[Show abstract][Hide abstract] ABSTRACT: We report a case of abducens palsy eight days after an intrathecal glucocorticoid injection followed by post-lumbar puncture syndrome. T1-weighted magnetic resonance imaging scans showed marked diffuse postgadolinium enhancement of the supra- and infratentorial meninges consistent with intracranial hypotension syndrome. The palsy resolved almost completely and a repeat magnetic resonance imaging scan done after four months was normal. The mechanism of the meningeal thickening and contrast enhancement is discussed.
No preview · Article · Jun 1998 · Revue du rhumatisme (English ed.)
[Show abstract][Hide abstract] ABSTRACT: The presence of autoantibodies to human brain galectin-1 was investigated in serum from patients with multiple sclerosis, patients with or without evidence of other neurological disorders, and healthy controls, using an ELISA on purified brain galectin-1. Levels of autoantibodies to galectin-1 were significantly higher in patients than in healthy controls. Comparison of levels of anti-galectin-1 and anti-idiotypic antibodies mimicking human brain galectin-1 (L-IgG) showed that the highest levels of autoantibodies were present in patients with low levels of L-IgG. This finding can be explained by hypothesizing that the concentration of autoantibodies to galectin-1 is possibly associated with impairment of the regulation of the immune system.
[Show abstract][Hide abstract] ABSTRACT: We report the assessment by MRI of a case of radiculomyelitis after vaccination against tetanus-poliomyelitis. In the acute stage the appearance was an isolated myelitis of the conus medullaris with contrast enhancement. The upper thoracic cord presented central areas of high signal intensity on T2 weighted images. Rapid clinical recovery was correlated with resolution of abnormal enhancement. Follow-up MR at 5 months showed persistence of slight T2 prolongation in the conus medullaris and syringohydromyela of the thoracic cord. A single lesion of the spinal cord is a rare presentation of acute disseminated encephalomyelitis, the course of such lesions, to date not previously displayed by MR, is unknown. Proper diagnosis should help prevent administration of further vaccine doses.
No preview · Article · Jun 1996 · Journal de Radiologie
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to identify the functional anatomic factors involved in the maintenance or disturbance of flow in the vertebral aa. during atlanto-axial rotation. Fourteen healthy volunteers were studied by magnetic resonance angiography (MRA) by a three-dimensional sequence in phase contrast centered on the vertebral aa. at the level of the cranio-cervical junction before and after left rotation of the head. A decrease in the signal intensity of the arterial flow was sought for. The results were compared to the posterolateral development of the loop of the vertebral a. in its atlanto-axial segment in neutral position, and to the measurement of the angular opening between the atlas and axis in dynamic position. Seven subjects also had a three-dimensional CT study (3D CT) of the bony relations of C1 and C2 after rotation. In 4 subjects a disturbance of flow in the right vertebral a. was observed in the transverse foramen of C2. This occurred when two factors were combined: an under-developed atlanto-axial arterial loop and a C1-C2 angle exceeding 35 degrees in maximal rotation. In the other subjects a well-developed arterial loop and/or a C1-C2 angle of less than 35 degrees in maximal rotation were factors preserving the arterial flow. The risk factor associated with the C1-C2 angle seemed correlated in 3D CT with loss of the usual asymmetric character of rotation. A clinical application is reported with a case combining chronic rotational dysfunction of the cranio-cervical junction as shown by 3D CT and complete compression of the vertebral a. in MRA, confirmed by conventional angiography. A knowledge of this physiopathologic mechanism allows clinical detection and evaluation of the risk of any effect of pathology of the cranio-cervical junction on the vertebral a.
No preview · Article · Feb 1996 · Surgical and Radiologic Anatomy
[Show abstract][Hide abstract] ABSTRACT: Behcet's disease is a multisystem immune-related vasculitis which may involve the central nervous system. Neurological complications occur predominantly in the brainstem and are usually reversible. The serial MR appearances of two patients with neuro-Behcet's disease are described. Contrast enhanced MRI and/or CT were performed in both cases during the acute and chronic stages of the illness. In one case, CT was non-contributory in the acute phase, MR was more sensitive in the detection of lesions which correlated well with the clinical neurologial deficit. The lesions were of high signal intensity on the T2-weighted images and did not enhance on the T1-weighted images following the administration of Gadolinium-DTPA. The MR abnormalities nearly resolved completely in conjunction with clinical improvement. In the second case, the deficits were more extensive in the acute phase than predicted by the CT appearances. Acute lesions exhibited contrast enhancement indicating breakdown of the blood-brain barrier. During the recovery phase, lesions decreased in size and signal intensity on follow-up MR scans with restoration of the blood-brain barrier. One lesion persisted in the internal capsule suggestive of ischaemic necrosis. This finding was consistent with the perivascular lymphocytic cuffing around venules and capillaries which is seen in Behcet's disease. These cases confirm the greater sensitivity of MRI over CT and illustrate the different evolution of Behcet's lesions varying from complete resolution ('restituto ad integrum') to irreversible ischaemia.
