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Frontal lobe epilepsy surgery is the second most common surgery performed for drug-resistant partial epilepsy. We investigated the longitudinal outcome in a cohort of patients investigated since 1990 with SEEG and modern diagnostic techniques. We reviewed 105 patients who underwent surgery between 1990 and 2005 (mean follow-up, six years; range: one to 17 years) and analyzed the year-per-year follow-up according to Engel's classification. Favorable outcome (Class I) was observed for 70% and this result was stable at least five years after surgery. More than 90% of patients with lesion-related epilepsies (focal cortical dysplasia and dysembryoplastic neuroepithelial tumors) became seizure-free. Less than 50% of patients classified as having cryptogenic epilepsy (defined as normal imaging and neuropathology on surgical specimen) had a favorable outcome. Permanent neurological sequelae were subtle and rare, especially after surgery for dysplasia in eloquent cortex (primary motor cortex). Our data indicate that frontal surgery is a successful treatment in patients when electrophysiological and morphological investigations demonstrate a well-defined epileptogenic zone or lesion to be surgically resected. Progress in electrophysiological and brain-imaging techniques will further improve the selection of frontal lobe epilepsy surgery candidates.

Many different surgical procedures are performed for medically refractory partial epilepsy. Some surgical therapies are performed to cure the epilepsy (for example unifocal epilepsy), others are palliative procedures. To cure epilepsy, temporal lobectomy is the most common surgical procedure. The different techniques are shortly described, indications and complications are discussed.

The need for medical images which can directly contribute to therapeutic decision making has led to the development of 3D visualization techniques. With this objective, a procedure capable of producing 3D volume reconstructions using isotropic voxels from digitalized 2D films obtained by rotation around the object has been developed: 3D morphometry. The technique has been assessed from 1993 through 1996 for vascular malformations in the brain, particularly aneurysms. Recognition of collateral vessels originating at the malformation was helpful in better identifying the lesions and evaluating possible therapeutic difficulties. The morphometric sequence thus is a possibility for the future assessment of neurovascular arches.

Both surgical (236 aortic valve replacements) and anatomical (62 dissections) studies have defined the aortic annulus diameter. Measurements (23.5 mm for women; 26 mm for men) are more considerable than established values. Furthermore, surgical study allows the authors to compare these results to several variables, more especially corporeal surface and stature: the height's increase perhaps explains the large sizes discovered.

Report on two cases of spontaneous, intermittent and long lasting spinal fluid rhinorrhea. The lesion responsible of the spinal fluid fistula is a glio-arachnoid expansion of the convexity of the frontal pole, contained into a fibrous pedicle ; it crosses the dura mater and penetrates, through a well individualized bone orifice, into the posterior wall of the frontal sinus or into an ethmoid-frontal cell. This arachnoid diverticle is not associated with an hydrocephalon. In the absence of any traumatic past history, its congenital nature may be admitted. No para-clinical investigation makes possible to detect such a minor abnormity ; the isotopic transit of the spinal fluid may remain silent, when performed at a moment of drying up of the nasal flow. Surgical exploratory study of the anterior level has to be complete, while numerous independent diverticles may coexist.

The natural history of malignant gliomas is compared to the mean survival duration after surgery alone and/or surgery associated with radiotherapy and chemotherapy. In the state of the art a combined treatment by surgery and roentgentherapy offers the best prognosis but does not allow for more than 35% of expectation of life at the end of the first year. According to the severity of the general prognosis the present authors advocate a strict care for the functional integrity. An improved knowledge in the biology of cerebral gliomas justifies further consideration in the surgical treatment preparing the expected effects of radiotherapy and chemotherapy.

The habenular complex of 11 cats and 13 rats was injected with horse Radish peroxydase (HRP) (30% solution, 0,05--0,4 microliter). Retrograde labelling of cells was visualized after a survival period of 24 to 48 hours by means of the method of Lavail et al. (1973). The resultats obtained with this method suggest significant species differences regarding the habenular afferents in cats and rats. One of the most striking differences is that the entopeduncular nucleus of the cat contains very few HRP labelled cells after lateral habenular nucleus injection in comparison to the entopeduncular nucleus of the rat which can be shown to be the major source of afferents to the lateral habenular nucleus by the same method.

