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J Brotchi

Publications and source records attributed to J Brotchi.

196 records · Page 11Linked to original sources
PubMedDate not supplied

[3-year evaluation of the surgical treatment of intracranial aneurysms. Apropos of 100 surgically treated aneurysms].

The authors present the results of surgical treatment of a consecutive series of 100 cases of intra cranial aneurysm. The results are analysed in relation to various factors such as the pre-operative delay, the clinical status, the location of the aneurysm and the age of the patient. Altogether, the percentage of excellent and good results is 83%. Bad results account for 10% of the total and deaths represent 7%. Shunted postoperative hydrocephalus was recorded in 10% of cases and half were due to aneurysm of the anterior communicating artery. Postoperative spasm (16%) was the severest complication, responsible for more than half the deaths.

Aged↗
PubMedDate not supplied

[Activated astrocytes and epileptogenic focus. Histoenzymology].

The author reports the discovery of an original entity, the activated astrocyte, which is an essential component and the first anatomical sign of the epileptogenic focus. The importance of the activated astrocyte is demonstrated by the fact that it is observed before the clinical signs appear and as soon as the first spikes are recorded on the electrocortigram. Cautious conclusions are drawn. The authors recognizes the essential role of the neurons and does not suggest that astrocytes are the cause of epilepsy. However, since astrocyte activation is observed before the first electrical signs announce the beginning of an epileptogenic focus, he suggests that activated astrocytes probably offer morphological evidence of certain mechanisms closely concerned in the formation of the epileptogenic focus. The metabolic activation of the astrocyte is not surprising, and is probably related to the increase in loco-regional metabolism due to neuronal hyperactivity, the starting point of epilepsy. It confirms current opinion, especially in biochemistry, on the importance of the glial cells in the neuronastrocyte association. This work opens up certain prospects. First, the significance of the activated astrocyte in the context of current biochemical, neuro-physiological and morphological studies of the glial compartment is a promising research field. Second, from the clinical angle, it is very important to be able to identify an epileptogenic gliosis on the basis of activated astrocytes. Used in conjunction with modern neuro-physiological techniques to locate the epileptogenic focus, the search for activated astrocytes in biopsy material obtained stereotactically should permit better detection of the affected area and thus ensure more successful surgery in cases of focal epilepsy resistant to medication.

Animals↗
PubMedDate not supplied

[Analysis of the results of nine-year experience in the surgical treatment of intracranial arterial aneurysm (author's transl)].

Two series of cerebral aneurysms are compared. The first was composed of 86 cases. The second, 73 cases, benefited from modern techniques, such as microscope, arterial hypotension, Yasargil's clips, bipolar coagulation, as well as from greater experience on the part of the surgical and anesthetic team. To avoid the risk of recurrent subarachnoidal hemorrhage, the surgical procedure has been done during the first week when consciousness is good or when corotid angiography shows a large cerebral hematoma. The surgical procedure is postponed if the patient shows a low state of consciousness or a cerebral vasospasm. In these cases, controlled external ventricular drainage improves patients' conditions and often allows for surgical intervention after three to five days. The Botterrel classification is used to evaluate the surgical results: good results were obtained in 71% of the entire series, as well as in 94% of grades 1 and 2 patients. The overall mortality rate was 15%. That for grades 1 and 2 was 2.7% and that for grades 1, 2 and 3 was 7.5%. The preoperative, operative and postoperative factors affecting results are discussed with particular attention to cerebral vasospasm and hydrocephalus.

Humans↗
PubMedDate not supplied

[Diagnostic and/or prognostic value of the nuclear level determination of desoxyribonucleic acid (DNA) in nervous system tumors].

The diagnostic and prognostic value of the DNA ploidy level (nuclear DNA content) was studied in a series of 847 tumours of the nervous system. This series included 93 nerve sheath tumours, 224 meningiomas, 389 neuro-epithelial tissue tumours, 46 primitive neuroectodermal tumours (retinoblastomas, medulloblastomas, neuroblastomas, etc.) and 95 brain metastases. The DNA ploidy level determination was carried out by means of the computer-assisted microscope analysis (digital cell image analysis) of Feulgen-stained nuclei. The results show that the DNA ploidy level does not contribute significant diagnostic information when tumours are analyzed individually. Indeed, some tumours which are definitely benign like certain schwannomas and meningiomas can exhibit very high levels of aneuploidy, while some highly malignant tumours like certain glioblastomas and neuroblastomas can be diploid. In contrast to its weak diagnostic value, the DNA ploidy level appears to be a powerful prognostic factor with respect to the supratentorial astrocytic tumours of the adult. Indeed, patients with hypertriploid astrocytic tumours exhibit a survival period which is significantly longer when compared to that of patients with non-hypertriploid astrocytic tumours. These hypertriploid astrocytic tumours could be involved in a process of biological degeneration when reference is made to their proliferation activity which is significantly weaker than that of non-hypertriploid tumours.

Aneuploidy↗
PubMedDate not supplied

Anterior sacral meningocele and Marfan syndrome: a review.

Anterior sacral meningocele is a not rare entity. Treatment is usually surgical and consists in a transacral posterior approach with patching of the communication between the malformation and the dural sac. But surgery can be difficult and require multiple procedures. We report the first case of a giant anterior sacral meeningocele rapidly cured by a simple endoscopic procedure. We believe that more attention should be used in the diagnosis of such cases as they can be so easily cured. We have reviewed the literature about anterior sacral meningocele and particularly its treatment and its association either with Marfan syndrome or a familial occurrence.

Adult↗
PubMedDate not supplied

Gadolinium-enhanced MR in the evaluation of preoperative meningioma embolization.

PURPOSE: To evaluate the use of postembolization gadolinium-enhanced MR imaging as a means to judge the efficacy of tumor embolization. METHODS: Fifteen patients with meningiomas were prospectively studied. The following data were evaluated for each tumor: the percentage of vascular supply to the tumor arising from the internal and external carotid arteries; the percentage of the tumor embolized as judged by angiography, by MR imaging, and by CT scanning; the estimated blood loss according to the surgeon; and histologic evidence of necrosis as seen by the neuropathologist. RESULTS: The data reveal an excellent correlation between the amount of tumor embolized as estimated by MR and both the estimated blood loss at time of surgery and the presence of histological necrosis in the specimen. CONCLUSIONS: Postembolization gadolinium-enhanced MR is an excellent means to evaluate the efficacy of an embolization and offers certain advantages over CT and angiography. One important advantage of this technique lies in the fact that it can be performed immediately postembolization.

Adult↗
PubMedDate not supplied

Ectopic prolactinoma in the clivus.

BACKGROUND: Ectopic pituitary adenomas are rare. Only 29 cases are reported in the literature. The clivus was involved in some cases but sella turcica was occasionally involved. CLINICAL PRESENTATION: Headache was the first symptom of a 47-year-old woman. Radiological examination diagnosed a clivus tumour. No connection with the pituitary gland was observed. Pre-operative diagnosis was metastasis of an unknown cancer. INTERVENTION: By a transphenoidal approach, we removed a haemorrhagic tumour. No connection between the normal pituitary gland and the tumour was observed. Neuropathological analysis showed a prolactinoma. CONCLUSION: We report a rare case of an ectopic prolactinoma in the clivus unrelated to the pituitary gland. Only one other case has been reported in the literature.

Choristoma↗