[Hydrocephalus due to non tumoral stenosis of foramens of Monro: report of four cases]. / Hydrocéphalie par sténose non tumorale des trous de Monro: à propos de quatre cas.

Non tumoral stenosis of the foramen of Monro is rare; pathogenic mechanisms remain a subject of debate. The narrowing can be unilateral causing monoventicular hydrocephalus, and exceptionally bilateral causing biventricular hydrocephalus. We present two cases of monoventricular hydrocephalus and two other cases of biventricular hydrocephalus. Clinically, all patients had the same signs as in common hydrocephalus. The CT scan and mainly the MRI allowed us to confirm the diagnosis and to avoid tumor obstruction of the foramen of Monro. With neuroendoscopy we were able to describe the foramen of Monro and perform a fenestration of the septum pellucidum. The prognosis is usually good.

[Calcified cerebral hydatid cyst]. / Kyste hydatique cérébral calcifié A propos d'un cas exploré par IRM.

Hydatid cyst is rarely observed in the brain (0.5-4.5%). The frequency of calcified cyst is less than 1%. We present a case of a 15-year-old girl with a 5-year follow-up for grand mal seizures that became resistant to three-drug therapy. The CT scan revealed a calcified parieto-occipital lesion. MRI disclosed a suggestive detached membrane. At surgery, the cyst wall was calcified with typical hydatid sand contents. Since surgery, seizure control has been achieved with one drug. Calcification of a cerebral hydatid cyst is exceptional. MRI enabled the diagnosis in this patient.

[Trapped temporal horn, an unusual form of obstructive hydrocephalus: 5 case-reports]. / Corne temporale exclue, une forme rare d'hydrocéphalie obstructive : à propos de 5 cas.

OBJECTIVE: "Entrapped temporal horn" is an unusual form of obstructive hydrocephalus which is due to an obstacle at the trigone of the lateral ventricle that seals off the temporal horn that may act as a space occupying process. In this study, our aim was to assess the clinical presentation, imaging, pathophysiology and the management of this entity. METHODS: The medical records of patients with entrapped temporal horn diagnosed between January 2003 and December 2012 were reviewed retrospectively. RESULTS: Five patients were identified. In four cases, the condition developed after cranial surgery; an infant having two revisions of a ventriculoperitoneal shunt; an adult operated for a glioblastoma, an infant operated on for cerebral hydatidosis and an infant operated for an occipital encephalocele. In the last patient, the entrapped temporal horn revealed sarcoidosis. CONCLUSIONS: Trapped temporal horn syndrome can act as a space occupying process and requires surgical management. Internal shunting provides good results. However, the long term outcome depends on the etiology.

Multiple spinal metastases from a well-differentiated liposarcoma of the iliac wing: a case report.

STUDY DESIGN: A case report. OBJECTIVES: To report an unusual case of multiple spinal metastases from an undiagnosed well-differentiated liposarcoma (WDLPS) of the iliac wing and to stress the need of a meticulous clinical examination and further screening of patients with chronic and asymptomatic bony lesions. SETTING: University of medicine of Monastir, Department of neurological surgery, Fattouma Bourguiba University Hospital, Monastir, Tunisia and University of Medicine of Tunis EL Manar, Department of neurological surgery, Tunisian National Institute of Neurology, Tunis, Tunisia. METHODS: A 39-year-old man presented with signs of spinal cord compression for the past 2 weeks. His medical history was consistent for an asymptomatic right iliac wing mass that appeared 3 years ago and for which he has not consulted. Magnetic resonance imaging revealed multiple bony lesions of the thoraco-lumbar spine associated with a 6-cm right paravertebral mass at the T4 level extending posteriorly through the intervertebral foramina to the spinal canal causing major spinal cord compression. An emergent T2-T6 laminectomy allowed for a complete resection of the epidural mass. Pathological examination confirmed the diagnosis of well-differentiated liposarcoma. Adjunctive radiation therapy was administered. RESULTS: The patient's neurological status improved remarkably under an intensive care and rehabilitation program. He was ambulatory without assistance in the second postoperative week. CONCLUSION: The case reported in this paper represents a genuine example of the possible metastatic potential of WDLPSs of the bone and underscores the importance of examining patients thoroughly, especially when they have chronic and asymptomatic lesions.

[Management of arachnoid cysts of the middle cranial fossa accompanied by subdural effusions]. / Traitement des kystes arachnoïdiens de la fosse cérébrale moyenne associés à une collection sous-durale.

Subdural effusions are uncommon but known complications of arachnoid cysts of the middle cranial fossa. They mainly occur after minor head traumas in young patients. Here, we report eight cases of arachnoid cyst of the middle cranial fossa associated with subdural hematoma in five cases and hygroma in three cases. Major symptoms are signs of raised intracranial pressure. CT scan and MRI showed the cyst and the subdural effusion. An excellent therapeutic result was achieved with evacuation of the subdural fluid via burr holes in the five cases of subdural hematoma while in the two cases of hygroma a subduro-peritoneal shunt was necessary. In the last case, a temporal craniotomy was performed with evacuation of the hygroma and fenestration of the cyst. We suggest treating only the complicating event in the case of a subdural hematoma via burr holes evacuation. Whereas, in the case of hygroma we think that craniotomy with fenestration of the cyst or the use of a subdural shunt are more often needed.