Reversible metronidazole-induced encephalopathy

We report the neuroimaging findings of a case of reversible metronidazole-induced encephalopathy. Magnetic resonance imaging (MRI) demonstrated lesions in highly suggestive locations. Follow-up imaging performed 1 month after cessation of metronidazole therapy demonstrated resolution of imaging findings.

Kyste épidermoïde intracrânien spontanément hyperdense

Intracranial epidermoid cysts are relatively rare tumors. These cysts are generally nearly isodense to CSF at CT and nearly isointense to CSF on T1W and T2W MR imaging. Spontaneously hyperdense epidermoid cysts are exceptional. We report the case of a 12-year-old girl with a spontaneously hyperdense epidermoid cyst of the posterior fossa presenting with focal neurological symptoms. The diagnosis was confirmed at histological examination.

Atypical CT and MRI aspects of an epidermoid cyst

We report a case of an unusual epidermoid cyst (EC) of the cerebellopontine angle that appeared hyperdense on computed tomography (CT) scanning, hyperintense on T1-weighted MR images and hypointense on T2-weighted magnetic resonance (MR) images. Diffusion-weighted imaging showed a hypointense lesion. We discuss imaging characteristics of ECs, explain the atypical findings in our case and confirm that the signal seen on diffusion-weighted images in the EC is related to a T2 effect.

Nasu-Hakola disease in two Tunisian siblings: new radiological findings

We report radiological features of a biopsy-proven early infantile form of Nasu-Hakoka disease in two Tunisian sisters with new bony and cerebral findings.

Intrasphenoidal rathke cleft cyst

Symptomatic Rathke cleft cysts (RCC) are reported in the sellar and suprasellar regions, but no case of sphenoidal RCC has been reported. We report a case of sphenoidal RCC in a 41-year-old man. The lesion was revealed by headaches and diplopia. Symptoms disappeared transiently after a spontaneous rhinorrhea but relapsed 4 months later. MR imaging showed a cystic sphenoidal lesion, isointense on T1-weighted images (WI) with peripheral gadolinium enhancement and hyperintense on T2 WI. The patient underwent surgery through a transrhinoseptal approach. The wall of the sphenoid sinus was paper-thin. The cyst contained a motor-oil-like fluid and communicated widely with the nasal fossa. Its wall was partially extracted. Symptoms and signs ceased after surgery. MR imaging performed 1 year later showed the disappearance of the sphenoidal cyst. Embryological origin of RCCs is discussed. The hypothesis of a continuum between the different epithelial cystic lesions of the sellar and parasellar region is discussed. Imaging has an important impact on the diagnosis; nevertheless, the specific characterization remains difficult.

[Transarterial embolization of intracranial dural arteriovenous malformations with ethylene vinyl alcohol copolymer (Onyx18): report of three cases]

BACKGROUND

This is a report of the endovascular treatment of three intracranial dural arteriovenous malformations (DAVM) using Onyx.

PATIENTS AND METHODS

We analyzed the clinical and angiographic results in three patients with intracranial DAVM, revealed by a hemorrhagic event and treated by endovascular way by the use Onyx. Angiographic investigation showed the DAVM to be located in the lateral sinus in two cases and in the tentorium region in the third.

RESULTS

In all three cases, embolization was performed by selective catheterization of the meningeal arterial feeder of the DAVM. The injection of Onyx resulted in complete anatomical exclusion of the DAVM, as demonstrated by posttreatment angiography. Clinically, the patients recovered partially or completely their neurological deficit.

CONCLUSION

Onyx is a liquid embolization agent recently introduced for the treatment of DAVM. When used under optimal conditions, it offers a feasible alternative option in the treatment of such vascular malformations.

[Gliomatosis cerebri]

The Gliomatosis Cerebri (GC) is an infiltrating and rare primitive tumour of the brain. It is characterized by diffuse neoplastic proliferation of glial cells involving of at least two lobes of the brain, without a distinct tumor mass and with the preservation of the anatomical and neuronal architecture. According to the WHO classification, GC is categorized as a high-grade neuroepithelial tumor of uncertain origin (GradelV). Now the diagnosis is facilitated via stereotactic biopsies of the representative lesion identified in magnetic resonance. Our objective is to present 4 new cases, and recall the clinical and radiological features and the prognosis.

[Nonketotic hyperglycemia-induced hemiballism]

Nonketotic hyperglycemia-induced hemichorea or hemiballism is a well-recognized entity that is rarely encountered. Particular computed tomography and magnetic resonance imaging findings have been described. The pathophysiological mechanism of this disease remains uncertain. We report here on two female patients that presented with hemiballism secondary to nonketotic hyperglycemia and underwent brain computed tomography and magnetic resonance imaging.