Imaging of epileptic lesions in adults. The three-dimensional approach.
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Biomedical subjects
Publications and source records attributed to D Fredy.
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The coexistence in an epileptic patient of a radiologically confirmed agenesis of the corpus callosum and other somatic abnormalities, notably skeletal, prompted us to perform a karyotype which showed an extra chromosome 8. The trisomy 8-callosal agenesis association is not exceptional, but it may easily be missed owing to the absence or scarcity of clinical signs of the cerebral malformation. We would suggest that patients with confirmed agenesis of the corpus callosum should be investigated for trisomy 8 and conversely, that patients with trisomy 8 detected during examination for a characteristic malformative syndrome should be systematically investigated for abnormality of the neocortical commissure.
The authors describe the epidemiology and the physiopathological aspects of ischemic strokes in patients with a history of oestroprogestogen use. They then study their main radiological correlates: arterial infarcts at CT scan and angiographic non-specific lesions which can be included in the extremely wide framework of arteritis and, much more rarely, venous thrombophlebitis.
Computerized tomography is usually adequate to explore supratentorial lesions of the skull and brain. However, it is often inadequate for a detailed analysis of lesions of the base of the skull and their anatomical rapports. Opacification of the subarachnoid spaces by means of a contrast medium (computerized cisternography) has proved extremely useful in such cases. The contrast media utilized are tri-iodized, water-soluble compounds which are well tolerated. The technique and anatomical data of the method are described, and its applications in different fields of tumoral and non-tumoral pathology are discussed.
Fronto ethmoidal osteoma are rare slow growth benign tumors. Exceptional ophthalmological and neurological complications can occur. The authors report a case of 32 years old man with eye compression by a giant frontal sinus osteoma. This lesion was responsible for a vertical diplopia and moderate proptosis. Plain skull X-Ray show a well defined opacity filling the whole left frontal sinus and C.T. scan delimited precisely orbital extension. Neurosurgical exposure enabled a complete extraction of the tumor and satisfying recovery. The authors have compared this case to those described in literature and insist on the importance of the pre-operative C.T. scan.
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This historical study briefly recalls the circumstances of Broca's death, and reports some new data concerning his autopsy, and an analysis of macroscopic, microscopic, and computed tomography appearances of his brain following its discovery by Huard. The authenticity of the origin of the brain was established, and the hypothesis the Broca's death was due to rupture of a vascular malformation or a cerebrovascular accident was confirmed.
A 19-year-old man presented with an apparently non-familial neurological disorder that had progressed from the age of 6 years. Dystonia of the trunk and limbs with extrapyramidal rigidity, dysarthria, a pyramidal syndrome with spasticity of the lower limbs, bilateral optic atrophy, and nystagmiform ocular movements were present. CT scan demonstrated symmetrical putaminal lesions. The different aetiologies of bilateral striatal lesions are considered, the final diagnosis being a juvenile form of Leigh's disease.
A series of 26 cases of injury to the extracranial carotid artery included 3 patients with false aneurysms, 21 dissecting aneurysms, and 3 aneurysms following direct trauma. Clinical and angiographic findings, and clinical course in the 26 patients are described, together with changes observed on angiography in the 11 cases where this was repeated. Prognosis in this series appeared to be better than that usually described.
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The authors emphasize the frequency of intracranial tumors in psychiatric patients. They make a distinction between the rare cases of psychiatric patients with intracranial tumors and the even most-frequent cases of tumors that express themselves through psychiatric disorders. According to the authors, the most important detection-tests are the brain scan and, more recently, the EMI scan or tomodensitometer.
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