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Biomedical subjects

J Brihaye

Publications and source records attributed to J Brihaye.

At least 19 recordsLinked to original sources
PubMed1988

Management and surgical outcome of suprasellar meningiomas.

The authors analyse 22 cases of suprasellar meningiomas, drawing attention to factors influencing on the surgical outcome. In all but one case, symptomatology began with progressive visual failure in one eye. Bilateral anosmia was noted in 4 patients with large tumour. Mental disorders were conspicuous in 5 cases and 3 patients suffered from epilepsy. Headache was severe in 5 cases. Endrocrinological disorders were observed in 3 patients. The sella turcica was of normal shape in all cases. Marked hyperostosis of the planum or tuberculum existed in 7 cases. The tumour was heavy-calcified in 2 cases. CT scanning showed everytime a marked enhancement of the tumour and in 4 cases, a large hypodense area surrounded the tumour. The patients were operated on through a bifrontal approach or a unilateral frontal flap. A partial anterior frontal lobectomy was regularly performed on one side. While the tumour is piecemeal exacavated, the dural attachment at the base is reached as quickly as possible. Complications consisted in rhinorrhea of CSF in 2 cases, once in a transitory diabetes insipidus and in a secondary hydrocephalus. Post-operative mortality remains high. Among the eleven cases of large tumours, a direct postoperative death occurred, due to a severe arterial bleeding. Two other patients died 4 and 6 weeks respectively after operation. An other patient died 8 years after operation, from meningitis. Among the 5 cases of medium-sized tumours, one post-operative death occurred in a young female, 30 of age, following urinary infection by Klebsiella, complicated by toxicemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Late occurrence of additional ocular and intracranial pathologies in the linear naevus sebaceous (Feuerstein-Mims) syndrome.

The linear naevus sebaceous syndrome of Feuerstein-Mims belongs to the phacomatoses and classically is composed of a linear cutaneous lesion associated with mental retardation and epilepsy, sometimes also with ocular dystrophies. During an unusually long follow-up of 32 years of such a case, which is reported here, the late occurrence of additional ocular and intracranial pathology are demonstrated: conjunctival and bulbar tumours with progressive deterioration of visual acuity, bilateral intracranial arachnoidal cysts, dilatation and tortuosity of the middle cerebral artery. As a consequence of these observations the prognosis in cases with this syndrome has to be given with special caution.

Adult↗
PubMed1982

[Post traumatic schizophrenic bouts: with regard to 6 cases of traumatic schizophrenia (author's transl)].

The authors describe 6 cases of post-traumatic schizophrenia and make a critical review of the literature concerning this unusual post-traumatic personality disturbance. Various schizophrenic manifestations are observed: they principally consist of delusion, hallucination, paranoid and mystical ideas, autism, psychomotor instability, fugues. Post-traumatic schizophrenia occurs mostly in young men, before thirty years. The severity of traumatic brain injury appears irrelevant in its genesis. Temporal lobes are more often involved (one third of the cases). Pre-traumatic personality disturbances are the main factor as demonstrated by the anamnesis and by the results of Rorschach test.

Adolescent↗
PubMed1982

[Normotensive hydrocephalus. Retrospective clinical study of 47 cases].

The clinical observation of 47 patients, undergoing surgery for "normotensive hydrocephalus" during the period January 1975 to January 1981 have been analysed retrospectively. The condition of half the patients improved following insertion of a cerebrospinal fluid bypass. Complications of varying degrees of severity were noted in 21 percent of cases. The correlation between the post-operative results and the clinical data was subjected to statistical analysis. Some factors appeared to have an important predictive value. These were the age, the absence of cortical atrophy on C.T. scan and the prolonged ventricular filling on cisternography. Other factors, although without statistical significance, seem to predict a better result: the existence of prior etiological data, presence of a frontal syndrome and evidence of periventricular hypodensity on C.T. scan. Finally, some other factors in our series appeared to have no influence on the prognosis. These were: duration of the preoperative evolution of the disorder, the degree of mental disturbance and difficulties of gait, the presence of urinary incontinence, the value of the ventricular cranial ratio. None of the recognized significant criteria was sufficiently reliable to predict the quality of surgical result, when studied in isolation. The association between the different significant criteria, such as have been described above notably, improves the chances of a favorable post-operative outcome but it is insufficient to predict it with great certitude. The continuous monitoring of the intracranial pressure during periods of 24 to 48 hours appears to be the most reliable factor on which to make a decision to operate in the light of the findings described in recent literature.

Adult↗
PubMed1981

Post neurosurgery Gram-negative bacillary meningitis.

The findings of a retrospective analysis of 20 patients who developed Gram-negative bacillary meningitis (GNBM) following neurosurgery are reported. The predisposing causes included surgery for skull fracture or cerebral contusion (9 patients), neoplasm (6) and vascular disease (2). Nine of the patients (45 per cent) had a cerebrospinal fluid (CSF) leak from a fistula. The organisms isolated, which included Pseudomonas aeruginosa (6), Klebsiella spp. (5) and Escherichia coli (4), had, in 75 per cent of cases, been isolated from other sites prior to the onset of GNBM. Initial diagnosis was achieved by Gram-stain of CSF in 15 of 19 cases (78 per cent). Culture of lumbar CSF was positive in 19 of the patients (95 per cent) and concommittant ventriculitis was confirmed by positive culture of ventricular CSF in 10 of 11 cases (91 per cent) from whom it was obtained. The overall mortality was 80 per cent, 11 patients dying of causes directly related to GNBM. Eradication of the infecting organism from CSF was achieved in 79 per cent of patients receiving intraventricular aminoglycoside therapy, but in only 40 per cent of those receiving intralumbar therapy. Deaths in the latter group were associated with ventriculitis whereas those in patients receiving intraventricular therapy resulted from intracranial abscess formation. These findings, plus the observation of chloramphenicol resistance in 80 per cent of the isolates, suggest that systemic and intraventricular aminoglycoside administration is indicated in patients with post-neurosurgical GNBM.

Adolescent↗
PubMed1979

Pseudo-tumoural aneurysm in the third ventricle: Report of three cases.

3 cases of giant sacciform aneurysm developed in the third ventricle are reported. They were observed in patients over 50 years. Clinical symptomatology evoked a tumor rather than a vascular malformation. Diagnosis can be difficult even with angiography and CT scan performed conjointly when the giant aneurysm is completely thrombosed. The size of the lesion is not a matter of age since 10% at least of these giant aneurysms are observed in children. They are mainly seen along the large arteries at the neck or at the base of the brain; the high focal pressure of the blood flow at these levels can perhaps play a role in the usual site of these lesions. Surgical treatment remains a challenge when the aneurysm is burrowed deep into the third ventricle and when being thrombosed, it is mainly symptomatic by its mass.

Aged↗