Background: Transverse Sinus Stenosis is increasingly recognized in Idiopathic Intracranial Hypertension, though its causal role remains controversial. Neuroendovascular dural venous sinus stenting has emerged as a therapeutic option to decrease intracranial pressure and restore cerebrospinal fluid resorption, thus reducing the symptoms. We present a prospective, observational, single-center study from September 2020 to July 2025, to evaluate the safety of this method and its hemodynamic and clinical outcomes. Methods: Consecutive patients with medically refractory, intolerant, or fulminant IIH and confirmed TSS underwent transverse sinus stenting. Pre- and post-procedure data included clinical and ophthalmologic examinations, catheter venography, and ICP measurements. Results: 10 females and 1 male were included with an average age of 29.6 years and a mean BMI of 29.86 kg/m 2 . All had headaches and papilledema, 81.8% reported pulsatile tinnitus, 54.5% nausea/vomiting, 45.5% visual dysfunctions, and 36.3% diplopia. The mean pre-stenting CSF was 45.2 cmH 2 O. Mean trans-stenosis gradient decreased from 11.3 mmHg to 1 mmHg post-stenting. Headache improvement was observed in the majority, with resolution or marked improvement of papilledema and visual symptoms in most cases. Other symptoms have fully resolved. OCT follow-up showed stabilization or improvement of retinal nerve fiber layer thickness in 27.2%. Two patients relapsed within 4 weeks, requiring a Ventriculoperitoneal Shunt. Conclusions: Endovascular VSS offers a safe, effective method to reduce ICP and resolve symptoms. While relapse rates remain a possibility, careful patient selection, optimal stent sizing, and long-term follow-up can help maximize the therapeutic potential.
OBJECTIVE:There is limited information concerning pediatric neuro-oncology in French-speaking Africa. The aim of this work was to assess the status of this specialty in member institutions of the Franco-African Group of Pediatric Oncology (GFAOP). METHODS:Data pertaining to pediatric brain tumors in the GFAOP registry were analyzed. A short questionnaire was sent to the GFAOP centers to collect information regarding the neuro-oncology activity. Recordings and minutes of the 17 teleconferences that took place between 01/2023 and 03/2025 were reviewed and analyzed. RESULTS:Only 331 patients were registered between 2016 and 2025. This suggests a considerable gap in terms of diagnosis. Most units manage between one and ten patients annually, with low-grade glioma and medulloblastoma being the most common tumors. In most units, the costs of treatment are borne by families. The review of the minutes of the teleconferences highlights important gaps in knowledge and obvious deficiencies in communication between the different teams involved. CONCLUSIONS:This work highlights the challenges associated with the development of pediatric neuro-oncology in French-speaking Africa. The implementation of multidisciplinary programs is a critical step to improve the care of children with brain tumors.
Early recurrence of radicular pain after lumbar discectomy is commonly attributed to recurrent disc herniation; however, non-compressive inflammatory mechanisms such as chemical radiculitis should also be considered. We report the case of a 30-year-old patient who underwent L5-S1 discectomy for S1 radiculopathy with motor deficit, with an initially favorable postoperative course and complete pain relief. Three weeks later, the patient developed severe recurrent S1 radicular pain without any new neurological deficit. Magnetic resonance imaging suggested recurrent disc herniation, leading to surgical re-exploration, which revealed no evidence of recurrent herniation or hematoma but instead an inflamed and swollen S1 nerve root. The patient was subsequently managed conservatively, with progressive resolution of symptoms. This case highlights the importance of recognizing chemical radiculitis as a potential cause of early postoperative radicular pain to avoid unnecessary reoperation.
Oral-facial-digital syndrome type 1 (OFD1) is an X-linked dominant ciliopathy characterized by facial, oral, and digital anomalies, often with neurological involvement. We report an 11-month-old girl presenting with multiple congenital milia on the cheeks, forehead, and auricular helices, accompanied by sparse wiry hair, partial occipital alopecia, and trichoscopic features of pili torti and comma-shaped black dots. Additional findings included craniofacial and oral anomalies, brachydactyly, preaxial polydactyly type 1 (PPD1), and agenesis of the corpus callosum with intracerebral cysts. This case highlights the diagnostic significance of congenital milia as an early clue for recognizing OFD1.
Guillain-Barré syndrome (GBS) is a well-known post-infectious acute polyradiculoneuritis, classically characterized by ascending muscle weakness. While dysautonomia affects up to two-thirds of patients, it almost always follows the onset of motor deficits. Arterial hypertension, when presenting as an isolated premonitory sign occurring weeks before neurological involvement, constitutes an exceptional clinical pitfall that can lead to exhaustive and unnecessary etiological assessments. We report the case of a 9-year-old girl with no prior medical history, initially admitted for persistent headaches, vomiting, and severe arterial hypertension (160/110 mmHg). An extensive initial investigation for secondary hypertension (renal Doppler, echocardiography, catecholamine levels, cortisol, and renin-aldosterone system) was normal. It was only 20 days later, with the onset of facial paralysis and progressive limb weakness (3/5 strength), that the diagnosis was reconsidered. Electromyography confirmed an axonal-demyelinating sensory-motor polyneuropathy, and cerebrospinal fluid analysis revealed classic albuminocytologic dissociation. The patient was treated with intravenous immunoglobulins, leading to favorable motor recovery and complete normalization of blood pressure. This observation illustrates a highly unusual "hypertension-first" presentation of GBS. It serves as an essential reminder for pediatricians: unexplained acute arterial hypertension can be the sole inaugural manifestation of GBS-related dysautonomia. Recognizing this early signal is crucial to avoid diagnostic delays and initiate life-saving treatment before the onset of severe respiratory or motor failure.
