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D Baleriaux

Publications and source records attributed to D Baleriaux.

At least 19 recordsLinked to original sources
PubMed1995

[Subarachnoid hemorrhage in patients over 65 years of age. Retrospective study of 72 patients including 65 cases of aneurysmal origin].

For this study, we reviewed a series of 564 consecutive SAH among which 72 cases (12.7%) were older than 65 years. Etiology of SAH was: arterial aneurysms (65), arteriovenous malformations (1), unknown origin (6). Among the 65 aneurysms, 28 operated cases were between 65-69 years old. One year after surgery, the results are: GOS 1 and 2: 22 cases (57%); GOS 3: 4 cases; GOS 5: 13 cases. In the non operated group, 19 cases died (73%) and among the alive patients, one was GOS 2 (4%), 5 GOS 3 and 1 GOS 4. In the operated group, mortality is similar to other published series. In the non operated group, mortality is unsurprisingly higher (73%) than in the operated group, but also than in the literature. An explanation could be found with analyses of the income of our patient whose many are not referred cases from other hospital. Our analysis confirmed that the severity of SAH after 65 years is increasing. The raise of anterior communicating aneurysms location is demonstrated. Operative indication and timing are dependent of neurological grading, general condition and secondarily of the location and anatomy of the aneurysm.

Age Factors↗
PubMed1994

PET in stereotactic conditions increases the diagnostic yield of brain biopsy.

We have recently described a technique allowing routine integration of PET scan data in the planning of stereotactic brain biopsy [Levivier et al:, Neurosurgery, 1992; 31:792-797]. We now report our results in a consecutive series of 38 patients that underwent combined FDG-PET and CT-guided stereotactic biopsy between June 1991 and January 1993. Stereotactic procedures were performed according to a standard protocol in which two biopsy trajectories were used whenever possible. This yielded to a total of 78 trajectories. In 31 patients, at least 1 trajectory was defined using an abnormality visualized on PET. The histological diagnosis was obtained in all cases. The diagnostic yield of each trajectory according to the FDG uptake of PET and contrast enhancement on CT showed that most low-grade tumors were found in hypometabolic/hypodense areas, glioblastomas were all diagnosed in areas with increased FDG uptake and contrast enhancement on CT while data for anaplastic astrocytomas were heterogeneously distributed. In the present series, 6 targets defined on CT were nondiagnostic; this never occurred when targets were defined on FDG-PET. In one case of anaplastic astrocytoma, the diagnosis was only made using a target defined on PET in a normal CT area; the second trajectory was made in a contrast-enhanced area on CT and was nondiagnostic. Because only structural images such as CT or MRI are available preoperatively, we analyzed separately the benefit of FDG-PET-guided biopsy in patients who have either an enhanced- or a nonenhanced lesion on CT. CT-enhanced lesions were found in 27 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

MRI of acute disseminated encephalomyelitis after coxsackie B infection.

Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating condition of the central nervous system, usually developing after a viral infection or vaccination. We report a case of ADEM predominantly affecting the spinal cord in an 8-year old boy evaluated by MRI. The radiographic picture consisted of multiple focal lesions of the spinal cord, a left posterior thalamic lesion and a subcortical right posterior parietal lesion. These lesions regressed several weeks after corticosteroid treatment. The clinical presentation, the laboratory results and the radiological findings suggest the diagnosis of ADEM secondary to viral infection by Coxsackie B.

Brain↗
PubMed1992

MRI of patients with cerebral palsy and normal CT scan.

Three children with clinical evidence of cerebral palsy (CP) and normal cerebral computed tomography (CT) scans were evaluated by magnetic resonance imaging (MRI) to identify CT-undetectable white matter lesions in the watershed zones of arterial territories. The two patients with spastic diplegia showed bilateral lesions either in the subcortical regions or in the occipital periventricular regions. The patient with congenital hemiplegia exhibited unilateral lesions in the periventricular region. We conclude that MRI is more informative than CT for the evaluation of patients with CP.

Brain↗
PubMed1992

Surgery of intramedullary spinal cord tumours.

MRI and Cusa have significantly modified the diagnosis and the treatment of intramedullary tumours. Our experience, based on 66 cases, is in favour of surgery performed when the patient's neurological status is still good. Radical surgery, whenever possible, is the best treatment and can be achieved for many histological diagnoses, even in gliomas where we succeeded in 36% of the cases. Surgery is the only way to be sure of the exact histological diagnosis of the lesion which can be suggested in 70% of the cases but not confirmed by MRI.

