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Biomedical subjects

A Tournade

Publications and source records attributed to A Tournade.

At least 19 recordsLinked to original sources
PubMed2003

Giant spinal perimedullary fistula in hereditary haemorrhagic telangiectasia: diagnosis, endovascular treatment and review of the literature.

Hereditary hemorrhagic telangiectasia (HHT, Rendu-Osler-Weber disease) is a vascular disorder with dominant autosomal transmission characterised usually by multiple mucocutaneous and visceral abnormalities. Neurological manifestations due to the primary involvement of spinal cord by vascular malformations are rare. We present a young man with HHT associated with a central nervous system arteriovenous malformation and a giant perimedullary fistula, that was manifested as progressive myelopathy. The diagnosis was made coupling magnetic resonance imaging to selective spinal arteriography. The therapeutic option was endovascular treatment by mechanically detachable coils which resulted in full exclusion of the fistula with full improvement of symptoms. During follow-up a stable clinical and morphological outcome was achieved. Clinical manifestations in HHT, with emphasis on neurological symptoms, are reviewed as well as the therapeutic options to deal with giant perimedullary fistula.

Adolescent↗
PubMed2003

Posterior cervical haemangiopericytoma with intracranial and skull base extension. Diagnostic and therapeutic challenge of a rare hypervascular neoplasm.

Haemangiopericytomas are rare hypervascular tumors arising from pericytes. They may occur anywhere in the body, but posterior cervical location is rather uncommon. A case of posterior cervical haemangiopericytoma with posterior fossa and temporal bone extension is reported. Although the patient had undergone preoperative endovascular embolization and surgical resection on three separate occasions, control of the skull base extension was not successful. Following endovascular embolization combined with radiotherapy, the patient has been asymptomatic for 48 months. Angiographic features may help in differentiating haemangiopericytomas from other hypervascular lesions. Preoperative endovascular embolization is recommended due to the pronounced tendency for haemorrhage throughout biopsy and surgical procedures.

Cervical Vertebrae↗
PubMed2001

Atypical MELAS syndrome associated with a new mitochondrial tRNA glutamine point mutation.

The authors studied a 47-year-old patient who presented with an association of deafness, acute cerebral stroke-like episode, leukoencephalopathy, and extensive basal ganglia calcifications. Late onset and neuroradiologic findings were atypical for MELAS syndrome (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Strokelike episodes). A heteroplasmic G to A transition at nucleotide 4332 in the tRNA glutamine gene was identified in the patient's muscle mitochondrial DNA. The pathogenicity of the mutation was shown in single muscle fibers by the correlation between high mutation load and cytochrome c oxidase defect.

DNA, Mitochondrial↗
PubMed2001

Chemonucleolysis of lumbar disc herniation with ethanol.

PURPOSE: To demonstrate the efficiency of the treatment of the lumbar disk herniation (LDH) with absolute alcohol. MATERIALS/METHODS: From June 1997 to September 2000, 118 patients with 126 LDH, 69 males and 49 females, aged 19 to 77 (mean age: 51.1 years) were treated with absolute alcohol nucleolysis. In 75 cases, the LDH were parasagittal, in 30 foraminal, in 17 medial and in 4 extraforaminal. In most cases, the sensitive symptoms and motor or reflex abnormalities corresponded to the lumbar disc herniation level. Nucleolysis was made in ambulatory condition and each patient underwent general anesthesia. All procedures were performed in surgical conditions and controlled under digital fluoroscopy. The disc puncture was laterally made at the junction of middle and posterior thirds of the disc, under strict lateral fluoroscopic control. A discogram was obtained before ethanol injection. Injection dose of absolute alcohol was 0.4 ml. The realization time was about 15 minutes. RESULT: Total improvement of symptoms was obtained in 97.55% of cases. Two patients remained with low-back pain and the failure treatment rate was 0.84% (1 case). CONCLUSION: Nucleolysis with ethanol is a very effective, safe and low cost treatment for any kind of LDH, that allows to treat several levels during the same procedure, and can be repeated several times. Nucleolysis with ethanol can be made in ambulatory condition and be proposed to patients who refuse surgical treatment and have allergic background.

Adult↗
PubMed1999

[Efficacy of lumbar chemonucleolysis in the treatment of foraminal and extra-foraminal hernias].

A retrospective review of 1,200 nucleolyses performed over a three year period from January 1995 to December 1997 showed 116 discal treatments for foraminal and extra-foraminal localizations. The anatomic localization through the foramen and the intense clinical signs typify these anatomoclinical forms of lumbar hernia. In contrast with complex and disruptive surgical cure, percutaneous nucleolysis offers a precise and rapid method which can be performed in a very short time in outpatients with a success rate of 80%. Most localizations concern L3-L4 and L4-L5 hernias which give the best clinical outcomes.

Adult↗
PubMed1997

Saccular intracranial aneurysms: endovascular treatment with mechanical detachable spiral coils.

