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Resume La decouverte fortuite d’anomalies lors d’une exploration en imagerie par resonance magnetique (IRM) est observee 1 fois toutes les 37 IRM si l’on exclue les anomalies de la substance blanche, les infarctus silencieux et les micro-saignements. Cette proportion augmente avec l’injection de gadolinium, des sequences angiographiques, et l’âge des personnes. Les consequences sont parfois benefiques pour le patient lorsqu’elles permettent un traitement (par exemple d’une tumeur), ou la surveillance d’une lesion a risque evolutif (syndrome radiologique isole susceptible de representer un stade precoce de sclerose en plaques). Elles sont plus souvent deleteres par les consequences psychologiques et sociales qu’elles induisent, et les strategies therapeutiques auxquelles elles exposent, soient en traitant des anomalies qui ne devraient pas l’etre (par exemple certaines malformations arterioveineuses), ou en privant par exces de prudence le patient d’un traitement (thrombolyse intraveineuse en presence d’un anevrisme silencieux). Dans la plupart des cas l’incertitude prevaut et la decision necessite, en l’absence d’essais randomises, une analyse multidisciplinaire du risque spontane et du traitement, et la preference du patient. Un medecin qui demande la realisation d’une IRM doit avoir a l’esprit le risque de decouverte d’une anomalie fortuite qui ne rendra qu’exceptionnellement service au patient. Cette decouverte peut generer de l’anxiete chez les patients et leurs proches, et les exposer a des refus d’assurances, et une consommation excessive et souvent injustifiee de ressources medicales. Une telle eventualite doit etre anticipee, ce qui serait plus aise si l’acces a l’IRM etait reserve aux specialistes du sujet.

Traumatic subarachnoid hemorrhage (SAH) has an annual incidence of 9 per 100 000 people. It is a rare but serious event, with an estimated mortality rate of 40% within the first 48hours. In 85% of cases, it is due to rupture of an intracranial aneurysm. In the early phase, during the first 24hours, cerebral CT, combined with intracranial CT angiography is recommended to make a positive diagnosis of SAH, to identify the cause and to investigate for an intracranial aneurysm. Cerebral MRI may be proposed if the patient's clinical condition allows it. FLAIR imaging is more sensitive than CT to demonstrate a subarachnoid hemorrhage and offers greater degrees of sensitivity for the diagnosis of restricted subarachnoid hemorrhage in cortical sulcus. A lumbar puncture should be performed if these investigations are normal while clinical suspicion is high.

Isolated optic nerve sheath meningocele is a rare affection defined as the cystic enlargement of the optic nerve sheath filled with cerebrospinal fluid. We report the case of a 39-year-old woman presenting with bilateral meningocele uncovered during a routine examination for headache complaints. A 5-year follow-up validated the lesion’s clinical and imaging stability. Magnetic resonance imaging (MRI) is an essential tool in the diagnosis of this pathology, alongside characteristic symptoms indicating that the meningocele might have progressively expanded into the orbit. In this case we present a therapeutic approach based on pathophysiological hypotheses and review of the literature.

Glioblastomas are the most aggressive of the brain tumors occurring in adults and children. Currently available chemotherapy prolongs the median survival time of patients by only 4 months. The low efficiency of current treatments is partly owing to the blood-brain barrier, which restricts the penetration of most drugs into the central nervous system. Locoregional treatment strategies thus become mandatory. In this context, viral tools are of great interest for the selective delivery of genes into tumoral cells. Gliomas express high levels of type 2 somatostatin receptors (sstr2A), pinpointing them as suitable targets for the improvement of transduction efficiency in these tumors. We designed a new adenoviral vector based on the introduction of the full-length somatostatin (SRIF (somatotropin release-inhibiting factor)) sequence into the HI loop of the HAdV fiber protein. We demonstrate that (i) HAdV-5-SRIF uptake into cells is mediated by sstr2A, (ii) our vector drives high levels of gene expression in cells expressing endogenous sstr2A, with up to 65-fold enhancement and (iii) low doses of HAdV-5-SRIF are sufficient to infect high-grade human primary glioblastoma cells. Adenoviral vectors targeting SRIF receptors might thus represent a promising therapeutic approach to brain tumors.

