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Biomedical subjects

H Dufour

Publications and source records attributed to H Dufour.

At least 109 records · Page 6Linked to original sources
PubMed1997

[Left temporal meningioma disclosed by ipsilateral hemiplegia].

A 46 year-old woman presented with a weakness of the left side. MRI of the brain showed a left temporal meningioma, a left temporal lobe herniation and two high-signals in the right cerebral peduncle. The involvement of the pyramidal tract in the foot of the cerebral peduncle, in this case, results from temporal lobe hemiation. These findings are different from the mechanisms reported in other cases of ipsilateral hemiplegia. The ipsilateral hemiplegia syndrome was classically described by Ectors in relation to a meningioma of the foot of the third frontal circonvolution. Pathophysiological theories of ipsilateral hemiplegia are reviewed.

Brain Neoplasms↗
PubMed1996

Treatment-resistant schizophrenia: clinical experience with new antipsychotics.

Approximately 20-30% of patients with schizophrenia are resistant to conventional neuroleptics (i.e. are treatment-resistant). Clozapine has been shown to be effective in a proportion of treatment-resistant cases and to have a low side effect profile. However, it can cause agranulocytosis, is sedative and has marked anticholinergic properties. Risperidone, which is effective in chronic schizophrenia and has a low side effect profile and does not require routine blood monitoring, was compared with clozapine in a double-blind comparative study in 86 treatment-resistant patients. Preliminary findings indicate that, at endpoint, risperidone and clozapine were almost equieffective (total PANSS, PANSS subscales and CGI). Both drugs caused few adverse effects, and the severity of extrapyramidal symptoms was no different in the two groups. It is concluded that risperidone could be another drug effective in treatment-resistant schizophrenia. Further, larger trials will be needed to confirm this.

Clozapine↗
PubMed1996

Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases.

OBJECTIVE: It is classically considered that the morbidity and mortality rates are greater for stereotactic biopsies of pineal region tumors, compared with tumors in other regions. However, to date, the number of cases studied in the literature has been insufficient to evaluate these parameters and compare them with the morbidity and mortality rates for stereotactic biopsies of tumors located elsewhere. METHODS: With the aim of evaluating these parameters, we reviewed 370 stereotactic biopsies of pineal region tumors, from 15 French neurosurgical centers. We statistically verified the absence of heterogeneity of the different French centers with regard to diagnostic, mortality, and morbidity rates. In contrast, statistical heterogeneity was clearly seen for the large stereotactic biopsy series (for all tumor locations) in the literature. RESULTS: The mortality rate was 1.3% (5 patients of 370), and 3 patients suffered severe neurological complications. This study is the first to clearly demonstrate that the mortality, morbidity, and diagnostic rates for stereotactic biopsies are not different in the pineal region. CONCLUSION: Our conclusion is that stereotactic biopsy must remain a main diagnostic modality for tumors of the pineal region.

Adolescent↗
PubMed1996

Unusual chromosome abnormalities in primary central nervous system lymphoma.

Primary central nervous system (PCNS) lymphoma is a relatively rare disease. The Epstein-Barr virus (EBV) has often been implicated in the development of lymphomas. Few cytogenetic. studies on PCNS lymphomas have been reported. We describe here an unusual case of PCNS B cell lymphoma, centroblastic polymorphic type without coexistent immune deficiency. The cytogenetic study showed unusual abnormalities: t(l;9) (q25;p21); del (6) (q14 q25), trisomy 12 and in addition one clone with trisomy 7 and loss of chromosome X. We did not observe any chromosome 14 abnormality, which is more commonly reported in PCNS lymphomas.

Aged↗
PubMed1996

[Corticotropic adenoma in slow adrenal insufficiency].

This case report deals with an insulin-dependent diabetic patient suffering peripheral adrenal insufficiency who, after 12 years of substitutive treatment exhibited resistance to mineralo- and gluco-corticoids with relapse of melanodermia and plasma ACTH levels higher than 1500 pg/ml despite increasing doses. A corticotrop macroadenoma was diagnosed by MR imaging and functional tests and confirmed by surgical excision followed by disappearance of resistance. Pre-operative functional investigation show autonomisation of the adenoma but with some partial persisting regulation. This case report draws attention to this rare either complication or association which can occur in peripheral adrenal insufficiency.

