Ocular motor nerve palsy in patients with diabetes: High-resolution MR imaging of nerve enhancement.

OBJECTIVE: To evaluate the extent of signal abnormality in impaired ocular motor nerves using high signal and spatial resolution MRI sequences and to discuss the involvement of inflammatory or microvascular impairment in patients with diabetic ophthalmoplegia. METHODS: We conducted a retrospective study of 10 patients referred for acute ocular motor nerve palsy in the context of diabetes mellitus from September 15th, 2021 to April 24th, 2022. 3T MRI evaluation included diffusion, 3D TOF, FLAIR, coronal STIR and post-injection 3D T1 SPACE DANTE sequences. RESULTS: Ten patients were included: 9 males and 1 female aged from 46 to 79 years. Five patients presented with cranial nerve (CN) III palsy, and 5 presented with CN VI palsy. Third nerve palsy was pupil-sparing in 4 patients and pupil-involved in 1 patient. Pain was associated in all patients with CN III deficiencies and in 2 patients CN VI deficiencies. In all patients, MRI sequences ruled out mass effect and vascular pathology, such as acute stroke or aneurysm. Eight patients presented with STIR hypersignals, some with enlargement of the involved nerve. The diagnosis was confirmed through a post-injection 3D T1 SPACE DANTE sequence, which showed extended enhancement along the abnormal portion of the nerve. CONCLUSION: High-resolution MRI evaluation of diplopia in diabetic patients is used to rule out a diagnosis of acute stroke and contributes to the positive diagnosis of ocular motor nerve impairment, possibly combining the influences of inflammatory and microvascular phenomena. Dedicated MR imaging should be included in the initial diagnosis and longitudinal follow-up of patients with diabetic ophthalmoplegia.

[Metastasis of breast cancer in frontal meningioma]. / Localisation secondaire d'un cancer du sein dans un méningiome frontal.

The authors report a case of metastasis from a breast cancer located in a frontal meningioma. A review of the literature revealed 43 cases of primary intracranial tumours containing a secondary from an unrelated extracranial primary malignant tumour; in 34 of these cases the intracranial tumour invaded was a meningioma.

[The association of 2 histologically different neuroepithelial tumors]. / Association de deux tumeurs neuro-épithéliales histologiquement différentes.

The association of two primary brain tumours is seen in phacomatoses. Tumours may also be induced by radiotherapy or a primary tumour may be associated with a secondary tumour. The presence of two histologically different primary neuro-epithelial tumours in a subject with no particular medical history appears to be very rare with a undefinable frequency.