Search PubMed⌕ Search

Biomedical subjects

B Pertuiset

Publications and source records attributed to B Pertuiset.

At least 55 records · Page 3Linked to original sources
PubMed1982

Preoperative evaluation of hemodynamic factors in cerebral arteriovenous malformations for selection of a radical surgery tactic with special reference to vascular autoregulation disorders.

After reviewing the literature with respect to hemodynamic factors in AVM the authors describe their experience monitoring the blood volume under induced arterial hypotension. They have been able to select cases which presented disorders of the vascular autoregulation of the brain and represent, for this reason, a challenge to a radical excision; in such cases they advise to remove the AVM in several programmed stages. In addition it was possible to predict the efficiency of the hypotension on AVM vessels pressure during operation enabling the surgeon in case of positive effect of the hypotension to realize more securely the haemostasis. Moreover, the authors present the first data regarding the mean circulatory time the knowledge of which seems very promising. The last 33 cases of a series of 179 radical removals have been monitored before and in some cases after operation; the knowledge of these hemodynamic factors allowed the surgical team of La Pitié to extend the surgical indications for radical removal to AVM recently considered as inoperable.

Adult↗
PubMed1982

[Use of a new antihaemorrhagic agent in neurosurgery. Trial in 35 cases (author's transl)].

A new hemostatic agent which can be applied locally on diffuse bleeding of the dura or of the brain has been used in 35 cases --12 cases on the dura mater; --6 cases on cerebral traumatic laceration; --15 cases in astrocytomas grade III and IV; --2 cases in cerebral AVM. This new material is made of sheets of natural collagen and is resorbable. The same kind of material is used in U.S.A. under the name of Avitene. The results have been very encouraging when compared to the use of oxycel. The authors think that the result can be more striking when a powder will be added to the sheet.

Brain↗
PubMed1981

[Clinical symptoms and anatomical locations in primary haemorrhages of the basal ganglia. A neuropathological study of 64 cases (author's transl)].

The signs, symptoms and courses of 64 cases of "primary" haematoma of the basal ganglia have been retrospectively studied, and the main clinical data have been analyzed in relation to the location and extent of the bleeding. Onset with hemiplegia, accompanied or not by impaired consciousness, was more frequent with intermediate and lateral haematomas than with medial haematomas (p less than 0.001). Among patients with initial hemiplegia, impaired consciousness was more frequent with intermediate and medial haematomas than with lateral haematomas (p less than 0.005). At a later stage, patients with intermediate and lateral haematomas more often went into deep coma than those with medial haematomas (p less than 0.01). There were no statistically significant differences between the three anatomical groups with regard to frequency of other signs and symptoms or duration of the disease before death occurred.

Basal Ganglia↗
PubMed1981

[Diagnosis of brain lesions and of early complications by CAT scan in traumatic patients in coma. Series of 265 cases (author's transl)].

In every patient admitted with a traumatic coma a CAT scan was performed immediately (less than 6 hours after the accident). As a routine procedure another scan was performed 48 hours later; further scans were done depending upon the clinical and ICP conditions. The patients were operated upon or given a medical treatment from the CAT scan analysis only. Until now the brainstem lesions have not been seen on the first day CAT scan images. The CAT scan performed on the second day will show a stabilization or an expansion of the previous lesions: haemorrhage or oedema. Any change in the patient condition or in the IPC monitoring must lead to a new CAT scan revealing epidural or subdural haematomas, hydrocephalus, subdural hygroma, persistent oedema. Therefore the CAT scanner used by a neurosurgical team must be able to work day and night.

Brain Injuries↗
PubMed1981

[Ruptured intracranial saccular aneurysm. Conduct to apply before direct surgical intervention (stabilization of arterial pressure with diazepam].

The 250 patients of this series, whatsoever was the location of the aneurysm, were operated radically on the 6th and 7th day following the rupture. That is to say at the end of the brain swelling period and before the rebleeding period. During these 5 or 6 days the blood pressure was stabilized by a daily intake of diazepam (15 to 30 millig); 10% only of the patients were resistant; in these cases clonidine was used. During this period antifibrinolitic agents were not given as well as antioedematous therapy. No case of rebleeding was observed in this series under this therapy.

Blood Pressure↗
PubMed1981

[Treatment of severe head injuries by external ventricular drainage and barbiturate therapy. Mortality and morbidity in 57 cases (author's transl)].

After severe head injury the majority of deaths, during the early period, is due to acute intracranial hypertension. We report a series of 57 severe head injuries with early signs of brainstem involvement. CT Scan performed within 6 hours after injury and repeated at 48 hours showed hemispheric lesions and edema, without shift of the middle line. Treatment consisted of controlled ventilation, water and sodium restriction and barbiturates. A ventricular catheter was inserted in 52 patients allowing intracranial pressure (I.C.P.) monitoring, and permanent subtraction of cerebrospinal fluid (C.S.F.). This treatment allowed the control of a normal I.C.P. in 80% of the patients. In 6 patients a secondary surgical treatment was performed. In this series the mortality rate was 31,5% the good results and moderate disability 54,3%, the severe disability and vegetatives states 14,2%.

