Positional cluster-like headache. A case report of a neurovascular compression between the third cervical root and the vertebral artery.

Symptomatic cluster-like headaches have been described with lesions of the trigeminal and parasympathetic systems. Here, we report the case of a 44-year-old woman with continuous auricular pain and a positional cluster-like headache associated with red ear syndrome. Clinical data and morphological investigations raised the hypothesis of a neurovascular compression between the C3 root and vertebral artery.

[Evaluation of the clinical and radiological results of cervical longitudinal median somatotomy without graft].

Objectives: To evaluate the clinical and radiological results of cervical longitudinal median somatotomy without graft, used for the treatment of cervical myelopathy and radiculopathy, and compare it to techniques with graft and to laminectomies.

Material And Method: Thirty-four patients (25 males and nine females), with a mean age over 60 years, were included in a study comparing pre- and postoperative clinical status on the Japanese Orthopaedic Association (JOA) functional scale and radiological status with evaluation of the cervical curve on plain films and dynamic tests in flexion and extension.

Results: No significant difference was found with the clinical and anatomical results published in the literature concerning median somatotomies performed with graft and/or osteosynthesis and laminectomies and their variants.

[Non traumatic spinal epidural hematomas. Report of twenty cases. Review of the literature and outcome aspects].

Background And Purpose: We report a personal series of 20 non traumatic spinal epidural hematomas and study outcome aspects with a review of data in the literature.

Method: Clinical presentation of non-traumatic spinal epidural hematomas observed between January 1980 and December 1998 was acute in 17 cases (85%) and chronic in 3 (15%). Symptoms were spinal and/or radicular pain, sensorimotor and sphincter dysfunction.

Macroprolactinaemia associated with prolactin adenoma.

Background: Macroprolactinaemia, defined as hyperprolactinaemia with a predominance of, or only, the big big prolactin (bbPRL) isoform, is considered idiopathic and poorly symptomatic. Since its association with a PRL adenoma is poorly documented, we examined a series of 13 patients with tumoral hyperprolactinaemia for the presence of macroprolactinaemia.

Methods: From a series of 36 patients with hyperprolactinaemia studied for PRL isoforms, we selected 13 with hyperprolactinaemia and a prolactinoma, and divided them into two groups on the basis of the predominant PRL isoform, the large PRL group (five patients), with a predominance of the big big PRL isoform, and the monomeric PRL (mPRL) group (eight patients), with a predominance of the mPRL isoform.

[Clinical recurrence of Cushing syndrome without evidence of tumor recurrence: radical hypophysectomy?].

Outcome following radiation therapy for hormonally-active Cushing adenoma is reported. Conventional radiation using 20 to 30 grays improved mass and hormone level in 30 to 80% of the patient. Gamma-knife radiosurgery was at least as effective.

Stromelysin-3 is expressed by aggressive meningiomas.

Background: Stromelysin-3 (ST3) that belongs to the metalloproteinase family is proposed to play a role in tumor invasion. The purpose of this work was to study the variation of ST3 expression in meningiomas.

Methods: Twenty atypical meningiomas were retrieved from the Pathology Department's files at Hopital de Bellevue, Saint-Etienne, France.

[Solitary fibrous tumor of the meninges].

We report a case of solitary fibrous tumor (SFT) of the meninges. SFTs have been initially described in the pleura. SFTs show similar histological findings as in other locations.

Phase II study of a radiotherapy/etoposide combination for patients with newly malignant gliomas.

Purpose: Etoposide, a semisynthetic derivative of podophyllotoxine, is a topoisomerase II inhibitor. This drug is currently used in several types of human cancer. The aim of this study was to evaluate the efficacity and tolerance of a near-concurrent association of radiotherapy and etoposide for newly malignant gliomas.

Aggressive treatment with complete remission in primary diffuse leptomeningeal gliomatosis--a case report.

Primary leptomeningeal gliomatosis is rare, and the diffuse form (PLDG) is even more unusual. The following report is an example. A 17 year-old man developed a syndrome characterized by extensive basal and chronic spinal meningitis.

[Adenoid cystic carcinomas of the maxillary sinus with intracranial invasion. Review of the literature, apropos of a case].

