Transcranial sonographic measurement of the third ventricle to detect hydrocephalus in children population: Correlation to computed tomography.

BACKGROUND: In neuro-intensive care, transcranial temporal ultrasound is used in adults and children to monitor brain-injured patients. It is accepted as a valuable tool for exploring brain structures. Our study aims to establish a correlation between the measurement of the third ventricle (V3) by transcranial ultrasound via temporal window and a reference method, computed tomography (CT), which could validate the method for hydrocephalus detection in the children population. DESIGN: This is a prospective double-blind study of 34 children under 15 years. Two consultants in intensive care performed the ultrasound while a radiologist performed the CT measurements. RESULTS: Of the 34 patients included, the V3 could be measured in 88% of cases. Among these 30 patients, there is a good correlation between CT and ultrasound measurements with a Spearman correlation coefficient of 0.773. This correlation is more important as the diameter of the V3 increases. We could determine a threshold of 3.65 mm in diameter to identify hydrocephalus on ultrasound with a detection sensitivity of 100%, and a specificity of 94.1%. CONCLUSION: Measuring the diameter of the V3 by trans-cranial sonography remains a simple, reproducible, non-invasive tool and has a good correlation with reference examinations such as CT.

Inoculum effect of Enterobacterales co-expressing OXA-48 and CTX-M on the susceptibility to ceftazidime/avibactam and meropenem.

BACKGROUND: The treatment of infections caused by OXA-48/CTX-M-coproducing Enterobacterales may be based on new beta-lactam/beta-lactamase inhibitors, such as ceftazidime/avibactam (CZA), or on high dose of meropenem (MER). However, bacterial density at the infection site may vary widely, and the inoculum effect of such antimicrobial strategies has never been specifically investigated. To determine if CZA or MER susceptibilities are impacted by high inocula of Enterobacterales co-expressing both enzymes: OXA-48 like and CTX-M. METHODS: Determination of an inoculum effect was performed with a standard inoculum of 108 CFU/mL (0.5 McFarland) as recommended by EUCAST guidelines and compared to a twofold increase as well as a tenfold increase (1 McFarland and 5 McFarland respectively). RESULTS: Thirty-nine isolates of ceftazidime-resistant Enterobacterales were included of which 27 (70%) co-expressed OXA-48 + CTX-M-15, 6 (15%) OXA-48 + CTX-M-14, and 6 (15%) OXA-181 + CTX-M-15. The susceptibility to the CZA combination was preserved whatever the inoculum used. Regarding MER, 24 (61.5%) of the isolates were susceptible to MER with the standard inoculum, 19 (48.7%) with a twofold increase, and only 15 (38.5%) with a tenfold increase. CONCLUSION: We showed that in vitro inoculum effect was observed with meropenem but not with CZA for OXA-48- combined with CTX-M-producing Enterobacterales.

Cherubism: a rare case report with literature review.

Cherubism is an autosomal dominant disorder caused by a mutation of the gene encoding the binding protein SH3BP2. However, non-hereditary forms are observed, probably related to a de novo mutation. It is clinically manifested by an enlargement or a deformation of the jaw associated with a malposition of the teeth. In severe forms, these deformations can have a psychological impact, associated with ocular complications, as well as a reduction of the pharynx lumen and phonation disorders. The appearance of the lesions on imaging is not very specific, however it remains essential for the mapping of the lesions. We report a case of cherubism in a 12-year-old boy with no family history. This case report's objective is to identify the radiological aspect of this pathology and establish an early diagnosis to oriented therapeutic interventions.

Eye of the Tiger Sign in Pantothenate Kinase-Associated Neurodegeneration.

Pantothenate kinase-associated neurodegeneration (PKAN) is a rare disorder associated with brain iron accumulation caused by a recessive mutation in pantothenate kinase 2 gene (PANK2). We present a case of an 11 year-old boy presenting extrapyramidal signs and developmental regression. T2-weighted images showed the classic eye of the tiger sign seen in pantothenate kinase-associated neurodegeneration.

[Telangiectatic osteosarcoma of the scapula: a case report]. / Ostéosarcome télangiectasique de l'omoplate.

