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Biomedical subjects

H Person

Publications and source records attributed to H Person.

At least 19 recordsLinked to original sources
PubMed2006

[Dumbell hemangioblastoma of the eighth cervical nerve root].

Hemangioblastomas involving cervical nerve roots are extremely rare. Only one case has been previously reported in the literature. We report the case of a 33-year-old man presenting with a 6-month history of upper limb pain. MRI and cervical angiography demonstrated the presence of a dumbell (intra and extradural) and highly vascularized tumor of the right C7-T1 foramina. Histological examination eventually confirmed the diagnosis of hemangioblastoma. Total removal of such a lesion may require combined (anterior and posterior) approaches and preoperative embolization.

Adult↗
PubMed2005

The morphometric study of the sacrospinal and sacrotuberal ligaments correlated with the morphometry of the pelvis.

Perineal neuralgias may be considered as nerve entrapment syndromes, which have been anatomically poorly studied. The pudendal nerve could be compressed between the sacrospinal and the sacrotuberal ligaments. This study tries to find a correlation between the pelvis and the lumbosacral junction morphometry, and sacrospinal and sacrotuberal ligaments morphometry. We did an anatomical study of eight anatomic specimens, and we performed the measures by using the computed tomography scanner. No correlations were found.

Cadaver↗
PubMed2001

[Dysphagia and cervical bony spurs].

A 74-year-old man had acute complete dysphagia due to esophageal compression cause by a degenerative osteophye on C4-C5. Functional improvement was immediate after surgical removal of the osteophyte via an anterior cervical approach. Reports in the literature show that vertebral hypertrophic spurs causing dysphagia result from bony degeneration or idiopathic causes (diffuse idiopathic skeletal hyperosteosis: DISH). Surgery is mandatory if medical care fails and dysphagia is complete. Discetomy-graft is indicated for degenerative lesions and simple removal of the bony spur for ossification of the anterior longitudinal ligament in DISH. In DISH, the cervical disc is not implicated but in degenerative disease it is the most important factor in the development of osteophytes.

Aged↗
PubMed1999

[Fotemustine (Muphoran) in 22 patients with relapses of high-grade cerebral gliomas].

Fotemustine is a third-generation nitrosourea characterized by a phosphoalanine carrier group grafted onto the nitrosourea radical, which gives it a high lipophilicity and a better penetration through the cell membrane. Between September 1988 and December 1997, 22 patients with inoperable or incompletely resected recurrent high-grade gliomas of the brain were treated at the University Hospital in Brest (France). Treatment consisted of three weekly infusions of fotemustine (100 mg/m2 days 1, 8 and 15). If patients responded or were stabilized, fotemustine was continued at the same dose, but every three weeks only. Four patients responded to the treatment (18%), while 6 were stabilized (32%). Main toxicity was haematologic (leucopenia and, above all, thrombocytopenia); treatment was only interrupted in one patient for leucothrombopenia, and there was no toxic death. Medium duration of response and/or stabilisation was 6.5 months, and median survival 9.4 months in responding and/or stabilized patients, while it was only 5.0 months if tumour progressed under chemotherapy (median survival for all patients: 7.5 months). Besides, there was a difference in survival in favour of the young patients (< 50 years-median survival = 11.8 months) in comparison with patients between 50 and 60 years (median survival = 6.8 months; p = 0.0282) or elderly patients (> 60 years-median survival = 5.8 months; p = 0.0634). In our series, we did not found any difference in survival according to the initial performance status of patients before treatment. Therefore, fotemustine seems to represent an interesting well-tolerated treatment possibility in patients with inoperable recurrent malignant gliomas of the brain.

Antineoplastic Agents↗
PubMed1998

Arterial and neural relations at the posterior and lateral aspects of the medullo-spinal junction.

The authors report the results of a series of 59 microdissections of the region of the foramen magnum. These dissections were made under the strict conditions of a surgical approach using an operating microscope. The major anatomic structures of the medullo-spinal junction are arranged mainly at its lateral aspect. The customary surgical approaches to the posterior cranial fossa give ready access to the cerebello- and latero-medullary cisterns. The description of the neurovascular structures contained therein assumes a particular importance because of the relative frequency of lesions developing at this level. This study deals particularly with the vertebral a. (VA), the inferior posterior cerebellar a. (IPCA), the cranial nn. IX (glossopharyngeal n.), X (vagus n.), XIc and XIs (cranial and spinal accessory n.) and XII (hypoglossal n.). The anatomy of this posterior and lateral region is characterised by the contrast between the relatively uniform course of the VA and the variable course of the IPCA, a true guideline whose very irregular arrangement accounts for the diversity of its relations with the last four cranial nn.

Cadaver↗
PubMed1997

[Benign glial cysts of the pineal region].

