Disappearance of essential tremor after stroke.

Improvement of a patient's essential tremor (ET) after a stroke has rarely been reported. In such patients, cerebral imaging could help to identify structures involved in the maintenance of ET and improves the knowledge of its physiopathology. This article reports the disappearance of ET, after a stroke in 4 patients and reviews similar previously published cases. These cases suggest that the interruption of cerebellar loops during a stroke could be responsible for the disappearance of ET.

Postoperative spinal recurrence of craniopharyngioma.

PURPOSE: Remote recurrence of craniopharyngioma is an unusual postoperative complication. It occurs either along a previous surgical route or by seeding via cerebrospinal fluid (CSF). METHODS: A 49-year-old male had been operated on twice for a suprasellar craniopharyngioma in September 1999 and February 2003. From August 2003, he noted progressive low-back pain followed by ischialgia along the right S1 dermatome, which was symptomatic of an intradural tumor at the level of the first sacral segment. RESULTS: Total resection was performed and the tumor was histologically confirmed to be an adamantinomatous craniopharyngioma. CONCLUSIONS: We report the first case of remote spinal recurrence of adamantinomatous craniopharyngioma. No growth hormone therapy was administered to this patient. One must bear in mind this rare complication in craniopharyngioma patients and underline the importance of long-term follow-up.

Treatment of primary orbital lymphomas.

We present an overview of the treatment and clinical outcome of 15 orbital lymphomas, carried out in our center from 1993 to 2002. The surgical approach was determined by the location, and type of the lesion. Lateral orbitotomy was performed in five laterally located lesions, a transconjunctival approach in five medial, basal, extra-, intraconal lesions. Pterional intradural and extradural and intradural approaches (three) were used in case of intracranial involvement or location in the apex and optic canal. Two lesions of the lid or extraconal space were operated via eyebrow incision. Ten patients were diagnosed as extranodal marginal zone lymphoma. Diffuse large B-cell lymphoma (DLCL) was encountered in two patients, follicular lymphoma (FCL) in two patients, and diffuse lymphoplasmacytic/lymphoplasmacytoid lymphoma in one patient. All patients except one failed to reveal systemic disease and had a localized orbital lymphoma. Twelve of the patients responded to radiation therapy with usually 40 Gy. Cyclophosphamide, doxorubicin, vincristine, prednisone chemotherapy was applied in two patients, once in combination with radiotherapy. Local recurrence was seen in one patient with FCL. Systemic manifestation occurred in one patient with DLCL, undergoing ifosfamide, carboplatin, etoposide chemotherapy with complete remission. The course of orbital non-Hodgkin's lymphoma is variable and requires a multidisciplinary treatment. Therapeutic options include surgical biopsy, radiation therapy, and chemotherapy.