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Biomedical subjects

D Gardeur

Publications and source records attributed to D Gardeur.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Non-lethal brain stem hematomas in hypertensive patients].

Brain stem hemorrhages (peduncular, pontine, medullary) were demonstrated by CT scan in hypertensive patients, the outcome being favorable without surgical intervention. Such lesions are considered as being usually massive and fatal. A review of the literature show that hemorrhages in the brain stem represent 5 to 9 p. cent of intraparenchymatous hemorrhages, and are usually located in the pons. A favorable course was known to occur before the use of computed tomography: the rare cases described were often related to subacute hematomas in young normotensive subjects which could be treated by surgery with or without ventricular shunting. Clinical diagnosis is based on the rapid progressive course of the disorder and the location of the lesion. Computed tomography provides an immediate correlation between anatomical and clinical findings, and allows a better evaluation of semiological and prognostic features that were previously considered well established. A major element appears to be the degree to which the hematoma is tolerated. As far as possible neurosurgical procedures should be avoided in hypertensive patients.

Aged↗
PubMed1981

CT analysis of intrasellar pituitary adenomas with emphasis on patterns of contrast enhancement.

Analysis of the computed tomograms of 85 purely intrasellar pituitary adenomas documents a highly variable pattern of response to contrast enhancement. Twenty-eight of 85 adenomas exhibited homogeneously increased density. Twenty exhibited heterogeneously increased, patchy or ringlike density; 16, hypodensity; and 8, isodensity with normal pituitary tissue. In 13 patients the predominant CT finding was an empty sella with variable enhancement of the adenoma and residual pituitary tissue. Pathological specimens demonstrated that the hypodense zones observed within pituitary microadenomas may represent pituitary necrosis, cyst, hemorrhage, intratumoral abscess, relatively less intense enhancement than the normal surrounding pituitary tissue.

Adenoma↗
PubMed1980

[Practical method for the preoperative spatial localisation of small intracranial neoplasms from scanner data (author's transl)].

When only transverse axial slices of a CT examination already performed are available, the localisation in space of small intracranial space occupying lesions is easy only if a lateral view is available at the same time. In terms of three dimensional localisation, it is possible to rely on the coordinates of transverse axial sections only if the examination has been carried out under stereotaxic conditions. In all other cases, uncertainty concerning the site of the plane of reference of the examination would be too great. The method suggested may be used to identify the site of the plane of reference of a computed tomography examination on a lateral skull X-ray with a margin of error of +/- 2 degrees. It uses the lateral skull X-ray of the patient examined by computed tomography, the transverse axial slices of the examination and a pre-established template. Once the plane of reference is identified, the lesion may be rapidly reconstructed using two other templates. The method has the advantage of being applicable to examinations already carried out and thus does not prolong the duration of investigations.

Brain Neoplasms↗
PubMed1980

Pharmacokinetics of contrast media: experimental results in dog and man with CT implications.

The pharmacokinetics of contrast media such as sodium iocarmate, sodium ioxithalamate, metrizamide, sodium/meglumine diatrizoate, and sodium ioxaglate (a recently introduced medium: a hexaiodinated monoacid dimer) was compared in 25 dogs. A biphasic phenomenon was observed due to the rapid diffusion of contrast media from plasma into tissue (interstitium) followed by slow urinary excretion. A bicompartmental analysis was performed in dogs for each agent, showing that the tissue distribution of ioxithalamate is higher than that of other media. Sodium/meglumine ioxithalamate, sodium iocarmate, and sodium/meglumine ioxaglate were also compared in 20 human subjects. The diffusion and excretion phases observed in man appear to be slower than in the dog. Significant variations of iodine plasma concentration from one patient to another were recorded for the same medium and at the same interval after injection. Significant differences were observed between ioxithalamate and iocarmate or ioxaglate plasma concentrations due to the greater tissue diffusibility of ioxithalamate. The mechanisms affecting contrast media diffusibility are discussed: osmolarity, liposolubility, protein binding, and molecular size. Variations in contrast medium concentration in plasma noted in different patients with the same medium are explained by variations in tissue distribution, contrast medium volume, patient age, and patient hydration. Some computed tomographic (CT) implications of these pharmacokinetic studies are discussed. The need for highly diffusible media in routine CT and for less diffusible media in CT angiography is emphasized.