Telangiectatic osteosarcoma is a rare entity and rarely involves flat bones. The authors report the case of a 4 year old child, with a four month history of progressive left shoulder swelling. Radiographs and CT of the left shoulder revealed a large lytic lesion with cystic areas of the scapula, simulating the appearance of an aneurysmal bone cyst. Surgical biopsy was performed and showed telangiectatic osteosarcoma.

[Unusual appearance of axillary lipoblastoma of infancy]. / Aspect inhabituel d'un lipoblastome axillaire chez un nourrisson.

Lipoblastoma is an uncommon benign soft tissue tumor of infancy and early childhood with a predilection for the extremities. CT and MRI can confirm the presence of fat components in the tumor. In addition, MRI better shows the anatomical extent. By showing lipoblastoma proliferation, histology confirms the diagnosis. Gross total excision is the treatment of choice. The authors report a case of unusual lipoblastoma of the axillary region, composed of fatty components with multiple cystic areas presenting at birth, with recurrence 9 months after excision.

[Rare cause of ischemic cerebrovascular infarct in a young patient: cardiac hydatic cyst]. / Cause rare d'accident vasculaire cérébral ischémique chez le sujet jeune: le kyste hydatique cardiaque.

The authors report the case of a 28-year-old man in whom the diagnosis of hydatic cyst of the heart was strongly suspected on echocardiography and CT-scan and confirmed by surgery. The interest of this case is based the total clinical latency of this hydatic cyst discovered by echocardiography during a systematic checkup for cerebrovascular disorders. Echocardiography and spiral scanography with bidimensionnal reconstruction in coronal and sagittal planes allowed a rapid anatomic and topographic diagnosis. CT-scan also identified spread of echinococcosis and discovered a calcifield hydatid cyst of the liver and a multivesicular hydatid cyst of the left kidney.

[Acute non-traumatic mediastinitis]. / Médiastinite aiguë non traumatique.

UNLABELLED: Acute mediastinitis is uncommon. When it occurs, it usually follows an esophageal perforation or thoracic surgery. CASE REPORT: We report on a case of a ten-year-old girl with non traumatic mediastinitis secondary to a pleuro-pulmonary infection due to Klebsiella pneumoniae.

[Cholestatic icterus due to primary duodenal lymphoma]. / Ictère cholestatique révélant un lymphome duodénal primitif.

Primary lymphoma of the duodenum presenting with obstructive jaundice is a rare entity. We report a case of primary non-Hodgkin lymphoma of the duodenum producing biliary obstruction, definitively diagnosed by ultrasound-guided fine needle biopsy. Complete remission of the disease occurred after chemotherapy.

[Metatropic dysplasia: two cases in siblings]. / La dysplasie métatropique : à propos de deux frères.

Metatropic dwarfism is a rare heritable skeletal dysplasia. We report on two brothers, 4-month-old and 9-year-old, affected by the disease. Clinical and radiological features of the disease at different ages are discussed. Prenatal diagnosis is possible by ultrasonography. No treatment is available. Prevention by genetic counselling remains the principal possible assistance to high risk families.

[Prenatal semiology of diastematomyelia]. / Séméiologie anténatale des diastématomyélies.

Diastematomyelia is a rare spinal malformation characterized by a division of the spinal cord. More often, the two hemicords are separated by a midline and sagittal osseous or fibrocartilaginous spur. In this report we describe two cases of diastematomyelia detected at routine second trimester detailed sonography and further assessed by MRI and spiral CT with surface shaded 3D-reconstructions. In addition to providing diagnosis, prenatal evaluation helps differentiate between diastematomyelia with good or bad prognosis.

[Tuberculosis of the breast: a case report]. / Tuberculose mammaire: à propos d'un cas.

Tuberculosis of the breast is rare. It occurs in young women. Because the clinical and imaging findings are non specific, the diagnosis of a breast cancer is often suggested. This requires to obtain cytology and/or histology for a definitive diagnosis. On the basis of a case report of tuberculosis of the breast in a 14 years old girl, imaged by ultrasonography and computed tomography, we attempted to demonstrate the contribution of imaging and associated diagnostic pitfalls.

