cholestasis.Pan African Medical Journal 2015; 2

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

Benign chondroid syringoma of the orbit: a rare cause of exophtalmos

Chondroid syringoma (CS) of the orbit is an extremely rare benign neoplasm. To the best of our knowledege, this is the second case reported in the english litérature