Adult↗
PubMed1980

[Recurrency of intracranial tumors operated. Diagnosis (author's transl)].

The records of 123 patients who had previously be operated upon for intra-cranial tumors are studied to find symptoms of recurrency. 82 of these patients underwent a second operation. The value of CT Scan, cinegammagraphy and angiography are compared. CT Scan yields the best results to detect recurrency and its place. Using both CT Scan and cinegammagraphy increases reliability for difficult cases, mainly in the cases of multiple lesions. Angiography is no longer used to detect recurrencies but only just before operation.

Angiography↗
PubMed1979

CT follow-up studies in postoperative craniopharyngiomas.

Thirty patients with histologically proved craniopharyngiomas were controlled by CT after surgical excisions. Recurrence occurred in 70%. Of these tumours 33% were cystic, 30% were solid, and 12% were calcified. The ventricles were dilated in 67%, and postoperative cavities were found in 33%. The effectiveness of various forms of therapy has been monitored by CT. The purpose of our study is to investigate the value of early and long term CT scanning in craniopharyngiomas after surgical excision.

Adolescent↗
PubMed1979

[Preoperative diagnosis of posterior fossa tumors (author's transl)].

The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.

Adult↗
PubMed1979

[Computerized tomography of craniopharyngiomas. Therapeutic consequences].

An analysis was made of the results of C.T. scanning in 43 patients with craniopharyngiomas. Filling of the suprasellar cisternae was observed in most cases, together with dilatation of the lateral ventricles. The appearances of the tumor before and after intravenous injection of the contrast medium are described and the frequency with wich calcification, cysts, and lipid densities were noted is reported. Regular C.T. scanning can define operative indications for craniopharyngiomas as a function of the results obtained.

Calcinosis↗
PubMed1979

[Computerized tomography in post-traumatic cerebral lesions (author's transl)].

A review of 108 cases of cranial injury, dating back for more than three months, and having had computerized tomography examinations, revealed 96 abnormalities in the results. These included overall, 65 times, and localized, 20 times, ventricular dilatations, generalized atrophy 27 times, porencephaly 27 times, enlargement of the sylvian fossa 28 times, chronic subdural hematomas 8 times, intracranial calcification 3 times, meningiomas 3 times, and a cerebral abscess in 1 patient. The computerized tomography results were normal in 12 patients. Very good correlations were found between clinical and computerized tomography results in patients with psychic disturbances and disorders of the higher centers. They were variable in cases of epilepsy and neurological deficiency states. The greatest number of normal results was found in so-called subjective syndromes.

Brain Diseases↗
PubMed1979

[C.T. scan appearances of acute necrotizing herpes encephalitis (7 cases). Preliminary therapeutic results after isoprinosine (author's transl)].

Seven cases of confirmed or probable acute necrotizing herpes encephalitis (ANE) were studied using computer tomography during the various acute or chronic stages of the disease. They were bilateral, or in some rare patients, asymmetrical pseudofocal cases of ANE. Computer tomography appearances are described from the morphological and topographical point of view, before and after intravenous injection of a contrast medium. Analogous data reported in the published literature is used to describe the findings and to emphasize the problem of differential diagnosis. Computer tomography appears to be an essential examination for establishing the diagnosis and prognosis in herpes encephalitis, but it must be correlated with the results of an electro-encephalogram, and biological and immunological tests of the cerebrospinal fluid. It can also be of value for choosing the optimal site for urgent cerebral biopsy with immunofluorescence. Treatment must be given very early, whether Ara A antiviral DNA or Isoprinosine (Inosiplex) which stimulates cellular immunity, as soon after diagnosis has been established as possible. The authors chose the latter medication for 6 of the 7 cases reported, as well as in 12 other cases of acute primary viral encephalitis, and 3 cases of subacute sclerozing panencephalitis, and obtained very positive results.

Adolescent↗