[Use of Harrington rods with wire cerclage in spinal pathology].
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Biomedical subjects
Publications and source records attributed to F Lesoin.
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A forty four year-old woman had had an amenorrhea-galactorrhea syndrome for 3 months when a Korsakoff's syndrome with headache suddenly appeared. Neuroradiological investigations revealed a hematoma involving the anterior part of the IIIrd ventricle. After a short period of neurogenic hypernatremia the lesion disappeared with the development of a spontaneous ventriculocisternostomy. Simultaneously, the Korsakoff's syndrome decreased until it went off almost completely, but a diabetes insipidus appeared and the hyperprolactinemia remained unchanged. Four years later, those are the only symptoms which are still present. This case, particular by its aetiology and evolution, illustrates well the possibility of functional Korsakoff's syndromes.
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The authors report their experience of the posterolateral approach for the treatment of spinal dorsolumbar metastasis. They underline the effect of osseous posterior wall compression. In this way the classical laminectomy is not indicated.
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The authors report the use of bilateral posterolateral approach by transversoarthropediculectomy with corporectomy in dorso lumbar rachidian pathology. They discuss the advantages and inconvenience of this approach before propose its indications.
The association of a meningioma and an arachnoid cyst is one of the many association of cyst and meningioma. The diagnosis could be difficult by CT scan. We report three cases of parameningiomal cysts and discuss their different mechanism of formation before stressing practical problems.
SEP contribution to diagnosis is interesting but limited to hardly examined complete syndromes in an emergency care unit. The predictive value of SEP is high if electrophysiological data are correlated the 10th. day with the clinical status. A good prognostic value is shown when the clinical posterior column and pyramidal tract dysfunctions are equal in intensity and distribution, i.e. in complete syndromes or central spinal cord syndromes or Brown-Sequard's ones. However, not any correlation exists in cases of anterior spinal cord syndromes. Dg.EMG. is an easy, atraumatic useful tool for the clinician. It must be a systematic approach of the brain stem and cervical spinal cord phrenic centers vitality that may be involved by the trauma. When a respiratory deficiency occurs, it allows the diagnosis of a "peripheral" or "neurological" etiology. Its high prognostic value for m tor diaphragmatic function (increase or decrease) must be discussed before any therapeutic decision.
An aneurysm of the superficial artery, developing after surgical removal of a frontal meningioma is described. This case shows an other topographic possibility to post operatory aneurysm, mainly developed on the intracranial internal carotid artery or her branches.
Twenty one patients with a spinal cord cavity are reported: 14 presented syringomyelia, 3 had a syringomyelic syndrome of another etiology, 4 had clinical symptoms different from those usually observed with such cavities. All patients had a plain C.T. and 20 had a C.T. of cervical and thoracic spinal cord 6 hours after cervical myelography with metrizamide or iopamiron. Morphologic and dynamic features given by this examination are reported. They allowed a discussion about the pathogenesis of the cavity: some cases were consistent with Gardner's theory, but the majority were consistent with Aboulker's. Nine patients had an examination by magnetic resonance imaging which gave the morphologic features necessary for the treatment: spinal cord cavity, Chiari malformation, hydrocephalus. Eleven patients were treated by a syringoperitoneal shunt: in spite of the short follow-up, the results seem favourable, especially for sensitivity and trophic troubles. Surgery should be based upon aggravating course and hydrocephalus. The results of syringoperitoneal shunting allow new considerations about pathogenesis.
Three cerebellar hematomas induced by a tumor are reported. A metastasis was present in two cases, but the lesion was unique on CT scan, vertebral angiography did not reveal abnormal vessels, and general investigations were normal. The third case was a medulloblastoma. The first two patients were treated medically or with ventricular shunting. In both cases the primary tumor was lately discovered. These cases show that a CT scan follow up is necessary when the patient is not operated, and a pathological examination of the hematoma must be done where there has been surgical intervention.
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