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Purpose To evaluate the diagnostic accuracy and reliability of computed tomographic (CT) angiography to distinguish true cervical internal carotid artery (ICA) occlusion from pseudo-occlusion (defined as an isolated intracranial thrombus that impedes ascending blood flow) in the context of acute stroke. Materials and Methods This was a retrospective study of patients who underwent thrombectomy with preprocedural CT angiography that helps to demonstrate a lack of attenuation in the cervical ICA on the symptomatic side (24 men and 13 women; mean age, 63 years; age range, 30-86 years). Seven readers, including five neuroradiologists and two interventional neuroradiology fellows, independently reviewed the CT angiography images to assess whether there was true cervical ICA occlusion. Their results were compared with digital subtraction angiography (DSA) as the reference standard. Sensitivity and specificity for detecting true occlusion as well as accuracy and diagnostic odds ratio were calculated, with inter- and intraobserver κ statistics. Results Cervical ICA pseudo-occlusion occurred in 12 of 37 patients (32.4%) with nonattenuation of the cervical ICA on the symptomatic side. Interobserver agreement coefficients did not reach the substantial value of 0.61 for either pairs or groups of readers. The cohort's average sensitivity and specificity was 68% (95% confidence interval [CI]: 59%, 76%) and 75% (95% CI: 71%, 80%), respectively, with a diagnostic odds ratio of 8 (95% CI: 3, 18) and only fair interobserver agreement (κ = 0.32; 95% CI: 0.16, 0.47). Conclusion In the context of acute ischemic stroke with ipsilateral ICA nonattenuation at single-phase CT angiography, even specialized radiologists may not reliably distinguish true cervical occlusion from pseudo-occlusion.

Pseudotumoral cerebellitis in childhood is an uncommon presentation of cerebellitis mimicking a brain tumor. It often follows an inflammatory or infectious event, particularly due to varicella virus. Patients could have a wide clinical spectrum on presentation. Some patients may be asymptomatic or present at most with mild cerebellar signs, whereas others may suffer severe forms with brainstem involvement and severe intracranial hypertension mimicking tumor warranting surgical intervention. Imaging techniques especially multimodal magnetic resonance imaging represent an interesting tool to differentiate between posterior fossa tumors and acute cerebellitis. We describe a case of pseudotumoral cerebellitis in a 6-year-old girl consequent to mumps infection and review the literature on this rare association.

Background and purpose Assess the evolution of gadolinium consumption and magnetic resonance imaging (MRI) scanners in France and Western Brittany (France) and compare regional practices between public and private hospitals for each organ specialty. Material and methods We collected data from national and universal health registries, and Western Brittany's health care structures, between 2011 and 2018, about the number of MR imaging exams and machines, the number of delivered GBCAs (gadolinium-based contrast agents), prescriptions and administration protocols. Results Over the last eight years, we observed an increase in the number of MRI machines implemented in France (62%), correlated with the increase of annual gadolinium consumption (amount of delivered GBCAs in kg, 64%), without modification of the annual quantity of gadolinium used per machine (2.7 kg in 2018). In Western Brittany, gadolinium impact is assigned to neuroimaging exams (50% CI95% [45;56] of all the contrast-enhanced exams), followed by thorax and abdomen exams (23% CI95% [18;28]). The ratio of injected exams to all exams is greater in public than in private hospitals (respectively 48% CI95% [46;49] versus 29% CI95% [26;30]). Conclusion Gadolinium consumption is increasing, correlated with the increase in the number of examinations carried out. Regionally, the main impact comes from neuroimaging exams. No change in practices has been observed in recent years despite some warnings about gadolinium deposits and environmental consequences.

Tfifha M, Gaha M, Gamaoun W, Chemli J, Mabrouk S, Hassayoun S, Zouari N, Jemni H, Abroug S. Clinical and imaging features of malignant infantile osteopetrosis. Turk J Pediatr 2017; 59: 452-457. Human osteopetrosis is a rare genetic disorder caused by osteoclast failure. It encompasses a group of highly heterogeneous forms, ranged widely in severity. Patients with autosomal recessive osteopetrosis are the most severely affected osteopetrotic patients. Here we describe Tunisian children with severe phenotype. They are native from the same geographic region, born to consanguineous parents. Clinical features were cranio-facial dysmorphy, macrocephaly, hepatosplenomegaly, severe anemia and thrombocytopenia with precocious onset of neuronopathic complications, blindness and deafness. Retinal atrophy, reported in a minority of forms is highlighted. Skeletal radiographs revealed generalized increase in bone density and abnormal metaphyseal remodeling, and superimposed rickets resulting from the defect in osteoclasts to provide a normal Ca/P balance. We report an exceptional association with congenital hypothyroidism. Multi-organ failure due to sepsis is one the most severe complications observed. The issue was fatal without hematopoietic stem cell transplantation.

