Difficult intubation in a parturient with syringomyelia and Arnold-Chiari malformation: Use of Airtraq laryngoscope.

Anesthetic technique in parturient with syringomyelia and Arnold-Chiari malformation is variable depending on the teams. Difficult intubation is one of the risks when general anesthesia is opted. Different devices have been used to manage the difficult intubation in pregnant women. We report the use of Airtraq™ laryngoscope after failed standard laryngoscopy in a parturient with syringomyelia and Arnold-Chiari type I malformation.

[Pachymeningitis associated with probable Horton's disease: a case report]. / Pachyméningite associée à une probable maladie de Horton : étude d'une observation.

INTRODUCTION: Horton's disease is the most common vasculitis of elder people. Several neurological complications are reported, but pachymeningitis is exceptional. OBSERVATION: A 71-year-old patient who presented headache, hyperesthesia of the scalp, weight loss with a biological inflammatory syndrome and meningeal thickening on MRI. The diagnosis of pachymeningitis related to Horton's disease was retained. The patient was treated by corticosteroids with a good clinical, biological and radiological course after 22 months. CONCLUSION: Horton's disease is a potential diagnosis in elderly persons with pachymeningitis and inflammatory syndrome.

[Interest of corticosteroids in neurological complications of celiac disease]. / Intérêt de la corticothérapie dans les complications neurologiques de la maladie coeliaque.

INTRODUCTION: Neurological manifestations of celiac disease are rare and polymorphic. Similar to lesions of the digestive tract, the standard treatment includes steroids. CASE REPORT: A 41-year-old woman, followed up for celiac disease resistant to gluten-free diet, developed rapidly spastic paraparesis, cerebellar syndrome, horizontal diplopia and decline of visual acuity. The diagnosis of neurological complications of celiac disease was established and the patient was treated with methylprednisolone, followed by oral prednisone. For 9 years, the patient's neurological status remained stabilized with a prednisone dose at 20mg per day. The patient relapsed when progressive reduction of prednisone dose was attempted; neurological and gastrointestinal signs worsening at 15mg per day; increasing the dose to 30mg improved the clinical status. DISCUSSION: The mechanism of onset of neurological disease remains unknown. Immunological, nutritional, toxic or metabolic factors could be involved. The positive response to corticosteroids observed in this patient suggest an immunological mechanism.

[A critical study of the screening practices of gestational diabetes of a service of gynecology and obstetrics]. / Etude critique des pratiques de dépistage du diabète gestationnel d'un service de gynécologie obstétrique.

Our study has for aim to describe the practices of screening of the gestational diabetes mellitus. Screening test was realised at 61% of the women included in the study. The HGPO in 50 g was prescribed in 47% of the cases, a single fasting blood glucose in 28% of the cases; 13,4% of the detected women had a glycaemia included between 1,30 and 2 g/L one hour after a load of 50 g of glucose. Among these patients, 52,63% did not realize test HGPO in 100 g. Gestational diabetes mellitus complicates about 7,7% of pregnancies in our study. In statistical analysis united varied, are considered as risk factors: the age, the family history of diabetes and the histories of macrocosmic during previous pregnancy.

[A rare cause of exophthalmos, hydatid cyst of the orbit]. / Une cause rare d'exophtalmie, le kyste hydatique de l'orbite.

INTRODUCTION: The orbital hydatid cyst is a rare (1 to 2%) localization of the Echinococcus granulosus parasite. OBSERVATIONS: An intra-orbital localization of hydatidosis was revealed in two patients by the occurrence of unilateral exophthalmia. After tumoral resection the diagnosis was confirmed by histological examination. COMMENTS: The principle clinical sign of an orbital hydatid cyst is exophthalmia. Imaging is essential for pre-operative diagnosis. Serology is insufficient and treatment is surgical.

Obstetric patients treated in intensive care units and maternal mortality. Regional Teams for the Survey.

OBJECTIVE: To ascertain the frequency of serious diseases in pregnant women. STUDY DESIGN: A population based survey was performed in France. The cases were all the women admitted for treatment in intensive care unit (ICU). The severity of the cases was measured with the simplified acute physiology score (SAPS) the lethality and the rate of still birth. RESULTS: 435 obstetric patients were included. The estimated frequency of severe diseases was 310 S.D.36 per 100,000 live births. The most frequent diagnose that motived admission in ICU was hypertensive diseases. The lethality rates differed greatly between specific disorders. The lethality rate was lower when scheduled maternity was located in a teaching hospital. CONCLUSION: Regarding these results it appears that the majority of obstetric patients with severe diseases are referred to suitable care, but a small proportion of women who had to change their type of care registered a significant higher lethality.

Thrombose veineuse cerebrale du post partum : a propos d'un cas

La localisation cerebrale des thromboses veineuses est rare au cours de la grossesse et le post partum. Nous rapportons le cas d'une patiente de 33 ans 3eme geste 3eme pare; cesarisee a 34 semaine d'amenorrhee pour placenta praevia hemorragique; les suites post operatoires sont marquees au 6eme jour par des cephalees suivies de crises convulsives et un deficit moteur de l'hemicorps droit. Le diagnostic de thrombose veineuse cerebrale est confirme par l'angio-IRM cerebrale. Le bilan etiologique restait negatif. L'evolution etait favorable sous anticoagulant. Les auteurs mettront l'accent sur les aspects physiopathologiques; cliniques; paracliniques; therapeutiques et evolutifs de la TVC du post partum