Biomedical subjects
Publications and source records attributed to M Jiddane.
We report a case of Maffucci syndrome in a 24-year-old patient, diagnosed thanks to the data of the clinical examination, the imagery and the histology. The clinical, radiological and evolutionary aspects are discussed, as well as the various therapeutic means.
INTRODUCTION: Solitary plasmocytoma is rarely located in the cranial vault. Usually observed, in elderly patients, occurrence during adolescence is extremely rare. We report the case of a 16-year-old patient presenting a cranial vault solitary plasmocytoma which revealed Kahler disease. CASE REPORT: A 16-year-old patient consulted for a frontal tumefaction becoming painful with diplopia. The cranio-encephalic radiography and the MRI showed a tumoral process involving cranial vault; biopsy revealed a solitary plasmocytoma. Search for multiple myeloma was negative. Six months later, a disease of Kahler was declared. CONCLUSION: Clinical and biological follow-up of cranial plasmocytoma is necessary, because progression to multiple myeloma is possible as in our observation. Imaging and particularly MRI are needed to specify the axial seat of the tumoral process and its relationship with the nervous and vascular structures.
INTRODUCTION: Carbon monoxide (CO) poisoning has been shown to result in cognitive impairments. These disorders have rarely been reported. The present study aimed to evaluate these disturbances in five patients with a neuroanatomical study. METHODS: There were two men and three women with an average of 25 years old. Patients were explored several months after acute CO poisoning. Neuropsychological testing was administered to assess memory, intellectual, executive, visual-spatial and constructional functions, language, praxis and gnosis. Cerebral magnetic resonance imaging (MRI) was performed in all patients using axial, sagittal and coronal slides with T1 and T2 weighted and flair images. None of the subjects had hyperbaric oxygen. They received 7, 5 mg bromocriptine per day. RESULTS: All patients presented cognitive disorders including marked impairment in long term memory with a severe defect in recall performance in comparison to recognition memory. Visual memory was more affected than the verbal one. There were also moderate disturbances in intellectual, executive, visual-spatial and constructional functions. One patient presented alexia agraphia, severe visual disturbances, constructional and dressing apraxia. Four patients had depression and one psychic akinesia. Cerebral MRI studies revealed that all patients had bilateral pallidal necrosis, bilateral hippocampal and moderate cortical atrophy. Fornix atrophy was found in 2 patients and corpus mammillary atrophy in 3 patients. Others lesions were also found: bilateral cerebellar in two cases and cortical in three cases. Treatment with bromocriptine was effective in three cases. There was no improvement in the patients treated 14 months and 5 years following CO poisoning. CONCLUSION: Neuropsychological impairments in CO poisoned subjects include memory, intellectual, executive, and visuospatial defects. In addition to pallidal necrosis, which is a typical feature of CO poisoning, hippocampal and cortical atrophy are often present. Bromocriptine can improve the cognitive disorders.
Cranial localization of osteosarcoma is rare, representing only 0,7-3% of cranial primary tumours. The authors present the case of a 33 year old man with occipital osteosarcoma diagnosed by CT scan, MRI and angiography. The radiological features of this pathology are discussed.
Tuberous sclerosis is a phakomatosis with central nervous system manifestations characterized by 4 lesions detectable on neuro-imaging: tubers, white matter abnormalities, subependymal nodules and subependymal astrocytomas. The first three are benign lesions composed of by identical cytological lesions varying only in size and location. At CT, enhancement of subependymal nodules is usually considered as evidence of transformation to subependymal giant cell astrocytoma. This latter poses the problem of its relative benignity: hydrocephalus source of morbidity or even mortality. From a series of 22 cases, the authors review the characteristics of these abnormalities.
Brown tumors are classic bony lesions of hyperparathyroidism. They usually occur in severe forms with osteolytic subperiosteal lesions. Facial bones are a rare localization: 2% of all cases. The aim of this study was to report a case of multiple craniofacial location of brown tumors and to discuss, within a review of the literature, the role of imagery in the diagnosis of this disease.