Astrocytoma↗
PubMed1992

[How can metastatic extension be assessed in the brain?].

MRI is the technique of choice to detect cerebral metastases. Double-dose delayed CT is the optimal CT examination to be performed in case of limited access to MRI. If the examination shows the presence of multiple metastases, MRI is not necessary. If CT shows an apparently single lesion, an MRI examination is essential, considering the number of lesions detected by MRI and not seen with CT.

Brain Neoplasms↗
PubMed1992

A patient with two upper lumbar disc herniations.

Of all lumbar disc herniations, less than 5% occur in the upper lumbar area. Though protrusions are common at all levels, truly extruded disc herniations in the upper lumbar area from L1 to L3 are rare. Even more unusual is the multilevel occurrence of herniations in this area. The authors stress the importance of accurate diagnosis and clinically directed medical imaging work-ups.

Humans↗
PubMed1991

[Neonatal pilonidal sinuses and screening by medullary ultrasonography: preliminary results].

The authors report on their preliminary experience with ultrasound as a screening examination in neonates presenting pilonidal sinuses. Of the 100 patients examined over the 2 previous years, three pathological cases were found (1 tethered cord, 1 lipoma of the filum terminale and one localized hydromelia). Abnormal or doubtful cases were confirmed or further investigated by magnetic resonance. Ultrasound seems to be an accurate technique for the detection of malformation of spinal canal content in neonates under one month of age.

Humans↗
PubMed1991

Vidian metastasis of adenoid cystic carcinoma.

Head and neck tumors may invade perineural space, especially the maxillary division of the trigeminal nerve and the pterygopalatine fossa (PPF). Computed tomography (CT) and magnetic resonance imaging (MRI) signs of perineural extension include essentially the obliteration of the PPF fatty content and the enlargement and erosion of neural foramina. We report a case of perividian metastasis studied with CT and MRI.

Aged↗
PubMed1991

[Subarachnoid hemorrhage of unknown origin. Apropos of 59 cases].

Fifty-nine subarachnoid hemorrhage with normal panangiography were reviewed (1982-1989). The mean age is 50 + 10. The grades at admission are compared following the Hunt and Hess and the World Federation Classification. Fifty cases (Hunt and Hess) or 45 (W.F.N.S.) are grade I or II. Compared with 278 cases of subarachnoid hemorrhage of aneurysmal etiology, 76% were in good grades versus 55% only for the aneurysms. Hypertension was present in 21 cases (35%) and represented a factor of gravity. Hydrocephaly is a rare complication in these cases and only 2 cases were shunted. The repetition of angiographic exploration seems to be unnecessary: all the examens remained negatives. The aspect on C.T. Scan was the same that the subarachnoid hemorrhage of aneurysmal origin. Angiography of 4 pedicles were performed in all cases and in the late 15 cases, external carotid explorations were added for exclusion of dural malformations. Seven suspected cases had had a secondary exploration between 12 days. The other cases were reexamined at 3 months. Three cases deceased from a second hemorrhage without aneurysm at autopsy. These cases confirm that subarachnoid hemorrhage of unknown etiology is of good prognosis. Low grades, rare complications, few rebleeding and good outcome scale are common. Etiology remains hypothetic.

Adult↗
PubMed1991

[Lesions of the pineal and tentorial region. Occipito-parietal approach in three-quarter prone position with infrasagittal craniotomy].

Surgical treatment of pineal-tentorial region lesions remains a challenge. The difficulty in approaching the pineal region can be verified with the number of operative plans that have been proposed to reach this area: transcallosal, occipital transtentorial, infratentorial supracerebellar approaches and sitting, prone or Concorde positions. This emphasizes the surgeon's dissatisfaction with the surgical techniques described. Recently, a three-quarter prone position with the bone flap placed under the midline has been described (1, 3, 8). We have decided to test this approach that we have slightly modified and we report our results on 13 cases: 2 arachnoid cysts, 3 vascular malformations and 8 tumors (3 brainstem gliomas, 2 dysgerminomas, 1 quadrigeminal plate metastasis and 1 meningioma plus 1 metastasis of the falx). Keeping the table in a horizontal plane, risks of air embolus are eliminated. Using the natural effect of gravity, traction on the occipital lobe is no more necessary and hemianopsia no more occurs. We recommand the parieto-occipital route which is the shortest way to reach epiphysis and falco-tentorial notch. We confirm the results of american colleagues (1, 3, 8, 15) and we advise to use this approach which seems to us the best way to treat pineal-tentorial lesions.

