External magnetic guidance of endovascular catheters with a superconducting magnet: preliminary trials. Experimental studies in dogs and prospects of application.
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Biomedical subjects
Publications and source records attributed to C Marsault.
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The authors present four cases of tuberous sclerosis examined with MRI. The patho-anatomic aspects are reviewed and analysed with respect to MRI data. MRI appears superior to the CT particularly for imaging of cortical tubers, cystic lesions, and heterotopic clusters; these last two features were never described with MRI before. Here is also presented the second progressive case of giant intracranial aneurysm associated with tuberous sclerosis.
The authors report the particular treatment of a traumatic cavernous fistula caused by the rupture of an exceptional lesion: a false aneurysm of the C5 segment of the right carotid artery situated at the origin of a persistent trigeminal artery.
Three clinicopathologic cases with a remarkable pattern of extensive diffuse subependymal periventricular spread of cerebral metastases from solid systemic cancer are reported. Two patients had a small cell carcinoma of the lung. In the third case, the histologic features of the brain metastases were consistent with a neuron-specific enolase-positive, small cell anaplastic carcinoma. Involvement of the choroid plexus and leptomeninges was moderate or absent. Intraparenchymatous nodular metastases were not found except in one case in which rare nodular superficial cortical metastases were present. The clinical data were nonspecific except for orthostatic hypotension, in one patient, which was probably due to the infiltration of the floor of the third and fourth ventricles. Results of the cerebrospinal fluid examination, available in two cases, were normal. The only diagnostic investigation was contrast-enhanced computed tomography scanning.
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About 37 cases of non-traumatic spinal cord and cauda-equina compression, the authors emphasize the value of CT-scan study after intra-thecal injection of water-soluble contrast-medium. This exploration gives accurate informations about the involvement of both spinal and para-spinal spaces. These data are helpful diagnosis purpose and for the choice of therapeutic especially when surgical procedure is decided.
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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The clinical and pathological findings of a 31-year-old woman, in whom the diagnosis of Leigh's disease was made, are reported. CT scan examination with contrast enhancement showed symmetrical areas of low density, in both thalami, anterior limbs of internal capsules and corpus callosum. Longstanding chronic lesions involved the optic chiasma and the cerebral peduncles and consisted of myelin loss, status spongiosus, astrocytic gliosis and marked capillary proliferation. The neurons were spared. In the basal ganglia, internal capsules and corpus callosum, these lesions were more recent and consisted of focal necrosis, perivascular oedema and few lymphocytic perivascular cuffings.
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4 months after a bone marrow transplantation performed for acute lymphocytic leukaemia, a 28-year-old man had encephalitis. A brain CT scan revealed bilateral and symmetrical temporal hypodense areas. Serological studies revealed a recent CMV conversion in serum and a higher conversion in cerebral spinal fluid. All other viral antibodies remained at low levels, especially for herpes simplex virus. Because of a high incidence of CMV infection after bone marrow transplantation, the responsibility of CMV as the cause of the encephalitis is discussed.
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In a patient presenting dysautonomia a severe orthostatic hypotension revealed the presence of a subependymal metastatic infiltration from a large cell anaplastic bronchial carcinoma. Clinical pharmacological studies were conducted. A paradoxical sinus bradycardia during orthostatism, and an absence of bradycardia after clonidine injection, were suggestive of a central origin of the dysautonomia. At post-mortem, metastatic infiltration involved the walls of the lateral ventricles, and the floor of the IIIrd and IVth ventricles, from where it invaded structures responsible for cardiovascular control. Correlations could be established between the results of the clinical pharmacological tests and the pathological findings. Also present were a) anterograde amnesia dating from the onset of the orthostatic hypotension, probably due to compression of the anterior pillars of the trigone by tumour invasion of the septum; b) behavioural disorders with absence of spontaneous movement and speech, indifference and docility, probably arising from destruction of the septum.
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The authors relate their experiences concerning tomodensitometric examination to evaluate the herniation of a disk. 45 patients and 50 herniations of a disk have been studied. 39 herniations have sustained surgical procedures. The tomodensitometric examination and the radiculosaccography have been performed among these patients in order to compare the findings. The fact that there has only been 3 failures prove the reliability of tomodensitometric examination; among these failure there is 2 post-operative recurrences and one L4 L5 herniation. The radiculosaccography fails 5 times (1 L4 L5 herniation and 4 L5 S1 herniations). There is not any common negative in the two methods. Because of its total innocuity (no injection of any kind) the tomodensitometric examination seems to be the first exploration to prescribe when an herniation of a disk is resistant to clinical treatment and when a surgery is planned.
Overall activity in an emergency neuroradiological department was altered when computed tomography facilities became available, as shown by comparative studies conducted during one year without and one year with the use of this investigational method. More examinations were conducted during the year the apparatus was available, and the diagnostic approach to patients with head or brain injuries was modified, computed tomography replacing the arteriography used as an initial examination during the first year. These findings can be related to the rapidity, safety, and diagnostic precision of computed tomography examinations.