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Pial arteriovenous fistulas (AVFs) are rare neurovascular malformations. They differ from arteriovenous malformations (AVMs) in that they involve single or multiple feeding arteries, draining directly into a dilated cortical vein with no intervening nidus. Pial and dural AVFs differ in blood supply, as the first originate from pial or cortical arteries and the latter from outside the dural leaflets. Unlike dural AVFs, most of the pial AVFs are supratentorial. The vast majority are congenital, manifesting during infancy. Acquired pial AVFs are significantly rarer and occur after vasculopathy, head trauma, brain surgery, or cerebral vein thrombosis. We describe a unique case of an acquired pial AVF in a 50-year-old man secondary to a cortical vein thrombosis manifesting as a focal-onset seizure with secondary generalization. A cerebral digital subtraction angiography revealed a low-flow pial AVF fed by a postcentral branch of the left middle cerebral artery draining to the superior sagittal sinus via a cortical vein. It also showed a collateral venous circulation adjacent to the previously thrombosed left parietal vein. There was no evidence of an associated dural AVF or venous varix. Endovascular treatment was scheduled three months later, but the angiogram preceding the embolization showed spontaneous and complete closure of the malformation. To our knowledge, this is the first case illustrating acquired pure pial AVF unaccompanied by a dural component following cortical vein thrombosis, eventually resulting in an unprompted closure.

The Salicornia species have been used for treatment and prevention of a various diseases. To the best of my knowledge, little information is regarding the antioxidant and protective activities of lipid extract from Salicornia Arabica (SALE). The objectives of this present work were designed to determine the in vitro antioxidant activities of SALE against cadmium-induced toxicity in erythrocytes isolated from rats. The distribution of fatty acid reflected the richness in saturated fatty acids that were predominated by palmitic acid. Our analysis showed that the major fatty acid components were palmitic acid (47.78%), linoleic acid (17.75%), followed by nanadecenoic acid (10.96%). Minor fatty acids including lignoseric acid and palmatoleic acid (C16:0). The in vitro antioxidant activity of SALE was evaluated using both test DPPH and ABTS assays. An important antioxidant potential was observed. The protective potential of SALE was evaluated by estimating the levels of stress markers like MDA concentration and SOD, CAT and GPx activities. Our results showed that cadmium significantly decreased the SOD, CAT and GPx activities in erythrocytes homogenates and enhanced lipid peroxidation. The pre-treatment with SALE ameliorated antioxidant status and inhibited MDA level in erythrocytes. In conclusion, the lipid isolated from S. arabica showed protective potential against Cd-induced erythrocytes damage, which could be related to active compounds present in this fraction.

BackgroundDuring the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study’s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.MethodsWe conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation.FindingsThere was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, pInterpretationThere was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.

Although rare, spondylodiscitis is the main manifestation of hematogeneous osteomyelitis in patients aged more than 50 years. In this chapter, we discuss the pathophysiology of spinal infections. We review the vascular supply of the spine and its development with age, which is important in understanding the typical patterns of infection in adults and children. Routes of pathogen spread are detailed, with a review of the literature. We identify specificities of pathophysiology in the most common causes of spinal infection, namely, pyogenic and tuberculous spondylodiscitis.

Salmonella osteomyelitis is uncommon and generally associated with sickle cell disease. Vertebral location is extremely rare and has mainly been reported in case reports. Magnetic resonance imaging (MRI) is the modality of choice for assessing discovertebral and soft tissue abnormalities. Imaging features are similar to other spondylodiscitis. Bacteria isolation is necessary for definitive diagnosis and antibiotic susceptibility testing, allowing adequate medical treatment.