Introduction For thirty years now, linear or macrocyclic gadolinium-based contrast agents (GBCAs) have been routinely used in MRI. They were initially assumed to have virtually no side effects, but gadolinium can accumulate in tissue, bone and brain. Moreover, linear GBCAs can cause nephrogenic systemic fibrosis, a debilitating and potentially life-threatening disease, for patients with kidney failure. Thus, the use of some linear GBCAs has been reduced over the last decade, and has even been stopped in Europe. Objectives Assess the evolution of the consumption of GBCAs in France and particularly in Finistere during the period 2011–2017. Provide explanation for this evolution. Material and methods We used the French Health Insurance Agency (CPAM) and the Brest university hospital databases to assess the evolution of GBCAs consumption and MRI examinations performed during the period 2011–2017. Results During this period 2011–2017, the number of GBCAs reimbursed boxes increased of 95 % in Finistere and of 119 % in France. There was a rise of 64 % in the consumption of GBCAs in the university hospital of Brest. The number of MRI examinations also increased during this period. The increase was of 65 % in private clinics in the Finistere. During this period, there was the equivalent of 1.5 MRI that were newly implemented in Finistere. Another point to consider was the increase of examinations realized by teleradiology. Conclusion Increase of GBCAs consumption during the period 2011–2017 in France ( Fig. 1 ) and particularly in Finistere is only partially related to the increase of MRI examinations’ number. Further studies should be performed to assess whether this increase of enhanced MRI examinations improves the patients’ management. As GBCAs are not recovered during wastewater treatment, impact of gadolinium concentrations increase in coastal seawaters should also be raised [1] , [2] .

Journal of Neuroradiology - In Press.Proof corrected by the author Available online since samedi 6 avril 2013

Sternocleidomastoid tumor of infancy (SCMTI) is a rare cause of benign neck masses in neonates and infants. It has to be differentiated from other congenital space-occupying lesions in the cervical region. 'Patients and methods: 'The files of 13 infants with a mean age of 6 weeks, presenting with a lateral neck mass at Sahloul University Hospital in Sousse (Tunisia) between 2007 and 2009 were retrospectively studied. All of them underwent physical and ultrasonographic examination. MRI was performed in only one case. 'Results: 'Ultrasonography (US) showed a soft tissue mass of sternocleidomastoid muscle (SCMM), or a homogenously enlarged muscle without any focal mass. MRI revealed a fusiform enlarged muscle. Diagnosis of SCMTI was established in all cases. Conservative treatment was recommended in all cases with physiotherapy in 2 cases. 'Conclusion: 'US is the best imaging modality for the diagnosis of SCMTI and the first one to be performed. Additional diagnostic imaging modalities are unnecessary in most of the cases.

Background: Integrated actions against selected risk factors (i.e. smoking, physical inactivity, and unhealthy diet) can lead to the reduction of major chronic diseases. Objective: To implement and evaluate a school-based intervention program to prevent cardiovascular risk factors among children. Materials and Methods: Design: Pre- test post-test quasi experimental design with a control group. Setting: Four secondary schools in Sousse, Tunisia. Intervention: The overall intervention program lasted for a school year and incorporated educative actions concerning tobacco use, physical activity, and healthy diet. Results: Globally, knowledge, behaviors, and intentions concerning smoking improved in both groups between baseline and the end of the study, particularly in the intervention group. Nutrition knowledge, behaviors, and intentions improved in both groups between baseline and final stage, particularly in the intervention group. At the final stage, there was an increase in the proportion of children walking to and from school in the intervention group. There was also an increase in the percentage of children with intention of practicing sport in the future particularly in the intervention group. There were no significant differences in BMI after the intervention neither in intervention nor in control groups. At the end of the study, the incidence of overweight and obesity was similar to that at baseline. Conclusions: This pilot study has demonstrated the potential of school as a suitable setting for the promotion of healthy lifestyles in children. The study resulted in substantial improvements concerning knowledge, behaviors, and intentions in the intervention group.

