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Résumé Introduction Il existe peu de données sur le pronostic des grossesses faisant suite à une thrombose veineuse cérébrale (TVC) et encore moins sur la prévention de la récidive. Méthodes Il s’agit d’une étude rétrospective de femmes ayant présenté une thrombose veineuse cérébrale. Les dossiers de 11 grossesses chez six femmes ont été étudiés. Résultats Le délai moyen entre la première grossesse et la TVC était de 58 mois. Une prévention par de l’aspirine ou de l’héparine était prescrite pour dix grossesses, et des anticoagulants en post-partum dans tous les cas. Aucune récidive de TVC n’était observée pendant la grossesse. Dans le post-partum survenait une embolie pulmonaire minime dans un cas. Conclusion Après une TVC, si un délai suffisant est respecté, les risques d’une grossesse paraissent faibles. En l’absence de résultats d’essais contrôlés, il paraît raisonnable d’utiliser une prophylaxie par héparine, le bénéfice paraissant supérieur aux risques. Elle est en tout cas fortement recommandée dans le post-partum. Introduction Few data have been published about the prognosis of a pregnancy following an episode of venous cerebral thrombosis (CVT), and far less about preventive strategy. Methods This is a retrospective study of a case series of 11 pregnancies in six women who had previously presented a CVT. Results The first pregnancies after CVT occurred on average 58 months later. Prevention with aspirin or heparin was administered in ten cases during pregnancy, and in all the cases with heparin in postpartum. No recurrence of CVT was observed. A minor pulmonary embolism was diagnosed in postpartum in one case. Conclusion Prognosis of a pregnancy after a CVT seems to be favourable if a sufficient delay after CVT is respected. Although no results of controlled trials are available, prophylaxis with heparin is probably reasonable as benefit seems higher than risks and is strongly advised during the postpartum period. [ABSTRACT FROM AUTHOR]

Introduction: Few data have been published about the prognosis of a pregnancy following an episode of venous cerebral thrombosis (CVT), and far less about preventive strategy., Methods: This is a retrospective study of a case series of 11 pregnancies in six women who had previously presented a CVT., Results: The first pregnancies after CVT occurred on average 58 months later. Prevention with aspirin or heparin was administered in ten cases during pregnancy, and in all the cases with heparin in postpartum. No recurrence of CVT was observed. A minor pulmonary embolism was diagnosed in postpartum in one case., Conclusion: Prognosis of a pregnancy after a CVT seems to be favourable if a sufficient delay after CVT is respected. Although no results of controlled trials are available, prophylaxis with heparin is probably reasonable as benefit seems higher than risks and is strongly advised during the postpartum period., (Copyright © 2014. Published by Elsevier SAS.)

Background: The papillary fibroelastomas are cardiac lesions, which typically occur on the cardiac valves, but rarely on the endocardium. The incidence of these benign primitive tumors varies from 0.002 to 0.33% and increases with advancing age., Methods: We report two cases of stroke, one in a 31-year-old man and the other in a 48-year-old woman, both admitted to the same stroke center., Results: The diagnostic studies were normal in these two patients, except for the echocardiography. The first showed an echogenic mass on the mitral valve on transthoracic echocardiography (TTE), confirmed by the transesophageal echocardiography (TEE). The second demonstrated a mass on the sigmoid aortic valve on TEE, but the TTE was normal. For these two patients, a surgical excision was carried out and pathologic examination concluded to a papillary fibroelastoma. After surgery, no recurrence was observed., Conclusions: The papillary fibroelastomas are usually asymptomatic and easily detected by TEE. However, it can be revealed by stroke, myocardial infarction and lower limbs ischemia. These cardiac tumors should be surgically removed, since their complete excision remains the only means of avoiding a recurrence of embolism.

Dysimmune lymphadenopathies during carbamazepine treatment. A report of two cases. We report on two cases of dysimmune lymphadenopathies with histological aspect of angio immunoblastic lymphadenopathy (AIL) developing after administration of carbamazepine. Clinical manifestations consisted of fever, erythroderma, generalized pruritus, facial edema, lymphadenopathy, liver enlargement. The two patients had anemia, hypogammaglobulinemia, impaired liver function and a negative Coomb's test. Lymphocyte stimulation test with carbamazepine in vitro was positive in both cases. Lymph node biopsy disclosed the angioimmunoblastic proliferation characteristic of AIL. After discontinuing carbamazepine, a complete remission was obtained.

The induction of a remission has been attempted in 28 patients with insulin-dependent diabetes of less than 3 months' duration by strictly normalizing glycemia either with a period of external artificial pancreas followed by continuous subcutaneous insulin infusion (22 patients) or with continuous subcutaneous insulin infusion alone (6 patients). HLA A, B and DR antigens were determined in every patient. Residual beta-cell function was evaluated by measuring C peptide and the ratio of C peptide to glycemia, and by testing the response to a glucagon stimulation before initiating and after withdrawing insulin treatment. Oral treatment with 15 mg glibenclamide and 840 mg metformin daily was administered when insulin had been stopped. A remission was obtained in 17 of the 28 cases. The likelihood of a remission was greater if: (1) the patient was older (mean age was 25.6 years in case of success and 16.6 Years in case of failure); (2) initial daily needs for insulin were smaller (0.88 v. 1.23 U/kg); and (3) stimulated secretion of C peptide was larger (0.22 v. 0.11 mmol/l).