In order to prepare thermally stable isosorbide-derived thermoplastic polyurethane, the synthesis of two new chiral exo–exo configured diols, prepared from isosorbide, and two types of diphenols (bisphenol A and thiodiphenol) was described. The synthesis conditions were optimized under conventional heating and microwave irradiations. To prove their suitability in polymerization, these monomers were successfully polymerized using 4,4′-diphenylmethane diisocyanate (MDI) and hexamethylene diisocyanate (HDI). Both monomers and polymers have been studied by NMR, FT-IR, TGA, DSC; intrinsic viscosity of polymers has also been determined. The results showed the effectiveness of the synthetic strategy proposed; moreover, a dramatic reduction of the reaction time and an important improvement of the monomers yield using microwave irradiation have been demonstrated. The monomers, as well as the polymers, showed excellent thermal stability both in air and nitrogen. It was also shown that the introduction of sulphur in the polyurethane backbone was effective in delaying the onset of degradation as well as the degradation rate.

A linear biobased polyacetal was prepared from the reaction between isosorbide and methylene chloride according a one step procedure. Cyclic polyacetal was obtained using the previous linear polymer as precursor. The respective architectures of both polymers and their chemical compositions were carefully established using 1 H NMR and MALDI-TOF spectroscopies. Their molecular weight characteristics were defined using a triple detection size exclusion chromatography while their thermal characteristics were investigated by the conduction of calorimetric and thermogravimetric experiments. The registering of the thermomechanical properties of each kind of isosorbide-based polyacetal showed that the cyclic polymer was the only one able to show a rubbery plateau. This peculiarity was justified by calculation of the threshold value above which entanglements were possible.

We report our assessment of the experience of female interventional radiologists in different Arab countries based on an online questionnaire that was sent to 57 female interventional radiologists in 5 Arab countries. These interventional radiologists were identified from the Pan Arab Interventional Radiology Society database and through personal communications. The survey included items related to demographics, social status, and the professional challenges of interventional radiologists, with a response rate of 93%. Forty-five percent of respondents were between 31 and 45 years of age. Interventional radiology practice represented 25%-50% of work time for 51% of respondents, and the main challenges reported were related to radiation exposure, balancing family/work life, and the male-dominated interventional radiology community.

The objective of this current study was to investigate the possible hyperlipidemic and antioxidative effects of Cystoseira crinita sulfated polysaccharide (CCSP) in rats fed with a high-fat diet, exhibited an inhibitory activity on pancreatic lipase in vitro. In vivo administration of this extract to HFD-rats lowered body weight and potentially inhibited key enzymes of lipid metabolism and absorption as lipase activity in both plasma and small intestine, which led to a notable decrease of blood LDL- cholesterol (LDL-Ch) and triglycerides (TG) levels, and an increase in HDL-cholesterol (HDL-Ch) levels in HFD-rats. CCSP was also observed to protect the liver-kidney functions efficiently, by decreasing of aspartate transaminase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH) and Creatine phosphokinase (CPK) activities and creatinine, albumin, T-bilirubin, uric acid, and urea rates in plasma. The histological analysis of liver and kidney tissues further established the positive effect of CCSP.

This paper describes both the synthesis and characterization of a biobased and non-aromatic polyacetal produced from the reaction between isosorbide and methylene chloride. The reaction was conducted in an aprotic dipolar and harmless solvent using a one-step, fast and economical procedure. The chemical composition of this polymer was investigated using Nuclear Magnetic Resonance and Fourier Transform Infra-Red spectroscopies. The molecular weights were examined by size exclusion chromatography and MALDI-TOF spectrometry. The synthesis conditions (concentration, mixing speed, solvent nature, stoichiometry, addition mode of one reactan) were found to strongly influence both polymer architecture and reaction yield. Under moderated stirring conditions, the polyacetal was characterized by a larger amount of macro-cycles. Inversely, under higher intensity mixing and with an excess of methylene chloride, it was mainly composed of linear chains. In this latter case, the polymeric material presented an amorphous morphology with a glass transition temperature (Tg) close to 55 °C. Its degradation temperature was evaluated to be close to 215 °C using thermogravimetry according to multi-ramp methodology. The chemical approach and the physicochemical properties are valuable in comparison with that characteristic of other isosorbide-based polyacetals.

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.

