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Biomedical subjects

B George

Publications and source records attributed to B George.

At least 253 records · Page 14Linked to original sources
PubMed1981

[Night sleep disorders during recovery of severe head injuries (author's transl)].

In 16 young (15 to 25 years) patients, sleep recordings have been performed one month (group T1, 10 cases) or 6 months (group T6,6 cases) after recovery of consciousness following severe head injury. Group T1 can be divided in two subgroups according to clinical and EEG datas: T1A (4 cases) with long duration of coma (15 to 40 days) and low level of brain stem dysfunction (diencephalic). In group T6 every duration of coma and level of dysfunction are present. Percentage of intrasleep wakefulness and number of awakenings are very increased in group T1A (31,5% and 24); these datas are less increased in group T1B (10,1% and 19) and T6 (11.8% and 19). Percentage of REM sleep is very low in group T1A (9,57%) and T1B (12,65%) because of short duration of each phase. In group T6 REM sleep is close to control subjects (16,15% and 20,52%). These results are compared to those reported in normal or insomniac subjects of same age or much older. They are very similar to sleep perturbations observed in elderly (70 years) but normal people. This may evoke an early ageing of brain stem structures involved in organization of wakefulness-sleep rhythm and REM sleep.

Adolescent↗
PubMed1981

[Occlusion of vertebral artery. About 33 cases. Therapeutic implications (authors' translation)].

33 occlusions of the vertebral artery on 29 patients were observed from 44 vertebro-basilar strokes and 20 sylvian infarcts (respectively 17 and 5 cases). 7 other cases were related to tumour, trauma or surgical ligation and were asymptomatic. In 10 out of 13 strokes could be related to a reduction of flow because of bilateral lesions onr on dominant artery. In 7 out of 9 occlusions without controlateral lesion embolism could be evoked. These results are analysed with the aim of defining indications for anastomosis on the vertebral artery.

Adult↗
PubMed1981

[C.T. scan and traumatic intracranial haematoma without clinical signs (author's transl)].

Patients having sustained head injuries were investigated by computerized axial tomography, a few hours after trauma. 24 conscious patients had large traumatic lesions: epidural haematoma, acute subdural haematoma and cerebral attrition. 12 had no focal sign and were well conscious or very slightly drowsy. 12 were slightly drowsy and/or had focal signs but these signs were very discrete in contrast with the huge lesions seen on the CT Scan. This seems to confirm that an epidural haematoma expands very early after the head injury, and, in any case, that it does exist during the free interval. From a practical view point, computerized tomography may greatly improve the treatment of patients who, other-wise, would have been operated upon in comatose state. This study is not a prospective one, it does not lead to any statistical value. But it points out the usefulness of CT Scan after severe head injury especially of conscious patients, above all if there is a skull fracture.

Adolescent↗
PubMed1980

[Significance and prognostic value of Parinaud's syndrome in hydrocephalus (author's transl)].

Eleven out of 260 cases of chronic hydrocephalus in adults were associated with mesencephalic symptoms, in particular Parinaud's ophthalmoplegia. Investigations aimed at detecting intracranial growth consistently gave negative results. In most cases, the midbrain symptoms were accompanied by intracranial hypertension and therefore reflected an aggravation of the hydrocephalus. They regressed when manoeuvres tending to reduce intracranial pressure were applied on time. On three occasions, they were followed by pontobulbar symptoms and treatment was ineffective. When brain stem symptoms (especially Parinaud's syndrome) occur in the course of hydrocephalus, one should always look for tumoral lesions, but they may also point to deterioration of the disease, which should be treated before it becomes irreversible. The mechanism of brain stem involvement in hydrocephalus is discussed in the light of electrophysiological recordings during experimentally-induced intracranial hypertension in the cat.

Adolescent↗
PubMed1980

Surgical approach to the whole length of the vertebral artery with special reference to the third portion.