A review of the pertinent literature regarding glial cysts of the pineal region is presented. Various pathogenic factors have been advocated such as the physiological involution of the pineal gland, a sequestration of the embryonic cavum pineale or the degenerative evolution of glial inclusions within the pineal gland. The pathological description is classical with three layers: an external fibrous capsule, an intermediate layer of pineal tissue and an internal glial wall. Imaging of these lesions is typical, namely the thin rim of peripheral contrast enhancement and the presence of calcifications. These cysts are more frequent in women in their third decade of life. They are almost always latent and their fortuitous disclosure at NMR examinations is common. Some of them will nevertheless cause intracranial hypertension due to hydrocephalus and hemorrhage. Those symptomatic cysts should be treated. Surgical excision has been the method of choice and the results are good. More recently a mere stereotactic needle aspiration has been performed with satisfactory long-term results.

Adult↗
PubMed1997

[Benign hemorrhagic cyst of the pineal region. Treatment by stereotactic puncture. 4-year follow-up].

We report the case of a 27 year-old male patient in whom acute intracranial hypertension led to the diagnosis of a pineal hemorrhagic cyst as demonstrated by CT-scan and MRI examinations. Treatment consisted in stereotactic needle-aspiration following insertion of a ventriculo-peritoneal shunt. Pathological examination confirmed a benign glial lesion. The outcome was good as complete shrinkage of the cyst and complete relief of the signs and symptoms were achieved. These clinical and radiological results persisted over four years. Approximately 70 cases of symptomatic benign pineal cysts have been reported to-date. Surgical excision has been the method of choice. The present case and twelve other cases of stereotactic management of the condition in the literature suggest the interest of a mere stereotactic needle aspiration of these lesions.

Adult↗
PubMed1996

The place of decompressive surgery in the treatment of uncontrollable post-traumatic intracranial hypertension in children.

The authors report two cases of post-traumatic uncontrollable intracranial hypertension in children (120 torr in case 1; 90 torr in case 2) who were treated within the first 12 h after trauma by surgery including decompressive craniectomy. The outcome was favourable in both children. Intracranial pressure (ICP) was recorded during the pre-, intra- and postoperative periods and during each specific step of the surgical procedure. Craniectomy alone induced a decrease in ICP of 45% (40 torr) in case 1 and 30% (35 torr) in case 2. Although this method remains controversial, given the lack of controlled trials, it can offer a salvage procedure in children with rapidly worsening intracranial hypertension, allowing survival without disabling neurological sequelae.

Brain Concussion↗
PubMed1994

The "anatomic" view of the suprarenals in medical imaging.

Based on coordinates derived from three series of anatomic sections, the authors propose a view for tomographic investigation, applicable in MRI and ultrasound, which reconstructs the ideal image of the suprarenal gland in its quadrilateral as described by Testut. This "anatomic" view is 45 degrees vertical and oblique, intermediate between the sagittal and frontal views, which it can advantageously replace. A new aspect of suprarenal tomography, recalling the image of a triskele, is described in the context of this view.

Adrenal Glands↗
PubMed1994

Anatomical basis of a fascio-cutaneous pedicle flap based on the infero-lateral collateral artery of the leg.

An anatomical study of 30 cases has been performed on the vascularisation of the distal third of the antero-lateral compartment of the leg, with particular reference to the relations of the infero-lateral collateral artery of the anterior tibial artery, the perforating branch of the peroneal artery, and the antero-lateral malleolar artery. A fascio-cutaneous pedicle flap based on the infero-lateral collateral artery is described noting that the superior, anterior, and posterior limits are similar to those of the lateral supramalleolar flap of Masquelet. The inferior limit of this new flap is 15 mm distal to the site of emergence of the perforating branch of the peroneal artery. The advantages of this flap are; a large surface area for cover, antegrade vascularisation, and no significant vascular sacrifice. The distal half of the calf can be covered both medially and posteriorly as well as the proximal half of the dorsum of the foot, the medial and lateral arch areas, the perimalleolar region, and the region behind the Achilles tendon. The flap requires the presence of the infero-lateral collateral artery of the tibialis anterior which can be confirmed either peroperatively or preoperatively by angiography.

Collateral Circulation↗
PubMed1994

[Treatment of chronic lumbago and radicular pain by spinal cord stimulation. Long-term results].

Seventy-seven patients with chronic, refractory, low back and radicular pain underwent implantation of a spinal cord stimulator between 1984 and 1992. Most patients had failed back surgery syndrome. In every case, an epidural quadripolar "Resume" electrode was implanted surgically. Results were evaluated after three months then after six to 98 months (mean follow-up 42 months). Long-term efficacy was good in 63.6% of cases, fair in 22%, and poor in 6.5%; treatment failure occurred in 7.9% of cases. Adverse events included one case of meningitis, two cases of local infection, and one case each of cerebrospinal fluid fistula and necrosis of the skin overlying the stimulator. The main causes of treatment failure were complications, inappropriate patient selection, and the escape phenomenon. The results of this study demonstrate that spinal cord stimulation is effective for the treatment of chronic low back and radicular pain in carefully selected patients; scrupulous application of restrictive selection criteria is essential to the success of the method.

