Listeria monocytogenes is a relatively uncommon pathogen affecting infants or adults with predisposing conditions, such as cirrhosis, diabetes mellitus, autoimmune disease, renal transplants, and solid and lymphoreticular malignancies. Cerebral parenchymal involvement is rare and consists of focal cerebritis, which may progress to abscess formation. This article presents three cases of early Listeria monocytogenes cerebritis, two of which demonstrated ill-defined superficial areas of low attenuation with curvilinear gyral enhancement and one of which demonstrated a deep, low-attenuation lesion with faint surrounding enhancement. Although these findings are nonspecific, their early recognition in the proper clinical setting may help institute early antibiotic therapy, which appears to be successful without surgical intervention.

Adult↗

PubMedDate not supplied

The white clot syndrome or heparin associated thrombocytopenia and thrombosis (WCS or HATT) (26 cases).

The Authors report a new iatrogenic complication of preventive or curative standard heparinotherapy. This so called "white clot syndrome" or "Heparin associated thrombocytopenia and thrombosis" is an anatomico-clinical entity characterized by severe, multiple, recurrent, arterial and/or venous thromboembolic accidents which are sometimes fatal. They appear, paradoxically, under heparin treatment and are concomitant with thrombocytopenia (generally less than 100 10(9)/l). Antiplatelet immunoallergic phenomena, via type IgG antibodies, induced by heparin, are the most commonly admitted in physiopathology; however they remain controversial. Treatment of "WCS" includes urgent suppression of standard heparin, administration of antivitamin K, or the new generation of low molecular weight heparin. This series presents 26 cases of HATT treated by LMWH (CY 216 CHOAY). Severe complications must be surgically cured. Prevention of WCS or HATT is mandatory by the systematic survey of platelet count during heparinotherapy.

Aged↗

PubMedDate not supplied

Doppler spectrum analysis and vascular imaging in the diagnosis of extracranial carotid artery disease.

Ultrasound methods are well suited for the exploration of the carotid system. High resolution echography can visualize atheromatous defects on the vessels walls with a resolution better than one mm, whereas Doppler examination detects haemodynamic disturbances due to these plaques. Conventional Doppler examination can reveal moderate or severe stenosis (greater than 60%); the recent development of frequency analysis of the Doppler audio signal makes now possible the detection of very light haemodynamic disturbances due to low grade stenosis even as small as 15%. Spectral distribution abnormalities have been classified in four grades according to their amplitude. The combination of the morphological and functional data provided by echography and Doppler spectrum analysis has drastically increased the diagnostic possibilities of the ultrasound methods in the field of the extracranial vascular pathology. With a new duplex system which combines echography and C.W. Doppler examination (duplex probe) it is possible to detect, and quantify carotid stenosis (in percentage of the lumen reduction), and to evaluate blood flow volume in ml/mn.

Carotid Artery Diseases↗