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Le Touquet – Paris-Plage, France

Pierot L.,Service de radiologie | Barbe C.,Reims University Hospital Center | Spelle L.,Service de Neuroradiologie
Stroke | Year: 2010

Background and Purpose- The strategy of treatment of small unruptured intracranial aneurysms is complex because of their presumably low risk of rupture. A precise knowledge of the perioperative complications in this specific subgroup is mandatory. The purpose of this study was to compare the results of the endovascular treatment of aneurysms ≤3 mm and aneurysms >3 mm included in the Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms study. Methods- The study included 626 patients harboring 682 unruptured aneurysms. Perioperative adverse events and clinical outcome were analyzed in patients treated for aneurysms ≤3 mm (51 patients, 51 aneurysms) and in patients treated for aneurysms >3 mm (575 patients, 631 aneurysms). Results- Endovascular treatment failed more often in aneurysms ≤3 mm (13.7%) compared to aneurysms >3 mm (3.3%; P=0.003). The rate of intraoperative rupture for aneurysms ≤3 mm (3.9%; 95% CI, 0.5-13.5) did not significantly differ compared to aneurysms >3 mm (2.4%; 95% CI, 1.2-3.6; P=0.37). Thromboembolic events were not significantly different in both groups (3.9%; 95% CI, 0.5-13.5 in very small aneurysms and 7.1%; 95% CI, 5.1-9.1 in larger aneurysms; P=0.57). One month morbidity/mortality was not significantly different for patients with very small aneurysms (2.0%; 95% CI, 0.05-10.45) and for patients with larger aneurysms (3.3%; 95% CI, 1.8-4.8; P=0.60). Conclusions- The risks of endovascular treatment are similar in patients with very small or with larger aneurysms. Because the risk of spontaneous rupture is lower in very small aneurysms, their management will include follow-up MRI and active treatment in case of morphological modification. © 2010 American Heart Association, Inc. Source

Sarrazin J.-L.,Hopital Americain de Paris | Bonneville F.,Service de Neuroradiologie | Martin-Blondel G.,Toulouse University Hospital Center
Diagnostic and Interventional Imaging | Year: 2012

Brain infections are relatively rare, but they are potentially serious and have a poor prognosis. The cornerstone of the diagnosis is cerebrospinal fluid (CSF) analysis. Imaging is not systematic, but the indications of imaging are broad, particularly when faced with suspected focal damage, depending on the characteristics of the patient (child, immunosuppressed patient, geographic origin, etc.). It is based on MRI, which allows for aetiological diagnosis and an extension evaluation. In addition, in a certain number of cases, the type of infection is not known and it is up to the MRI via use of an exhaustive technique to diagnose an infectious origin when faced with a mass syndrome. This technical mastery, associated with knowledge of major brain infections, their method of contamination and their particular appearance on the MRI, should make it possible for the radiologist to fulfill his or her diagnostic role. © 2012 Published by Elsevier Masson SAS on behalf of the Éditions françaises de radiologie. Source

Kemp J.,University of Strasbourg | Berthel M.-C.,CM2R de Strasbourg Colmar | Dufour A.,University of Strasbourg | Despres O.,University of Strasbourg | And 5 more authors.
Cortex | Year: 2013

Most studies in social cognition have focused on developmental diseases or analyzed the consequences of acquired frontal lesions on the integrity of Theory of Mind (ToM), but, to our knowledge, none to date has addressed the eventual consequences of damage to the basal ganglia on ToM. To investigate the possible consequences of such lesions on social cognition, we tested a selected patient, MVG, a 44-year-old man with a focal caudate nucleus (CN) lesion following stroke. In the aftermath of this stroke, MVG shows loss of empathy and difficulties recognizing emotions in others. The dual aims of this study were first, to evaluate the implications of CN on ToM and recognition of emotion, and second, to discuss these results as a consequence of a disconnection of the sub-cortical orbito-frontal (OF) loop due to caudate damage. We performed a complete neuropsychological assessment of MVG, as well as different tasks evaluating social cognition, such as the Faux-Pas Test and the Reading the Eyes in the Mind Test. No deficits were found in the neuropsychological tests. However, on tasks assessing social cognition, MVG showed impairments in the " warm" or " affective" part of ToM as well as in the ability to recognize negative emotions (i.e., sadness and fear). These results indicate that damage to the head of the left CN can lead to impairment of ToM and emotion recognition. Furthermore, the data shows that, in MVG, such impairment appears to be due to a disconnection of the sub-cortical OF circuit resulting from damage to the CN. Neuro-imaging data tends to confirm this hypothesis by bringing out a hypo-perfusion in both, the territory of his left CN and prefrontal (i.e., ventromedial) brain areas. © 2012 Elsevier Ltd. Source

Caron S.,Service de Neuroradiologie
American Journal of Roentgenology | Year: 2015

OBJECTIVE. The aim of this article is to describe the imaging features of the most common benign or malignant skull vault lesions, which may be focal, multifocal, or diffuse. CONCLUSION. Imaging features, in association with the age, history, and clinical symptoms of the patient, make it possible to propose a course of action: simple survey, pathologic confirmation, or complete surgical resection. © American Roentgen Ray Society. Source

Manto M.U.,FNRS | Jissendi P.,Service de Neuroradiologie
Frontiers in Neuroanatomy | Year: 2012

The study of the links and interactions between development and motor learning has noticeable implications for the understanding and management of neurodevelopmental disorders. This is particularly relevant for the cerebellum which is critical for sensorimotor learning. The olivocerebellar pathway is a key pathway contributing to learning of motor skills. Its developmental maturation and remodeling are being unraveled. Advances in genetics have led to major improvements in our appraisal of the genes involved in cerebellar development, especially studies in mutant mice. Cerebellar neurogenesis is compartmentalized in relationship with neurotransmitter fate. The Engrailed-2 gene is a major actor of the specification of cerebellar cell types and late embryogenic morphogenesis. Math1, expressed by the rhombic lip, is required for the genesis of glutamatergic neurons. Mutants deficient for the transcription factor Ptf1a display a lack of Purkinje cells and gabaergic interneurons. Rora gene contributes to the developmental signaling between granule cells and Purkinje neurons. The expression profile of sonic hedgehog in postnatal stages determines the final size/shape of the cerebellum. Genes affecting the development impact upon the physiological properties of the cerebellar circuits. For instance, receptors are developmentally regulated and their action interferes directly with developmental processes. Another field of research which is expanding relates to very preterm neonates. They are at risk for cerebellar lesions, which may themselves impair the developmental events. Very preterm neonates often show sensori-motor deficits, highlighting another major link between impaired developments and learning deficiencies. Pathways playing a critical role in cerebellar development are likely to become therapeutical targets for several neurodevelopmental disorders. Source

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