Addison Disease↗
PubMed1996

[Angiographically occult vascular malformations of the brain stem. Apropos of 25 cases].

Due to the current use of magnetic resonance imaging (MRI), angiographic occult vascular malformations (AOVM) located in the brain stem are frequently reported in the last ten years. The term AOVM is ambiguous and controvers. For, most of these lesions presented with MRI pattern of a cavernous angioma, but only few cases received pathological confirmation. In this location, the operative treatment while worthwhile could be hazardous indeed, so a conservative management is more commonly discussed first. However, the potential risk of rebleeding or poor clinical condition sometimes encourage a more aggressive decision. We report our experience in 25 patients (4 children and 21 adults) admitted between 1982 and 1994 with an AOVM located in the brain stem. In 17 patients, the cryptic vascular lesion was removed surgically. A cavernous angioma was strictly confirmed in only 8 cases. Conversely, 8 patients were managed conservatively. In the surgically treated group of patients, 10 improved their neurological deficit postoperatively, 2 patients remained unchanged, 3 patients worsened, and 2 patients died. The final outcome in 14 patients was evaluated after 51 months of mean follow-up (17 to 70 months). In 5 cases (35.7%) the result was excellent (no symptoms), 5 cases had a good result (normal activity with minimal residual disability), and 4 cases (28.5%) remained with severe permanent disability. In the non-surgically treated group of patients, the final outcome was evaluated after a mean follow-up period of 67 months (from 1 to 120 months). One patient experienced a rebleeding and remained severely disabled. Another patient had two bleeding episodes leaving only a minor facial numbness. Four patients were symptom-free, and the last case was lost for follow-up.

Adolescent↗
PubMed1996

[Acute Weston Hurst necrotizing hemorrhagic leukoencephalitis].

The clinical and pathological findings of a 43-year-old woman, diagnosed as having acute hemorrhagic leukoencephalitis at postmortem examination, are presented. The acute hemorrhagic leukoencephalitis affects mainly young adults and is the most fulminant from of demyelinating disease. It is frequently preceded by a respiratory infection. Diagnosis is facilitated by CT scanning and MRI, which reveal the massive lesion in the cerebral white matter. Many cases terminate fatally in 2 or 4 days, but in others survival is longer. The pathological findings are distinctive.

Acute Disease↗
PubMed1995

Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity?

Two cases of entirely suprasellar cysts are reported. Total surgical removal was performed in both cases. Pathological and immunohistochemical profiles were consistent with neurenteric cysts, Rathke's cleft cysts or colloid cysts and was also in keeping with an endodermal origin. It is now admitted that these three kinds of cysts share similar histological and immunohistological features. We propose an hypothesis of common embryological origin from endodermal remnants.

Adult↗
PubMed1995

[Meningoradiculitis and bilharziasis].

A 55-year-old French man was admitted with acute retention of urine. Three days before admission he developed back pain, lower limb pain and weakness. He had last been in Nigeria 2 years previously. Schistosoma mansoni ova were identified on rectal mucosal biopsy. Our patient showed spontaneous clinical improvement. He was treated with Praziquantel and corticosteroids. The clinical manifestations of spinal schistosomiasis can be diverse, and there should be a high index of suspicion for all patients from endemic areas. Currently, praziquantel and corticosteroids are the drug of choice for Schistosoma mansoni infection.

Humans↗
PubMed1995

Effect of the Gamma Knife on trigeminal neuralgia.

The Gamma Knife radiosurgical treatment of 20 patients suffering from trigeminal neuralgia is reported. Eleven patients received radiosurgical treatment with the goal of pain relief. Six had secondary trigeminal neuralgia due to AVM, large cavernous sinus and petrous bone meningiomas, trigeminal neurinoma, or chordoma; 5 others had essential trigeminal neuralgia. Radiosurgical treatment was considered only after the failure of conventional medical and surgical treatment. For the other 9 patients, the control of the tumor was the main objective (four acoustic and one trigeminal neurinoma, one petroclival chordoma, and three tumors of the cavernous sinus: one hemangiopericytoma, one metastasis, one meningioma). We have not been using this method for sufficient time to evaluate long-term results. However, we believe that a large majority of our patients benefited greatly from this technique with a rapid clinical improvement, which is a reflection of the relevance of the chosen target.

