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Biomedical subjects

D Leys

Publications and source records attributed to D Leys.

270 records · Page 15Linked to original sources
PubMedDate not supplied

Cerebral venous infarction following thrombosis of the draining vein of a venous angioma (developmental abnormality).

We report two cases of cerebral venous angioma presenting as venous infarction, one in the left parietal lobe, the other in the left frontal lobe. Cerebral imaging demonstrated thrombotic occlusion of the draining vein of the venous angioma associated in the latter case with thrombosis of the anterior part of the superior longitudinal sinus. Both patients were free of coagulopathy. They were treated with anticoagulant therapy. One completely recovered, while the other was left with slight residual disability. Thrombosis of the draining vein has been reported in only 6 previous cases, of whom only 2 received anticoagulant therapy. Discovery of a venous angioma in the diagnostic workup of a patient with recent neurological disorders should raise the question of a possible occlusion of the draining vein and lead to an appropriate therapy.

Adult↗
PubMedDate not supplied

Epidemiology of vascular dementia.

Although epidemiological studies are limited by diagnostic uncertainties, they suggest that stroke increases the risk of dementia. The mortality rate is higher in vascular dementia (VaD) than in Alzheimer's disease (AD). Community-based studies have provided several consistent findings: (i) age dependence with prevalence rates doubling every 5 years, (ii) a higher frequency in men and (iii) nation-to-nation differences. The prevalence of VaD ranges from 2.2% in 70- to 79-year-old women, to 16.3% in men >80 years. One sixth of acute stroke patients have preexisting dementia. The incidence of VaD has been studied much less extensively than that of AD, and substantial variations in the incidence rates have been observed: annual incidence rates (per 100,000) range from 20 to 40 between 60 and 69 years of age and from 200 to 700 over 80. The incidence rate of VaD declined over the last 2 decades, probably as a consequence of effective stroke prevention. It is generally assumed that risk factors for VaD are those of stroke, with arterial hypertension as leading factor, followed by atherosclerotic disease, low education level, alcohol abuse and heart disease. Stroke characteristics, such as lacunar infarction and left-sided hemispheric lesions, are major determinants of VaD. The cerebrovascular lesions are likely to be the only cause of dementia in strategic infarcts, in lacunar state, in hereditary cystatin C amyloid angiopathy and in CADASIL. However, white matter changes, and associated Alzheimer pathology, which are both frequent in this age category, may also contribute to the cognitive decline.

Aged↗
PubMedDate not supplied

Role of white matter lesions in cognitive impairment of vascular origin.

White matter changes are detected with high frequency by neuroimaging techniques in aged subjects with cerebrovascular risk factors or diseases and in cognitively impaired patients. Their direct role in causing cognitive deterioration has not been established, although their frequency is higher in demented subjects than in normal controls, and they are associated with specific cognitive deficits, particularly those related to impairment of frontal lobe functions. The aim of this paper is to critically review the existing knowledge about the role of white matter lesions in cognitive impairment of vascular origin. After reviewing the scarce evidence and the numerous clues suggesting a possible role of white matter lesions in causing mental decline, proposals are advanced about elements that could be a basis for revised criteria for vascular dementia for clinical trials. Finally, some items requiring future joint investigations in the fields of age-related white matter lesions are identified.

Cerebrovascular Disorders↗
PubMedDate not supplied

Contrast-enhanced MR angiography of supraaortic vessels: the effect of voxel size on image quality.

BACKGROUND AND PURPOSE: Several acquisition strategies may be used for imaging supraaortic vessels by using contrast-enhanced MR angiography. The purpose of this study was to assess the effect of voxel size on image quality of MR angiograms. METHODS: Fourty-four patients underwent 3D MR angiography in the coronal plane. Patients were randomly assigned into two groups according to the voxel size of MR angiograms: group 1 referred to a 1.3 x 1.29 x 1.25-mm voxel size and group 2 to a 0.95 x 0.76 x 0.82 mm voxel size. Signal-to-noise ratios (SNRs) were measured and image artifacts were analyzed by consensus between observers. The delineation of the arterial lumen was independently ranked on a four-point scale (1 = not assessable; 2 = poor delineation; 3 = fair delineation; 4 = optimal delineation). RESULTS: The overall interobserver agreement for the delineation of the arterial lumen was good (K = .84, P < .0001), with a rank significantly higher in group 2 (68% of arteries graded as 4) compared with group 1 (76% graded as 3). SNRs were significantly higher by using the conventional resolution technique, with a negative correlation between SNRs and artery delineation (P < .0001). Image artifacts, however, were more frequent with the high-resolution technique, including wrap-around artifacts and signal fall-off at the origin of the great vessels. CONCLUSION: MR angiograms with a decreased voxel size improve the delineation of cervical carotid and vertebral arteries, despite reduced SNRs and additional artifacts.

Adult↗
PubMedDate not supplied

[Mood disorders and right hemisphere infarction].

Persistent depression of mood following stroke and acute psychiatric disturbances in conjunction with infarcts in the right hemisphere has been well reported. Sometimes its psychiatric features were most salient although neurological signs could not be elicited. We treated two patients with infarcts in the right hemisphere. The first developed depression with melancholia, the second a bipolar disorder. We question whether aprosodia or mood neglect may give a melancholic profile of depression following right hemisphere damage.

Bipolar Disorder↗
PubMedDate not supplied

Severe hypoglycorrhachia after subarachnoid hemorrhage. Two cases with spontaneous recovery in adults.

We report two patients with severe hypoglycorrhachia after a subarachnoid hemorrhage. They had no obvious meningeal infection, and they spontaneously recovered within a few weeks. Such cases have previously been reported in neonates, but exceptionally in adults. Contrary to detailed cases from the literature, our patients recovered without antibiotics, and hypoglycorrhachia was very severe.

Aged↗
PubMedDate not supplied

[Late posttraumatic syringomyelic syndromes. Pathogenetic theories apropos of 3 cases].

Three patients with a post-traumatic spinal cord cavity are described: clinical signs are identical to those of syringomyelia, but pain is more frequent. Diagnosis is made easier by magnetic resonance imaging (MRI) and a syringoperitoneal shunt is proposed for treatment. Nevertheless, if results are good, they seem worse than in idiopathic syringomyelia. The main pathogenic theories are discussed: the rupture and coalescence of microcysts developed at a distance of 1 or 2 mm from the transected spinal cord, subsequently leads to syrinx formation; haemorrhagic or ischemic post-traumatic areas could also lead to syrinx formation. Hydrodynamic factors could be expected and make the pathogenesis not far from syringomyelic one.

Adult↗
PubMedDate not supplied

[Technics and indications for surgical treatment in surgical neurologic complications of rheumatoid polyarthritis].

A critical study of 11 cases of rheumatoid arthritis with neurological complications due to involvement of the cervical region of the spinal column induces the authors to reconsider their therapeutic strategy. After reviewing the various neurological complications and mechanisms involved, they propose wider use of surgical treatment within limits defined on the basis of neurological and radiological criteria and the risks of the respective methods.

Adult↗