[Value of MRI in the diagnosis of unilateral optic nerve aplasia: a case report]. / Intérêt de l'IRM dans le diagnostic de l'aplasie unilatérale du nerf optique: à propos d'un cas.

Optic nerve aplasia is a rare congenital anomaly consisting of complete absence of the optic disc and nerve, ganglion cells and nerve fibers, and retinal blood vessels. Optic nerve aplasia may be associated or not with anomalies of the eye ball, and may be unilateral or more rarely bilateral, the latter sometimes associated with major central nervous system anomalies. We report the MRI appearance of a case of unilateral optic nerve aplasia associated with microphthalmos. Coronal T2 weighted and 3D T1 weighted images disclosed the absence of the 3 portions of the optic nerve. This observation shows the usefulness of systematic MRI in case of microphthalmos associated with suggestive anomalies of the fundus.

[Paraganglioma and pregnancy]. / Paragangliome et grossesse.

A paraganglioma is an extra-adrenal pheochromocytoma, rarely observed during pregnancy. Maternal prognosis depends on early diagnosis and multidisciplinary management prior to tumor resection. The tumor is localized by ultrasonography or MRI. During the post-partum, and if MRI is not available, CT is often sufficient. We report a paragangliona in a patient with intrauterine fetal demise at 27 weeks gestation diagnosed by ultrasonography and computed tomography, who underwent surgical resection.

[Emergency ultrasound diagnosis of ovarian torsion in children : nine case reports]. / Diagnostic échographique en urgence d'une torsion de l'ovarie chez l'enfant: à propos de neuf observations.

OBJECTIVE: To report the ultrasonographic aspects of ovarian torsion in nine pediatric cases. PATIENTS AND METHODS: The age range was from 16 months to 14 years. The patients presented with a variety of symptoms, including pain in the site of torsion. Ultrasonography was performed in all patients, and color Doppler studies in four. RESULTS: Ultrasonography showed a cystic mass in six patients, a solid mass with peripheral cysts in two patients and an adnexal cyst in one patient. Color Doppler revealed absence of flow in three patients. The patients were treated by coeliosurgery. CONCLUSION: Ovarian torsion is a serious gynecologic emergency. Torsion is rare during childhood and has a non-specific clinical presentation. Ultrasound and Doppler are the imaging study of choice. The ovarian salvage was attributable to the combination of delay in patient presentation and surgical delay.

[Pericardial hydatid disease: three case reports]. / Hydatidose péricardique: à propos de 3 observations.

Hydatid disease of the heart is very rare, representing about 0.2 to 2% of all cases. Most hydatid cysts of the heart are located within the left ventricular wall. Pericardial location is also very rare and patients present with various symptoms. US and CT have a primary role in the diagnostic workup of this disease.

[Spinal intradural hydatid cyst. A case report]. / L'hydatidose intradurale rachidienne à propos d'un cas.

The authors report the case of a 13-year-old girl in whom the diagnosis of intradural hydatid cyst was suspected on CT scan and MRI and confirmed at surgery. The interest of this case is related to the extremely rare location and its severe prognostic. CT scan and MRI can easily make an anatomic and topographic diagnosis of the intradural hydatid cyst.

[Post-traumatic hepatic artery pseudoaneurysm. A case report]. / Faux anévrisme post-traumatique de l'artère hépatique. A propos d'une observation.

CASE REPORT: We report a case of traumatic hepatic artery pseudoaneurysm in a 9-year-old child. The diagnosis was made by duplex sonography and helical CT angiography. Arteriography confirmed and managed the lesion with transcatheter embolization. CONCLUSION: The traumatic hepatic artery pseudoaneurysm is an uncommon complication of liver trauma in children whose diagnosis is made by duplex sonography and CT angiography. Endovascular embolotherapy is the treatment of choice.

[Subcapsular hematoma of liver during pregnancy: report of 4 cases]. / Hématome sous-capsulaire du foie et grossesse: à propos de 4 observations.

A Subcapsular hematoma of the liver is a rare but very serious complication of pregnancy. Diagnosis is confirmed at imaging (Ultrasound, CT, MRI) since clinical symptoms are not specific and biological signs have a delayed manifestation. The management of this complication depends on the integrity or rupture of Glisson's capsule. We report the cases of 4 patients and review of the literature.