Headache during pregnancy is a common issue for which there is a broad differential diagnosis, ranging from common benign primary headaches to certain life-threatening conditions. Although it can be a challenging diagnosis, the presence of previously unknown or new-onset headaches can alert the clinician to the possibility of an underlying secondary process, and orient the subsequent investigation.Here, we present the case of a 33-year-old migrainous patient presenting in her 36th week of pregnancy with recurrent thunderclap headaches (TCH) in association with multifocal cerebral arterial vasospasms, compatible with a diagnosis of reversible cerebral vasoconstriction syndrome. This case serves as a starting point to briefly discuss this syndrome, its particularities during pregnancy, and its management before reviewing some other important entities that can present with TCH during pregnancy. This case also underscores the paramount importance of identifying the presence of a different pattern of headaches in a patient consulting for this symptom, in order to plan further investigation.

DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome is a severe adverse drug-induced reaction. It manifests with pyrexia, eosinophilia, and lymphadenopathy, with multiple organ involvement, mainly the skin, liver, and kidneys. The purpose of this article is to demonstrate that DRESS syndrome can be associated with cerebral manifestations, a concept not well known in the neuroradiological literature. We describe three cases of DRESS syndrome associated with cerebral vasculitic-like lesions and realize a review of the literature to demonstrate that this association represents a very rare entity. Acute ischemic lesions were found among two patients. In all cases, perivascular enhancement was present. Magnetic resonance angiography (MRA) sequence was normal. Although no cerebral biopsy was performed, this enhancement pattern is strongly suggestive of a vasculitic process associated with DRESS syndrome. Diagnosis of cerebral vasculitic-like associated lesions must be considered in patients with DRESS syndrome since it can be reversed completely by withdrawing the causal medication and instigating corticosteroid treatment in a timely fashion.

Introduction La fusion des sequences fluid attenuation inversion recovery (FLAIR) et white matter attenuation inversion recovery (WAIR) est une methode permettant la soustraction du signal du liquide cerebro-spinal (LCS) et de la substance blanche a partir d’un algorithme mathematique. L’objectif de ce travail est d’evaluer l’apport de l’utilisation de ces images de fusion dans la detection des lesions de sclerose en plaques (SEP) dans le cerveau comparativement aux sequences T2 FLAIR et T2 TSE ( turbo spin-echo ). Materiel et methodes Tous les examens d’IRM cerebrale realises chez les patients suivis pour SEP certaine au « King Saud Medical City » en Arabie Saoudite ont ete recenses durant la periode allant de janvier a juin 2016. Les examens ( n = 50) ont ete effectues sur une machine GE Discovery 1.5 Tesla. La sensibilite des images de fusion a ete comparee a celle des sequences T2 FLAIR et T2 TSE. Le contraste entre les lesions et la substance blanche apparemment normale, la substance grise apparemment normale et le LCS a ete determine pour toutes les sequences. Resultats L’utilisation de l’imagerie de fusion a permis de detecter une charge lesionnelle significativement plus elevee aux etages sus-tentoriel et infra-tentoriel comparativement aux sequences T2 FLAIR et T2 TSE. Le contraste entre les lesions de SEP, la substance blanche apparemment normale et le LCS etait significativement plus eleve en utilisant les images de fusion. Conclusion Les images de fusion FLAIR/WAIR semblent etre superieures aux sequences T2 FLAIR et T2 TSE dans la detection des lesions de SEP. Il serait interessant lors de prochaines etudes de comparer cette imagerie avec la classique sequence double inversion-recuperation.

BACKGROUND AND PURPOSE: Angiographic results are commonly used as surrogate markers of the success of intra-arterial therapies for acute stroke. Inter- and intraobserver agreement in judging angiographic results remain poorly characterized. Our goal was to assess 2 commonly used revascularization scales. MATERIALS AND METHODS: A portfolio of 148 pre- and post treatment images of 37 cases of proximal anterior circulation occlusions was electronically sent to 12 expert observers who were asked to grade treatment outcomes according to recanalization (of arterial occlusive lesion) or reperfusion (TICI) scales. Three expert observers had to score treatment outcomes by using a similar portfolio of 32 patients or when they had full access to all angiographic data, twice for each method 3–12 months apart. Results were analyzed by using κ statistics. RESULTS: Agreement among 9 responding observers was moderate for both the TICI (κ = 0.45 ± 0.01) and arterial occlusive lesion (κ = 0.39 ± 0.16) scales. Agreement was similar (moderate) when 3 observers had access to a portfolio (κ = 0.59 ± 0.06 and 0.49 ± 0.07, respectively) or to the full angiographic data (κ = 0.54 ± 0.06 and 0.59 ± 0.07, respectively). Intraobserver agreement was “fair to moderate” for both methods. Interobserver agreement became “substantial” (>0.6) when outcomes were dichotomized into “success” (TICI 2b, 3; arterial occlusive lesion II, III or “failure”; the results were judged more favorably when the arterial occlusive lesion rather than the TICI scale was used. CONCLUSIONS: There is an important variability in the assessment of angiographic outcomes of endovascular treatments, invalidating comparisons among publications. A simple dichotomous judgment can be used as a surrogate outcome when treatments are assessed by the same observers in randomized trials.

