Biomedical subjects
Publications and source records attributed to F Lesoin.
Repeated Computerized axial Tomography (CAT) scanning of 4 patients with head injuries showed tardive development of 2 intracerebral hematomas and 2 extradural hematomas. The initial CAT scans were normal; the hematomas were late in developing. The value of repeated post-traumatic CAT scanning, and the pathogenesis of late developing hematomas are discussed.
Twenty nine cases of plasmocytic spinal cord tumors which were responsible for neurological troubles were collected over the 19 year period between 1962 and 1981. In 25 of the cases, spinal cord compression was the first sign of the tumor. In 4 of the cases, spinal cord compression was a secondary complication of an already known tumor. The various problems associated with this pathological process are discussed. The neurological problem is fairly straight forward: whether the compression is the first sign of the tumor, and whether it is a secondary complication, it must be surgically removed. Subsequent radiotherapy and chemotherapy are advisable. The oncogenous problem is more delicate. If the plasmocyte is a solitary tumor, and surgical removed is complete, the patient is, in theory, "heated", but should be regularly seen an outpatient basis. On the other hand, a multiple myeloma may first show it self as a spinal cord tumor, where as the patient is in reality suffering from a generalized disease.
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The roof of the third ventricle is lying on the thalamus parts. When a tumor fills and expands the third ventricle it is always possible to lift up this velotrigonal roof like the cover of a box and to access to these lesions. The authors have approached 15 tumors of the third ventricle or pineal area by this route interthalamotrigonal about 78 cases of tumors operated in the Lille's neurosurgery department during 30 years. The technical possibilities are compared and the advantages of this route emphasized with usual access. The interthalamotrigonal access gives a great convenience during operation. It make easy the complete removal of removable tumors of the pineal area and the third ventricle. It is possible with minimum during operation and after effects for the patient.
Twelve cases of Scheuermann's disease associated with neurological disorders are reported. The relation between the two conditions can be established through herniated disc, kyphotic angulation or spinal cyst. A more interventionist attitude is justified by the progress and results of neuroradiological investigations and surgical techniques.
The Authors report their experience using Harrington rods with segmental wiring for spinal pathology. They describe the advantages of this technical point in neoplastic and traumatological dorsal compression.
A case of subarachnoid hematoma of the cauda equina is described. The lesion developed in a patient receiving anti-coagulant treatment after a seemingly ordinary fall from a ladder. Neurosurgery achieved complete regression of the neurological defects in two weeks. The mechanism of development of the lesions is discussed. This form of complication of spinal trauma is fortunately exceptional.
Panmedullary ependymoma is an unusual disease last reported by Fuentes in 1986. The present case is the first to have been studied by magnetic resonance, using gadolinium. The findings indicated a panmedullary lesion rather than a tumour. Histopathological investigation confirmed the hypothesis.
Restricted thalamic infarctions are in man a useful model for investigating the consequences of limited diencephalic lesions on memory and verbal or visual learning. Two new cases of amnesia with thalamo-sub-thalamic infarctions are presented, with a general review of the problem. The gathering of the different cases according to the vascular thalamic territories and, as a consequence, to nuclear or associative structures concerned, allows a better approach of the relations between amnesia and infarctions. Uni or bilateral anterior lesions are the cause of more important and pure memory deficits, posterior infarctions are more often associated to language involvement or spatial cognitive problems which interfere with memorizing.
Dorsal spinal tumours have sometimes an intrathoracic development. The authors report the technique that permits by transversoarthropediculocostectomy the complete removal of these hourglass lesions by one approach. The advantages and inconveniences are analysed and its indications discussed.
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.
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.
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An acute amnesic syndrome accompanied the development of a hematoma of the upper part of the third ventricle affecting the fornix. The initial deficit was substantial with corresponding forgetfulness, but there was no false recognition nor fabulation. Recollection of past events was fairly well conserved, subject to difficulties with the temporal structuring of memories. Secondarily. psychometric tests showed preferential impairment of spontaneous recollection and logical learning. The role of lesions of the upper fornix projecting onto the dorsomedian nuclei of the thalamus is discussed.