We report a case of adenocystic carcinoma (cylindroma) of the maxillary sinus with intracranial extension in a 35-year-old man with no previous clinical history. The patient underwent primary neurological and maxillofacial surgery. He then developed two successive recurrences of the tumor in the temporo-parietal area of the brain treated by surgery and radiotherapy for the first one and surgery alone for the second.

[Acute pituitary necrosis after multiple pituitary stimulation test].

Iatrogenic necrosis of the pituitary gland is well-known but rarely caused by stimulation tests used to investigate pituitary adenomas; 26 cases have been reported in the literature. We report 2 new cases where the chronology of the events suggests the sudden necrosis resulted from stimulation tests. Several mechanisms have been proposed.

[Spontaneous spinal epidural hematoma: 2 cases].

The authors report on two cases of spontaneous spinal epidural hematomas with atypical subacute clinical presentation and good recovery after surgical treatment. Etiologies, physiopathology, early diagnosis and treatment are considered through a brief review of the literature.

[Anterior and antero-lateral surgery of the lower cervical spine (25 years after H. Verbiest). 2: Indications, results, complications)].

The present course on the anterior and antero-lateral surgical approach of the lower cervical spine was organized for the neurosurgery trainees by the French Speaking Neurosurgical Society, and was held during the winter meeting in December 1995. The aim of this course was to recall the basic technical principles of the microsurgical anterior cervical approach, and to discuss the main indications of this surgical treatment. Many theoretical points were strengthened by the author's personal experience and comments.

[Anterior and anterolateral surgery of the lower cervical spine (25 years after H. Verbiest). I: Technical bases].

The anterior approach to the cervical spine is currently a worldwide traditional surgical technique used by neurosurgeons or orthopedists in the treatment of traumatic, degenerative or tumoral cervical spinal lesions. Many original rules of these techniques were raised by pioneers as R. Cloward and H.

[Complications of lumboperitoneal shunts. A retrospective study of a series of 195 patients (214 procedures)].

Background And Purpose: We report our experience with the lumboperitoneal shunt (LPS) in 195 patients. The aim of this retrospective study was to assess and compare the rate of complications and to discuss 4 indications.

Material And Method: Between January 1983 and July 1994, 195 patients including 14 pediatric cases were treated with a LPS.

[Preservation of procedural memory in 18 patients operated for aneurysm of the anterior communicating artery].

Organic amnesia is typically associated with lesions in either the diencephalic or medial temporal regions of the brain. However, amnesia can result from other kinds of lesions, in particular those resulting from an aneurysm of the anterior communicating artery (ACoA). In the present study, 7 patients who became amnesic following a ruptured and operated ACoA aneurysm were comparated neuropsychologically with 11 patients with ruptures but no cognitive complaints and 18 normal control subjects.

Cervical root compression by a loop of the vertebral artery: case report.

A case of an abnormal loop of the extracranial vertebral artery enlarging the intervertebral foramen at C5-C6 and the transverse foramen at C5 is reported. This occurrence is rare and was associated with cervicobrachial neuralgia caused by neurovascular compression of the C6 root. The patient was cured by microvascular decompression.

[Anterior osteosynthesis of the cervical spine by phusiline bioresorbable screws and plates. Initial results apropos of 5 cases].

The authors have designed a biocompatible and bioresorbable plate (1) in Phusilines* for anterior cervical interbody stabilization. Phusilines* are polymer of alpha hydroxyacid (poly lactic acid), and their in vivo degradation (in lactic acid and via the Krebs circle, in water and carbon dioxide), is complete within 18 months. Screws are available in the same material.

[Post-traumatic syringomyelobulbia and inferior vertical nystagmus].

A case of post-traumatic cervico-thoracic syringomyelia was complicated, 3 years after the injury, by a bulbar extension manifested by a downbeat vertical nystagmus which became a source of disabling oscillopsia. The syringobulbia was visualized at MRI. The usefulness of syringostomy in such a case is discussed.

[Anterior sacral meningocele with urologic manifestations. Report of 3 cases].

Anterior sacral meningocele is defined as a spinal fluid-filled thecal sac in the pelvis communicating with the spinal subarachnoid space through a defect in the anterior sacral wall. Since scimitar shape of the sacrum is characteristic, diagnosis is easily confirmed by echography and myelography. The sac very often contains benign tumors and a thickened filum terminale which can achieve a tethered cord syndrome.