Biomedical subjects
Publications and source records attributed to A Gaston.
Authors report a case of fatal CNS toxoplasmosis in a young homosexual man suffering from Kaposi angio-sarcoma. This paper is principally concerned with CT scan and neuropathological correlations.
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Aneurysmal degeneration is the most serious complication of persistent sciatic artery. In the literature there have been only 16 surgically treated cases. We report one additional case to present an original and safe method of treatment: balloon endovascular occlusion and femoropopliteal bypass. Diagnosis and other methods of treatment are discussed.
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The clinical and computerized tomodensitometric data and postmortem examination findings from a case of xanthogranuloma of the third ventricle, producing hydrocephalus, are described. A review of 8 recently reported cases resembling ours shows that, on clinical and radiological grounds, third ventricle xanthogranulomas are usually indistinguishable from colloid cysts. From an embryologic and pathologic point of view, these entities seem also to be closely related.
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Effects of laser radiation on atherosclerotic plaques were evaluated in vitro and in vivo. Necropsy artherosclerotic femoral and coronary arteries were submitted to a laser beam. Arteries were perfused by saline or blood solution and a silicone fibro-optic system was placed near the plaques through a balloon dilatation catheter. After laser radiation (20 to 40 W, 2 to 10 seconds) angiograms and histologic sections were obtained. Aorta of 20 atherosclerotic New Zealand rabbits was exposed in dry condition to a CO2 laser beam (2-4 W, 0,2 second). After reinstatement of blood flow, animals were sacrificed from 24 hours to 3 weeks for microscopical examination. In vitro studies showed a significant recanalisation of the thrombosed arteries under blood flow but not under saline solution. Histologically the laser radiation produced a crater surrounded by thermal intimal damage and decollated calcified plaques. In vivo studies showed the healing process: no perforation, no aneurysm, no thrombosis occurred. After 24 hours the crater was filled with a non extensive thrombus, on the first week the thrombus contained phagocyte cells and on the third week, the endothelial damage was completely healed. These results suggest that laser radiation may be effective to recanalize totally occluded arteries in human.
Surgical exposure of the vertebral artery above C2 may be used in very selected cases to embolize medullary or cerebral arterio-venous malformations. 3 cases are reported which were treated by this technique. It allows to use a catheter of sufficient diameter for solid emboles, when balloon catheter cannot be used because IBC seems too hazardous (2 cases). This intra-operative technique may also be indicated when standard embolization is impossible for technical reasons : tortuosity, occlusion (1 case).
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We have developed a method for creating brain slices in the same plane and intervals as pre-mortem CT scan images. Our experience with this very simple technique on 20 brains confirms the practicality, reliability and usefulness of this tool for correlating complex CT images with the pathologic anatomy. Corresponding case-material of cerebral astrocytomas with be presented.
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The case reported here is that of a woman, without any significant pathological antecedent. At age 54, she developed signs of thalamic dementia and died 5 years later. The prominent symptoms were massive anterograde amnesia, apathia, apragmatism, ataxia and a frontal syndrome. She never showed aphasia, apraxia, agnosia or disorders of ocular motility. The C. T. Scan showed lacunar low densities in the mesencephalon and both thalami, mainly on the left side, as well as hydrocephalus caused by a stenosis of the aqueduct as shown by other neuroradiological procedures. The neuropathological examination showed space-occupying lacunae, bulging in the third ventricle, squeezing the aqueduct and protruding into the fourth ventricle. These lacunae were situated in the territory of the paramedian mesencephalo-thalamic arterial pedicle. They were perivascular spaces distensions, probably caused by disorder of the permeability of the arterial wall. This hypothesis is supported by the presence of severe lesions of segmental necrotizing angeitis on a paramedian mesencephalic artery. The etiology of this angeitis is unknown. As far as we know, such neuropathological lesions have never been reported previously. Therefore the pathology and etiopathogeny of cerebral lacunae should be reconsidered.
The authors report a case of testing of the temporary occlusion of origin of the radiculo-medullar artery for the cervical enlargement by balloon occlusion and both testing by clinical evaluation and evaluation of somesthesic evoked potentials and F wave. This testing allowed the surgical removal of a malignant tumor of the cervical vertebra including the vertebral artery and the origin of the radiculo-medullar artery for the cervical enlargement. About this case, they discuss possibilities and the theorical value of these pre-operative tests.
CT was performed on ten cases of dural intracranial arteriovenous fistulas. There were 3 fistulas of the transverse sinus draining directly into the homolateral jugular vein; 2 fistulas of the sinus with distal occlusion of the sinus and back flow into the cortical veins (one was on the transverse sinus, the other on the sagittal sinus); 2 fistulas of the middle fossa; 3 fistulas with direct venous drainage into the cortical veins, one of these forming a tumor process in the posterior fossa. Osseous abnormalities were seen in only one case. Cerebral CT abnormalities, such as patchy or vermicular enhancement, were seen in all the cases with fistulas draining into the cerebral veins. Cerebral CT was normal in cases of fistulas of the sinus without back flow into the cerebral veins.
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Spinal vacuum phenomenon may be encountered in many circumstances, such as degeneration of the intervertebral disk, disk injury, vertebral metastases, ischemic vertebral collapse, Schmorl's nodes, and infectious processes. The high spatial and densitometric resolution of computed tomography (CT) makes it possible to show gas in tissues with high frequency than by conventional radiography. In certain circumstances, the CT findings may be the decisive diagnostic element.