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Biomedical subjects

F Lafitte

Publications and source records attributed to F Lafitte.

At least 19 recordsLinked to original sources
PubMed2001

Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients.

Because of the increasing incidence of primary central nervous system lymphoma (PCNSL), it is essential to recognize this disease in order to start appropriate treatment. We present the characteristic CT and MRI features of this tumour. The findings of 32 CT and 31 MR of 37 immunocompetent patients with biopsy-proved PCNSL are reviewed. The main features are presented and analysed, and are discussed in comparison with proven literature data. Primary central nervous system lymphoma presents as supratentorial solitary lesions in approximately 80% of the patients and multiple lesions in 20%. In contrast to classical data, the lesions are located in deep structures only in one-third of the cases, and involve posterior fossa in 10% of cases. Most of the lesions are hyperdense or isodense (92%) on CT, hypointense or isointense on T1-weighted images, and only about 40% are hyperintense on T2-weighted images. Nearly all the lesions enhance, except after corticosteroid administration. They produce mild oedema and mass effect. Meningeal or ventricular enhancement are rare but suggestive. Calcification, haemorrhage or necrosis are scarce. Although PCNSL in immunocompetent patients have a variable CT and MR appearance, the imaging data often suggest the diagnosis.

Brain Neoplasms↗
PubMed2001

Multiple glioblastomas: CT and MR features.

The aim of this study was to analyze the CT and MR features of multiple glioblastomas, and to determine the best imaging modality for the initial diagnosis. The CT (four exams) and MR imaging (eight exams) of eight patients with proven multiple glioblastomas were reviewed by two neuroradiologists. The lesions were always hypo- or isodense on CT and hyperintense on T2-weighted images (100%). They were usually hypo- or isointense on T1-weighted images (90%). Edema and mass effect were very variable. After contrast media administration, the enhancement was mostly strong (71% on CT and 70% on MR), often either heterogeneous or ring-like. The different lesions of a patient often had a different pattern on MR (75% of cases). Meningeal or ventricular enhancement, suggestive of a possible way of dissemination, was rare. In case of multiple cerebral masses, multiple glioblastomas should be considered as a possible diagnosis in addition to the better known diagnosis of brain metastases, abscesses, or multifocal lymphomas. Moderate edema and mass effect on MR associated with strong and heterogeneous enhancement are suggestive of feature of multiple glioblastomas. Magnetic resonance allows rarely the visualization of a dissemination route.

Brain↗
PubMed2001

[Traumatic superior orbital fissure syndrome: report of 4 cases and review of literature].

PURPOSE: The authors retrospectively analyzed four cases of posttraumatic superior orbital fissure syndrome and reviewed the literature. METHOD: Four patients (three male and one female) were followed for this complication in the department from october 1995 to december 1996. RESULTS: The mean age was 31 years, the median follow-up was 8 month. Computed tomography showed involvement of the superior orbital fissure but no in three patients, in the fourth. The treatment consisted of osteosynthesis of craniofacial fracture in three patients and corticosteroid therapy in the last one. All patients presented partial recuperation of external ophthalmoplegia and ptosis. Twelve months after the traumatism, one patient underwent surgery for persistant ptosis and diplopia. CONCLUSION: The superior orbital fissure syndrome is an exceptional complication of orbital traumas. Partial recuperation of the neuro-ophthalmologic function usually occurs within a period of several months.

Accidents, Traffic↗
PubMed2001

Pilocytic astrocytoma: unusual feature.

Juvenile pilocytic astrocytoma is a well-defined brain tumor. It most often occurs in children and young adults. It is located in the posterior fossa and has typical imaging features, associating cystic and strongly contrast enhancing mural nodule. After complete surgical removal, its prognosis is excellent. Adult cases are seldom observed. They develop almost exclusively within the cerebral hemispheres and share the same imaging and prognostic characteristics as the pediatric forms. We describe the case of a 42-years-old man presenting with a huge heterogenous posterior fossa lesion. Histopathological analysis of the lesion after surgical resection diagnosed a juvenile pilocytic astrocytoma. These peculiar location and imaging features in an adult patient may be misdiagnosed for infectious lesions and must be recognized.

Adult↗
PubMed2001

[Diagnosis and follow-up of pseudo-meningiomatous metastasis of prostatic cancer: value of MRI].

We present the case of a patient with neurological signs, who underwent a CT scan then a MRI which displayed a meningiomatous lesion. The general and biological examination revealed a metastatic prostatic carcinoma, and the meningeal lesion was considered a secondary lesion. Follow-up during hormonal therapy showed the regression of the meningeal lesion and thus confirmed our hypothesis, which avoided surgical biopsy.

Follow-Up Studies↗
PubMed2001

[Atypical cerebral lymphoma with ocular onset: report of a case].

