Spontaneous spinal epidural hematoma in a 22-month-old girl.

The authors report the case of a 22-month-old girl who developed cervical pain, neck stiffness, and quadriparesis over 12 days. An epidural hematoma was removed, with complete recovery after 6 months. There was no history of trauma. A search of the literature revealed eight previous cases of spontaneous spinal epidural hematomas in children under the age of 10 years.

[Cerebral atrophy and chronic alcoholism]. / Atrophie cérébrale et alcoolisme chronique.

Fifty chronic alcoholic male patients, were investigated to determine characteristics of alcohol intoxication, neurologic and hepatic complications and degree of cerebral atrophy by CT. CT imaging criteria for definition of alcoholic cerebral atrophy are proposed, discussed and compared with those previously reported. Findings showed that alcoholic cerebral atrophy is added to atrophy due to age and is in correlation with the duration of intoxication. It appears after 40 years of age and increases progressively in parallel with polyneuropathy, cerebellar disorders and dementia. It appears to progress independently of the hepatic lesions.

[Neurologic complications of vaccination against rabies. Magnetic resonance imaging in 1 case]. / Les complications neurologiques de la vaccination anti-rabique. Imagerie par résonance magnétique dans un cas.

On the basis of case well documented by CT and NMR, the authors describe the nature, course, pathology and pathogenesis of neurological disorder consecutive to the use of rabies vaccines prepared from animal brains. The new vaccines obtained by the tissue cultures have completely suppressed the neurological risk.

[Acute polyradiculoneuritis and toxoplasmosis]. / Polyradiculonévrite aiguë et toxoplasmose.

A patient developed acute polyradiculoneuritis during the course of a recent infection due to toxoplasma. A cause/effect relation is discussed and appears likely. A review of 3 published cases failed to determine any specific clinical features of the polyradiculoneuritis. Serology for toxoplasmosis should be included in the etiologic investigations of apparently primary Guillain-Barré's syndrome.

[Spontaneous giant intramural hematoma of the esophagus. Apropos of a case]. / Hématome géant intra-mural spontané de l'oesophage. A propos d'un cas.

Spontaneous esophageal hematoma is rare, occurring in a context of high esophageal pressure with abnormalities of hemostasis in some cases. We report a case involving the whole length of the esophagus with no evidence of any etiologic factor. The value of CT Scan is reviewed comparatively with esophageal barium examination and endoscopy. CT Scan confirms the diagnosis and the absence of true esophageal perforation. The general course monitored by CT scanning is uneventful, even in the case of extensive mucosal lesions. This justifies the nonaggressive attitude advocated by the majority of authors.

[Double contrast radiological exploration of the major duodenal papilla (author's transl)]. / Exploration radiologique de la grande caroncule duodénale en double contraste.

The major duodenal papilla can be outlined in 75% of cases by double contrast examination. It is composed of an oval-shaped nodule covered by a mucous cap which is prolonged into a frenum in its lower part. Its mean dimensions are 11 X 7 X 6 mm. Many variations are observed, and these are analyzed as well as the features suggesting pathological modifications. These may arise from inflammation: during the course of primary or secondary (ulcer, pancreatitis) duodenitis, or be related to a stone blocked in the region of the ampulla. Tumors in this region are rare, and are usually malignant tumors, the characteristics and extension of which can be determined from radiological images. Use of this radiological technique as a preliminary step enables a complete study of the upper digestive tract to be conducted at the same time.

[The value of echography in the early diagnosis of renal lesions in the Laurence-Moon-Bardet-Biedl syndrome. Apropos of a case]. / Intérêt de l'échographie dans le diagnostic précoce des lésions rénales au cours du syndrome de Laurence-Moon-Bardet-Biedl. A propos d'un cas.

The Laurence-Moon-Bardet-Biedl syndrome (LMBB) is characterized by the association of obesity, hypogonadism, polydactyly, mental retardation and pigmentary retinitis. Symptomatic or asymptomatic renal dysplasia (calyceal diverticula, precalyceal tubular ectasia, cysts) is frequently associated with LMBB. The authors consider renal sonography as the convenient investigation for an early detection of such dysplasia as in the case they reported here.

[Value of transfontanelle echography in the diagnosis and surveillance of pericerebral effusions]. / Intérêt de l'échographie transfontanellaire dans le diagnostic et la surveillance des épanchements péricérébraux.

The authors report 3 cases of peri-cerebral fluid collection in infants. They emphasize the importance of anterior fontanelle real-time ultrasonography to set up the diagnosis and for the follow up of these patients. From a technical point of view they recommend the use of a water bag to facilitate the examination.

[Carotid-cavernous fistulas by tearing or rupture of the meningo-hypophysial trunk or of one of its branches. Anatomo-radiologic study of 4 cases. Pathogenic hypotheses]. / Fistules carotido-caverneuses par arrachement ou rupture du tronc méningo-hypophysaire ou de l'une de ses branches. Etude anatomo-radiologique de 4 observations. Hypothèses pathogéniques

Thr authors report observations relative to four cases of traumatic carotid-cavernous fistulas for which angiographic pictures were similar. Autopsy examination permitted in two cases to establish that the tentorial branch of the meningo-hypophyseal trunk was involved in the genesis of both fistulas. One case was from a rupture, the other from tearing of that branch. Further examination of these two cases showed an absence of sphenoid bone fracture which suggested that any arterial perforation or shearing process could be excluded. Thus the pathogenic hypothesis of PARKINSON is further sustained. The authors suggest that the observed arterial lesions may be due to tensions occuring at the proximal part of branches of the meningo-hypophyseal trunk. Such tensions may be carried out through tractions on the posterior meningeal walls of the cavernous sinus when trauma occur on the posterior temporal area and the petrous bone. Such traction forces were shown to be real in one case where a fracture of the dorsum sellae and a bilateral caroti-cavernous fistula were caused by a bilateral temporo-petrous trauma.

