Intrasellar arachnoid cysts.

Objective: To evaluate the clinical, endocrinological, and radiological presentation of nine cases of surgically verified intrasellar arachnoid cysts and to discuss the physiopathological mechanisms of formation of these cysts.

Methods: Among 1540 patients presenting with pituitary lesions, nine presented with an intrasellar arachnoid cyst. Their charts were retrospectively reviewed.

Primary temporal bone angiosarcoma: a case report.

We present a rare case of temporal bone angiosarcoma diagnosed in a 26-year-old female patient at 36 week of pregnancy. The patient was referred with a 2 months history of left otalgia and tinnitus with a tender swelling above the mastoid. Cranial imaging studies showed a 7 x 5 x 4 cm hypervascularized mass located in the left middle fossa with lysis of the temporal bone and extension to the subcutis.

Endovascular treatment of intracranial wide-necked aneurysms using three-dimensional coils: predictors of immediate anatomic and clinical results.

Background And Purpose: Aneurysms with a wide neck constitute a persistent challenge for endovascular therapy with coils. Our purpose was to evaluate the immediate anatomic and clinical results of treating intracranial wide-necked aneurysms by using three-dimensional (3D) coils.

Methods: During a 2-year period, 160 aneurysms (116 with a neck < or = 4 mm, group A; 44 with a neck > 4 mm, group B) in 157 patients in eight participating centers were consecutively treated.

[Vascular complications after cranio-facial trauma].

Despite recent advances in automobile safety, facial trauma remains a common event. Cranio-facial trauma, which usually occurs within a context of multiple trauma, can, in some patients, lead to serious life-threatening vascular complications. Such injury usually involves the carotid system (hemorrhage, aneurysm, dissection).

Selective endovascular treatment of intracranial aneurysms using micrus microcoils: preliminary results in a series of 78 patients.

Purpose: To determine the safety and reliability of a new platinum microcoil (Micrus), in the treatment of intracranial aneurysms.

Patients And Methods: Seventy-eight patients (28 male and 50 female patients; age range, 28-83 years; mean age, 44 years) with 80 intracranial aneurysms were treated in 10 centers in Belgium and France. All aneurysms were smaller than 15 mm.

[Multihormonal bilateral petrosal sinus sampling in Cushing's disease: radiological, surgical and pathological correlations].

Multihormonal bilateral petrosal sinus sampling (BPSS) has been proposed to improve corticotroph microadenomas prediction of lateralisation. Few series have simultaneously compared data of pituitary MRI, surgical findings and multihormonal BPSS. Seven patients (6F/1M) with Cushing's disease, mean age at diagnosis of 35 years (range 24-55) were prospectively studied to compare radiological and multihormonal BPSS data with surgical and pathological findings.

Extensive inflammatory pseudotumor of the pituitary.

A 40-yr-old female presented with an extensive lesion of the sellar area and the sphenoid sinus, spreading to the optic nerves and associated with pachymeningitis. Histological findings were consistent with an inflammatory pseudotumor, and steroid treatment allowed the disappearance of all the lesions. Inflammatory pseudotumors of the pituitary are very rare.

[Management of hemangiomas and vascular malformations].

Vascular anomalies can be classified as hemangiomas or vascular malformations. Hemangiomas are benign neoplasms, frequently diagnosed in infancy. The vast majority of these anomalies are totally harmless and spontaneously regress, although they often worry the parents because of esthetic reasons.

[Percutaneous vertebroplasty].

Percutaneous vertebroplasty consists in the injection of acrylic cement under fluoroscopic control into a vertebral body presenting with destabilizing and painful lesion such as vertebral haemangioma, osteoporotic vertebral crush syndrome and malignant tumors. Owing to the strong analgesic effect following the vertebral stabilization, this method represents the procedure of choice for the treatment of this kind of lesions.

Unusual CT and MRI appearance of carbon monoxide poisoning.

Unilateral low attenuation areas within the right putamen, globus pallidus and thalamus were observed on CT in a patient after exposure to carbon monoxide. A transient bilateral appearance was found on subsequent CT examinations. Hemorrhagic infarction of the right putamen, and ischemic lesions in both thalami were visualized on MRI 2 weeks later.

Arterial embolization of bone metastases: is it worthwhile?