Resume Objectifs Rapporter trois observations de malformations arterioveineuses durales (MAVD) intracrâniennes, traitees par injection transarterielle d’ethylvinyl alcool copolymere (Onyx®18). Patients et methodes Nous avons analyse les resultats cliniques et angiographiques chez trois patients porteurs d’une MAVD revelee par une complication hemorragique et traitee par embolisation a l’aide d’Onyx. L’exploration angiographique a montre une MAVD localisee au niveau du sinus lateral chez deux patients et de la tente du cervelet chez le troisieme. Resultats L’embolisation a ete realisee par catheterisme selectif du pedicule arteriel meninge alimentant la MAVD et injection unique d’Onyx®. Un controle angiographique realise en fin de traitement a confirme l’exclusion anatomique complete de ces trois MAVD. Cliniquement, les patients ont recupere de facon partielle ou totale leur deficit neurologique. Conclusion L’Onyx® est un agent embolique recemment introduit pour le traitement des MAVD intracrâniennes. L’utilisation de ce produit dans des conditions optimales, offre des options therapeutiques interessantes dans le traitement de ces malformations.

SUMMARY Neurenteric cysts (NECs) are dysraphic lesions. They are usually extramedullary, the intramedullary forms are very rare. To our knowledge, only 10 cases of isolated intramedullary NECs have been reported. We report a case of intramedullary NEC without any associated dysraphic lesion. The clinical findings were: cervical pain and left hemicorporal weakness which predominated at the upper limb. Neuroradiological evaluation was performed by means of MRI which revealed a cystic lesion at C3-C4 level. A partial excision was performed and the diagnosis of NEC was established by histological study.

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.

Journal of Neuroradiology - In Press.Proof corrected by the author Available online since mardi 17 aout 2010

Cerebellar liponeurocytoma is a newly recognized, rare clinicopathological entity commonly described in the cerebellar hemispheres or the vermis. We present a rare case of cerebellar liponeurocytoma arising from the left cerebellar amygdala with extracranial extension. Such a condition has never been previously reported.

Introduction Atrial fibrillation is associated with a prothrombotic state with an increased risk of stroke. Recent studies suggested that there is an apparent link between thrombogeneses and inflammation. Aim we sought to study the relation between high sensitive C reactive protein (HS CRP) and clinical (CHAD score) and echocardiographic prothrombotic indexes in patients with atrial fibrillation. Methods we prospectively measured HS CRP in 100 patients with atrial fibrillation. The mean age was 56 ± 12 years. All patients underwent transoesophageal echocardiography (TEE). The TEE risk factors for thromboembolism considered were: a peak left appendage velocity 0.2 m/s, the presence of a thrombus and a dense spontaneous echo contrast. Results HS CRP was correlated with the clinical CHAD score (r = 0.54, p = 0.0001). CRP value was significantly higher among patients with a CHAD score 2 (6.91 ± 4.4 mg/dl vs 4.35 ± 3.8, p = 0.001). Values of HS CRP were comparable between patients having 1 TEE risk factor and those with no TEE risk factor (5.13 ± 3.7 vs 6.5 ± 0.5 p = NS). Discussion and conclusion the significant correlation between the CHAD score and HS CRP could be explained by the existence in this score of factors associated with elevated CRP. Although no apparent relation was found between the HS CRP and echocardiographic risk factors of thromboembolism, these results do not exclude the inflammatory hypotheses in the pathogeneses of thromboembolism. A study of the correlation between CRP and thrombo-embolic complications during follow up of patients is mandatory.

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.

