Treatment of cerebro-spinal fluid rhinorrhea from traumatic or tumoral origin, by simple dural patching, is not always sufficient because of the possible necrosis of the patch, mainly in case of severe osteo-meningeal defects. After having pointed out the frequency of such recurrences (5 to 30%, according to the data of literature), the authors report 6 personal cases successfully reoperated in order to repair the osteo-dural lesions with autogenous aponeurosis and bone grafts. 4 were after traumatism and 2 after removal of a tumor, in fronto-ethmoido-sphenoidal base of the skull. The authors suggest to combine bone reconstruction by autograft to the dural repair, even in case of primary fistula, when there is a severe traumatic or tumoral bone defect, or when we are dealing with a spontaneous rhinorrhea which is known to be generally due to local C.S.F. hyperpressure.

Adolescent↗

PubMedDate not supplied

[Extra-intracranial anastomosis preliminary to ligation of the carotid artery. Its value apropos of a case of traumatic aneurysm of the cervical internal carotid artery].

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Adult↗

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99mTc-MIBI uptake in a primitive leptomeningeal melanoma.

Primitive leptomeningeal melanoma is a rare and aggressive condition. The authors report on a case of primitive leptomeningeal melanoma imaged with 99mTc-Sestamibi (MIBI). There was an intense accumulation of the radiotracer in the frontal and parietal leptomeningeal regions and even after injections of gadolinium the MRI continued to reveal a cystic image of the brain. In view of the diagnosis, MRI demonstrated only limited usefulness. On the other hand, this case highlights the important role of MIBI for the imaging of malignant tumors.

Female↗