Abstract Objectives Intracranial aneurysms are rare in children although giant aneurysms more commonly occur in adolescence. The aims of our study were to perform an extensive review of the ...literature over the past two decades and assess intracranial aneurysm management. Methods Based on a Pubmed search, we carried out a review of the literature from 1990 to 2012 regarding giant intracranial aneurysms diagnosed in the paediatric population. This descriptive study concerned clinical presentation, cerebral aneurysm characteristics, therapeutic management procedures and outcome. Results Forty-six cases were reported in 31 papers. The male/female sex ratio was 1.15, the clinical presentation was a tumour mass syndrome in 56.6%, followed by rupture in 30.4%. The aneurysm location was the posterior circulation in 41.3%, and microsurgical treatment (52.2%) predominated over endovascular coiling (28.3%). Conclusion To date, no evidence-based medicine recommendation has been accepted for the management of rare intracranial aneurysms. Each reported patient was the object of a multidisciplinary clinical decision. Management of this challenging pathology should be performed on a case-to-case basis.
Propos. –
La troponine occupe désormais une place essentielle dans le diagnostic d'infarctus du myocarde. Avec pour objectif d'améliorer la pratique quotidienne du praticien face à une suspicion ...d'évolutivité coronarienne, la présente mise au point se propose de préciser l'interprétation des dosages de troponine en fonction du contexte clinique et des pathologies associées.
Actualités et points forts. –
Dans un premier temps, la place de la troponine par rapport aux autres marqueurs d'ischémie coronarienne sera précisée. Ensuite, les données de la littérature disponibles sur la troponine dans les pathologies cardiovasculaires mais aussi dans les pathologies extracardiaques seront analysées. Enfin, les difficultés techniques du dosage seront abordées.
Perspectives et projets. –
La possibilité de disposer d'un marqueur aussi sensible et spécifique que la troponine est incontestablement un progrès pour la prise en charge des patients atteints de syndrome coronaire aigu. Il n'en reste pas moins un outil au service de la prise en charge d'un patient dans son ensemble. Il est donc essentiel de connaître les circonstances susceptibles de modifier les taux sous peine de mauvaise interprétation du dosage, pouvant conduire à des erreurs à la fois diagnostiques mais aussi thérapeutiques.
Purpose. –
Troponin is now the gold standard for the diagnosis of myocardial infarction. Aiming at improving the management of a patient suspect of an acute coronary syndrome, this article will point the interpretation of troponin dosages according to the clinical presentation and concomitant diseases.
Actualities. –
First, the interest of troponin dosage as compared with other markers of myocardial ischemia will be underlined. Then, the literature available about troponin in cardiovascular diseases but also in extracardiac diseases will be analysed. Finally, the difficulties of assay will be discussed.
Perspectives. –
The availability of a sensitive and specific marker such as troponin is definitively a progress in the management of patients with an acute coronary syndromes. But it remains a biological contribution to the global management of the patient. It is important to know the causes susceptible to increase the levels of troponin to avoid a wrong interpretation of the dosage, leading to diagnostic but also therapeutic mistakes.
Abstract Methods A case report of a giant thoracolumbar synovial cyst is presented. Results A 74-year-old woman presented with a chronic lumbar pain associated with pain in the left leg. MR imaging ...showed a voluminous extradural cyst extending from T12 to L2. The cyst was surgically removed entirely. Microscopic examination revealed a synovial cyst. Conclusions In spite of a careful review of the literature, no other description of a giant thoracolumbar synovial cyst developed on three metameric levels was found. The diagnosis was made with a MRI scan combined with microscopic examination. The pathogenesis and therapeutic strategy are discussed.
A case of a meningeal B-cell lymphoma is described. A 48-year-old man presented with an episode of grand mal seizure following a brain injury. An initial diagnosis of extradural hematoma was made ...based on the results of the cerebral computerized tomography scan. Magnetic resonance images demonstrated an enhanced mass with a dural tail attached to the meningeal layer of the temporal bone, suggesting a meningioma "en plaque". The mass was surgically excised. Tumoral removal was subcomplete (Simpson 2). Operative inspection also suggested a meningioma, but histological analysis and electron microscopy revealed a grade IV follicular B-cell lymphoma. Biological studies were normal. An extensive workup found an external iliac adenopathy with several osseous locations on PET. The patient underwent chemotherapy and radiotherapy. Three years after the first symptoms appeared, the patient is alive and free of symptoms. The clinicopathological features and treatments were discussed.
Abstract A case of a meningeal B-cell lymphoma is described. A 48-year-old man presented with an episode of grand mal seizure following a brain injury. An initial diagnosis of extradural hematoma was ...made based on the results of the cerebral computerized tomography scan. Magnetic resonance images demonstrated an enhanced mass with a dural tail attached to the meningeal layer of the temporal bone, suggesting a meningioma “en plaque”. The mass was surgically excised. Tumoral removal was subcomplete (Simpson 2). Operative inspection also suggested a meningioma, but histological analysis and electron microscopy revealed a grade IV follicular B-cell lymphoma. Biological studies were normal. An extensive workup found an external iliac adenopathy with several osseous locations on PET. The patient underwent chemotherapy and radiotherapy. Three years after the first symptoms appeared, the patient is alive and free of symptoms. The clinicopathological features and treatments were discussed.