Cette presentation nous a permis de passer en revue les criteres de McDonald de 2010 concernant le diagnostic de la sclerose en plaques (SEP) au stade initial et d’emettre des recommandations facilitant leur application. Nous avons egalement discute du protocole IRM optimal a realiser pour le diagnostic et la surveillance de la SEP. Enfin, nous nous sommes interesses aux moyens d’ameliorer la communication entre les neurologues et les radiologues concernant l’utilisation de l’IRM dans l’analyse de la SEP.

Introduction La technique de fusion des images provenant des sequences densite protonique (DP) et T2 Dual Echo Fast Spin Echo est basee sur l’utilisation d’un algorithme mathematique combinant les deux types d’images produites au cours d’une meme acquisition. L’objectif de ce travail est d’evaluer l’apport de l’utilisation de ces images de fusion dans la detection des lesions spinales de sclerose en plaques (SEP) comparativement aux sequences DP et T2. Materiels et methodes Tous les examens d’IRM spinale cervico-thoracique realises chez des patients suivis pour SEP certaine au « King Saud Medical City » en Arabie Saoudite ont ete recenses durant la periode allant de janvier a juin 2016. Les examens (n = 50) ont ete effectues sur une machine GE Discovery 1.5 Tesla. Le nombre de lesions detectees sur les images de fusion, la sequence DP et la sequence T2 a ete comptabilisee. Le contraste entre les lesions et la moelle apparemment normale et le ratio signal/bruit ont ete egalement quantifies. Resultats L’imagerie de fusion a permis de detecter un nombre de lesions significativement plus eleve comparativement aux sequences DP et T2. Le contraste par rapport a la moelle apparemment normale et le ratio signal/bruit etaient significativement plus eleves en utilisant les images de fusion. Conclusion L’imagerie de fusion est superieure aux sequences DP et T2 pour la detection des lesions spinales de SEP. Elle permet egalement d’obtenir des images avec un meilleur contraste. Cette imagerie de fusion pourrait s’integrer dans le protocole de routine des IRM spinales pour l’exploration des affections demyelinisantes, notamment la SEP.

Langerhans cell histiocytosis (LCH) is a rare condition mostly seen in children and adolescents. Eosinophilic granuloma (EG) is one of its three clinical entities and is considered as a benign osteolytic lesion. Many reports of patients with spine histiocytosis are well documented in the literature but it is not the case of atlantoaxial localization. We report here a new observation of atlantoaxial LCH in a 4-year-old boy revealed by persistent torticollis. He was successfully treated with systemic chemotherapy and surgery. Inter-body fusion packed by autologous iliac bone was performed with resolution of his symptoms. It is known that conservative treatment is usually sufficient and surgery should be reserved for major neurologic defects in spine EG. In atlantoaxial lesion, surgical treatment should be frequently considered.

Oligodendrogliomas are the tumors of normal glial cells of brain called oligodendrocytes. They represent a small proportion of childhood brain tumors and are infrequently encountered in the posterior fossa. CT scan and MRI are very helpful for the preoperative management of oligodendrogliomas. However, due to the rarity and non-specific imaging features, it may be difficult to differentiate oligodendroglioma from astrocytoma especially in an infratentorial location. The short- and long-term outcome and the exact treatment protocol of posterior fossa oligodendroglioma is yet to be established. We report a rare case of an oligodendroglioma of the vermis in an 8-year-old female with a brief review of the literature.