Adolescent↗
PubMed1981

[The histologic extemporaneous examination in neurosurgery. About 1000 cases (author's transl)].

One thousand extemporaneous examinations performed in the neurosurgical department over a nine years period have been reviewed. The purpose of these examinations was to deal with the following points: - presence or absence of a tumor, - primary or secondary nature of this tumor, - appreciation of the malignancy degree. It seems possible to draw the following conclusions: The frequency of false diagnoses was not significantly different from the one observed in out precedent series. On the other hand, with experience, the number of "approximate diagnoses" was strongly reduced. Some special diagnosis problems were discussed. The importance of the clinical data in establishing a correct diagnosis was emphasized.

Brain Neoplasms↗
PubMed1980

[Neuropathological study of adult intracranial hemorrhage. III. Analysis of 107 meningeal hemorrhages due to rupture of arterial aneurysms].

The findings in 107 pathological studies of meningeal hemorrhages due to rupture of arterial saccular aneurysms are reported. There were 62 women (58 p. 100) and 45 men (42 p. 100). Mean age was 56, lower in men (53) than in women (58). 45 aneurysms of the Anterior Communicating Artery, 26 of the Middle Cerebral Artery, 15 of the Internal Carotid Artery, 10 of the Anterior Cerebral Artery, 1 of the Anterior Choroidal Artery and 10 of the Posterior System were studied. These ruptured aneurysms were compared to 31 non ruptured ones. Mean size of the ruptured aneurysms was 10, 62 mm, not statistically different from that of non ruptured aneurysms (9, 05 mm). Multiple aneurysms represent 10 p. 100 of the whole ruptured aneurysms population. They affected mostly the Middle Cerebral Artery. High blood pressure had been present in 56/107 cases of ruptured aneurysms (52 p. 100). The prevalence of high blood pressure in patients with ruptured aneurysms (men: 60 p. 100 between 35 and 49, 63 p. 100 between 50 and 64; women: 31 p. 100 between 35 and 49, 54 p. 100 between 50 and 64) was statistically higher than in the same age and sex ranges of the general French population. The other causes of bleeding were rare: 4 liver cirrhosis (2 of the patients were also hypertensive) and 5 anticoagulant therapies (2 of which were also associated with high blood pressure). Intracerebral hematomas were found in 43 cases (40 p. 100): 39 lobar, more frequent in the frontal (26) than in the temporal (13) lobes, due mainly to Anterior Communicating Artery and Anterior Cerebral Artery aneurysms; very few were in the basal ganglia (3) or brainstem (I). Intraventricular hemorrhage was found in 39 cases (36 p. 100). Forty (37 p. 100) cerebral infarcts had occurred. They were located in the territory of the same artery in 20 cases (19 p. 100), in a different territory in 11 cases (10 p. 100), in both in 9 cases (8. p. 100).

Adult↗
PubMed1980

[Estrogen and progestin receptors in meningiomas: a study in 22 cases (author's transl)].

The authors have searched for oestrogene (RE) and progesterone (RP) receptors in 22 cases of meningiomas. Hormone receptors were determined on the cytosol and nuclear fractions of tumor tissues, using synthetic oestrogen R 2858 and progestin R 5020 in conditions where exchange was nearly achieved. The receptors were considered as present for values equal or higher than 100 femtomoles per gram of tumour tissue (fmol/gT). For the 22 studied cases the RE were present in 13 cases (59 p. 100) with values between 100 and 500 fmol/gT in 9 cases and higher than 500 fmol/gT in 4 cases. The RP were present in all cases (100 p. 100), with values between 100 and 500 fmol/gT in one case, between 500 et 5 000 fmol/gT in 13 cases and higher than 5 000 fmol/gT in 8 cases. The results were compared with neuropathologic data obtained by light microscopy. The clinical and biological significance of results are discussed.

Adult↗
PubMed1979

[Diagnosis of cerebral hemorrhages. A report of 247 anatomo-pathological cases (author's transl)].

A series of 247 cases with simple and apparently primitive cerebral hemorrhages selected from the pathological records of Charles Foix laboratory from 1962 to 1977 is reviewed with regard to the accuracy of the premortem diagnosis as a function of the size, the location and the age of the bleeding, the patient's age, the practices of angiography or lumbar puncture and the considered period of death. The clinical diagnosis of cerebral vascular disease was made in 75% of the cases from that serie but the hemorrhagic mechanism was identified only in 50,6% of cases. The diagnosis accuracy was enhanced in large and recent hemorrhages occuring in patients under 70 years old. It seemed better in cerebellar and intermediate locations. It was enhanced in more recent observations (collected since 1974). The practice of cerebral angiography and lumbar puncture rose up (in a somewhat equivalent way) the proportion of accurate diagnoses. The lumbar puncture practice was not associated with a higher rate of cerebral herniae.

Adult↗