Our results indicate that, in patients with no aphasia despite LGGs within Broca's area, thanks to brain plasticity, the tumor can be removed while involving this "unresectable" structure without inducing sequelae and even improving the quality of life when intractable epilepsy is relieved on the condition that subcortical language connectivity is preserved.

No abstract

Background:The incidence of tuberculosis is increasing, and skeletal tuberculosis accounts for 10-20% of all extrapulmonary cases. Spinal tuberculosis occurs mostly in children and young adults. It causes bone destruction, spinal deformity and neural complications.Materials and Methods:Our study includes 37 children (below 15 years of age) with spinal tuberculosis treated in our department in the last 6 years. The demographic data, clinical profile, surgical intervention and outcome of these children are reported.Results:The mean age ranged from 4 to 15 years, with an average of 9.1 years, and the male/female ratio was 1.8. Thirty patients (81%) had progressive inflammatory rachialgia and only six patients (16.2%) had neurological symptoms. The lumbar spine was mostly affected (23 cases). All patients have benefited from antituberculous chemotherapy (Regimen 2SRHZ/10RH) associated with spinal immobilization during 3 months. The surgical treatment was indicated in seven patients because of the presence of large bilateral abscess of the psoas muscle in one patient and the presence of severe neurological symptoms in the six remaining patients. The evolution was favorable in all cases, including those with neurological symptoms. There was no case of death and the length of follow-up for these patients ranged between 1 and 4 years.Conclusion:Spinal tuberculosis is still a prevalent disease in developing countries, mainly occurring in children. Complications of the disease can be devastating because of its ability to cause bone destruction, spinal deformity and paraplegia. Therefore, an early diagnosis and establishment of treatment are necessary to expect a good outcome.

No abstract

F i g u r e 1 . CT s c a n s h o wi n g a r i g h t f r o n t a l v e n t r i c u l a r s h u n t p l a c e d a s a n e me r g e n c y t r e a t me n t

No abstract

Tuberculosis remains one of the most common infectious diseases in the world. Vertebral tuberculosis is the commonest form of bone and joint tuberculosis; however, isolated sacral tuberculosis is rare. This atypical presentation may lead to a delay in diagnosis and treatment. We report three cases of sacral tuberculosis diagnosed in young women, aged 30, 23, and 35 years old, respectively. Lombosciatic pain was the main symptom in all cases. All patients had a biological assessment, plain radiographs, and CT scan. However, magnetic resonance imaging was done in only two cases. All patients underwent surgical sacral biopsy, and the diagnosis of tuberculosis was confirmed by histology in all cases. The evolution was satisfactory with the adjunction of antituberculous chemotherapy in all cases. Spinal tuberculosis should be the first and foremost differential diagnosis in the presence of atypical clinical and radiological features of a sacral lesion, particularly in developing countries. Early diagnosis and treatment could prevent or minimize the neurological morbidity in such cases.

L’objectif de notre étude est d’illustrer l’intérêt de l’imagerie en coupe (TDM, IRM) dans le diagnostic positif et le suivi post-thérapeutique du kyste hydatique cérébral chez l’enfant et de mettre en lumière les particularités et les difficultés rencontrées dans la prise en charge de la localisation cérébrale de cette affection, par notre expérience basée sur 15 cas de kyste hydatique cérébral de l’enfant. Il s’agit d’une étude rétrospective de 15 cas d’hydatidose cérébrale de l’enfant colligés sur une période de 10 ans. La TDM cérébrale en coupes axiales de 5 mm d’épaisseur sans et avec injection de produit de contraste a été réalisée chez 15 patients. L’IRM encéphalique a été réalisée en séquences pondérées en T1 et en T2 chez un patient dans les trois plans de l’espace sans injection de Gadolinium. L’âge moyen de nos patients était de 9 ans. La symptomatologie clinique était dominée par le syndrome d’hypertension intracrânienne. Le kyste hydatique était solitaire et se situait au niveau de l’étage sus-tentoriel avec un important effet de masse sur le système ventriculaire et la ligne médiane dans la majorité des cas. Tous nos patients ont été opérés et l’évolution était favorable dans tous les cas. La TDM représente l’examen de choix pour le diagnostic et le suivi postopératoire du kyste hydatique cérébral. L’IRM trouve son intérêt essentiellement dans le diagnostic des formes multiples et des formes atypiques permettant une planification thérapeutique plus adaptée.Our study aimed to highlight the role of cross sectional imaging techniques (CT, MRI) in positive diagnosis and post-therapeutic follow-up of cerebral hydatid cysts in children as well as to describe the peculiarities and the difficulties encountered in the management of these cysts based on our experience about 15 cases. We conducted a retrospective study of 15 cases of cerebral hydatidosis in children whose data were collected over a period of 10 years. CT scan of the brain with 5 mm slice thickness without and with injection of contrast product was performed in 15 patients. One patient underwent brain MRI creating either T1-weighted or T2-weighted images in all three planes without Gadolinium injection. The average age of patients was 9 years. Clinical symptoms were dominated by intracranial hypertension syndrome. Hydatid cyst was solitary and was located in the supratentorial level with an important mass effect on the ventricular system and the median line in most cases. All patients underwent surgery and patients’ evolution was favorable in all cases. CT scan is the test of choice for the diagnosis and the postoperative follow-up of patients with cerebral hydatid cysts. MRI is used essentially in the diagnosis of multiple and atypical type of cerebral hydatid cysts, enabling the design of more effective treatment strategy.