Objectifs Determiner l’apport de l’analyse de la position des yeux dans l’interpretation des scanners realises pour accidents ischemiques aigus, notamment sur l’identification de l’hypodensite ischemique et/ou du signe de l’artere hyperdense. Materiel et methode Nous avons selectionne sur une periode de 6 mois (janvier–juin 2015) 30 dossiers successifs de patients admis au service des urgences pour symptomatologie d’ischemie arterielle aigue datant de moins de 3 heures. Les scanners ont ete revises par un neuroradiologue, un radiologue general et deux residents en radiologie (un resident junior et un resident senior), tout d’abord en cachant les yeux des patients et un mois plus tard en visualisant leur position. Les lecteurs ne connaissaient pas dans les deux cas le cote deficitaire. Ils ont ete questionnes sur la presence ou non d’une hypodensite sur le territoire de l’artere cerebrale moyenne ou d’une hyperdensite sur le trajet de cette derniere. En cas de reponse positive, il leur a ete demande de preciser son cote. Les statistiques Kappa inter- et intra-observateur ont ete calculees pour evaluer l’agrement entre les differents observateurs et pour un meme observateur entre deux lectures. Resultats L’analyse de la position des yeux etait associee a une amelioration de l’agrement inter-observateur pour la detection des hypodensites d’origine ischemique aigue. De plus, nous avons note une amelioration de la sensibilite, specificite, valeur predictive positive et valeur predictive negative notamment dans le groupe « residents ». Conclusion L’analyse de la deviation de la position des yeux ameliore l’identification au scanner de l’hypodensite d’origine ischemique aigue, notamment au sein du groupe des residents. Ceci peut constituer une piste pour minimiser les erreurs d’interpretation des residents pendant les gardes de neuroradiologie et ainsi ameliorer la prise en charge des patients des la phase aigue.

Objectifs Connaitre l’anatomie des paires crâniennes. Decrire les sequences a utiliser en IRM. Decrire l’anatomie radiologique des 12 paires crâniennes en IRM. Materiels et methodes IRM 1,5 Tesla avec des sequences ponderees en T2 SE, T1 SE sans et avec injection du PDC et T2 3D EG. Resultat Connaitre l’anatomie des nerfs crâniens est necessaire pour realiser une exploration radiologique optimale et interpreter avec fiabilite les images et ainsi distinguer le normal du pathologique. L’IRM est la methode a utiliser en premiere intention pour explorer directement les nerfs crâniens et leurs rapports vasculaires. En raison de leur petite taille, il est indispensable d’obtenir des images avec une haute resolution spatiale. Conclusion L’etude des differentes paires crâniennes dans leur trajet cisternal offre des informations precieuses sur le rapport entre tout processus pathologique avec le nerf adjacent. Pour profiter pleinement de cette information, chaque radiologue doit se familiariser avec l’anatomie des paires crâniennes et les reperes anatomiques les plus importants.

Objectifs Connaitre les signes echographiques d’un nodule thyroidien suspect. Connaitre les recommandations recentes pour le suivi du cancer thyroidien. Connaitre la technique et les indications de la cytoponction echoguidee des nodules thyroidiens. Resume L’echographie est systematique dans le bilan des nodules thyroidiens. Pour repondre a ses buts, elle doit etre realisee de facon rigoureuse et methodique. Toute echographie pour nodule thyroidien doit comporter une evaluation predictive de malignite, reposant essentiellement sur le caractere tres hypoechogene, la presence de microcalcifications, des contours flous, une forme plus epaisse que large et une hypervascularisation intranodulaire. Un schema de reperage tridimensionnel est indispensable en cas de multinodularite et souhaitable dans tous les cas. La recherche des signes echographiques de suspicion de malignite comprend aussi l’evaluation des ganglions cervicaux. La cytoponction est un examen de routine, a condition d’en posseder la technique et d’en avoir une pratique reguliere et suffisante. Il s’agit du meilleur examen pour selectionner les nodules qui devront etre operes.