Arterial embolization was performed in ten skeletal metastases occurring in nine patients: eight patients presented with renal cell carcinoma and one with bronchogenic carcinoma. Five metastatic lesions were located in the spine, one in the pelvis, three in the proximal humerus and one in the proximal femur. Selective arterial embolization was performed preoperatively in seven cases and as a palliative treatment in three cases.

Probable trigeminal nerve schwannoma in a dog.

A 7-year-old male Husky dog developed atrophy of the right masseter muscle and pruritus of the right side of the face. A myogenic origin was excluded using muscular biopsy. Electrophysiologically, there was involvement of the motor and sensory fibers of the trigeminal nerve, suggesting a lesion located between the brainstem and the trigeminal ganglion.

Comparative evaluation of cerebral aneurysms with selective arterially enhanced CT and DSA.

The purpose of our study was to compare selective arterially enhanced spiral computed tomographs (ACT) with digital subtraction angiographies (DSA) in the presurgical assessment of cerebral aneurysms. A total of 24 aneurysms in 18 patients were explored in a prospective study by ACT and DSA, using an interactive combined CT-angiography suite. Dimensions of the aneurysm, its relation to the parent vessel, and the aneurysmal index were defined on DSA and on surface-shaded display of 3D reformatted images obtained from ACT.

A combined CT and angiography suite with a pivoting table.

In a suite with fully interactive computed tomography (CT) and C-arm fluoroscopy units, emergency and elective interventional procedures were performed successfully in 41 patients (overall time range, 40-180 minutes [mean, 80 minutes]). The table can be manually pivoted from the fixed CT position to the free-floating angiography position, in an overall working space of about 40 m(2), with room for anesthesiology and monitoring equipment and personnel.

[Use of biodegradable microspheres in experimental anticancer therapy. Chronopharmacological application].

We describe the initial experimentations which show that is possible to chronomodulate the cisplatin liberation out of some microspheres. The goal is to generate, inside one tumeur embolished by those cisplatin loaded microspheres, some concentration peaks at the best tolerance time. The cancer is than more hit, by the high local anticancer drug concentration, and doses chronomodulations preserve the patient by following his tolerance.

Vertebra plana: benign or malignant lesion?

The case of a 9-year-old boy presenting with a vertebra plana at T7 is reported. The initial diagnosis, as suggested by clinical presentation, conventional radiographs and CT scans, was eosinophilic granuloma. Positive radionuclide bone scan led to biopsy of the posterior arch, which suggested giant cell tumour.

Radiation-induced gliosarcoma. Case report and review of the literature.

A 13-year-old boy presented with a cerebral gliosarcoma 12 years after having acute lymphoblastic leukemia treated by chemotherapy and central nervous system prophylaxis treated by radiation therapy (24 Gy) and intrathecal methotrexate. A review of the literature disclosed 129 possible radiation-induced gliomatous and/or sarcomatous brain tumors: namely, 89 gliomas, 36 sarcomas, and four gliosarcomas, including the present case. An analysis of these cases revealed several characteristics that differentiate them from similar spontaneous brain tumors, thus providing arguments for the carcinogenic effect of radiation therapy on intracranial tumors.

Treatment of mandibular arteriovenous malformations by direct transosseous puncture: report of two cases.

Mandibular arteriovenous malformation (AVM) is a potentially life-threatening pathology requiring radical treatment. We report two female patients, aged 14 and 16 years, in whom occlusion of the AVM with Ethibloc after percutaneous transosseous puncture achieved definitive recovery. The first case was treated by direct injection of Ethibloc following inefficient arterial embolization with Ivalon particles.

A single focus of probable multiple sclerosis in the cervical spinal cord mimicking a tumour.

A case of probable multiple sclerosis (MS) in the cervical cord without brain involvement, mimicking a tumour is reported. The patient had a progressive left Brown-Séquard syndrome. The diagnosis was suggested by MRI.

[Pseudotumoral medullary syndrome manifesting a probably beginning multiple sclerosis. Clinical, radiological and neuropathological correlations].

A 19-y old sportsman was admitted because he complained of ascending paresthesia since two weeks, muscular strength diminution in both arms, then respiratory difficulties without fever. Clinical examination confirmed an asymmetric bilateral pyramidal syndrome affecting the four limbs, a hyposensitive level up to C5, without meningeal symptoms. MRI detected a widening of the cervical (C2-C5) spinal cord, with gadolinium enhancement.