A 72 year-old woman is hospitalized and explored in the neurological department because of dementia discovered after a vitrectomy performed to treat a relapsing chronic uveitis. MRI examination shows atypical hyperintense white matter lesions on T2 weighted images related to Lyme disease. Worsening of clinical status, despite appropriate medical treatment and apparition of enhanced nodules MR images rules out the diagnosis of lyme disease and is attributed to brain metastases. The search for primitive tumor is not contributive and a brain biopsy is performed. It discloses a B cells non-hodgkin lymphoma. This case report stresses two points: first, a lymphoma must be one of the diagnosis to evocate if imaging shows an enhancing nodule, or extensive hypersignal of the white matter, second: it emphasizes the value of vitreous analysis searching for lymphoma during chronic uveitis associated to neurological symptoms.

Aged↗
PubMed2000

Brain tuberculomas.

Although brain tuberculomas have become rare in developed countries, diagnosis should be kept in mind when confronted with brain space-occupying lesion(s), particularly in immigrants from endemic countries. Surprisingly, Human Immunodeficiency Virus (HIV) infection does not seem to have affected the incidence of this tuberculous lesion. Clinical, biological and radiological signs are only suggestive. Thus, when no other active extracranial tuberculous process is found, the diagnosis should be confirmed by a biopsy before beginning antituberculous treatment which is rapidly effective. Adjunction of steroids may be warranted owing to the common paradoxical enlargement of lesions during the first weeks of therapy, as is now well described in lymph node tuberculosis. Cure can be obtained in more than 85% of the cases, but neurological sequelae are not rare.

AIDS-Related Opportunistic Infections↗
PubMed1999

Deep cerebral venous thrombosis: imaging in eight cases.

Deep cerebral venous thrombosis (DCVT) is a rare, potentially fatal disease. We carried out a retrospective analysis of eight patients presenting with DCVT, using CT and MRI data. Digital subtraction angiography (DSA), MR angiography (MRA) (2D phase-contrast), and angiography were performed in four, four and two patients, respectively. Direct (venous abnormalities) and indirect (parenchymatous involvement) signs of thrombosis were assessed. Follow-up MRI and MRA were performed on two patients. CT was initially normal in two patients, demonstrated a "cord sign" in deep veins in five and deep venous infarcts in three. When performed within a week of admission (seven patients), MRI showed thrombosis as into intense or high signal in deep veins on sagittal T1-weighted spin-echo images in all patients, and on axial T2-weighted spin-echo images in two. Deep venous infarcts were found in five patients. Direct or indirect signs of sagittal or lateral sinus thrombosis were present on CT in two patients and on MRI in five. CT angiography, MRA and DSA were concordant with MRI findings. CT venography showed persistent flow in thrombosed veins. MRI follow-up demonstrated progressive deep venous recanalisation.

Adolescent↗
PubMed1999

[The persistence of a spheno-occipital synchondrosis in an adult].

The postnatal development of the central skull base is a complex process: at least 25 separate ossification centers are assimilated in the maturing sphenoid and occipital bones. Some synchondroses may only be partially fused and persist during adulthood. We report the case of a 30-year-old man with a penetrating trauma of the central skull base. Skull computed tomography demonstrated a rare anatomic variant: incomplete fusion of the spheno-occipital synchondrosis. Knowledge of the normal skull base development and of its variants may prove helpful in differentiating a post-traumatic injury from a normal variant.

Adult↗
PubMed1999

Cross-sectional anatomy of the facial nerve.

The length and complexity of the anatomical course of the facial nerve explains the difficulty of its accurate morphologic evaluation. CT and MR appear to be complementary techniques to precisely depict the nerve from its pontine origin to the parotid gland. Anatomical variations exist in length or thickness of all intrapetrous segments or as frequent dehiscences which can lead to false positive results or at the opposite falsely negative diagnoses. Close relations with the antero-inferior cerebellar artery in the intracisternal and intracanalicular segments must be known. Gadolinium enhancement is usual in the fallopian canal with variable intensity and thickness and should be differentiated from pathological enhancement. Finally the intrapetrous course of the chorda tympani can be precisely displayed on CT in the intra-osseous canal and in the middle ear near the ossicles.

Anatomy, Cross-Sectional↗
PubMed1999

[Vertebro-epidural lumbosacral vascular malformations. An unusual cause of lumbo-sciatic pain].

Sciatica is most commonly caused by nerve root compression secondary to herniated disk. Rarely, it can be due to a lumbosacral vascular malformation. We present five cases with such a malformation, presenting as a chronic lumboradiculagia. The patients were explored with computed tomography, MRI and selective spinal angiography. Polymorphic anatomic and hemodynamic aspect of these cases are reported: 1. One vertebral hemangioma with epidural extension; 2. Three purely epidural malformations: a) one epidural cavernous hemangioma, b) one epidural arteriovenous malformation, c) one epidural varix; 3. One paravertebral arteriovenous fistula with epidural venous drainage. Diagnosis of these rare malformations may be difficult. A multiplanar cross-sectional magnetic resonance and computed tomography scan with contrast enhancement can show characteristic abnormalities and may assist in recognition these malformations. Selective spinal angiography confirms the diagnosis, allows to classify the malformation and is required to evaluate endovascular therapeutic possibilities.

