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Biomedical subjects

J Bonnal

Publications and source records attributed to J Bonnal.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Conservative and reconstructive surgery of the superior longitudinal sinus].

Neurosurgeons are confronted with the superior longitudinal sinus (SLS) in three circumstances: following injuries; compression or invasion of the sinus by tumors, particularly parasagittal meningiomas; and other less common occasions such as measuring pressure in the SLS or in the presence of a ventriculosinusal shunt or phlebitis of the SLS. Anatomical and physiological features of the sinus can be summarized as follows. The emissary veins open directory into the sinus at different angles according to whether they are anteriorly, medially, or posteriorly located. Their orifices are protected by willis cords, provoking laminar flow in the sinus. Pacchionian bodies are found mainly in the parasinusal blood lakes. To ensure an effective cerebral blood flow, pressure in the sinus must be less than that of the cerebrospinal fluid which itself must be at a lower pressure than that in the cortical veins. The anatomical structure of the sinuses in the rigid dural folds explains why they are compressed little or not at all by increased intracranial pressure. Surgery on the sinus should therefore include conservation or re-establishment of its two fold structure; internal venous, perfectly visible under the operating microscope, and external dura mater structure. Based on these anatomophysiological considerations, experimental sinus surgery was performed in the dog: either replacement of one or two sinus walls by a venous autograft doubled with dura mater. These techniques have been employed in humans mainly for parasagittal meningiomas, but they can be used for sinus injuries. A provisional shunt is necessary only when there is cerebral edema with venous turgescence, particularly posterior to the rolandic veins. Suturing of wounds, or their repair by means of a vein graft is employed whether they are associated or not with hematomas. Sinus invasion of meningiomas is diagnosed from the venous time of bilateral carotid angiography employing the subtraction process.

Brain↗
PubMed1981

[Total venous autograft of the superior longitudinal sinus. Experimental study in the dog (author's transl)].

The authors describe an original technique for the total replacement of a segment of the superior sagittal sinus in the dog. The graft, by its venous structure lined with a dural wall and by its triangular shape ensured through a certain tension, is close to the anatomical aspect. The authors use an autogenous vein graft. The latter is kept open by a wide suture to a fragment of dura which is fastened to the falx and to the dura of the vault. This fragment forms a "V" gutter in which lies the venous graft, thus protected from post-operative brain oedema. After suturing, a first sinusography is done, and a second one between the 7th and the 15th post-operative day. A study is thus made of the permeability of the graft. This permeability depends on the quality of the sutures and on the reconstruction of the dural wall of the sinus. Twenty operations have been carried out using various techniques. With the technique described, there were 11 permeable sinuses for 11 operations shown by the first sinusography. On second sinusography, 8 sinuses in 11 remained permeable.

Animals↗
PubMed1980

Invading meningiomas of the sphenoid ridge.

The authors report a series of 34 meningiomas of the sphenoid ridge. Eight tumors were totally removed uneventfully: two from the middle sphenoid ridge and six from the pterion or Sylvian point. Five tumors were not operated on because of their extensions or the patient's age. Twenty-one tumors raised serious surgical problems, resulting in a classification into three groups: deep or clinoidal, invading beyond the sphenoid wings, and a combination of both. Histological study of the hyperostotic bone showed meningiomatous cells in the bone in 12 of 13 cases so examined. Surgical limitations included invasion of the cavernous sinus (15 cases), of the dura mater of the sella turcica (seven cases), of the lateral part of the sphenoid body at the insertion point of the ala magna (seven cases), and of the common tendinous annulus of Zinn in the orbit (five cases), and basilar extracranial extension, particularly in the pterygomaxillary fossa (three cases). Following extensive removal, there were no early recurrences and three late recurrences (9 years and more). In 13 cases with a follow-up period of 1 to 8 years, there were no clinical recurrences. In only two cases was the meningioma totally removed. There were three postoperative deaths, two cases of hemiparesis with aphasia and epilepsy, one case with a frontal lobe syndrome, and nine with slight oculomotor, visual, or esthetic sequelae.

Adult↗
PubMed1978

Surgery of the superior sagittal sinus in parasagittal meningiomas.

The management of 21 parasagittal meningiomas is described; three were located in the anterior third of the sinus, 14 in the middle third, and four in the posterior third. Of these, four meningiomas were attached only to the lateral wall, two invaded the external layer of only one sinus wall, two involved the lateral recess of the sinus, and seven invaded one or two sinus walls. The remaining six tumors invaded the three walls of the sinus, which was completely blocked. There was bilateral meningiomas in four cases. Complete excision of the meningioma with preservation of the venous flow in the sinus and its collateral veins was attempted in each case. In the first eight cases it was possible to preserve the patency of the sinus without graft. In six of the next seven cases the removal of the two invaded walls permitted preservation of the third healthy wall and entailed the repair of the two involved walls by a partial graft, either dural graft (three cases) or venous graft (three cases). In one of the last six cases, a total vein graft was performed after complete excision of the invaded sinus. Two cortical veins were sutured to a collateral branch of the autogenous vein graft. The surgical technique of the partial and the total vein graft is described and clinical results and angiographic controls are discussed.

Adult↗
PubMed1976

Surgical treatment of subdural effusions in infants.

We puropose a simplified method for external drainage of subdural effusions in infants, not calling for a second operation to remove the catheters. This method allows the daily control of evacuated fluid, guarantees smooth and uninterrupted drainage, and permits analysis of the subdural collection. This operation which we would like to call external controlled drainage, does not call for parenteral feeding, but demands paediatric and neurosurgical collaboration. The method has no pretensions other than being simple, easy, and safe.

Drainage↗