[Intracranial meningioma in an infant. Report of a case]. / Méningiome intracrânien du nourrisson. A propos d'une observation.

We report a case of a benign temporal meningioma in 1 month old infant. The diagnosis was revealed by atypical seizure. The physical exam was normal. We underline the epidemiological, clinical and prognostic aspects of this condition.

[Hydatid cyst of the spine and spinal cord. Study of 24 cases]. / Hydatidose vertébro-médullaire. Etude de 24 cas.

In this retrospective study, we report our experience of severe hydatid disease located to the spine and the adjacent spinal cord observed in 24 cases between 1970 and 1994. In our series the sex ratio was predominant for males, and the mean age was 29 years. Clinically, the patients presented predominantly with a motor deficit. The diagnosis was assessed on radiological and biological investigations and was confirmed preoperatively. Hydatid serology was positive in 7 out of the ten cases explored. On standard X rays, the bone lesions were frequent: lysis in 10 cases, vertebral deformation in 3 cases, costal invasion in 5 cases, and paravertebral collection in 2 cases. These lesions were predominantly located at the thoracic level. Myelography confirmed a complete blockade in 8 out of 11 cases. When possible, the CT scan confirmed the bone lesion in all of the 10 cases explored, with an intrathecal cyst in 7 cases and a paravertebral collection in 8 cases. Magnetic resonance imaging was possible in one case only. Medical antihelminthic treatment was indicated as the sole treatment in one inoperable case. All the other patients were operated on, and the adjunctive specific medical treatment was associated in 5 cases. Using a posterior approach in 20 cases, the operative technique consisted in a complete removal (if possible) of the invaded bone and soft tissue, thus achieving a complete relief of the spinal cord compression. Complementary bone fixation was indicated in 2 cases. During the postoperative follow-up, two patients died from infection and trophic ulceration, 11 patients improved and 8 patients remained unchanged. In 5 cases, a reoperation was indicated and performed from 2 to 4 times. Three patients were lost for follow-up. The severity of this affection is confirmed in the literature. A complete recovery is quite exceptional. The best treatment remains an active nationwide prevention of the disease.

[Thoracic medullary epidermoid cyst. Apropos of a case with MRI and review of the literature]. / Kyste épidermoïde médullaire dorsal. A propos d'un cas avec IRM et revue de la littérature.

We report the case of a 14 year-old patient presenting with a thoracic spinal cord compressing syndrome (T5-T6). The myelography and magnetic resonance imaging showed an intramedullary cystic mass. One year after the surgical excision of the capsule and an easy aspiration of the tumoral content, this patient had a good neurological recovery.

[Anal migration of ventriculo-peritoneal shunt catheter. Apropos of 3 cases]. / Migration anale du cathéter de dérivation ventriculo-péritonéale. A propos de 3 cas.

Three cases of abdominal catheter migration through the anus following ventriculo-peritoneal shunt are described. Two cases involved hydrocephalus secondary to tuberculous meningitis and the third myelomeningocele. Among the reasons for migration, the length of the abdominal catheter, trauma during the operation and infection must be taken into consideration. One patient was suffering from meningitis at the time of admission, while the two others were asymptomatic. Treatment involved removing the peritoneal catheter in 2 cases and the entire shunt system in the patient with meningitis. The shunt was replaced one to two weeks later. The outcome was favourable in all three cases.

[Multiple and bilateral cerebral hydatid cysts. A case]. / Kystes hydatiques cérébraux multiples et bilatéraux. Une observation.

The authors report one case of multiple and bilateral cerebral hydatic cysts in a eight years old child. The disease was revealed by cranial hypertension signs, with homonymous hemianopsia. The diagnosis was based on the cerebral CT scan, and confirmed by surgical operation which was performed in two stages. The evolution was uneventful.

[Intra-orbital hydatid cysts. 10 cases]. / Kystes hydatiques intra-orbitaires. 10 cas.

Ten cases of intra-orbital hydatid cysts were operated from January 85 to December 91. The aim of this retrospective study is to show the importance of this pathology with regard to other intra-orbital expansive processes and to discuss the efficiency of neurosurgical approaches. The mean age was 25 years, with 5 women and 5 men. The symptoms consisted in progressive unilateral exophthalmia in 8 cases and acute one in 2 cases. Visual deterioration was observed in 7 cases: a reduced vision acuity in 6 cases and blindness in one case. Fundus oculi showed papillary oedema in 4 cases and optical atrophy in one case. Slight disturbance of ocular mobility was observed in 5 cases. CT Scan gave positive diagnosis and predicted the hydatid nature in 9 cases. Fronto-orbital approach, taking away the squamous portion of the frontal bone, orbital arc and roof, was made in 9 cases. It permitted to remove the cyst without rupture of the capsule in all cases. Fronto-temporal approach was used in one case. The evolution was excellent after 8 months to 6 years in 4 patients. Five patients were improved with reduction of exophthalmia, stabilisation of visual acuity and eye movements. Blindness remained unchanged in one patient.

[Cerebral hydatid cyst. Apropos of 48 cases]. / Le kyste hydatique cérébral. A propos de 48 cas.

From a study of 48 cases of intracranial hydatid cysts operated on, we describe the clinical and prognostic aspects of this disease. This localisation is more prominent in children. The clinical picture is dominated by the symptoms of increased intracranial pressure (96%) and the neurological manifestations (77%). The immunological data have little diagnostic value. The brain scanning is for us the most valuable diagnostic tool. The treatment is only surgical and the prognosis is good after the one piece enucleation by the Arana-Iniguez procedure.