[Show abstract][Hide abstract] ABSTRACT: Gerstmann-Sträussler-Scheinker's disease is a familial spongiform encephalopathy whose pathological hallmark is the existence--especially in the cerebellum--of numerous amyloid plaques. We report here the third clinicopathological case in a French family. Brain tissue from one of its members--initially described as familial Creutzfeldt-Jakob's disease--has been reported as successfully inoculated to monkeys. We present the currently accumulating data favouring the hypothesis of a common etiology for familial Creutzfeldt-Jakob's disease and Gerstmann-Sträussler-Scheinker's disease. The familial characteristics, resulting in different durations of incubation and evolution, could lead to different clinical and histological expressions.
No preview · Article · Feb 1992 · Revue Neurologique
[Show abstract][Hide abstract] ABSTRACT: Neuropathologic study of an 82-year-old male who died from massive cerebral hemorrhage showed extensive amyloid angiopathy, with morphologic and immunohistochemical characteristics similar to those observed in Alzheimer's disease, associated with granulomatous angiitis, including the presence of numerous giant cells. Some of the giant cells contained, in their cytoplasm, congophilic material immunoreactive for the Alzheimer A4 peptide, supporting the hypothesis that the granulomatous angiitis may, in part, represent a foreign body reaction to A4 amyloid deposition.
[Show abstract][Hide abstract] ABSTRACT: We describe a patient with solitary plasmacytoma of the skull, in whom mononeuritis multiplex was the presenting manifestation. Some features of the POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal [M] protein, skin changes), including thrombocytosis, were found. Muscle and nerve biopsies disclosed a small vessel hypersensitivity-type vasculitis and complement-fixing immune complex deposits in vessel walls. Removal of the plasmacytoma resulted in clinical improvement and clearance of the vasculitis and immune complex deposits.
No preview · Article · Nov 1989 · Arthritis & Rheumatology
[Show abstract][Hide abstract] ABSTRACT: The authors report a new observation of thrombocytopenia thrombosis syndrome induced by a synthetic heparinoid: pentosan polysulfate and presenting with dural sinus thrombosis. This syndrome was aggravated by standard heparin therapy. Thrombocytopenia was due to an immunological mechanism and preceded thrombotic phenomena, so emphasizing the need for platelet counts in all patients considered for heparin or synthetic heparinoid therapy.
No preview · Article · Feb 1988 · Annales de medecine interne
[Show abstract][Hide abstract] ABSTRACT: The authors report the anatomic and radiologic findings in a case of ectopic origin of the right renal artery in front of the T11-12 intervertebral disc. This seems to be an extremely rare variant, and the rarity of the reported cases is such as not to allow definition of a percentage incidence. An explanation of this variant may be found in modern concepts of the organogenesis of the renal artery.
No preview · Article · Feb 1987 · Surgical and Radiologic Anatomy
[Show abstract][Hide abstract] ABSTRACT: The clinical, electrophysiological and histopathological features in seven cases of cisplatinum peripheral neuropathy are reported and compared with the literature data. The neuropathy appears for an average intake of 500 mg/m2 of DDP. The symptoms are those of a symmetric, distal, predominantly sensitive neuropathy of an axonal type with major involvement of proprioception. Neurological improvement is poor after withdrawal of the drug. A post mortem study performed in one case showed a degeneration of the posterior column in the cord and residual nodules of Nageotte in a lumbar spinal ganglion. The systematic study of the tendon reflexes and distal pallesthesia in subjects treated with the drug, may reveal the neuropathy before the onset of the most disabling symptoms (paresthesia, ataxia, pain, Lhermitte's sign).
No preview · Article · Feb 1987 · Annales de medecine interne
[Show abstract][Hide abstract] ABSTRACT: A 55 year-old man complained of headaches, dizziness and vomiting. Neurological examination only showed a cerebellar syndrome. CT scan revealed two hyperdense round areas in the right frontal lobe and cerebellar vermis consistent with metastases and a lung carcinoma was diagnosed. Two months later he presented with typical right hemichorea. A second CT scan showed another hypodense lesion with slight contrast enhancement in the left subthalamic region. He died 6 months after clinical onset. Post mortem examination showed an adenocarcinoma of the right lung with liver metastases. Neuropathological examination revealed four intraparenchymatous metastases one of which involved the left subthalamic nucleus. Hemichorea secondary to metastatic neoplasm of the corpus Luysii is uncommon; only 6 cases have been reported previously; five of them had a post mortem examination of the brain. In three cases a CT scan was available and had demonstrated the site and nature of the lesion.
No preview · Article · Feb 1986 · Revue Neurologique