[Post-traumatic carotid cavernous fistula: report of two cases]. / Fistule carotido-caverneuse post-traumatique: à propos de deux cas.

Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The authors reported the clinical presentation and therapeutic procedure of two cases. The physician has to be aware of this diagnosis when a patient is referred for a posttraumatic exophthalmia. The medical behaviour is multidisciplinary (ENT, ophthalmologist, radiologist and neurosurgeon). The imaging of choice is the angiography but angio-MRI and angio-CT can help to confirm the diagnosis. The endovascular embolization is the treatment of choice. It presents an acceptable risk of complication and a low risk of failure. In this paper the authors report 2 posttraumatic CCF cases treated with success by endovascular embolization.

[Cranial nerve functional neurosurgery: evaluation of surgical practice]. / La neurochirurgie fonctionnelle des nerfs crâniens Evaluation de l'activité

We report the results of an investigation carried out on the activity of functional neurosurgery of the cranial nerves in the French-speaking countries, based on the analysis of a questionnaire addressed to all the members of the SNCLF. Eighteen centers responded to this questionnaire, which showed that activities and indications varied greatly from one unit to another. The results appear homogeneous and comparable with those reported in the literature. The questionnaire sought to provide a global perspective, open to the comments and questions of all responders on the various techniques raised, with the objective of establishing a common decisional tree for these pathologies and providing if possible to a consensus for better dissemination of these therapies.

[Spinal cord compression by arachnoid cysts]. / Compression médullaire par kystes arachnoïdiens.

Spinal arachnoid cysts are considered to be rare entities, intradural locations are even less common. We report two cases of patients (two women aged 77- and 21-year-old) who presented spinal cord compression by intradural arachnoid cysts. For the second patient, repeated surgical procedures were necessary to improve the neurological status. After presenting the case reports, we expose the pathophysiological mechanisms and clinical features, and the surgical difficulties of treating this rare cause of spinal cord compression.

[Paraplegia and the sitting position]. / Paraplégie et position assise.

The sitting position in neurosurgery may lead to complications such as air embolism and neurological complications. We report the case of a 16-year-old male who suffered from post-operation paraplegia after surgery for Arnold Chiari disease. This patient had several risk factors and serious morphological spinal abnormalities. We propose to include monitoring of somatosensory evoked potentials (SSEP) during this surgery in order to detect this type of devastating incident.

[Primary dural lymphoma. A case report]. / Lymphome méningé primitif.

Primary central nervous system lymphoma is an invasive disease in both HIV-positive and HIV-negative patients. Atypical presentations, including leptomeningeal involvement often described in cases with aggressive histology, have been reported but primary meningeal B-cell lymphoma appears to be very rare. A 40-year-old immunocompetent man developed a voluminous frontoparietal cranial vault tumor. The neurology examination demonstrated a large extra-axial mass involving the anterior part of the superior longitudinal sinus. The tumor extended through the cranial vault, without osteolysis, and grew in the subcutaneous tissue. Craniotomy was performed and the entire mass was resected without neurological deterioration. Pathology reported B-cell lymphoma. No other localization was found. Primary B-cell meningeal lymphoma, as illustrated in this case, can be another atypical presentation of CNS lymphoma.

[Neuronavigation in third ventricle tumors]. / Tumeurs du troisième ventricule et neuronavigation.

The authors present the results of neuronavigation as a help to open neurosurgery for the tumors of the third ventricle. From January, 1995 to August, 1999, six image-guided surgical procedures were performed to remove third ventricle lesions : 4 colloïd cysts, 1 ependymoma, and 1 craniopharyngioma. The operative approach was transcortical in 5 cases, and transcallosal in 1 case. The use of neuronavigation allows a decrease of the surgical trauma during the surgical approach. The procedure secures the neurosurgeon in the choice and execution of his pathway to the target. It becomes however less accurate after opening the ventricle, because of the brainshift induced by the loss of cerebrospinal fluid becomes important. Nevertheless, neuronavigation is useful in the surgery of the third ventricle, especially if it is used with neuroendoscopy.

[An unusual cranial vault tumor: the chondromyxoid fibroma]. / Une tumeur osseuse rare de la voûte crânienne: le fibrome chondromyxoïde. À propos d'un cas et revue de la littérature.

Chondromyxoid fibroma is an uncommon benign bone tumor of cartilaginous origin. It is often located in long bone metaphysis. We report a case involving the left frontotemporal cranial vault in a 44-year-old woman. Fifteen cranial vault cases have been reported in the international literature. Surgical resection of the lesion with tumor-free margins is the key factor to cure it and avoid local recurrence.

[Intramedullary tuberculoma of the conus: a case report]. / Tuberculome du cône médullaire: à propos d'un cas et revue de la littérature.

Tuberculomas of the spinal cord are rare. The objective of this study was to illustrate the diagnosis and treatment of tuberculomas of the conus medullaris. They must be suspected in patients with a clinical context and a typical spinal cord mass lesion. Treatment is primarily medical. Surgery is reserved for cases of rapid neurological deterioration or doubts concerning the diagnosis. We report a case of intramedullary tuberculoma of the conus in a 27-year-old woman with paresthesias and weakness of the lower limbs who had been treated for pulmonary tuberculosis. The spinal MR showed a characteristic intramedullary ring-enhancing lesion. She improved neurologically one month after the beginning of the antituberculous drugs and a laminectomy. Seven months later, the patient is asymptomatic and the lesion has nearly completely disappeared completely.

Microsurgical DREZotomy for pain due to brachial plexus avulsion: long-term results in a series of 37 patients.

The authors analyzed the postoperative and long-term results of the microsurgical DREZotomy procedure performed in 37 patients suffering from chronic pain due to brachial plexus avulsion. The evaluation was based on clinical parameters. The immediate results consisted of good pain relief (pain relief > 75%) in 79% of the patients. A long-lasting good pain relief has been achieved in 66.5% of the patients with a mean follow-up of 60 months (range 12-120). The morbidity rate was 5%.