Search PubMed⌕ Search

Biomedical subjects

J C Gautier

Publications and source records attributed to J C Gautier.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Cerebellar infarction in the area of the posterior cerebellar artery. Clinicopathology of 28 cases].

We report a neuropathological study of cerebellar infarctions involving the territory of the posterior inferior cerebellar artery (PICA) in 28 cases. Fifteen cases involved the PICA territory only. In 13 cases infarctions in the anterior inferior cerebellar artery (AICA) territory and/or in the superior cerebellar artery (SCA) territory were also present. A thorough post-mortem study of the arterial supply of the brain from the heart up to the cerebellar arteries, including the cervical spine segment of the vertebral arteries was performed in 27 cases. The territory of the cerebellar infarcts has been ascertained. In 15/28 cases (54 percent), infarction involved the PICA territory only (17 infarcts). All of these cases had a benign outcome and death was due to another cause. Six of these were recent infarctions. None had evidence of swelling and tonsillar herniation. Infarcts were generally of small size and involved the entire PICA territory in only 2 cases. Most of these cases were unexpected discovered at autopsy. Cerebellar infarction in the territory of the medial branch of the PICA (9/17 infarcts) drew grossly a set square with a dorsal base and a ventral top headed for the IVth ventricle. Five out of these cases were associated with infarction in the dorsal and lateral medullary territories. Retrospective clinical study showed that they had been unnoticed or overshadowed by other neurological disorders (4 cases), or presented as Wallenberg's syndromes (4 cases), or as a pure vestibular syndrome (due to an infarction involving only the cerebellum) mimicking an acute labyrinthine disorder (1 case). Infarctions in the territory of the lateral branch of the PICA (5/17 infarcts) always occurred without medullary involvement. All of them were unexpectedly discovered at autopsy, and were unnoticed during the life (3 infarcts) or were overshadowed by other neurological disorders (2 infarcts). That was also the case in 2 cases of infarction in the whole PICA territory (3/17 infarcts). Thus infarctions strictly localized to the entire PICA territory only were rare. Thirteen/28 cases (46 p. 100) of infarction in the whole PICA territory were associated with infarction in the AICA and/or the SCA territories. This resulted from an association with other infarctions and not from an abnormally large territory of the PICA. Cerebellar swelling with brain stem compression and tonsillar herniation occurred 8/13 cases (62 p. 100). There were other massive median and paramedian brain stem infarctions involving midbrain, pons or medulla in 55 p. 100 of 13 cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1989

[Homografts in the human brain. Current data].

Since 1982, grafting of human nervous tissue on human central nervous system has been realized, mainly in Parkinson's disease. The present article reviews the theoretical basis of such procedures, i.e., the remarkable experimental work that began around the turn of the century. New approaches, e.g., using hydroxydopamine or MTPP, have greatly enlarged the field of experimental research. In man, grafts of adrenal medulla and, in a few cases, of fetal substantia nigra, have been realized in several hundreds of patients. The known results invite great caution. Brain grafting has also been considered in Huntington's chorea, trauma of the spinal cord and even schizophrenia. In animals, transplants of hypothalamus and pre-optic area have counteracted genetic endocrine disorders. Experimental researches are of high interest but their application to man raises major problems of efficiency and fundamental ethical and legal questions.

Animals↗
PubMed1989

[Cerebral vascular accidents in young subjects. A study of 133 patients 9 to 45 years of age].

We report 133 cases of strokes in patients aged 9-45 (male: 68, female: 65), mean age: 33.5 years. There were 112 arterial infarcts (84%), 9 venous infarcts (7%), 12 hemorrhages (9%). Among the arterial infarcts, 23 (20.5%) were due to a dissecting aneurysm, 17 (15%) to atherosclerosis, 13 (12%) to cardiac embolism. Echocardiography with contrast was performed in 69 patients showing a patent foramen ovale in 15. Mitral valve prolapse was present in 8, among which 5 had in addition a patent foramen ovale. Among 16 migrainous patients there were 7 dissecting aneurysms and 3 patent foramen ovale. Twenty two of 65 women were taking oral contraceptives at the time of the stroke. Strokes in patients taking oral contraceptives or during the puerperium accounted for 43% of the strokes in women. Ten cases (9%) have had no explanation. Venous infarctions were mainly due to puerperium and oral contraceptives. Hemorrhages were mainly due to arterial hypertension. No cause was found in 4/12 cases. The most useful investigations were angiography and echocardiography with contrast. This study confirms that extensive and early investigations are necessary in strokes in the young and particularly in women taking oral contraceptives, migraine patients and patients with mitral valve prolapse.

Adolescent↗
PubMed1988

Acquired ocular motor apraxia due to bilateral frontoparietal infarcts.

A case of acquired ocular motor apraxia in a 78-year-old man is reported. Disordered saccades and pursuit movements in the horizontal and vertical planes were recorded electro-oculographically. Magnetic resonance imaging showed bilateral border-zone infarcts, involving the frontal lobes and the superior part of the inferior parietal lobules.

Aged↗
PubMed1988

[Dolichoectatic intracranial arteries. Association with aneurysms of the abdominal aorta].