Introduction Several studies proved that obstructive sleep apnea (OSA) is associated with cardio-vascular diseases such as cardiac arrhythmia. QT duration and dispersion reflect the heterogeinity of ventricular repolarization and are considered as precursors of ventricular arrhythmia Aim The aim of this study is to assess the relation between the severity of OSA parameters as apnea hypopnea index and QT intervals. Methods Forty patients (18 men and 22 women) who were diagnosed with OSA by overnight polysomnography were included in this prospective study. The mean age was 56±10 years old. They were all in sinus rhythm. Before initiating continuous positive airway pressure therapy, we calculated on a 12 lead ECG : QT duration (QTend) corrected to Bazett formula and QT dispersion (QT end max -QT end min). Results Twenty four patients had severe OSA (AHI >30), 4 had moderate OSA (AHI between 15 and 30) and 12 had a mild OSA (AHI between 5 and 15). There was a significant positive correlation between QT dispersion and AHI (r=0.48, p=0.001) Conclusion The severity of OSA seems to be correlated with ventricular repolarization heterogeinity These results suggest that the higher is the AHI the higher is the risk of ventricular arrhythmia occurence. Further studies are needed to validate these results.

Oral anticoagulation with vitamin K antagonists (VKA) are widely prescribed for the prophylaxis and treatment of many thrombo-embolic disorders. The management of patients with VKA represents a public health problem according to higher number of death and hospitalization in relation to bleeding complications.Aim of studyTo evaluate patients’ knowledge about the acenocumarol treatment, the therapeutic range of International Normalized Ratio (INR), the bleeding and thrombotic risks and its interactions with other medications and food.Material and methods139 consecutives patients on long-term acenocumarol treatment were included in this single center descriptive study. The mean age was 58.9±14 (26–86 years) and 50.4% were male. They were interviewed by a fellow using a questionnaire specifically prepared by the authors. This questionnaire had 10 questions concerned their understanding of the goal of the oral anticoagulant therapy, knowledge of target INR ratio, frequency of INR examination, factors influencing INR values e.g. drugs-drugs interactions (like aspirin therapy) and food. One point was giving for each question answered correctly.ResultsThe mean total knowledge level was 3.9±2.5 (0–10). Percentages of correct answers (Level test score>6/10) for the questions evaluating know-ledge about acenocoumarol treatment did not exceed 18%. Only 23 patients (16.5%) declared knowledge of target INR ratio and only 52 (37.4%) answered correctly about the bleeding risk. The knowledge of interactions between acenocoumarol and other medications in particular aspirin was low (28.6%). The importance of diet was unknown by almost patients (95.5%). Multivariate analysis showed two independent predictor factors linked with an insufficient knowledge (Level test score60 years (OR=4.7; p

IntroductionRamadan fasting is one of the five pillars observed by Muslim adults worldwide. Data on incidence of acute coronary syndrome during fasting Ramadan are scarce and conflicting. Inflammation plays a major role in atherothrombosis, and measurement of cardiac biomarkers such as High sensitive C-reactive protein (hs-CRP) may provide a strong independent predictor of future cardiac events.Aim of this studywas to evaluate the effect of fasting during Ramadan on hs-CRP in patients with stable coronary artery disease (CAD).Patients and Methodsit was a prospective pilot study among 27 patients with stable CAD (within the last 6 months) who were observed before and at the end of Ramadan fasting. Patients were recruited from outpatients department. Twenty one were males and 6 were females with a mean age of 59±8.2 years (52-75 y). Fifteen patients had hypertension, 10 were smokers and 7 were diabetics. Blood was analyzed at the first visit was a week before the onset of Ramadan and the second visit at the third week of Ramadan. The assay of hs-CRP was done with the collected sera by Demeditec Diagnostics Systems Laboratories (Germany).ResultsSix patients were excluded for the second visit due to various reasons (break voluntary of fasting in two cases, 4 patients with concurrent inflammatory disorders e.g. rheumatoïd disease in 2 cases and intercurrent infections in two others). A total of 21 subjects were screened during this period. There was a significant reduction in hs-CRP during Ramadan compared before this period: 6.6±8.7 vs 3.8±5.5 (p

P O S T E R S separated into access site used, and procedural and clinical outcomes were compared. MACE was reported at 30 days. Results: 685 patients underwent RA PCI (Radial n 1⁄4 398 and Femoral n 1⁄4 287) during the study period. There was a predominance of male patients in the radial group (75.4% Vs 63.4% p