Rat bite is rarely reported in the literature. We report the case of a 33-year-old woman who was bitten by a rat on her upper eyelid. The clinical examination showed a large palpebral edema extending to the side of the face, associated with local signs of inflammation. Visual acuity was preserved and tomodensitometry showed a small exophthalmia that did not extend to the sinuses. This lesion led to a diagnosis of orbital cellulitis. Progression was favorable with antibiotics: amoxicillin, clavulanic acid, gentamicin, and metronidazole. The authors discuss the compromised prognosis of this disease and the necessity of rapid diagnosis and prompt therapeutic management.
INTRODUCTION: Gingival fibromatosis is frequently an isolated condition, but rarely associated with certain illnesses, or uncommon syndromes. CASE: This work describes a young patient presenting cherubism, with perturbed consciousness and very hyperplastic gingiva covering the major part of the dental crowns. DISCUSSION: We recall the characteristic clinical features of cherubism. Outcome is generally favorable with regression of the swelling. The combination with gingival fibromatosis is a particular manifestation.
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Craniocervical Pott's disease remains exceptional, and may cause spinal instability and severe cervicomedullary complications. We report eight cases of tuberculous spondylodiscitis at the craniocervical junction revealed by signs of spinal cord compression, torticollis and dysphagia. The value of CT and MR imaging is discussed.
PURPOSE: to present a case of post traumatic anterior spinal epidural hematoma. CASE REPORT: a 55-year-old man presented with abrupt onset of paraparesia following a motor vehicle accident. Magnetic resonance imaging showed an anterior lumbar epidural hematoma. Surgical evacuation of the hematoma resulted in complete recovery.
The authors report a case of intracranial textiloma in a 36-year-old male diagnosed 3 years after surgery for a left spheno-orbital meningioma.
The authors report three cases of non-tuberculous epidural abscess. Presenting symptoms included lumbar back pain, muscle spasms, soft tIssue swelling, and neurological deficits in all three cases. MR imaging was helpful for diagnosis and showed involvement of perivertebral soft tissues and an epidural abscess of variable size. There was no significant involvement of intervertebral disks or vertebrae. Diagnosis was confirmed by bacteriologic exam. Clinical outcome was favourable with antibiotic treatment.
The Authors report the US, CT and MR features of sclerochoroidal tuberculosis simulating a choroidal tumor in a 16 Year old female presenting with acute unilateral visual loss. Fundoscopic examination and fluorescein angiography showed a tumor at the posterior pole of the globe. CT and MRI showed the choroidal process and cerebral lesions suggestive of tuberculomas. The evolution was favorable with antituberculous treatment. Ocular tuberculosis is rare, especially the pseudotumoral form. It can simulate a choroidal tumor. Radiologists should be familiar with this appearance because the lesion is reversible with antituberculous treatment.
Infectious arthritis of the temporomandibular joint is very uncommon, and arthritis of the TM joint as a result of candida albicans infection has not previously been reported. The authors describe a patient treated for chronic otitis media complicated by arthritis of the temporomandibular joint. The diagnosis was made using CT scan and bacteriologic sampling.
INTRODUCTION: The orbital hydatid cyst is a rare (1 to 2%) localization of the Echinococcus granulosus parasite. OBSERVATIONS: An intra-orbital localization of hydatidosis was revealed in two patients by the occurrence of unilateral exophthalmia. After tumoral resection the diagnosis was confirmed by histological examination. COMMENTS: The principle clinical sign of an orbital hydatid cyst is exophthalmia. Imaging is essential for pre-operative diagnosis. Serology is insufficient and treatment is surgical.
Atypical sciatic pain without apparent discogenic origin should raise the possibility of a non-discogenic etiology, especially tumoral but also infectious or inflammatory. We report the case of a young patient presenting with non-discogenic S1 radiculopathy due to sciatic nerve involvement in the subpiriformis canal secondary to piriformis muscle inflammation. The authors review technical considerations and results of MRI which is of great value in the evaluation of piriformis muscle pathology.