Dolichoectatic intracranial arteries (DIA) have been given several names, e.g. fusiform aneurysms, dolichomega-arteries. It is not an uncommon condition and it raises interesting points: 1) symptoms and signs result from compression (cranial nerve palsies; hydrocephalus) from ischemic or hemorrhagic episodes; 2) the diagnosis is made easier with CT since the arterial wall is often calcified; 3) the pathophysiology has long been assumed to be atherosclerotic in nature, but controversial assumptions are discussed; 4) associated arterial abnormalities are common: one of our cases and approximately half of the post mortem reported DIA were associated with aneurysm of the abdominal aorta. Two cases are reported here: 1) A 56 y/o male presented with progressive gait disorder, deafness and ischemic episodes. CT showed DIA and hydrocephalus. DIA involved the basilar artery, both intracranial carotid arteries, the abdominal aorta and probably one renal artery. A ventriculo-atrial shunt was performed unsuccessfully. Post mortem findings are reported; 2) A 52 y/o male had suffered from trigeminal neuralgia for about one year and from trigeminal permanent pain for two weeks. He had developed left hemiparesis and dysarthria. DIA involved the basilar artery and the left intracranial internal carotid artery. The right internal carotid artery and the right vertebral artery were hypoplastic. Clinical, radiographical and pathophysiological features are reviewed.

Aorta, Abdominal↗
PubMed1986

[Tethered spinal cord and lipoma. Contribution of magnetic resonance imaging].

A 12 year-old boy was investigated for progressive deformity of the left foot developing over 2 years. The foot was hollow with equinus varus and claw toes. Signs of a lesion of left L5 and S1 roots were present and spina bifida at L5 was noted on X-rays. Magnetic resonance imaging (MRI) showed a tethered spinal cord associated with a lipoma at the level of the S1 vertebra. Modes of presentation and physiopathology of disorders related to tethered cords are reviewed and the diagnostic value of MRI is emphasized.

Child↗
PubMed1985

[Spasm or dimpling of the hypothenar eminence].

Bilateral hypothenar muscular spasm ("dimpling") was discovered in a 62 year-old man. The spasms consisted of recurrent arrhythmic contractions of the palmaris brevis muscle. E.M.G. showed no signs of denervation but the contractions could be stopped by infiltration of the ulnar nerve by xylocaine. Apparently, this syndrome has previously been reported in only two cases. Its clinical and electromyographic characteristics are similar to hemifacial spasm. Compression of the ulnar nerve after its division at the wrist could be a cause.

Diagnosis, Differential↗
PubMed1985

[Recurrent multiple paralysis of cranial nerves. Gougerot-Sjögren syndrome].

A 53 year-old woman presented with 6 episodes of recurrent cranial nerve palsies over seven years, each episode lasting several weeks. She had three episodes of diplopia, one of difficulty with swallowing, a left facial paralysis and two episodes of trigeminal sensory neuropathy. Sjögren's syndrome was diagnosed when the patient developed dryness of the eyes and mouth, 7 years after the first episode. The diagnosis was proved by biopsy of the accessory salivary glands, the presence of a hypergammaglobulinaemia and anti-tissue antibodies.

Cranial Nerve Diseases↗
PubMed1984

[Cavitary orthochromatic leukodystrophy in the adult. Oligodendroglial proliferation and inclusions].

A 41 year-old woman presented with two Grand Mal fits followed by progressive spastic paraparesis and intellectual impairment. After 18 months there was a remission which lasted for 4 years but thereafter inexorable progression of the disease and many fits led to a state of akinetic mutism. Death occurred nine and a half years after the onset of the illness. There was no family history. The neuropathological studies included light and electron microscopy of a cerebral biopsy and a complete post mortem examination. Myelin loss and cavitation of the white matter was associated with the presence of sudanophilic lipid and abundant cells at the periphery of the lesions. These cells had the characteristics of oligodendrocytes. The combination of sudanophilic leucodystrophy, cavitation of white matter and oligodendrocyte proliferation has previously been observed only in childhood.

Adult↗
PubMed1984

[Interatrial septal aneurysm. Echocardiographic diagnosis].

Interatrial septal aneurysm is a rare abnormality and can now be diagnosed by echocardiography. We report the case of a 52 year old woman in whom this condition was diagnosed after an embolic cerebrovascular accident. M mode recordings showed a linear echo in the left atrial cavity in early and mid systole. The aneurysm was directly visualised by 2D echo as a hemispherical bulge in the mid portion of the interatrial septum, which was mobile and had a to-and-fro motion between the two atria in relation to the different phases of the cardiac cycle. The diagnosis was confirmed by angiography, and at surgery. A feature of this case was the close correlation between echocardiographic, angiographic and operative findings. The pathogenesis of this type of aneurysm remains conjectural as does its role in the production of cerebral embolism, the evidence for which was circumstantial in the absence of other demonstrable causes and in the light of previously reported cases.

Angiography↗
PubMed1984

[Cerebral embolism. A neurologist's point of view].

Cardiac emboli (CE) are the second most frequent cause of ischemic or hemorrhagic cerebrovascular accidents, and also the second cause of cerebral infarction. This present work comprises: pathologic arterial findings (the principal sites where stimuli lodge) and cerebral findings (of variance size with an often hemorrhagic aspect of infarctions); infrequently encountered clinical presentations; the etiologies of CE, emphasizing in particular, the increasing role of idiopathic atrial fibrillation; and lastly, current information available on the indications for immediate anticoagulant therapy.

Anticoagulants↗