[Angiographic signs of extra-dural hematomas of the posterior fossa (author's transl)]. / Aspects angiographiques des hématomes extra-duraux de la fosse postérieure. Formes aiguës et subaiguës.

Traumatic subacute and acute extra-dural hematomas of the posterior fossa are infrequent lesions which can be considered as exceptional From 1973 to 1977, we have collected 12 such cases. We performed 11 carotid angiographies and 7 vertebral angiographies in the series. Only in one case among 5 did clinical signs suggested a lesion of the posterior fossa. One of the best clinical elements to suggest such a lesion is the presence of a fracture line that crosses the lateral sinus, which necessitated a complete angiographic study. Arteriographic signs are function of the topography of the hematoma. The carotid angiography reveals only the supratentorial extension of the extra-dural collection of the blood clot. The most frequent sign is a filling defect of the affected sinus. The classic sign of detachment of the torcular is seen only in about 25% of cases. Vertebral angiography shows the existence of an expanding posteroinferior mass of the posterior fossa. Axial views always permits to find the avascular zone which corresponds to the extra-dural collection of the blood clot. In addition, vertebral angiography permits a good study of the sinusal drainage of the posterior fossa. In the purpose to find a supra-tentorial extension the prognosis of the extra-dural hematoma depends on its early discovery. The procedure of choice to make and to confirm such a diagnosis is vertebral angiography and it is not necessary to perform a carotid angiography in the cases where a supra-tentorial lesion does not seen associated.

[Duodenal leiomyosarcoma. Apropos of a case]. / Léiomyosarcome duodénal. A propos d'une observation.

The authors report a new case of leiomyosarcoma of the duodenum. The exoluminal growth and the volume of this tumor explain the difficulties of the imaging methods diagnostic. Computed tomography, magnetic resonance imaging and angiography were not sufficient to determine the origin of the tumor. Surgical exposure itself was not conclusive and only pathology provided the definitive diagnosis. We think that endoscopic ultrasonography should be indicated in these submucosal tumors of the duodenum to differentiate them from pancreatic neoplasms.

[Double contrast hypotonic duodenography]. / La duodénographie hypotonique en double contraste.

Double contrast hypotonic duodenography, as carried out by the authors, is a simple and rapid examination, suitable for routine use. At the same time, it includes a double contrast study of the oesophagus and stomach. The normal appearance is easily analysed, in particular that of the great caronculus. It is a selective examination of the duodenal outline, playing an essential role in the detection of lesions of the latter as well as in adjacent organs which may alter its shape. It provides only a suggestion as to aetiology and must therefore be completed, when appropriate, by other studies.

[Spontaneous giant intramural hematoma of the esophagus. Apropos of a case]. / Hématome géant intra-mural spontané de l'oesophage. A propos d'un cas.

Spontaneous esophageal hematoma is rare, occurring in a context of high esophageal pressure with abnormalities of hemostasis in some cases. We report a case involving the whole length of the esophagus with no evidence of any etiologic factor. The value of CT Scan is reviewed comparatively with esophageal barium examination and endoscopy. CT Scan confirms the diagnosis and the absence of true esophageal perforation. The general course monitored by CT scanning is uneventful, even in the case of extensive mucosal lesions. This justifies the nonaggressive attitude advocated by the majority of authors.

[Brain stem auditory evoked potentials and chronic alcoholism]. / Potentiels evoques auditifs du tronc cérébral et alcoolisme chronique.

Brain-stem auditory evoked potentials (BAEPs) were obtained from 25 chronic alcoholic patients. The patients had been drinking heavily for an average of 15 years and a minimum of 5 years. All patients were totally abstinent for a minimum of 3 weeks. The morphology of waves were often altered. All presented prolonged I-III, III-V, inter-peak latencies (IPLs) and a loss of amplitude of wave V. The I-III, III-V and I-VIPLs were increased between 30 and 40 years, and III-V and I-VIPLs between 40 and 50 years. The incidence of abnormal BAEPs in patients with alcoholic epilepsy was not different from that of patients without a history of alcoholic seizures. Patients with clinical manifestations of alcoholic polyneuropathy had the highest incidence of abnormal BAEPs. BAEPs are more reliable in chronic alcoholic patients than EEG. The mechanisms of the increase in neural transmission time within the auditory brain-stem are discussed.

[Multiple cerebral tuberculomas. X-ray computed tomographic diagnosis and follow-up: a case]. / Tuberculomes multiples intra-cérébraux. Diagnostic et contrôles tomodensitométriques de l'évolution: un cas.

A 31-year-old man who had never left France, rapidly developed right cerebellar signs accompanied by an alteration of his general condition. CT brain scan showed 7 intracerebral tuberculomas, six of which were asymptomatic. The patient was treated with three anti-tuberculous drugs and steroids, and made a good recovery. The CT changes disappeared. CT brain scan should be performed in patients with extra-cerebral tuberculosis and no CSF abnormalities.

[Retroperitoneal lymphocele: a rarely reported complication of abdominal aortic surgery. Apropos of a case]. / Lymphocèle rétropéritonéale: complication rarement décrite de la chirurgie aortique abdominale. A propos d'un cas.

The authors present a case of a retroperitoneal lymphocele following prosthetic reconstruction of the abdominal aorta followed by a discussion about the principal differential diagnosis of a retroperitoneal collection following surgery on abdominal aorta. To date, only ten cases have been reported in this post-operative; it is probably a more frequent complication; the radiologist must play a major role both in the detection and the treatment of such collections.