Adult↗
PubMed1994

[Traumatic atlanto-axial dislocation in children: 7 cases].

Seven cases of atlantoaxial rotatory dislocation in children are reported. The CT scan permitted differentiation of the lesions in all the cases. Analysis of the results has led us to introduce two modifications for Fielding's classification: a distance between the atlas and odontoid of less than 5 mm is normal. sagittal dislocation must be included in the same classification. We propose the following therapeutic protocol: rotatory luxation without tears of the transverse ligament should receive orthopedic treatment, rotatory luxation with tears of the transverse ligament should have surgical treatment if orthopaedic treatment fails. sagittal luxation with or without rotatory fixation needs surgical treatment.

Adolescent↗
PubMed1993

Thoracoscopic dissection of the esophagus in human cadavers.

A technique for thoracoscopic dissection of the esophagus is described which gives a large and magnified view of the pleural cavity, the mediastinum, and the esophagus. This technique was developed on human cadavers which gives excellent technical resources for learning and practicing endoscopic surgical anatomy of the esophagus. It avoids the need to change the position of the patient to perform a total thoracoabdominal esophagectomy via a triple surgical approach.

Azygos Vein↗
PubMed1993

[Juxta- or trans-condylar lateral extension of the posterior suboccipital approach. Anatomical study, surgical aspects].

In order to improve the surgical approach to tumors and aneurysms of the anterior or antero-lateral aspect of the foramen magnum, some authors have proposed a lateral extension of the posterior sub-occipital approach to the occipital condyle including in some cases its partial or complete resection. The evaluation of this close medio-condylar or trans-condylar suboccipital approach has been performed on eight coloured-latex injected specimens in the conditions of a microsurgical operation. The extra- and intradural steps have been studied so as to define the optimal position of the patient's head and the surgeon and to precise the accessible anatomical structures: Vertebral artery (and its control), Cranial nerves IX, X, XI & XII, Posterior-inferior cerebellar artery and collaterals, Vertebro-basilar junction, antero-lateral aspect of the brain stem and spinal cord. Depending on the extent of the condylar resection, the lateral extension of the posterior sub-occipital approach may be defined as minimal, moderate or large. Based on anatomical and surgical constations it appears that a complete resection of the occipital condyle (resulting in occipito-cervical instability) should be reserved for those very extensive lesions. Yet a partial drilling of the condyle provides a better angle of approach, minimises the hazards of retraction of nervous structures and enables the surgeon to take the best advantage of the dissection and control of the vertebral artery.

Female↗
PubMed1992

[Contribution of ultrasonic cavitation--CO2 laser combination in the excision of panmedullary ependymoma].

The authors report an uncommon case of panmedullary ependymoma (C2 to T12), totally removed in one stage with the use of ultrasonic cavitation and CO2 laser. The preoperative topographical diagnosis without M.R.I. was very difficult. CO2 laser in addition with ultrasonic cavitation allows the removal of the tumor without any prohibitive tractions on the spinal cord. The stable course with a long follow-up period (seven years) confirms the good prognosis of such a pathology.

Adult↗
PubMed1988

The venous hilum of the testis and epididymis: anatomic aspect.

The venous return from the testis is effected by 3 venous pathways: the pampiniform plexus gathrs the centripetal and centrifugal paths of the testis with the marginal vein of the epididymis; the deferential vein accompanies the ductus deferens; and the cremasteric vein travels more superficially between the internal and external spermatic fasciae on its way to the inferior epigastric vein. At the caudal pole of the testicle these different pathways form such close connections as to constitute a real vascular junction.

Adult↗
PubMed1987

Radiologic anatomy of duplication of the inferior vena cava: a trap in abdominal imaging. A report of 8 cases.

Eight cases of duplication of the inferior vena cava are reported. Three of these bear witness to the errors of interpretation that may be committed when the anomaly is not initially detected in the ultrasonographic transverse sections and when no preliminary phlebography is available. Two other cases illustrate the influence of this duplication on the choice of the prophylactic surgical treatment of pulmonary embolism. The last clinical observation indicates the need to puncture both the femoral veins when performing iliocaval phlebography. Finally, two observations on the cadaver help to clarify the imaging appearances of this anomaly. The report concludes with a review of the classical anatomic and pathogenic concepts and a short discussion of the practical problems posed by duplication of the inferior vena cava.

Adult↗