Langerhans Cell Histiocytosis Causing Cervical Myelopathy in a Child

Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corpectemy and fusion. A 5-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying right arm motor weakness. CT scans revealed destruction of C7 body and magnetic resonance imaging showed a tumoral process at C7 with cord compression. Interbody fusion using cervical mesh packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of right arm. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered.     

Isolated Sphenoid Sinus Mucocele Presenting as Third Nerve Palsy

A sphenoid mucocele often presents late due to its deep seated anatomical site. And it has varied presentation due to its loose relationship to the cavernous sinus and the base of the skull. We describe a case of large sphenoid sinus mucocele. A middle aged old man suddenly developed third cranial nerve palsy. Brain imaging study revealed an isolated sphenoid sinus mucocele, compressing right cavernous sinus. Endoscopic marsupialization of the mucocele via transnasal approach led to complete resolution of the third cranial nerve palsy. Involvement of the third cranial nerve in isolated mucocele is rare but important neurosurgical implications which must be excluded. In addition, proper and timely treatment must be performed to avoid permanent neurologic deficit.     

The influence of physical therapy and anti-botulinum toxin antibody on the efficacy of botulinum toxin-A injections in children with spastic cerebral palsy

Objective: To identify factors associated with the efficacy of botulinum toxin-A (BoNT-A) injections. Methods: Thirty-eight children with spastic cerebral palsy (CP) received BoNT-A injections into the gastrocnemius. The baseline anti-botulinum antibodies were checked. The Static dorsiflexion range of motion (ROM), Modified Tardieu Scale (MTS) and Physician Rating Scale (PRS) were assessed at pre-injection as well as 4- and 12-week post-injection. Results: No samples contained anti-botulinum antibodies. Greater baseline MTS dynamic range was associated with greater changes in MTS dynamic ranges at 4-week post-injection. More frequent physical therapy was associated with greater changes in static dorsiflexion ROM at 4-week post-injection and greater changes in PRS at 4- and 12-week post-injection. Conclusion: The improvement in PRS at 12-week post-injection was associated with the frequency of physical therapy. Therefore, intensive physical therapy programs may be necessary to maintain the beneficial effects of BoNT-A injections in children with CP.     

Grande précarité, psycho-traumatisme,souffrance narcissique : résultats d’une recherche-action à méthodologie quantitative et qualitative intégrée

In the context of a multi-annual research project, aiming at exploring the relations between traumatic biographic events since childhood and the structural functioning of personality at adult age, the results of a cross-sectional study with people living in great precariousness (n = 105) are discussed.     

Restoration of an injured lower dorsal ascending reticular activating system in a patient with intraventricular hemorrhage

正The ascending reticular activating system(ARAS)plays a key role in the control of arousal and awareness for consciousness(Paus,2000;Zeman,2001;Van der Werf et al.,2002;Weiss et al.,2007;Siposan and Aliu,2014).It is well known that the ARAS originates from the reticular formation(RF)of the brainstem,and connects to the cerebral cortex via intralaminar     

Recovery of injured cingulum in a patient with traumatic brain injury

<正>The cingulum is the neural fiber bundle that connects the basal forebrain and medial temporal lobe.The cingulum contains the medial cholinergic pathway,which originates from the basalis nucleus of Meynert in the basal forebrain.Therefore,it is important for memory function(Malykhin et al.,2008;Hong and Jang,2010).In the past,identification of the cingulum on conventional brain MRI has been impossible