Adult↗
PubMed1995

Suprasellar granular-cell tumour, presenting with intraventricular haemorrhage.

A case of suprasellar granular-cell tumour (GCT), presenting with intraventricular haemorrhage is described. The authors emphasize the exceptional character of spontaneous haemorrhage for a GCT, although haemorrhagic state during surgery has often been reported and may hinder total removal. Preoperative arteriography discloses a suprasellar blush in half of the cases. This facilitates the preoperative diagnosis. By taking special preoperative and operative precautions against haemorrhage complete removal can be carried out provided there is no encasement of the optic chiasm.

Cerebral Ventricles↗
PubMed1994

Ectopic basisphenoidal craniopharyngioma: case report and review of the literature.

We report the case of a patient with a nasopharyngeal craniopharyngioma. The presenting symptoms included a diminished visual acuity, a dysmorphic syndrome, and impaired endocrine function. The computed tomography and magnetic resonance imaging scans showed a partially cystic tumor that had destroyed most of the craniofacial sinus and anterior part of the cranial base. The patient was operated on through a rhinoseptal approach. We found 14 similar cases in the available neurosurgical and otorhinolaryngologic literature. The pathogenesis of this tumor and more especially its origin from Rathke's pouch remnants or pharyngeal hypophysis are discussed.

Adult↗
PubMed1994

Cavernous angiomas and arteriovenous malformations of the spinal epidural space: report of 11 cases.

We have retrospectively studied 11 cases of solitary cavernous and arteriovenous malformations of the spinal epidural space. The acute or subacute onset of symptoms was found in all cases, with a neurological deficit in five cases. A plain x-ray study revealed abnormal calcification in one case. Hyperdensity with no iodine enhancement was found on computed tomographic scans in all cases. Magnetic resonance imaging studies showed ovoid or round lesions with isosignal and gadolinium enhancement on T1-weighted images and hypersignal on T2-weighted images, except in one case with hypersignal on T1 and T2 before the administration of a contrast medium. Four lumbar cases were localized in the posterior vertebral ligament; all the thoracic cases were posterior with foraminal extension. The other cases were anterolateral. The surgical findings revealed a dark vascularized epidural lesion associated in two cases with a localized epidural hematoma. A pathological examination revealed seven cavernous angiomas and four arteriovenous malformations. These arteriovenous malformations were all lumbar, and two of four localized within the posterior ligament. The pathophysiology of these vascular malformations is discussed. In light of the good postoperative prognosis of these lesions, surgical removal is recommended for all the symptomatic cases.

Adult↗
PubMed1994

[Meningioma of the floor of the temporal fossa. Anatomo-clinical study of 11 cases].

The authors present eleven cases of middle fossa floor meningiomas. They describe the anatomical and clinical features of these tumors in this rare localisation. They emphasize the strait anatomical relations with the cranial base, eight cases were inserted above the superior surface of the petrous bone, two above the endocranial face of the horizontal part of the greater sphenoid wing, one above the horizontal part of the temporal squama. Headache (6 cases) and memory loss (4 cases) are the most frequent clinical feature, seizures (2 cases) and neuropsychologic troubles were probably undervalued. Auditory signs were present in three cases. There was no visual defect and cranial nerve impairment. They insist on the necessity to obtain a complete preoperative temporal bone CT scan exploration. They think that a well advised surgical act is sufficient for these meningiomas inserted above weak structures and with good prognosis: there's no recurrence in this study with a follow up from 12 to 132 months.

Adult↗
PubMed1992

Minocycline and benign intracranial hypertension.

A case is reported of a 16-year-old girl who developed benign intracranial hypertension, with severe bilateral papilledema after minocycline therapy. A lumboperitoneal bypass was carried out in view of the ophthalmologic signs and the pressure of cerebrospinal fluid.

Adolescent↗