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Biomedical subjects

B Guiraud

Publications and source records attributed to B Guiraud.

43 records · Page 3Linked to original sources
PubMedDate not supplied

Pure motor hemiplegia: CT study of 30 cases.

Pure motor hemiplegia (PMH) is a well defined syndrome usually caused by ischemic lesions of lacunar type located either in the internal capsule or in the pons. Angiography and isotope scanning are usually normal. CT scan reveals small deep infarcts and appears to be the most reliable investigative method. The CT scan findings are described of thirty patients with PMH of rapid onset (less than 36 hours). In 29 of the 30 cases a lesion was found which could explain the PMH. Small hemorrhages (2 cm in diameter) in the posterior limb of the internal capsule were noted in two cases. Ischemic lesions were found in 27 patients, 22 patients had a single lesion (20 capsular and 2 pontine), while 5 patients had 2 lesions (2 bi-capsular, 3 capsular and pontine). Three varieties of ischemic capsular lesions were observed. We found in 15 cases a capsulo-putamine-caudate infarct (type I); in 8 cases a capsulo-pallidal infarct (type II); and in 2 cases an anterior capsulo-caudate infarct (type III). Type I corresponded to the area of the lateral lenticulostriate branches of the middle cerebral artery. Type II involved the territory of the perforating branches of the anterior choroidal artery. We suggest that type III involves the territory of the internal lenticulostriate branches of the anterior cerebral artery. Lacunes are generally linked to arterial systemic hypertension. However, only 16 of 30 patients in this series were chronically hypertensive.

Adolescent↗
PubMedDate not supplied

[Computerized cisternography with metrizamide].

Metrizamide, a new water-soluble contrast medium with low toxicity, was used for cranial computed tomography (computerized cisternography) in 26 patients. When injected by lumbar puncture, the pericerebral cisterns (posterior fossa and sella turcica especially), can be visualized with much greater precision than with classical computed tomography. It also allows the normal and pathological circulation of the CSF to be studied. The authors report on 6 cases of tumours of the posterior fossa, 10 cases of pituitary tumours, 2 cases of "empty" sella, 2 cases of CSF rhinorrhoea, 2 cases of normal pressure hydrocephalus, and 2 cases of syringomyelia, studied by this method. The examination was normal in 3 cases. The authors stress the rapidity, reliability, and good tolerance of this new method.

Adenoma↗
PubMedDate not supplied

Internal capsule: normal anatomy and ischemic changes demonstrated by computed tomography.

The purpose of this study was two-fold: (1) to attempt to localize the different parts of the internal capsule on computed tomography (CT) axial sections and (2) to correlate clinical data and CT appearance of 25 cases of ischemic capsular lesions. Twenty-three of the ischemic lesions produced a pure motor hemiplegia. The internal capsule was studied on routine CT axial sections parallel to the canthomeatal line with 8 mm collimation before and after intravenous contrast medium injection. Absorption values of the white matter at the level of the anterior limb of the internal capsule were found to be a little higher (mean, 32 Hounsfield units [H]) when compared with the posterior limb (mean, 28 H). Lesions were classified according to the topography of the internal capsule: anterior limb (three), genu (one), posterior limb (seven), and putaminocapsulocaudate (14). CT appears to be the most sensitive and reliable method to investigate small deep cerebral infarcts since isotope scans were positive in only two of 13 cases, while angiography was positive in eight of 17 cases.

Adolescent↗
PubMedDate not supplied

Investigation of extracranial cerebral arteries by intravenous angiography: report of 1,000 cases.

Intravenous angiography is a a safe, rapid, simple examination, which, with sonography, is complementary in selecting patients for conventional angiography. This examination is not designed to replace conventional angiography, but, rather, to study high-risk stroke patients, patients with asymptomatic cervical bruit, or postoperative patients. Improvements in contrast media, film subtraction, the use of oral anesthesia with viscous lidocaine, and the technique of cooling the contrast medium have made the procedure more successful. A review of 1,000 examinations was undertaken to determine the accuracy of the technique and to emphasize technical points. Excellent results, comparable to conventional angiography, were obtained in 50.3% patients and good results in 32%. Poor or uninterpretable results were obtained in 17.7%. These were secondary to either patient movement or the presence of venous reflux or statis of contrast medium.

Adult↗
PubMedDate not supplied

[Cognitive evaluation of patients with Alzheimer-type dementia by French revised version of the Hierarchic Dementia Scale].

The revised French version of the Hierarchic Dementia Scale (HDS) was assessed in 88 DAT patients (30 men, 58 women, mean age: 70, MMS from 0 to 26). The HDS consisted of 20 subtests which covered the entire range of cognitive functions; each subtest was hierarchically organized. This scale has been validated by the authors in 149 control subjects (Démonet et al., 1990). The goals of the present study were to validate this scale in DAT patients in comparison with the MMS scores and to specify the cognitive impairments of our pathologic population. Results showed that the scores on the HDS were highly correlated with the MMS scores (p < .0001). Some subtests of the HDS (memory subtests and mental control) allow good discrimination between mild demented patients and controls (sensibility = 80.8 p. 100, specificity = 96 p. 100). Conversely some subtests allowed a cognitive follow-up of patients for whom the MMS was no longer useful (MMS scores from 0 to 10). In conclusion, it appears that this scale is useful for drawing cognitive profile of DAT patients and to approach the heterogeneity of dementia.

Aged↗