PURPOSE: To evaluate endovascular treatment of saccular intracranial aneurysms with mechanical detachable spiral coils. MATERIALS AND METHODS: Fifty-three patients with 56 saccular aneurysms underwent endovascular treatment with spiral coils. All but five had symptomatic subarachnoid hemorrhage staged according to the Hunt and Hess classification as follows: stage IV or V (n = 20), stage III (n = 10), stage I or II (n = 20), and stage 0 (asymptomatic [n = 6]). RESULTS: Forty-seven aneurysms were occluded (100% occlusion) on follow-up angiograms with the following time distribution: 24 months for six aneurysms (six patients), 12 months for 14 aneurysms (11 patients), 6 months for 13 aneurysms (13 patients), 4 months for four aneurysms (four patients), and only immediate postprocedure study for 16 aneurysms (16 patients) (excludes two deaths and one failure). CONCLUSION: In this relatively small group, endovascular treatment with mechanical detachable spiral coils had a success rate of 90%, and it appears to be a rapid, reliable, and relatively safe technique in the treatment of life-threatening subarachnoid hemorrhage.

Adolescent↗
PubMed1995

[Dural fistula of the cavernous sinus. Treatment through an intravenous approach apropos of 4 cases].

The authors report 4 cases of symptomatic dural fistula of the carotid cavernous sinus treated by transvenous coils. The objectives of dural fistula treatment are now clearly established and several methods are available. Abstention is the rule for asymptomatic forms, whereas symptomatic forms with ophthalmological complications may respond to manual compression of the jugular vein and the carotid artery, arterial embolization, radiotherapy or venous embolization. Arterial embolization results in complete cure in 72% to 78% of the cases, but it is limited by the meningeal supply of the internal carotid artery, with the microcatheter the transvenous route make it possible to treat the meningeal supply from the internal and external carotids without affecting the arterial system, but this technique is restricted by the anatomy of each patient.

Aged↗
PubMed1994

[The role of magnetic resonance angiography in the follow-up of intracranial arteriovenous malformations treated by an intravascular approach].

The purpose of our work was to measure the accuracy and reliability of MR-Angiography in the study and follow-up of intracranial arteriovenous malformations, and in particular to evaluate the results of endovascular treatment. Over an 18-month period 4 patients with such malformations were examined by MR-Angiography. There was an angioma of the corpus callosum, a left parieto-rolandic angioma, a posterior thalamic angioma and a cerebellar angioma. All examinations were performed with a Magneton-Impact 1 Tesla machine (Siemens, Erlangen, Germany), using a head coil, MR-Angiography with time-of-flight sequences and differential arterial and venous saturations. Each patient was examined by MR-Angiography first at the beginning of treatment, then when ambulatory after embolization. The morphological study applied to the afferent vessels, the nidus and the efferent veins. MR-Angiography proved to be very good in identifying the arteries feeding the malformation, and this made it easier to evaluate the reduction of their input after treatment, without having recourse to any arteriography. Beside, analysis of the nidus was facilitated by the judicious arrangement of arterial and venous saturations. In fact, the systematic use of MR-Angiography in the follow-up of intracranial arteriovenous malformations makes it possible to measure, with full reliability, the efficacy of the endovascular treatment under conditions of comfort unequalled in these out-patients, and selective angiography sequences need to be performed only during therapeutic phases.

Adolescent↗
PubMed1992

A comparative study of the anatomical, radiological and therapeutic features of the lumbar facet joints.

An anatomical study of the lumbar apophyseal joints was carried out to facilitate recognition of facet joint lesions, which we now examine routinely by percutaneous arthrography. Special attention was given to the configuration of the different compartments of the joint space and to its relationships with the contents of the intervertebral foramen. The abnormalities seen on lumbar facet joint arthrography are very varied; two major groups should be stressed: synovial fringe hypertrophy and pseudodiverticular synovial ectasia. The percutaneous approach to lumbar facet joint arthrography allows it to be used a therapeutic measure, with injection of anti-inflammatory drugs into the joint space, the beneficial effects of which were confirmed in our series. The precision, efficiency and cost-effectiveness of this outpatient technique justify and should encourage its more widespread application in the diagnosis and treatment of low back pain.

Adult↗
PubMed1991

Contribution of discography to the diagnosis and treatment of lumbar disc herniation.

In this study, based on 600 cases of lumbar disc herniation treated by chemonucleolysis, the authors underline the importance of performing good discography and interpreting its results. A discographic classification of intervertebral disc deterioration is suggested. A CT-discographic study is reported and its results are compared with those of standard discography. On the basis of these studies, the authors have established methodological data concerning the efficacy of chemonucleolysis and its evaluation.

Chymopapain↗
PubMed1989

[Chemonucleolysis of lumbar intervertebral disk herniation].

Chemonucleolysis is an advantageous alternative to surgical treatment of lumbar disc herniation. To achieve the best results the indications must be strictly observed and the procedure itself must be technically perfect. In these circumstances a rapid, noninvasive and less expensive treatment of lumbar disc herniation is possible.

Humans↗
PubMed1989

[Superselective angiography of the circumflex arteries in preoperative evaluation of femoral neck fractures].

The study of arterial vascularity in the head and neck of the femur is performed as an emergency exploration of femoral neck fractures by means of selective catheterization. The systematization of vascular lesions thus obtained is compared with the anatomical types of fractures. The posteromedial circumflex artery is not injured definitively as a rule, so that conservative osteosynthesis can be preferred to arthroplasty.

Angiography↗
PubMed1987

Percutaneous endoluminal angioplasty of post endarterectomy carotid stenoses.

Percutaneous transluminal angioplasty of the carotid artery was performed in four patients with recurrent stenosis following endarterectomy. Balloon catheter dilatation was successful in 3 of the 4 lesions. Post dilatation angiography demonstrated an increase in luminal diameter: there were no neurological complications with the procedure. PTA appears to be an effective method of treating recurrent stenosis following carotid endarterectomy.

Aged↗