[Pseudo-autoinflammatory attacks of temporal arteritis]. / Manifestations d'allure auto-inflammatoire d'une maladie de Horton.

INTRODUCTION: Usually, temporal arteritis progresses as a chronic disease. CASE REPORT: The authors report the observation of a 74-year-old woman who presented with two acute flares of temporal arteritis with headache, fever and inflammatory syndrome, which have spontaneously resolved. DISCUSSION: The observations of auto-inflammatory attacks of arteritis disease are rare, but maybe underestimated. The pathophysiology remains unclear.

[Troponin and other markers of myocardial ischemia injury, what is the relevance in internal medicine?]. / La troponine et les autres marqueurs de souffrance myocardique, quelle signification en médecine interne?

PURPOSE: Troponin is now the gold standard for the diagnosis of myocardial infarction. Aiming at improving the management of a patient suspect of an acute coronary syndrome, this article will point the interpretation of troponin dosages according to the clinical presentation and concomitant diseases. ACTUALITIES: First, the interest of troponin dosage as compared with other markers of myocardial ischemia will be underlined. Then, the literature available about troponin in cardiovascular diseases but also in extracardiac diseases will be analysed. Finally, the difficulties of assay will be discussed. PERSPECTIVES: The availability of a sensitive and specific marker such as troponin is definitively a progress in the management of patients with an acute coronary syndromes. But it remains a biological contribution to the global management of the patient. It is important to know the causes susceptible to increase the levels of troponin to avoid a wrong interpretation of the dosage, leading to diagnostic but also therapeutic mistakes.

[Thrombosis of the cerebral veins. X-ray computed tomography and MRI imaging. 11 cases]. / Thrombose des veines cérébrales. Imagerie TDM et IRM. 11 cas.

11 cases of cerebral venous thrombosis in adults are reported. Main clinical signs are: intracranial hypertension (headache, nausea, papilledema in 7 cases, loss of consciousness in 6 cases, neurological deficit in 6 cases, seizure in 4 cases. 1 patient is dead, who did not receive heparin treatment. Delay before diagnosis is between 2 and 20 days, and is shortened when arteriography or MRI are available and prescribed. At least one (or several) CT examination was performed in 10 patients. Direct signs of thrombosis are uneasily detected without contrast injection, seen here in 4 cases. Empty delta sign is observed in 7 patients, lately in 4 cases, and once only afterwards. Cerebral infarction is visualized in 7 cases over 10. Its features frequently seem evocative for cerebral venous thrombosis: triangularin 4 cases or nodular shape in 3 cases with hemorragic infarct in 7 cases, with bilateral topography in 6 cases, in frontal or central areas in 7 cases. 6 patients had a MRI examination. All cerebral infarctions appeared haemorragical, even at early stages. During subacute period, venous thrombosis is constantly and easily detected by the mean of methemoglobin high signal intensity on T1 weighted images. The prediagnosis delay is short, without necessity of arteriography. MRI should take the place of CT and arteriography in investigation of a clinically suspected cerebral venous thrombosis.

[Radiological aspects of acoustic neurinoma]. / Les aspects radiologiques du neurinome du VIII.

For a long time CT constituted the technique of choice for the investigation and pretreatment staging of acoustic neuroma. It is sometimes inadequate especially for defining the extra-axial site of a tumour or for identifying small lesions. Today, any case of suspected acoustic neuroma should undergo first-line MR studies. MR identifies almost all extra-axial lesions, clearly visualises small lesions and provides a satisfactory pretreatment staging in the majority of cases, acoustic neuroma presents a signal intensity identical to or lower than that of the brainstem with a high intensity signal on T2-weighted SE sequences and post-gadolinium T1-weighted SE sequences, generally with a mixed intra- and extra-meatal location and eccentric in relation to the anterior border of the porus.

[Rare tumors of the cerebellopontine angle]. / Tumeurs rares dans l'angle ponto-cérébelleux.

Tumours of the cerebellopontine angle are essentially benign in adults, are generally treated surgically and require a preoperative assessment as precise as possible. MRI simplifies the diagnostic assessment; it is indicated as the first-line investigation and is usually sufficient whenever a tumour of the posterior cranial fossa is suspected. Acoustic neuromas represent 75% of all tumours of the cerebellopontine angle. Other tumours are rare and essentially consist of meningioma, detected in 10 to 14% of cases and cholesteatoma in 1 to 5% of cases. Cholesteatoma, with a pathognomonic appearance, must be distinguished from arachnoid cyst. Other tumours are exceptional. The authors define the diagnostic criteria based on their experience and present a recent review of the literature.

[Hemangiopericytoma. Apropos of a case]. / Hémangiopéricytome. A propos d'un cas.

Haemangiopericytomas are ubiquitous tumours with an equivocal clinical and radiological expression. They generally have a slow course and the lesions are usually revealed by a non-specific mass effect on adjacent structures. The authors report a case of subcutaneous haemangiopericytoma of the elbow which presented clinically as a vascular malformation. Amongst the various imaging techniques performed, only arteriography defined the vascular nature of the lesion and should have suggested the diagnosis of haemangiopericytoma on the basis of classically described specific signs. Instead of preserving the muscular environment, the surgical resection had to be extensive because of the poorly determined malignant potential of the tumour.