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Biomedical subjects

J Brotchi

Publications and source records attributed to J Brotchi.

At least 163 records · Page 9Linked to original sources

[Ischemic pituitary apoplexy and cerebrovascular accident].

Operative findings of degenerative changes in pituitary adenomas are not uncommon; however, clinical apoplexy is rare. We report the case of a 43-year-old man who presents a sudden right hemiplegia with aphasia and right ophthalmoplegia, in relation with an ischemic pituitary apoplexy and cerebral vasospasm. A few cases of arterial obstruction or vasospasm associated with pituitary apoplexy have been reported in the literature. Cerebral arterial spasm has also been observed after pituitary surgery. Inclusion of blood or necrotic material in the subarachnoid space seems not to be the only mechanism of vasospasm. The role of hypothalamic dysfunction is considered.

Adult↗

[Histochemical study of central nervous system lesions in experimental epilepsy caused by kainic acid].

In former investigations on human focal epilepsy and on experimental epilepsy by cobalt implantation, the authors have demonstrated the signaletic importance of "activated astrocytes": cortical astrocytes endowed with a modified metabolism and an accelerated turnover. The present study concerns the results of the intra-amygdaloid injections of kainic acid, a strong excitatory and neurotoxic amino acid. Injections in semi-chronic conditions in the rat lead to electrical and motor seizures and to the production of activated astrocytes not only in regions that might trigger off epileptic seizures (cerebral cortex, amygdala, possibly hippocampus), but also in the neostriatum. Stimulation of this last region results in a Huntington chorea-like syndrome. Thus, the importance of activated astrocytes must be extended to include other conditions of intense hyperactivity of neurons than epilepsy.

Animals↗

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↗

Histochemical study of cobalt-induced focal epilepsy.

A previous study showed a strong relationship between human focal epilepsy and the presence in the cortex of "activated" astrocytes characterized by an intense activity of dehydrogenases (DH) involved in glucose metabolism and of glutamate DH. Using the semi-chronic model of cobalt-induced experimental focal epilepsy in the rat, we investigated a possible correlation between astrocyte modifications and the chronological development of the epileptic manifestations on the ECoG. After a few days the cobalt-implanted rats present spikes, then sharp waves followed by an electrical crisis and ultimately motor seizures. Activated astrocytes were found in each phase of this evolution. Their number increases with the intensity of the manifestations. There is a close relationship between activated astrocytes and focal epileptic phenomena. At this stage of our study it is clear that the presence of activated astrocytes is not a consequence of seizures. However, it is impossible to say whether the activation is secondary to the hyperactivity of the neurons or directly responsible for the constitution of the epileptic focus. In any case, activated astrocytes provide a new means of localizing an epileptogenic focus.

Animals↗

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↗

[Phosphorylase and glucosyltransferases at the level of reactive astrocytes. A histochemical study].

Implantation of cobalt powder in the cerebral cortex of rat determines an epileptogenic focus where two types of reactive astrocytes are observed. The first type is mostly represented in the subcortical white matter but it does exist in the cortex around the implant. Phosphorylase and branching enzyme are both very active in these cells which are filled with glycogen. The second type is limited to the cortex and phosphorylase activity leads to an unbranched polysaccharid. These cells correspond to the "activated astrocytes" described by the authors in a previous paper and observed round irritative lesions which, in the cerebral cortex, produce epileptogenic foci.

1,4-alpha-Glucan Branching Enzyme↗