Adolescent↗
PubMed1998

Imaging findings of central nervous system neuroepithelial cysts.

Neuroepithelial cysts are rare and mostly asymptomatic cerebrospinal fluid (CSF)-like cysts. We describe herein the imaging findings in five patients with neuroepithelial cysts. Two cases of proven and three of presumed neuroepithelial cysts are presented. Three of five are located in the thalamus, a location which is not characteristic for neuroepithelial cysts. In the case of incidental finding of asymptomatic neuroepithelial cyst, clinical and radiological follow-up is indicated and surgical intervention is not necessarily warranted.

Adult↗
PubMed1998

[Intracranial dural arteriovenous fistula with perimedullary venous drainage].

Two cases of intracranial dural arterio-venous fistula (DAVF) with perimedullary venous drainage are reported. In both cases, MRI T2-weighted (T2W) images showed an hypersignal within the cervical cord with sparing of the thoracic cord. In one case perimedullary vessels were demonstrated on T1W images after gadolinium i.v. administration. A complete spinal angiogram did not show evidence of fistula but demonstrated the lack of opacification of the conus medullaris venous drainage. Cerebral angiogram demonstrated in the first case a foramen magnum DAVF and in the second case a petrous apex DAVF. Hypersignal limited to the cervical cord at MRI on T2W images remain exceptionnal in case of intracranial DAVF with perimedullary venous drainage. When neurological symptoms are suggestive, post gadolinium T1W sequences should be conducted, followed by selective spinal angiogram. If normal venous drainage is not objectivated (e.g. opacification of radiculo-medullary veins on the late phase), cerebral angiogram should be done to rule out an intracranial DAVF.

Aged↗
PubMed1998

[The encephalon. Notions of neuroanatomy].

A good knowledge of the brain anatomy is necessary for all physicists interested in neurologic pathology, and especially for the radiologists. The aim of this paper is to summarize the important data in morphological but also in functional brain anatomy. The main neurologic pathways are represented on MR standard slices for practical application. The international anatomica nomenclatura (french terms) is used.

Brain↗
PubMed1997

MRI and MRA for diagnosis and follow-up of cerebral venous thrombosis (CVT).

OBJECTIVE: To assess the sensitivity of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in the diagnosis and the follow-up of cerebral venous thrombosis (CVT). To describe MRI and MRA features in CVT. MATERIAL AND METHODS: The clinical and neuroradiological studies of 20 patients with proven CVT were reviewed. All patients underwent computed tomography (CT), MRI (with MRA for 15 patients) and digital substraction angiography (DSA). Eleven patients had follow-up after treatment with MRI (nine with MRA). RESULTS: MRI and MRA together provided the diagnosis of CVT in all cases. The sensitivity of MRI alone was 90%. MRA showed abnormalities in all cases of CVT. Progressive sinus recanalization was demonstrated by follow-up with MRI and MRA at least 15 days after diagnosis and treatment. CONCLUSION: In most of cases, the combination of MRI and MRA is sufficient to allow diagnosis of CVT and obviates the need for invasive angiography. MR studies are also useful for the follow-up of CVT.

Adolescent↗
PubMed1997

[Imaging of non-osseous malignant tumors of the anterior skull base. Preoperative evaluation].

Imaging is fundamental in pre-operative evaluation for cancers of anterior cranial base and ethmoido-sphenoidal region, particularly because clinical examination is poorly contributive and cannot evaluate the tumoral extension. Radiological data are based on CT-scan and MRI. The first goal of radiological evaluation is to recognize the presence of a tumor and to differentiate it from inflammatory lesions, which is not always very easy. The second aim is the evaluation of tumoral extension, particularly towards the intra-cranial cavity and the orbit. It leads to an extension grading which is essential for the choice of a therapeutic strategy (inductive chemotherapy, surgical approach, radiotherapy). The third goal of imaging examination is the evaluation of tumoral response to pre-operative inductive chemotherapy.

Humans↗
PubMed1997

[The nasopharynx and deep spaces of the face: anatomy and applications to pathology].

Deep facial spaces are anatomically delineated by the layers of deep cervical fascia. They are located between the skull base and the hyoid bone. Each space contains specific anatomic structures, which can be responsible for specific pathologic processes. Deep facial spaces can be divided in two medial odd spaces (pharyngeal mucosal and retropharyngeal spaces), and in three lateral even spaces (retrostylian, prestylian, and masticator spaces). The dividing of these core tissues are useful for the analysis of the lesions found in this area. CT scan and MRI (with axial and coronal views) provide precise analysis. The main lesions are: -medially, adenoidal hyperplasias and squamous cell carcinomas (pharyngeal mucosal space), adenopathies and abscess (retropharyngeal space). -laterally, salivary tumors (prestylian space), adenopathies, schwannomas and paragangliomas (retrostylian space). Masticator space (and especially pterygopalatine fossa) is an important way of communication and is often involved by the extension of locoregional pathologic processes.

Adenoids↗