L’imagerie fait partie du bilan de tout syndrome dementiel. La tomodensitometrie est l’examen de premiere intention. Elle elimine les causes de demences chirurgicales. L’imagerie par resonance magnetique (IRM) est preferee dans le bilan des demences. Dans les demences neurodegeneratives, elle montre une atrophie dont la topographie oriente vers l’etiologie de la demence : une atrophie temporale mediale predominante dans la maladie d’Alzheimer ; une atrophie frontale et temporale anterieure marquee et une atrophie temporale mediale moindre que celle decrite dans la maladie d’Alzheimer dans la demence frontotemporale ; des infarctus, des lacunes, des anomalies de signal de la substance blanche et parfois des microsaignements dans les demences vasculaires. La tomographie a emission de simples photons (TEMP) et la tomographie a emission de positrons (TEP) sont utilisees dans les formes cliniquement atypiques. L’etude du transporteur de la dopamine (DATscan ® ) est utilisee pour distinguer la demence a corps de Lewy de la maladie d’Alzheimer. De nombreux efforts sont deployes pour trouver des biomarqueurs d’imagerie dans les demences, incluant la volumetrie cerebrale, l’imagerie de diffusion, la spectroscopie, l’imagerie des plaques seniles en IRM a tres haut champ et les marqueurs des plaques seniles en TEP.

Objectifs pedagogiques Connaitre la radio-anatomie des loges musculaires et des espaces cellulo-graisseux de la cuisse. Savoir les sequences IRM necessaires a l’etude de cette region. Connaitre la nature des masses des parties molles developpees a ce niveau. Connaitre leurs aspects et specificites en IRM. Messages a retenir Les masses extra-osseuses de la cuisse sont dominees par les tumeurs graisseuses et les sarcomes. Importance d’eliminer une cause neoplasique devant toute tumefaction chronique de la cuisse. L’IRM est le « Gold standard » pour une meilleure caracterisation tissulaire, distinguant les masses benignes et malignes. L’IRM est un outil indispensable dans le bilan d’extension pre-therapeutique et le suivi.

Objectifs Connaitre les differents types des tumeurs cartilagineuses. Connaitre la semiologie radiologique d’une matrice cartilagineuse. Connaitre la semiologie tomodensitometrique d’une matrice cartilagineuse. Connaitre la semiologie IRM d’une matrice cartilagineuse, connaitre la semiologie IRM d’une tumeur cartilagineuse benigne et d’une tumeur cartilagineuse maligne. Connaitre les signes IRM distinctifs entre une tumeur cartilagineuse benigne et une tumeur cartilagineuse maligne de bas grade. Materiels et methodes Ce poster decrit les elements semiologiques necessaires au diagnostic d’une tumeur cartilagineuse en evaluant l’apport de chaque technique (surtout le couple radiographies standard-IRM), et en insistant sur les signes en imagerie permettant de distinguer entre une tumeur benigne et une tumeur maligne de bas grade (signes de degenerescence d’une lesion prealablement benigne). Resultats Les tumeurs cartilagineuses peuvent etre benignes (representees essentiellement par les osteochondromes et plus rarement par les chondromes, les chondroblastmes et les fibromes chondromyxoides) ou malignes (representees essentiellement par les chondrosarcomes). En radiographies standard, la matrice cartilagineuse est evoquee devant la presence de calcifications au sein d’une lesion osteolytique. En IRM, la matrice cartilagineuse est caracteristique devant un aspect multilobule, en hypersignal franc en sequence ponderee T2 surtout quand elle est associee a une saturation du signal de graisse. Les difficultes diagnostiques resident dans la differenciation entre tumeur benigne et une tumeur maligne de bas grade notamment en presence d’osteochondrome. L’epaisseur de la coiffe cartilagineuse, le signal des cloisons et la dynamique de la prise de contraste semblent donner des importants elements d’orientation et ils doivent etre confrontes aux donnes cliniques, radiologiques et histologiques. Conclusion La matrice cartilagineuse est souvent typique en imagerie, cependant des problemes diagnostiques peuvent se poser essentiellement quand on veut detecter des signes de degenerescence d’une lesion prealablement benigne (essentiellement un osteochondrome). L’IRM est un excellent examen pour faire le bilan de ces tumeurs et pour rechercher les signes distinctifs entre une tumeur benigne et une tumeur maligne de bas grade.

Objectifs pedagogiques Connaitre les principaux tableaux cliniques et aspects etiopathogeniques. Connaitre les types de lesions retrouvees en IRM. Connaitre la possibilite de correlation entre les lesions retrouvees et les differents tableaux cliniques. Messages a retenir L’IMC resulte de lesions cerebrales precoces, non hereditaires, stabilisees. L’IMC correspond a une deficience motrice exclusive ou predominante. L’IRM doit etre realisee precocement en cas d’IMC pour etablir un bilan lesionnel. L’IRM peut trouver des anomalies de la substance blanche ou des noyaux gris centraux, des lesions cortico-sous-corticales, des lesions ischemiques focales ou des malformations.