Long term sequelae of hemispheric abscesses as a function of the treatment.

The authors compared the clinical, electroencephalographic and CT evolution of 31 cases of brain hemispheric abscesses. The vital prognosis was largely improved by the introduction of the CT scan, as compared with previous series. The functional evolution was better in the group of patients receiving high dosage (15 cases) antibiotics and/or puncture (4 cases) in the case of a large lesion, than in patients whose abscesses were removed (12 cases).

"Pseudotumoral" cystic cerebellar infarction with slow evolution.

A 63-year-old female patient presented with cerebellovestibular symptoms and posterior headaches. The onset of the symptoms was sudden, and the neurological condition slowly worsened over a 5-month period. It was found that she suffered from a cystic infarction of the cerebellar lobe, with subsequent hydrocephalus.

[Post-traumatic retrograde amnesia].

A case of post traumatic retrograde amnesia is described. The patient presented after an initial coma a global amnesia, but the fixation deficit rapidly disappeared, and a severe retrograde amnesia dating back to childhood experience and learning remained the main symptom. Amnesia for remote events was associated with didactic memory deficit and, at a lesser degree, with a verbal memory deficit.

[Acute amnesia caused by a hematoma of the 3d ventricle and the fornix].

An acute amnesic syndrome accompanied the development of a hematoma of the upper part of the third ventricle affecting the fornix. The initial deficit was substantial with corresponding forgetfulness, but there was no false recognition nor fabulation. Recollection of past events was fairly well conserved, subject to difficulties with the temporal structuring of memories.

Intradural rupture of lumbar intervertebral disc: report of three cases with review of the literature.

The intradural herniated disc is a rare complication of disc herniation. A study of the literature shows that this location is often responsible for severe neurological deficit with loss of sphincter control and a complete block shown on the myelogram. We report three cases to demonstrate the radioclinical interpretation of intradural herniated disc and the possibility of definite and misleading symptoms.

[Chiasmatic tuberculoma. 2 cases].

The authors report two cases of chiasmatic tuberculomas. They emphasize that diagnosis is still difficult despite CT scan if a picture of tuberculous meningitis is lacking. Surgical approach may be justified when diagnosis remains uncertain, especially as tuberculoma is sometimes responsible for recurrent meningitis.

Spinal dysraphia and elongated spinal cord in adults.

Spinal dysraphia with stretching of the spinal cord is usually diagnosed in the adolescent or young-adult patient. Two types of the condition are distinguished: a stretched spinal cord with an intradural lipoma, and a stretched spinal cord with both an intra- and extradural lipoma. The pathogenesis of the condition and mechanical role of the lipoma and the late appearing neurological signs are presented.

[Value and limitations of isolated ventricular shunt in non-traumatic cerebellar hematomas].

Two cases of cerebellar haemorrhage with hydrocephalus are presented which were successfully treated with isolated ventricular drainage. Both occurred in high risk patients, 77 and 68 years old. The first observation confirms the value of this operative procedure when the volume of the haemorrhage is relatively restricted, whatever may be the importance of the neurologic symptoms and brainstem disfunction.

[Isolated cervicothoracic spinal amyotrophy caused by hydromyelia. Stabilization by a ventricular shunt].

A 25-year-old man developed marked weakness of the upper limbs and shoulder girdle over a period of 6 months. On examination there was amyotrophy, fasciculations and areflexia of the upper limbs with increased lower limb reflexes. Sensation and CSF were normal.

[Regressing median peduncular infarction].

A case of a medial and caudal infarction of the midbrain in a 56 years old woman is reported. The clinical syndrome included a rapidly recovering sleepiness, an ophthalmoplegia related to damage to the caudal part of the oculomotor nuclear complex, a slow extrapyramidal dysarthria and a severe ataxia. The latter was characterized by the prevalent involvement of posture control, resulting from an axial hypotonia and the lack of balance reflexes.

[Arachnoid cysts of the cerebellopontile angle].

Ten cases of arachnoid cysts of the ponto-cerebellar angle are presented. In most cases, local arachnoiditis is disclosed during surgery, directing the discussion toward acquired pathology, and perhaps toward local infection. The clinical symptoms are dominated by the cochleo-vestibular deficit, but the involvement of the V and the VII cranial nerves is inconstant and discreet.

[Dorsal interapophyseal arthropathy and spinal cord compression in syringomyelia].

A dorsal spinal cord compression by exuberant arthropathy and osteophytes of the articular processes occurred in a 61 years old patient with syringomyelia. The clinical symptoms were related to postero lateral cord involvement and rapidly appeared after syringo-peritoneal shunting. C.

[Neurinoma of the intracranial and intraspinal spinal nerve].

Two personal cases and a review of the literature permit to distinguish by anatomical, clinical and paraclinical aspects : neurilemmoma of the jugular foramen (type III), neurilemmoma of the bulbar spinal (type I), and of the medullary spinal (type II). This classification permits to choice surgical approach.

[Parietal multilocular arachnoid cysts in adults. 2 cases].

Two cases of multiloculated arachnoid cysts of the parietal area are discovered at the ages of 57 and 69. The terrain, the situation and the morphology, the evolution, distinguish these lesions from the more classic cysts of the sylvian fissure. Their pathophysiology is discussed anatomically, these cysts are not far from the post traumatic ones, developing in childhood.

[Alternating oblique deviation of the gaze. 3 cases].

Three cases of alternating skew deviation of gaze are reported. In two patients, it was associated with oculomotor disorders suggestive of a medial mesencephalic lesion. CT scan showed 3rd ventricule abnormalities accounting for the mesencephalic involvement.

[Intracranial subdural empyema. 3 cases].

With reference to three cases the main features of subdural empyema are recalled. These collected suppurations are often secondary to frontal or maxillary sinusitis due to a streptococcus. Clinical features are those of meningo-encephalitis but signs of cortical damage are more prevalent.

[Deafness, mutism and behavior problems caused by bitemporal cerebral lesions].

The case of a 29 years old woman with bilateral ischemic lesions in superior temporal and temporo-parietal areas is presented. An important speech reduction evolving toward muteness is associated to cortical deafness and behavior perturbations. The study of symbolic functions shows the partial respect of occipital activities and connexions between visual system and areas supporting graphism and manual praxia.

[Palpebral and cephalic oculomotor deficits in deep cerebral hematomas].

Oculomotor functions are analysed by clinical examination and oculography in 21 cases of deep cerebral hematoma. Significant paralysis of verticality and of movements contralateral to the lesions was observed in all cases where the hemorrhage affected the paramedian thalamo-subthalamic region. A slight deficit of elevation and controlateral movements was observed in the external thalamic and capsular hematomas.