Summary Reasons for performing study: Intense physical exercise can induce the degranulation of neutrophils leading to an increase in plasma concentration of the neutrophil marker enzymes myeloperoxidase (MPO) and elastase (ELT). These enzymes have pro-oxidative and pro-inflammatory properties and may play a role in the exercised-induced muscular damage. Objectives: To measure MPO and ELT concentrations in plasma and muscles of endurance horses and to correlate them to the extent of exercise-induced muscular damage. Methods: Seven endurance horses qualified on 120 km races were tested in this study. Neutrophil count, serum creatine kinase (CK), plasmatic and muscular MPO and ELT concentrations were measured before and 2 h after a 120 km endurance race. Results: The race produced a significant increase of neutrophils, CK, and plasma MPO and ELT levels. A significant correlation was observed between the MPO and ELT values in plasma (r2= 0.92, P

Introduction: Osteochondrosis (OC) is a developmental disease in horses which has a significant impact on the horse's welfare and performance. The early disturbance in the process of endochondral ossification progresses to inflammatory and repair processes in older horses. Previously, differentially expressed genes in leukocytes of OC-affected horses have been identified. The aim of the present study is to detect age-related changes in these differentially expressed genes. Materials and Methods: The expression of OC-related genes was analysed by real-time PCR and subsequent statistical analysis (ΔΔCT) in the leukocytes of 135 Belgian Warmblood horses divided into three different age groups: 30 months (n=38). Results: Relative expression of genes of horses less than 12 months of age showed significant induction of the genes MGAT4A, PRKCG, MHCI, ApoB, ApoB3G, B4GALT6 and a significantly lower expression of the genes OAS3. Horses of 18–24 months of age, showed a significantly higher expression of the genes TBC1D9, MGAT4A, IFIH1, MHCIIa and MMP1. Horses of more than 30 months of age showed a significantly higher expression of the genes MGAT4A, HP, SECTM1 compared with their age-matched control groups. Conclusions: The study demonstrates that OC-related genes are differentially expressed in horses of different ages compared with their age-matched controls. Some of the genes may be implicated in cell signalling and differentiation as well as carbohydrate and lipid metabolism and inflammation. However, the causal relationship between the differentially expressed genes and the development and progression of the OC lesions needs to be determined.

In the exercising horse, the oxygen delivery to the muscle enables the regeneration of high-energy phosphates (ATP) which are necessary for sustaining an effort and for subsequent recovery. For a fixed and constant level of submaximal exercise, the pulmonary oxygen uptake (VO2) reflects a balance between the energy required by the working muscles and ATP production via the aerobic metabolism. In horses performing

Behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture in a 44-year-old man. Callosal apraxia was associated with an alien hand. The latter remained 1 year after surgery while diagonistic apraxia disappeared after 3 months. Other callosal signs included left agraphia, tactile anomia and auditory suppression. MRI revealed posterior callosal infarction and a right frontal infarct. The association of diagonistic apraxia and alien hand is rarely reported.

We report the case of a meningeal inflammatory pseudotumour occurring in a 23-year-old male presenting with focal seizures and headaches. Brain imaging techniques showed a 3.5 cm left parietal meningeal tumour. Histology of the surgical specimen showed a dense lymphoid infiltrate permeating the dura mater and leptomeninges, consisting of a predominant polyclonal B cell population as confirmed by immunophenotyping and genotyping. Cultures of serum, CSF, and surgical specimen were negative and there was no serological evidence of a systemic dysimmune disease. The postoperative course was complicated by an episode of brain oedema resolving under steroid therapy. The patient, free from all medication, is asymptomatic at 3 years of follow-up. We discuss previously published cases and the nosology of intracranial inflammatory pseudotumours.

PURPOSE: To investigate the usefulness of preoperative percutaneous injections in vertebral hemangiomas. METHODS: Four patients presented with complicated vertebral hemangioma (spinal cord compression in three cases, intermittent spinal claudiction in one case). A three-part treatment was performed: initially, arterial embolization in three cases; 1 day later, percutaneous injections of methyl methacrylate into the vertebral body to strengthen it and of N-butyl cyanoacrylate into the posterior arch to optimize hemostasis during surgery; finally, the day after percutaneous injections, decompressive laminectomy and epidural hemangioma excision (when present). RESULTS: Laminectomy was performed with minimal blood loss. The epidural component present in three cases was excised without any difficulty. The follow-up (average, 20 months) showed no evidence of vertebral collapse. CONCLUSION: Percutaneous injections of methyl methacrylate and N-butyl cyanoacrylate might be useful before surgery for vertebral hemangiomas.