[Interest of MR perfusion and MR spectroscopy for the diagnostic of atypical cerebral toxoplasmosis]. / Apport de l'IRM de perfusion et de la spectroscopie dans le diagnostic de toxoplasmose cérébrale atypique.

We report an atypical case of cerebral toxoplasmosis (CT) in a 70-year-old woman with a history of breast cancer. Contrast-enhanced computed tomography revealed a single ring-enhancing lesion in the pons with perifocal oedema and mass effect. Toxoplasma encephalitis was suggested by means of diffusion weighted imaging, MR perfusion and MR spectroscopy, leading to the discovery of HIV infection. The patient was put on antitoxoplasma therapy. Subsequent clinical and radiological improvements confirmed the diagnosis.

[Role of modern cross-sectional imaging in thanatology: a pictorial essay]. / Application à la thanatologie de l'imagerie en coupe: revue iconographique.

The development of new imaging modalities such as computed tomography and magnetic resonance imaging is a new phenomenon in thanatology. The growing accessibility to these technologies allows, under some conditions, the acquisition of cross-sectional images on cadavers. The authors present a practical pictorial review of post-mortem changes and deadly injuries, illustrating the contributions of modern cross-sectional imaging techniques in thanatology.

[Paraneoplastic limbic encephalitis associated with epidermoid lung carcinoma]. / Encéphalite limbique paraneoplasique et carcinome épidermoide du poumon.

Paraneoplastic limbic encephalitis is a rare clinical entity, most often associated with small cell lung cancer. We report a case of a 54-year-old man presenting status epilepticus, cognitive dysfunction and loss of short term memory associated with epidermoid lung carcinoma. CT scan was normal whereas MRI revealed hyperintensities on T2WI and FLAIR images in the temporolimbic regions. Treatment of the primary tumour was followed by neurological improvement.

[Imaging of cerebral ischemia within first hours: computed tomography (CT)]. / Imagerie de l'ischémie cérébrale dans les premières heures: scanner.

Imaging of stroke has evolved with the development of stroke units and the CE approval of intravenous thrombolysis in the first three hours after stroke onset. The goal of imaging in the acute phase of stroke is: to make the diagnosis of stroke; to rule out other diagnosis (above all hemorrhagic strokes); to precise the location of the arterial occlusion; to assess the level of hypoperfusion; to evaluate the viability and reversibility of brain lesions; to understand the origin of the stroke by evaluating cervical arteries. Constraints of imaging in the acute phase of stroke are: the need to be performed as fast as possible to not delay IV thrombolysis (time is brain); machines must be available 24 hours a day, 7 days a week as close as possible to the stroke unit. The aim of imaging are: in routine practice to evaluate the likely benefits (provided by penumbra imaging) and risks of IV thrombolysis; in term of "evidence based medicine" to better evaluate new specific stroke therapies in randomized studies (IV thrombolysis between 3 to 4 hours, use of anti GpIIbIIIa, intra-arterial mechanical or chemical thrombolysis...). Magnetic resonance imaging is considered the goal standard of stroke imaging allowing to evaluate in a "one stop shopping" the level of arterial occlusion, hypoperfusion and brain viability. However, stroke management is a regional issue and performing MR in extreme emergency is almost impossible in all stroke units outside or even within university hospitals 24 hours a day. CT-perfusion and CT angiography are therefore an accurate alternative tool for acute stroke imaging. Multislice CT is indeed available in almost all stroke units. The examination is very time-saving and clinically relevant to make the decision for IV thrombolysis.

[Spontaneous resolution of syringomyelia in a child with Chiari I malformation: a case report]. / Résolution spontanée d'une cavité syringomyélique dans le cadre d'une malformation de Chiari I chez un enfant: à propos d'un cas.

Cervicothoracic syringomyelia is a frequent feature in Chiari I malformation. It can be symptomatic or not, and is well demonstrated by magnetic resonance imaging (MRI). Its spontaneous resolution is uncommon. The authors report a case of spontaneous resolution of a thoracic syrinx in an 18-year-old patient with a Chiari I malformation. MRI study performed 6 years previously because of worsening headaches demonstrated a Chiari I malformation associated with a syrinx cavity. The cavity disappearance was noted after improvement of the symptoms.

Inflammatory myofibroblastic tumour of the spinal cord: case report and review of the literature.

Inflammatory myofibroblastic tumours (IMT), also called inflammatory pseudotumours, nodular lymphoid hyperplasia, plasma-cell granuloma and fibrous xanthoma, are rare soft-tissue lesions characterised by inflammatory cells and a fibrous stroma. Clinically and radiologically, they may look like malignant tumours. They rarely affect the central nervous system and are very rare in the spinal cord. We report an IMT of the spinal cord in a 22-year-old woman presenting with spinal cord compression and a cauda equina syndrome. MRI showed a lesion at T9 with extramedullary and intramedullary components giving low signal on T2-weighted images and enhancing homogeneously. Pial lesions on the lumbar enlargement and thoracic spinal were present 11 months after surgery, when the lesion recurred. We present the radiological, operative and pathological findings and review the literature.

Intracranial vascular involvement of brain pathologies and venous occlusions.

In this paper, the authors present the contribution of CT and MRI to the diagnosis of acute stroke caused by arterial or venous occlusion. The term "early" used in this context means within 6 h of the onset of symptoms. Signs of early ischemic edema are subtle and sometimes difficult to detect by CT or MRI. The purpose of this presentation is to familiarize the clinician and the radiologist with the subtle brain parenchymal changes seen within the first 6 h after onset of symptoms, in order to improve detection of early ischemic infarction and to improve patient care.