Mucormycosis of the external and middle ear complicated by parotid abscess and facial paralysis: A very rare case report

Mucormycosis is a serious and relatively rare invasive fungal infection. The rhino-orbito-cerebral localization is the most frequent. Mucormycosis of external ear with facial palsy is extremely rare. We describe a case of mucormycosis of the external ear complicated by parotid abscess and facial palsy in a diabetic patient.

Mucormycose Rhino-Orbito-Cerebrale: Bonne Evolution

Mucormycoses are opportunistic, rare, aggressive, often rapidly fatal infections caused by fungi of the zygomycete class. They are most often associated with decompensated diabetes or immunosuppression. They manifest themselves in different forms, the rhino-cerebral localization of which is the most frequent. The early diagnosis of this affection is essentially based on the histopathological analysis. Therefore, it must be evoked and sought by biopsies in any diabetic or immunocompromised patient suffering from complicated rhinosinusitis. We present in this work the case of a 14-year-old patient who suffered from rhino-orbito-cerebral mucormycosis successfully treated in our department of otolaryngology and head and neck surgery.

‘Neurologie: the doctrine of the nerves’

Chapter 16: ‘Neurologie: the doctrine of the nerves: the brain and nervous stock’ summarizes Willis’s treatises in Cerebri anatome, Nervorumque descriptio et usus (1664), De motu musculari (1670) and De anima brutorum (1672). Willis’s coinage of the term ‘neurologie’, intending this as the doctrine of the nerves based on the anatomy of the cranial nerves rather than the study of diseases affecting the brain and nervous stock, is described. The chapter explains why these treatises are additionally important for assigning function to the cerebrum and cerebellum rather than the ventricles; the concept of cerebral localization; the distinction between voluntary and involuntary, or reflex, movement; Willis’s account of the autonomic nervous system; and his ideas on muscular movement. Apart from these innovative contributions, Willis’s description of the arrangement of blood vessels supplying the brain and spinal cord, for which the book is celebrated, is described. The fifteen engraved plates are included. {148 words}

Cerebral localization of chronic myelomonocytic leukemia: a case report

Background Chronic myelomonocytic leukemia is a myelodysplastic/myeloproliferative neoplasm characterized by the infiltration of blood and bone marrow by immature monocytes. Cerebral localization of chronic myelomonocytic leukemia has never been described. Case presentation We report the case of a Caucasian 59 year-old man with multiorgan chronic myelomonocytic leukemia infiltration, associated with uncommon brain involvement. There was no evidence of evolution to acute myeloid leukemia. The evidence of cerebral infiltration by chronic myelomonocytic leukemia was made after autopsy. Conclusions The fatal outcome of the patient raises the question of the potential benefit of early specific treatment, such as demethylating agents or intensive chemotherapy. Sharing such images of atypical and rapidly evolving chronic myelomonocytic leukemia and the disease history may help clinical decision-making in the future.

Charcot's motor brain map and 19th-century neurosurgery

Neurosurgery is predicated on the knowledge of the structure-function relationship of the brain. When the topic is broached in its historiography, it begins with Fritch and Hitzig's report on the localization of motor function in the cortex of the dog and skips rapidly to Wilder Penfield's homunculus. In that gap are found the origins of modern neurosurgery in 3 papers published by Jean-Martin Charcot and Albert Pitres between 1877 and 1879 in which they describe the somatotopic organization of the human motor cortex and draw the first human brain map. Their findings, obtained through the clinicopathological method, gave relevance to David Ferrier's observations in animals. Their work was extensively cited, and their illustrations reproduced by Ferrier in his landmark lecture to the Royal College of Physicians in 1878. It was known to William Macewen, who used localization to guide him in resecting intracranial mass lesions, and to William Osler and John Hughlings Jackson, who were early advocates of intracranial surgery. This paper describes Charcot and Pitres' discovery of the cortical origin of human voluntary movement and its somatotopic organization, and their influence on 19th-century intracranial surgery. It fills a gap in the historiography of cerebral localization and neurosurgery.

Cerebral localization of higher functions: Memory-related anatomic structures

ABSTRACT The nature of memory and the search for its localization have been a subject of interest since Antiquity. After millennia of theoretical concepts, shifting from the heart to the brain, then from the ventricles to solid parts, the core memory-related structures finally began to be identified through modern scientifically-based methods at the diencephalic and cortical (hippocampal and neocortical) levels, mostly in the late Modern period, culminating in the current state of knowledge on the subject.

Jean Talairach: a cerebral cartographer

Although French psychiatrist-turned-neurosurgeon Jean Talairach (1911–2007) is perhaps best known for the stereotaxic atlas he produced with Pierre Tournoux and Gábor Szikla, he has left his mark on most aspects of modern stereotactic and functional neurosurgery. In the field of psychosurgery, he expressed critique of the practice of prefrontal lobotomy and subsequently was the first to describe the more selective approach using stereotactic bilateral anterior capsulotomy. Turning his attention to stereotaxy, Talairach spearheaded the team at Hôpital Sainte-Anne in the construction of novel stereotaxic apparatus. Cadaveric investigation using these tools and methods resulted in the first human stereotaxic atlas where the use of the anterior and posterior commissures as intracranial reference points was established. This work revolutionized the approach to cerebral localization as well as leading to the development of numerous novel stereotactic interventions by the Sainte-Anne team, including tumor biopsy, interstitial irradiation, thermal ablation, and endonasal procedures. Together with epileptologist Jean Bancaud, Talairach invented the field of stereo-electroencephalography and developed a robust scientific methodology for the assessment and treatment of epilepsy. In this article the authors review Talairach’s career trajectory in its historical context and in view of its impact on modern stereotactic and functional neurosurgery.