A lateral route between the SCM and the lateral border of the internal jugular vein is defined from an anatomical study for exposure of the VA. It offers the simplest route for controlling any part or the whole length of the VA, including its intracranial portion. Surgical indications are discussed on the basis of our experience in eight cases with, in all cases, control of the VA in its third segment between C2 and the foramen magnum. Arteriovenous malformations are the most frequent indications; two cases were treated by direct approach and one by exclusion and anastomosis between the internal carotid artery and the vertebral artery at C1-C2. TUmours of the lateral cervical space (one haemangiopericytoma and one jugular glomus tumour) or of the posterior fossa extruding out of the foramen magnum or the jugular foramen (one meningioma) may require control of the VA. Traumatic lesions (one case) or compression by an osteophytic spur are also indications for this approach. Wall lesions of the VA (aneurysm or stenosis) are best treated by exclusion and anastomosis between either the carotid or the subclavian artery and the vertebral artery at C1-C2 level. One case of aneurysmal dysplasia was cured by anastomosis between the subclavian artery and the vertebral artery at C1-C2 with a saphenous vein graft and clipping of the VA proximal to the by-pass. Radiological examinations are fundamental for diagnosis, treatment when embolization is necessary, and choice of surgical treatment, according to the importance of the contralateral VA and the medullary branches.

Arteriovenous Malformations↗
PubMed1980

Neurophysiological effects of experimental intracranial hypertension on three different structures of the brain stem in the cat. Rostrocaudal deterioration.

Modifications if multi-unit activity are analyzed during experimental intracranial hypertension in the cat at three levels of the brain stem red nucleus (NR), nucleus giganto-cellularis (Gc), and lateral geniculate body (GO). An initial increase of activity is observed in NR and Gc, which is followed by a fall of activity. This fall is sooner and more important for the rostral structures than for the caudal ones. In GO, activity decreases as soon as intracranial hypertension starts. These results are similar to those already recorded in the mesencephalic and bulbar reticular formation. They are discussed on the basis of monoamine levels and local CBF variations studied in the brain stem, following the same protocol. The higher sensitivity of rostral brain stem structures to intracranial hypertension is correlated to the clinical concept of rostro-caudal deterioration.

Brain Stem↗
PubMed1980

[Variations of 3' 5' cyclic AMP level in CSF after SAH with or without vasospasm (author's transl)].

Levels of 3' 5' AMPc in CSF were analysed by radioimmunoassay in 56 patients. 12 were used as control and 33 had a Subarachnoid Haemorrage (SAH) between 1 and 22 days before sampling. Out of these 33 cases, 20 had an arterial aneurysm, 7 showed a more or less relevant degree of vasospasm on arteriography. 11 other patients presenting different neurological diseases were studied for comparison. (Ischemia, Hydrocephalus, Atrophy, Hematoma). 3' 5' AMPc level in CSF was found to be very low in case of SAH, especially in patients harboring a definite vasospasm. The significance of AMPc level in CSF is discussed in relation with impairment of consciousness, spasm, ischemia, cortical atrophy, hydrocephalus and hematoma.

Cyclic AMP↗
PubMed1980

[Cerebral infections due to anaerobic organisms (author's transl)].

Most of intracranial suppurations, especially those from E.N.T. origin, are secondary to anaerobic germs, which can be cocci Gram (+) or Gram (-), in association or not with aerobic bacteria. 97 cases have been observed between 1968 and 1979 at Lariboisière Hospital. When the bacteriological study was realised in correct conditions, anaerobic germs were found in more than 60% of cases, and less than 10 % of cultures were negative. A lower mortality (11 %) and morbidity (34 %) rates follow an improvement in bacteriological diagnosis. Anaerobic bacteria stay very susceptible to antibiotics, such as the association Penicilline-Metronidazole; now, we prescribe immediately such a therapeutic, and eventually modify it after having received the antibiogram. As a conclusion, the treatment of brain abscesses could be simplified: CT scan and a rigourous bacteriology make possible an accurate control and follow-up of the suppuration after simple punction.

