[Recent craniocerebral injuries].
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Biomedical subjects
Publications and source records attributed to C Thurel.
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An acoustic neurinoma involving the internal auditory canal, the vestibule, the cochlea, the middle ear, and extending into the cerebellopontine angle and the external auditory canal, is described in a 56-year-old woman. An initial episode of vertigo was followed by a 27-year history of progressive unilateral hearing loss leading to complete deafness and areflexia with central compensation. The tumor was removed by a two-step surgical procedure, and the histologic features were those of a schwannoma.
In the presence of any "expansive process" of the sellar region, one must recall that in I % of the instances there may be the possibility of a pseudo-tumoral aneurysm. In a number of cases, neither the clinical study, nor the roentgenologic and tomographic balance of the sellar region, will allow to differentiate an aneurysm and a pituitary tumor. Only the carotid arteriography makes possible a diagnosis of certainty under the condition to make a bilateral study (compression being insufficient). This kind of investigation will therefore be systematic, particularly in those cases in which a sphenoid route of access is considered for the management of the expansive process of the sellar region.
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The authors report their experience in the Treatment of essential Trigeminal Neuralgia with controlled increments of radiofrequency heating from an electrode inserted in the Gasserian ganglion or the posterior rootlets. Assuming that the less myelinated small fibers (A delta and C) are more sensitive to the heat than the heavily myelinated A beta and A alpha fibers, graduate controlled thermo coagulation could produce a differential destruction of pain fibers. 30 patients were treated with this method since 10 months. In all cases, the patients experienced immediate relief. There was no mortality and no neurological morbidity outside the trigeminal nerve. The most serious undesired result has been the production of anesthesia or marked hypesthesia in 10% of our cases.
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