The respective role of surgical ablation versus palliative methods (i.e. shunting followed by irradiation) in the treatment of tumors of pineal region is still questionnable and must take into account the variability of their pathology. Thus, knowledge of tumoral type in each case is the first step to therapeutic discussion. The stereotactic methods allow a faithful biopsy, easy to interpret and without major risks.

The authors describe an exceptional case of aspergillosis from sphenoidal sinus showed by oculomotar palsy its follow up simulates a malignant tumour.

A new case of thoracopagus twins is reported. Radiological, hemodynamical and surgical explorations showed a communication between the two hearts, situated at the atrial level and associated with digestive and cardiovascular malformations. These abnormalities were definned by the anatomical study realized after vascular injection:hypoplastic pulmonary artery (associated with a persistent atrio-ventricular canal in one case, with a tricuspid atresia in the other case), a large fused liver, common pancreas and ileum. A bibliographic study allows the authors to define surgical separation possibilities. The prognosis depends essentially on cardiovascular abnormalities associating abnormal connections between the twins' hearts with malformations often too severe for surgical repair.

Seventy tests of stimulation with hypothalamic thyreotrophic hormone liberation factor, and 35 bromocriptine inhibition tests were carried out on a routine basis in patients with latent or frank hyperprolactinaemia. Pathological hyperprolactinaemia does not have a single clinical pattern: frank, it takes the form either of an exteriorised pituitary adenoma (14 cases), or of an amenorrhoea-galactorrhoea syndrome with or without micro-adenoma (12 cases); latent, it takes the form either of isolated amenorrhoea (17 cases) or of dysovulatory sterility (16 cases). Amongst the dynamic tests available, it is worthwhile to make a choice, and in the case of frank hyperprolactinaemia, the authors propose use of the bromocriptine inhibition test in the first instance. The TRH test is reserved for verification of the results of neurosurgery. As far as latent hyperprolactinaemia is concerned, it may be identify only by the TRH test, with the resultant possibility of specific treatment.

After a double study (anatomical--50 dissections--and radiological--100 arteriograms) the following points can be stressed: the femoral tripod is only found in 38 per cent of the cases. One or several nutrient arteries of the thigh originate often separately (62% of cases). Their origine is situated highup in a number of cases (at 3 cm below the inguinal ligament). The collateral network develops from each of the arteries forming a complete "profunda femoris system". Two surgical consequences deserve to be underlined: 1. The approach to all the branches is possible by a transverse incision in the fold of the groin. 2. Surgical revascularisation must concern the whole of the "profunda femoris" network.

From a necropsy series of 14 kidneys, it is very easy to prove, that there is a quite good correlation between the theorical calculated volume of the kidney and its real volume. It is possible to compare the kidney to an ovoid, and to calculate its volume, knowing the 3 dimensions which are its length, its width, its depth. In this way, by echotomography it is possible to estimate these three parameters at the level of the transplanted and to calculate the volume and if, after two successive examinations of control, the kidney volume is found to be enlarged (over 20%) a reject phenomenon must be diagnozed.

Agenesis of the internal carotid artery was discovered during emergency cerebral angiography carried out on a comatose 28 year old man. The left cerebral hemisphere was supplied from the controlateral carotid artery, via a large vessel running through the sphenoid bone, between the intracavernous portions of the internal carotid arteries. Postmortem examination showed that death resulted from massive haemorrhagic infarction of the cerebellum and brain stem. Absence of the cervical and petrosal portions of the left internal carotid artery was confirmed. The anastomotic vessel was found to run through the spongiosa below the dorsum sellae. The heart, major vessels and circle of Willis were otherwise normal. An intercarotid anastomosis of this type has been reported on three previous occasions, in none of which was there anatomical confirmation.