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Biomedical subjects

G Broere

Publications and source records attributed to G Broere.

12 recordsLinked to original sources
PubMed1991

[Attacks of apnea in an infant with achondroplasia].

Infants and children with achondroplasia are at increased risk of sudden death because of apneic attacks caused by compression of the medulla oblongata or spinal cord by a constricted foramen magnum or narrow upper cervical spinal canal. This history of an infant with achondroplasia is discussed. As a result of apneic attacks she developed severe brain damage. Cervicomedullary compression was revealed at CT-scan and NMRI of the basicranium and upper cervical canal, and confirmed at decompressive surgery. Early symptoms can be clues to the existence of cervicomedullary compression. These clues are indication for further investigations. Decompressive surgery has good results when performed at an early stage. Knowledge of the signs and symptoms of cervicomedullary compression and of factors which increase the risk of complications are important in the management of achondroplastic patients.

Achondroplasia↗
PubMed1989

Chemonucleolysis versus discectomy: a randomized multicenter trial.

A randomized clinical trial was carried out to compare the results of open discectomy with those of chemonucleolysis in 151 patients suffering from a disc herniation at L4-5 or L5-S1. All patients fulfilled strict entry criteria; 78 patients underwent open discectomy and 73 were subjected to chemonucleolysis. An increase in radicular pain immediately after treatment was encountered in 16 patients (22%) in the chemonucleolysis group, as compared to none in the discectomy group. The efficacy of discectomy appeared to be definitely superior to that of chemonucleolysis. Within a follow-up period of 1 year, 18 patients (25%) required open discectomy following failed chemonucleolysis; two patients (3%) in the discectomy group needed a second operation. Open discectomy following previous chemonucleolysis was successful in only 44% of cases. Comparison of the final results of the two modes of treatment 12 months after the last intervention (including second treatment) did not reveal any significant differences. The duration of the preoperative symptoms, the level of disc herniation, and the leakage of contrast medium out of the disc appeared to be of no relevance to the final outcome. The complication rates in both treatment groups were low.

Adolescent↗
PubMed1988

Chemonucleolysis or discectomy? Results of a randomized multicentre trial in patients with a herniated lumbar intervertebral disc (a preliminary report).

A randomized trial was carried out to compare the results of discectomy and chemonucleolysis in 151 patients, suffering from lumbar disc herniation L4-L5 or L5-S1. All patients fulfilled strict entry criteria. Seventy eight patients underwent surgical discectomy, 73 were treated with chemonucleolysis. Within one year of follow-up 18 patients (25%) required surgery after chemonucleolysis, whereas 2 patients (3%) in the surgery group underwent re-operation. Increase of radicular pain within 30 days after treatment was encountered in 16 patients (22%) in the chemonucleolysis group, as compared to none in the surgery group. The results of open surgery after preceding chemonucleolysis was successful in 44% and unsuccessful in 56%. The final result of chemonucleolysis, including second treatment, was still slightly less favourable (73%) the result of primary surgery (79%).

Adolescent↗
PubMed1987

Treatment of fractures of the shaft of the humerus accompanied by paralysis of the radial nerve.

This paper reports the results of treatment of 17 patients with fractures of the shaft of the humerus accompanied by paralysis of the radial nerve in a series of 111 patients with fractures of the shaft of the humerus. In early operative explorations in 14 cases the radial nerve appeared undamaged in 13 cases. In cases where spontaneous recovery of the function of the radial nerve failed to occur, no evidence has been found that the delay in exploration influenced eventual motor recovery. The high incidence of undamaged nerves at exploration suggests that a conservative approach by collar and cuff or Sarmiento bracing is justified in such cases of fractures of the shaft of the humerus. Paralysis of the radial nerve associated with fractures of the shaft of the humerus is, in our opinion, not an indication for early operative treatment.

Adolescent↗
PubMed1986

Further experience with ultrasound examinations in the postoperative brain.

Ultrasound examinations (US) of the brain are possible in the presence of an acoustic window in the skull, either after craniotomy or through an open fontanelle. In this study 19 children were examined, 11 via a suboccipital craniectomy; 9 cases were examined more than once. Via this suboccipital route most of the contents of the posterior fossa, the third and lateral ventricles could be made visible. In two patients with a temporal or parietal craniotomy the involved hemisphere could be visualized. Six patients were examined via the open fontanelle after insertion of a ventriculoperitoneal shunt (VPS). In three of these cases the examination was undertaken to evaluate also a posterior fossa cyst. The findings were compared with CT if the findings were equivocal.

Adolescent↗
PubMed1986

Management of medulloblastoma in children, a multidisciplinary problem.

The diagnosis and treatment of the medulloblastoma has made remarkable advances in the 60 years that this tumor has been known. The survival time has increased but the quality of survival leaves much to be desired, according to a survey of the literature and the limited experiences in this study. The psychologic sequelae are particularly striking. This study gives a survey of diagnostic and therapeutic possibilities at this moment and goes further into some problems which are met during this process. A multidisciplinary approach is necessary because of the multitude of problems which are encountered. The problematic factors in the treatment and the course of the disease justify taking the patients into a trial in order to evaluate the different forms of treatment.

Adolescent↗
PubMed1985

Surgical aspects of pineal region tumors in children.

The use of the operating microscope and specialized anesthesiologic techniques make it possible to operate safely on tumors in the pineal region. A survey is presented of the main surgical and anesthesiologic techniques used: the supracerebellar infratentorial approach in the sitting position and the occipital transtentorial approach in the semi-sitting position. For selecting the optimal approach a CT scan with sagittal sections is very important to localize the tumor in relation to the tentorium cerebelli, the straight sinus and the great vein of Galen. Based upon the comparison of the two techniques the author concludes that nearly all tumors in the pineal region in children can be operated by the infratentorial supracerebellar route and that the transtentorial route offers relatively little advantage.

Adolescent↗
PubMed1980

[The spontaneous cerebral hematoma (author's transl)].

This retrospective study from two hospitals is about a hundred patients who have been operated upon a spontaneous cerebral hematoma. By a spontaneous cerebral hematoma we mean a hematoma without a proven tumor, without aneurysm, without arteriovenous malformation, without preceding trauma, without aortical phlebitis and without pathology of the vessel-wall. In this study patients with coagulopathy, arterial hypertension and artherosclerosis are included. In order to comply with these conditions an angiography will have to take place pre-operatively as well as postoperatively. Moreover histological examination of the wall of the hematoma will have to be done. The etiology of the spontaneous cerebral hematoma is not clear in most cases. The indication to operate, the way of operating and the moment in which the operation takes place, vary strongly in medical literature. We operate when there is an aggravation of the clinical picture, persisting severe headache and neurological paresis which does not improve. As a rule we abide for one week before operating, if the clinical picture allows this. After the operation unconscious patients may recover and a hemiparesis may improve. The best way of diagnosing a cerebral hematoma is computerised tomography.

Adult↗