Adult↗
PubMed1991

[The value of current imagery techniques in dentistry and stomatology].

Computed tomography, ultrasonography and magnetic resonance imaging are currently used in stomatology and dentistry. These recent imaging modalities have suppressed or reduced classic examinations (by example: conventional tomography and sialography). Efficient, exact and fast, they improve the diagnostic capacities and optimize the choice of the treatments. After some technical considerations, their applications in various stomatology and dentistry problems are evoked.

Diagnostic Imaging↗
PubMed1990

Neuroradiologic findings in leptomeningeal carcinomatosis: the value interest of gadolinium-enhanced MRI.

Four patients with leptomeningeal metastases documented by neuroradiological examinations are reported. All had central nervous system or systemic neoplasms and showed clinical signs of carcinomatous meningitis. Gadolinium-enhanced MRI (Gd-MRI) disclosed for each patient pathological foci, allowing delineation of the extent of meningeal disease. Although non-specific, these findings, combined with the clinical context and CSF analysis, may lead to a rapid diagnosis and treatment of carcinomatous meningitis, even when malignant cells are not detected in the cerebrospinal fluid.

Adult↗
PubMed1990

[Magnetic resonance imaging (MRI) of cervico-facial tumors].

Magnetic Resonance Imaging (MRI) gives substantial advantages for the study of tumoral extension in the anatomically complex cervico-facial region. The multiplanar approach permits a better analysis of the anatomical relationships of the tumor, including relationships with the vascular structures, without the need for injecting a contrast medium. The method is able to accurately differentiate tissues and is very sensitive for detecting tumoral tissue. Lesions poorly visible with CT, with poor contrast enhancement or lying in a muscular environment, are well demonstrated. Some difficulties remain for obtaining from patient a complete immobility for a long examination. We think MRI gives a substantial benefit for the diagnostic work-up of cervico-facial tumours, and could be the first imaging technique in this area, particularly if further shortening of the examination time is gained with fast imaging methods and if availability of MRI installations is improved.

Head and Neck Neoplasms↗
PubMed1990

[Magnetic resonance imaging of the pituitary gland and the sella turcica region. Normal and pathological aspect].

MRI may be presently considered as the optimal imaging technique for the study of the sellar and parasellar region. Excellent anatomic and multiplanar approach, absence of irradiation, spontaneous visualization of vascular elements, absence of artefacts characterize MRI. The normal aspect of the sellar region is first described on both spin-echo, T1 and T2 weighted images. MRI appearance of micro and macroadenomas is described. The use of paramagnetic contrast agents (Gadolinium DTPA or DOTA) is widely accepted as a useful complementary diagnostic tool. Moreover the most commonly encountered lesions of the sellar region are reviewed and their behaviour on MRI discussed. Although MRI is an outstanding imaging technique, particularly useful for the study of the sellar region it must be stressed that MRI lacks of specificity. As a consequence, it is of utmost importance to compare MRI with clinical and biological examinations in order to reach a confident final diagnosis.

Adenoma↗
PubMed1990

Argyrophilic breast carcinoma, single metastasis to the pituitary gland.

Five years ago, a 44 year-old woman presented with an apparently localized cancer of the right breast, initially treated by surgery, adjuvant chemotherapy and radiotherapy. After a 4 year disease-free interval, she developed bi-temporal hemianopsy, due to a suprasellar tumor causing compression of the optic chiasma. The tumor was resected by the transsphenoidal route and histological examination revealed neuroendocrine characteristics described as "argyrophilic breast carcinoma". The exceptional association of this peculiar histology for breast cancer with a rare pattern of recurrence (single pituitary metastasis) is worthwhile reporting.

Adult↗
PubMed1989

Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS).

We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaïre and Rwanda) (n = 5) or had had sexual intercourse with the local African population (n = 3). The nervous system complications encountered included: toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis + toxoplasmosis (1 patient); toxoplasmosis + lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: one had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS.

Acquired Immunodeficiency Syndrome↗