Anti-Bacterial Agents↗
PubMed1979

[Exposure of the extracranial portion of the vertebral artery. Anatomical study--Surgical value (author's transl)].

Exposure of the vertebral artery, in particular in its extracranial course, may be of surgical value. The treatment of lesions affecting this entire artery must be discussed in the context of the revascularisation of the vessels supplying the brain. The anatomical study forms defines the features of this surgical approach. Selective vertebral arteriography and the assessment of tolerance of vertebral clamping are the main features of pre-operative evaluation.

Arteriovenous Fistula↗
PubMed1979

Relevance of antibiotics in the treatment of brain abscesses. Report of a case with eight simultaneous brain abscesses treated and cured medically.

A case of eight simultaneous brain abscesses in the right cerebral hemisphere, treated medically after puncture of two of them, is reported. Antibiotics and hypertonic mannitol and, after seven days, dexamethasone were sufficient to cure these lesions. CT scan was of primary importance to follow the evolution under treatment. To get the best efficiency from antibiotics, identification of the microorganism and assessment of its resistance to antibiotics are necessary. It is suggested that in certain conditions medical therapy might be sufficient to treat cerebral abscess, after simple puncture to isolate the infecting agent. Corticosteroids should be avoided in the acute phase because they prevent antibiotics from penetrating the abscesses.

Adult↗
PubMed1979

Surgical possibilities in the third portion of the vertebral artery (above C2). Anatomical study and report of a case of anastomosis between subclavian artery and vertebral artery at C1-C2 level.

A reappraisal of surgical possibilities in the third portion of the vertebral artery (VA) above C2, has been done from an anatomical study on twenty autopsy specimens. A route passing between the internal jugular vein and the Sterno-cleido-mastoid muscle allows a simple approach to the transverse process of C1. After division of two muscles attached to this process, 1.5 cm of the VA can be exposed. For larger exposure of the artery, the foramen transversarium of C1 must be unroofed and the artery dissected in the guttering of the posterior arch of the atlas. This surgical route was used in a case of aneurysmal dysplasia at the C3 level. An anastomosis between the subclavian artery and VA at the C1-C2 level was performed with an autologous saphenous vein graft. The key points are the highest possible freeing of the XI nerve and the head position. Rotation and extension move the transverse process and the posterior arch of the atlas superficially and anteriorly.

Cerebral Revascularization↗
PubMed1979

Surgical treatment of chronic subdural hematomas in infants.

Subdural hematomas in infants are associated with a high risk of recurrence. In an effort to combat this risk, a surgical procedure consisting of excision of the subdural membranes, a reduction of the craniocerebral disproportion and a restoration of the normal angle of junction of the cerebral bridging veins and the superior sagittal sinus is proposed.

Age Factors↗
PubMed1979

[Anastomosis between subclavian artery and V. A. at C1-C2 level. Case report and reappraisal of surgical possibilities on the third portion of the vertebral artery (author's transl)].

A reappraisal of surgical possibilities on the third portion of the Vertebral Artery (V.A.) above C2, have been done from an anatomical study on 20 autopsied specimen. A route passing between the Internal Jugular Vein and the Sternocleido-mastoidian muscle allows a rather simple approach of the transverse process of C1. After dividing two muscles taking insertion on this process, 1,5 cm of the V.A. can be exposed. For larger exposure of the artery, the Foramen Transversaris of C1 must be unroofed and the artery dissected in the guttering of the posterior arch of Atlas. This surgical route was used in a case of aneurismal dysplasia at C3 level. An anastomosis between Subclavian Artery and V.A. at C1-C2 level was realized with an autologous saphenous vein graft. The keypoints are the highest possible freeing of the XI nerve and the head position. Rotation and extension move the transverse process and the posterior arch of Atlas superficially and anteriorly.

Humans↗