Radiologically guided lumbar injections

Lumbar injections of corticosteroids are an established part of sciatica nonsurgical treatment; that's to their anti-inflammatory properties. Fluoroscopically monitored injections are more likely to place medication at the exact target site and with higher concentration; then they maximize therapeutic results. Lumbar steroid injections are efficient at short and middle term, and they precipitate relief.     

First tier measures in the treatment of intracranial hypertension in the patient with severe craniocerebral trauma. Proposal and justification of a protocol

The management of severe head injuries in general and that of high intracranial pressure (ICP) in particular are among the most challenging tasks in neurocritical care. One of the difficulties still faced by clinicians is that of reducing variability among centers when implementing management protocols. The purpose of this paper is to propose a standardized protocol for the management of high ICP after severe head injury, consistent with recently published clinical practice guidelines and other clinical evidence such as that provided by the systematic reviews of the Cochrane Collaboration. Despite significant advances in neuromonitoring, deeper insight into the physiopathology of severe brain trauma and the many therapeutic options available, standardized protocols are still lacking. Recently published guidelines provide sketchy recommendations without details on how and when to apply different therapies. Consequently, great variability exists in daily clinical practice even though different centers apply the same evidence-based recommendations. In this paper we suggest a structured protocol in which each step is justified and integrated into an overall strategy for the management of severe head injuries. The most recent data from both the preliminary and definitive results of randomized clinical trials as well as from other sources are discussed. The main goal of this article is to provide neurotraumatology intensive care units with a unified protocol that can be easily modified as new evidence becomes available. This will reduce variation among centers when applying the same therapeutic measures. This goal will facilitate comparisons in outcomes among different centers and will also enable the implementation of more consistent clinical practice in centers involved in multicenter clinical trials.     

Autoantibodies to ribosomal P proteins in systemic lupus erythematosus

Autoantibodies to ribosomal P proteins (anti-P) are directed against three ribosomal phosphoproteins (P0, P1, and P2) and are believed to be specific markers for systemic lupus erythematosus (SLE), particularly with neuropsychiatric manifestations. The objective of this study was to determine the rate of occurrence and clinical significance of anti-P in Tunisian patients. METHODS: We included 100 Tunisian patients with SLE whose sera were received between January 1998 and December 2000 by the immunology laboratory of the Charles Nicolle Teaching Hospital in Tunis, Tunisia, and were tested for anti-P. An immunodot technique based on a synthetic protein shared by all ribosomal phosphoproteins was used. RESULTS: Sera from 22 (22%) patients were positive for anti-P. This rate is consistent with the literature. We found no statistically significant associations between anti-P and specific manifestations of SLE. CONCLUSION. We found that anti-P were significantly associated with anti-Sm and anti-RNP, as reported previously. The significance of these associations remains debatable.     

Modification of particle replacement in a case of benign paroxysmal positional vertigo (BPPV) of the horizontal canal

A variant of the particle repositioning maneuver was used in a patient diagnosed as benign paroxysmal positional vertigo of the horizontal canal. The patient was treated initially with Lempert's maneuver, but a paradoxical response was elicited by videonystagmography so we had to develop a maneuver adapted to the location of the patients otoliths. The likely physiopathology is discussed in the light of videonystagmographic events.     

Nasal localization of the Crohn's disease

Crohn's diseases is a chronic granulomatous inflammatory disease of the gastrointestinal tract. Any part of the gastrointestinal tract may be affected, and 9% of cases have oral lesions (1). Nasal involvement is exceptionally rare. We report a case of nasal involvement revealed by chronic atrophic rhinitis in a patient with known Crohn's disease.     

Remédiation cognitive et fonctionnement scolaire chez les enfants avec trouble du spectre autistique

Introduction

Autism Spectrum Disorder (ASD) is known to be associated with Cognitive impairment, especially executive dysfunction. Cognitive Remediation Therapy (CRT) is a rehabilitation method aiming to produce improvement in cognitive processes by teaching information processing strategies through guided mental exercises. CRT has been used in patients with schizophrenia. Taking into account the overlap between ASD and schizophrenia, we aimed in this study to examine the effectiveness of CRT for cognitive flexibility, inhibition and school results in children with ASD.

Thrombosis of the posterior cerebral artery

Summary The authors report a case of thrombosis of the posterior cerebral artery.

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Verschluß der Arteria cerebri posterior

Zusammenfassung Die Verfasser berichten über einen Kranken mit einem arteriographisch nachgewiesenem Verschluß der A. cerebri posterior li.

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Thrombose de l'artère cérébrale postérieure

Résumé Les auteurs rapportent un cas d'occlusion complète du segment latéro-pédonculaire de l'artère cérébrale postérieure gauche.

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(Prof. Agr. A. Wackenheim)