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Introduction: Hypoplastic basilar (BA) and vertebral arteries (VA) can cause posterior circulation infarctions. Distinction between hypoplastic and atherosclerotic BA can be difficult with usual angiographic methods (MR, CT or conventional angiographies), only showing arterial luminogram. High-resolution MRI (HRMRI) of the arterial wall is promising in identifying intracranial artery plaques., Observation: A 70-year-old man with vascular risk factors suddenly presented with vertigo. MRI showed no brain infarction. Contrast-enhanced MRA showed small and irregular BA lumen compatible with severe atherosclerotic stenosis. An associated persistent primitive trigeminal artery was noticed. HRMRI of the BA rectified the initial angiographic diagnosis by showing a normal vessel wall without any thickening that could suggest atherosclerotic plaque., Conclusion: In the event of BA lumen narrowing, HRMRI may help distinguish between hypoplastic and atherosclerotic artery., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Introduction: Neurosyphilis is rare today. It arises on average 20 years after poorly treated or untreated primary syphilis. Considering the decline in the incidence of syphilitic meningo encephalitis and the little known MRI aspects, we report the case of a patient affected by neurosyphilis occurring after primary syphilis untreated for 25 years., Case Report: A 65-year-old man presented typical clinical features including general paresis with psychiatric disorders, maniac access, and frontal syndrome as well as tabes dorsalis and Argyll-Robertson pupil. Brain MRI showed bilateral high intensity signals on the T2 weighted sequence located in mesiotemporal, insular, frontal regions., Conclusions: Very few cases of neurosyphilis with detailed brain MRI aspects have been reported. The interest of this case report is first to recall the importance of syphilitic serology in patients with subacute psychiatric disorders and secondly to present rarely reported aspects of the brain MRI., (Copyright © 2011. Published by Elsevier Masson SAS.)

Introduction: Hypermanganism is primarily linked to inhalation exposure. Several observations of exogenous manganese poisoning have been reported associating neuropsychiatric symptoms, parkinsonian syndrome and hyperintensities of the two pallida on T1 weighted sequences on brain MRI. Recently, similar neurological and radiological signs have been described without exogenous exposure to manganese but in the framework of endogenous poisoning particularly in chronic hepatic failure., Case Report: We report the case of a 41-year-old HIV-positive and HVC-positive man who presented psychomotor impairment associated with bipallidal T1 hyperintensities on the brain MRI. The diagnosis of a hypermanganesemia was made on blood samples. We present a literature review on exogenous and endogenous hypermanganesemia and discuss differential diagnosis in the radiological setting of bipallidal T1 hyperintensities., Conclusion: Bipallidal T1 hyperintensities on brain MRI may suggest hypermanganism even in the clinical setting of a non-specific neurological disorder such as psychomotor impairment., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

We report the case of a 79-years-old woman, hospitalized for a suspicion of Creutzfeldt-Jakob disease because of subacute dementia associated with gait disorder. Laboratory testing revealed elevated serum calcium at 3.51 mmol/l (N=2.25-2.60 mmol/l) caused by a hyperparathyroidism. After symptomatic treatment of hypercalcemia by biphosphonate, cognitive functions as well as the gait disorder improved quickly. A double parathyroid adenoma was removed surgically. Primary hyperparathyroidism is a curable cause of a Creutzfeldt-Jakob like syndrome. Serum calcium should be checked in this clinical setting.

Introduction: Few cases of patients with both Familial Mediterranean Fever (FMF) and Multiple Sclerosis (MS) have been reported, mainly from Turkey. Central nervous system manifestations are rare in FMF., Case Report: We report the case of a 37-year-old right-handed man with FMF diagnosed at 17 the age of years and successfully treated with colchicine. The patient was born in Algeria and lived in France since he was four years old. He had a brother who had multiple sclerosis. When the patient was 23 years old, he experienced diplopia and leg numbness that resolved spontaneously without treatment. Ten years later, new neurological events appeared every six months and were treated with corticoid-steroids. The diagnosis of MS was made. In 2006, he was hospitalized for new explorations in order to search for neuro-Behçet's disease, because of the development of a canker sore. There was no argument for neuro-Behçet's disease., Discussion: Neurological complications of FMF are rare. It is important to rule out a neuro-Behçet disease in a FMF patient with neurological disorders. Previous studies and case reports on the association between FMF and MS have failed to draw a clear conclusion as to whether this is a true association or a simple coincidence. In our patient's clinical situation, we found no argument for changing the treatment of MS and FMF.

Transient splenial lesions of the corpus callosum have been mainly reported in epileptic patients. We report the case of a non-epileptic woman with bipolar affective disorder treated by oxcarbazepine which was withdrawn because of a mild hyponatremia (128 mmol/l). A confusional state followed withdrawal and the electroencephalogram was free of spike or sharp waves. Brain MRI showed a single splenial lesion of the corpus callosum revealed by a high intensity T2 signal on FLAIR and diffusion sequences. Because of a major depressive episode, twelve sessions of electroconvulsive therapy were performed and yielded clinical improvement. A second brain MRI performed 5 weeks later was normal. The relevances of this cases are the non-epileptic status of the patient, the drug incriminated (oxcarbazepine), and the normalisation of brain MRI despite electroconvulsive therapy. Different mechanisms of this brain MRI abnormality are discussed including the sudden withdraw of oxcarbazepine. Prognosis of transient splenial lesions of the corpus callosum is good. Clinicians should search for recent metabolic disorders and therapeutic modifications.

We report the case of a 47-year-old man with an aneurysm of the anterior cerebral artery revealed by lateral homonymous hemianopic non congruent scotoma. The aneurysm was successfully treated with interventional radiology procedures. In 10p. cent of cases, intracranial aneurysms present prior to their rupture with headache or neuro-ophthalmological symptoms and signs. Isolated visual field defects are rare, and isolated compression of the optic tract is extremely unusual. Although rare, the development of a non-congruent controlateral homonymous hemianopic scotoma is highly suggestive of optic tract compression, and can be explained by the somatotopy of the fibers within the optic tract.