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Biomedical subjects

C Thurel

Publications and source records attributed to C Thurel.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Tympanic and jugular paragangliomas. I. Clinical symptomatology and evaluation of extension. Apropos of 25 cases].

Based on a review of 25 cases of tympanic and jugular paragangliomas treated and followed up in the Lariboisière hospital, Paris between 1978 and 1986, clinical aspects and extension of these tumors are studied. The often long delay in making the diagnosis is related to lack of knowledge of presenting symptomatology, frequent discordance between functional and physical symptomatology exists, but remarkable progress has been made in assessment of extension of tumors using new imaging techniques, particularly angiography, which can also guide the preoperative embolization and surgical procedures.

Adult↗
PubMed1987

[Tympanic and jugular paragangliomas. II. Angiographic, surgical and irradiation treatment. Results. Indications. Apropos of 25 cases].

Results of treatment are reviewed in 25 cases of tympanic and jugular paragangliomas treated and followed up in the Lariboisière hospital, Paris between 1978 and 1986. Therapy has been transformed by the use of embolization but its non-negligible neurologic accident risks, whatever the carotid artery territory involved, justify prior weighing of indications for its application. New surgical technics allow more extensive exeresis, but intrapetrous extension to the nerve compartment of the jugular foramen and the anterior pericarotid region still raises difficult surgical problems and appears to be the principal reason for failure of treatment. Radiotherapy is very effective and applicable for inoperable forms, as a complement to incomplete surgical removal and for recurrences.

Cerebral Angiography↗
PubMed1984

[Intramedullary astrocytoma and ependymoma in the adult. Do therapeutic tactics influence the long-term results? Evaluation of 23 surgically treated cases and discussion of the literature].

The authors tried to determine the best treatment of intramedullary tumors nowadays. They studied a personal series of 23 intraspinal ependymomas and astrocytomas. 15 patients had a mean long term follow-up of 5 1/2 years. Among these, only patients with ependymomas were clinically cured or dramatically improved (30%). On the contrary, no patients operated on an astrocytoma received benefit of the surgical procedure. This study was compared to most of the recent series of the literature , the results of which are superimposable . Concerning an intraspinal ependymoma, a logical attitude is to proceed, under optic magnification, to the most complete excision as possible, as long as a well individualized plan of cleavage is visible. Radiotherapy is indicated only in case of incomplete excision or recidive. Concerning an astrocytoma, a total excision is almost always impossible since it is an infiltrating tumor. It appears more dangerous than advantageous to try to take off as much tumor as possible. Radiotherapy appears inefficient.

Adolescent↗
PubMed1983

[Acute interhemispheric subdural hematomas].

Three cases of acute interhemispheric subdural hematomas, one of which bilateral, are reported. These are secondary to cranial traumatism and/or to treatment by anticoagulants and have stereotyped clinical signs. Following a lucid period, intracranial hypertension appears, then a sudden predominantly crural hemiparesis or even paraplegia. The aspects shown by computerized tomography are characteristic. The literature and our experience suggest that the best treatment is complete evacuation of the hematoma by craniotomy performed before alteration of consciousness.

Aged↗
PubMed1983

[Analysis of infectious sequelae of 1000 neurosurgical operations. Effects of prophylactic antibiotherapy].

Postoperative infections: cellulitis at the site of skin incision and/or meningitis, were reported in 5.1 p. cent of 1 000 cases treated by neurosurgery in Pr R. Houdart's department between december 1980 and march 1982. Statistically significant factors predisposing to infection were: emergency surgery, opening of the sinus, presence of a foreign body, and operation lasting more than 5 hours. The age of the patient, diabetes, or previous corticoid therapy did not significantly alter the risk of infection. Prophylactic antibiotic therapy had been administered to 37 p. cent of patients, but this had not affected the incidence of general infection, a statistically significant effect being observed only after operations lasting for more than 5 hours. The risk of infection was high after craniotomies and major after external ventricular shunts (valves). For the latter type of operation it was not possible to determine factors favorable for infection: neither duration of surgery, nor age of patient, nor absence of antibiotic therapy. The risk of postoperative infection was low (less than 1 p. cent) in the absence of factors favorable for its development, but its frequency increased considerably in patients presenting one or more other intercurrent infections. It is therefore possible to recognize surgical and general factors influencing infection, but prophylactic antibiotic therapy has only a weak effect on morbidity modification.

Anti-Bacterial Agents↗
PubMed1982

A new radionuclide method for the diagnosis of posttraumatic cerebrospinal fistulas. A study of 308 cases.

The authors describe their technique for identifying and localizing posttraumatic cerebrospinal fluid fistulas. The method entails injection of radionuclide tracer into the subarachnoid frontal space with the patient in a sitting position followed by gamma camera scintigraphic recordings. The results in 308 patients are presented; these are compared with those of suboccipital radionuclide cisternography in 40 cases and metrizamide computerized tomography cisternography in nine cases. Transient complications occurred in only three patients.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1981

Frequency of primary brain stem lesions after head injuries. A CT scan analysis from 186 cases of severe head trauma.

Analysis of level of brain stem dysfunction, evolution, and CT scan profile was made on 76 cases of head injuries with prolonged unconsciousness and without hemispheric focal lesion and midline shift on CT scan. Eleven cases were considered normal on CT scan. The CT scan aspect of primary brain stem lesion was identified in 31.5% of these series, and in 14.5% of all severe head traumas (186 cases), from which this series is taken. Primary and secondary CT scan profiles were observed whatever the clinical level of dysfunction and its evolution. Pontine lesions were mainly associated with haemorrhage in the brain stem and diffuse brain swelling; but minimal signs (cortical level) and benign outcome can also be related to axial haemorrhage. These results emphasize the frequency of primary brain stem lesions and the value of CT scan in head injuries.

Brain Diseases↗
PubMed1980

[Herpes encephalitis treated using adenine-arabino-side and followed-up by densitometry (author's transl)].

In a 52-year-old man suffering from encephalitis, immunofluorescent study of cerebral tissue led to a diagnosis of herpes encephalitis 4 hours after biopsy. Cell cultures on the fourth day confirmed the diagnosis. Such a hypothesis had already been advanced before biopsy on the basis of the electroencephalogram which showed electrical changes with a periodic tendency. Following treatment with adenine-arabinoside, motor deficit and aphasia disappeared in one month whilst there was a parallel increase in antibody levels in the blood and cerebrospinal fluid.

Encephalitis↗
PubMed1980

[Anesthesia using methohexital for thermocoagulation of the gasserian ganglion (author's transl)].

The authors report their experience of the treatment of essential trigeminal neuralgia by percutaneous thermocoagulation of the Gasserian ganglion (400 patients). This method has always been performed on anesthetized patients, using an ultra short acting barbiturate: methohexital. Most often, two or three successive coagulations are needed to obtain the desired analgesia. No complications have resulted, although 30 p. cent of our patients were over 70 years old.

Aged↗