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Biomedical subjects

J-F Bonneville

Publications and source records attributed to J-F Bonneville.

8 recordsLinked to original sources

The dural tail sign--beyond meningioma.

There have been somewhat conflicting reports published about the significance of linear meningeal thickening and enhancement adjacent to peripherally located cranial mass lesions on contrast-enhanced magnetic resonance (MR) images. Most of the authors consider this so-called "dural tail sign" or "flare sign" almost specific for meningioma. This review illustrates the MR imaging findings of a wide spectrum of disorders that show this dural sign. Causes include other extra-axial lesions and also peripherally located intra-axial lesions such as neuromas, chloromas, metastases, lymphoma, gliomas, pituitary diseases, granulomatous disorders, and also cerebral Erdheim-Chester disease. The dural tail sign is not specific to a particular pathological process. Nevertheless, useful conclusions can be drawn from the morphology of the lesion, its enhancement pattern, and its solitary or multifocal presentation. The final diagnosis must be based on cerebrospinal fluid studies or histological studies after biopsy.

Adolescent↗

[MRI of the pituitary gland: indications and results in gynaecology and in obstetrics].

MRI is the sole radiological examination to be obtained if abnormal menses, galactorrhea or anovulation evokes the diagnosis of prolactinoma. Nevertheless, iatrogenic hyperprolactinemia or presence of big prolactin has to be ruled out before MRI is asked for. MRI of the pituitary gland must be technically optimal; analysis of the images has to be directed by clinical and biological data.

Amenorrhea↗

Split atlas in a patient with odontoid fracture.

We report the unusual association of a split atlas and an odontoid fracture in a case of a cervical trauma, thus mimicking a complex C1-C2 fracture. The normal embryology of C1 and the literature on this rare malformation are reviewed.

Adult↗

[Reninoma: a rare but curable cause of high blood pressure, a case report].

We report a case of a renin secreting tumor, which is a very rare cause of secondary high blood pressure. A 22-year-old woman was hospitalised for exploration of high blood pressure (160/110 mmHg) with severe hypokaliemia (2,7 mmol/l) and secondary hyperaldosteronism. Physical examination was normal except the high blood pressure. Bioassays show increased kaliuresis (66 mmol/24h), plasma renin (89 pg/ml in clinostastism--108 pg/ml in orthostatism), pro-renin (1207 pg/ml in clinostastism--1412 pg/ml in orthostatism) and aldosterone (210 pg/ml in clinostastism--566 pg/ml in orthostatism). The rest of the endocrine tests were normal (cortisol and ACTH at 8:00 am, urinary free cortisol, overnight 1 mg dexamethasone suppression test). Doppler ultrasound method, performed by an experienced radiologist, did not show renal artery stenosis. Abdominal computerized tomography showed a nodular formation at the upper pole of the right kidney, isodense to renal medullary. The size tumor was 15 mm. The renal vein sampling shows high values of renin on both sides whereas, for the pro-renin, the values were higher on the tumor side. In spite of treatment with CEI (Converting Enzyme Inhibitors) and calcium antagonists, the blood pressure was not controlled. Hypokaliemia persisted (3 mmol/l) in spite of high daily potassium intake (64 mmol/l of potassium chloride). After tumor resection, reninoma was diagnosed by the pathology examination and blood pressure, plasma rennin, plasma aldosterone level returned to normal.

Adult↗

[Rathke's cleft cyst].

Rathke's cleft cyst (RCC) are frequent benign cystic sellar lesions. Most RCC are small, intrasellar and asymptomatic. Larger cysts may compress adjacent structures and rarely become symptomatic. Diagnosis is strongly suggested at MRI by the presence of a midline non-enhancing lesion located exactly between the anterior and posterior lobes of the pituitary gland. Even if its signal is variable and related to intracystic protein concentration, it must be homogeneous with no fluid-fluid level. Once a diagnosis of RCC made, routine MR and clinical follow-up is sufficient for incidental asymptomatic cysts whereas the rare symptomatic lesions are neurosurgically resected.

Central Nervous System Cysts↗

[Follow-up MRI after trans-sphenoidal surgery].

The authors report their 10 year experience on postsurgical MRI of the sphenoidal region. All patients underwent MRI examination 4 days after surgery, then between 2 and 3 months and one year or more after surgery. The reproducibility of pulse sequences is mandatory to make a diagnosis of recurrent adenoma as early as possible.

Adenoma↗

Hypervascular intracisternal acoustic neuroma.

The diagnosis of acoustic neuroma is usually evoked in a patient presenting with a long history of hearing disturbance in whom an enhancing lesion within the internal auditory canal and/or the cerebellopontine angle is found on MRI. Hypervascularity with arteriovenous shunting and early filling of enlarged veins is a common feature of malignancy and has been reported very rarely in benign acoustic neuroma. We present the case of a patient without hearing disturbance, who showed a highly vascular lesion with no component in the internal auditory canal, making the preoperative diagnosis of acoustic neuroma very challenging. We discuss here the intracisternal site of origin and hypervascularity of acoustic neuroma, and also the differential diagnoses and management of such tumors.

Adult↗