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Biomedical subjects

J C Gautier

Publications and source records attributed to J C Gautier.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Sociological effects of cerebrovascular accidents. What does the clinician expect from the epidemiologist?].

Epidemiological research has developed along two principal paths: determination of the prevalence and incidence of cerebrovascular accidents. In this respect, there is already a useful collection of data, though inadequate and, from a specifically French standpoint, new studies are required; research into risk factors, and in this area, also, available facts are sufficient to determine primary and secondary prevention strategies, though remain inadequate. The Authors suggest widening areas of epidemiological enquiry, in particular involving short, middle and long-term hospital stays, and family or community life following the accident. Mention is made of the value of developing socio-economic studies by methods of human capital and personal preferences.

Cerebrovascular Disorders↗
PubMed1983

[Spontaneous dissecting aneurysms of the cerebral arteries].

A review of the literature on Spontaneous Dissecting Aneurysms (DA's) of cerebral arteries is presented with 3 personal cases of DA's of the Internal Carotid Artery (ICA). Patients with spontaneous DA's of the extracranial ICA are of middle age (30 to 60 year old) and present with an ipsilateral pain in the neck or face and/or with TIAs (45 p. 100 and 50 p. 100 of the cases respectively). Claude Bernard-Horner's sign is frequent. The clinical, radiological and pathological data suggest that in most cases, if not all, neurological deficits are due to embolism and/or anterograde thrombus. This has led to recommend anticoagulant therapy. Nevertheless, surgery may be indicated is some situations such as in DA's on kinking arteries. The treatment of spontaneous DA's of extracranial vertebral arteries is still a detectable matter, though they have common features with DA's of the extracranial ICA. The DA's of the basilar and intracranial vertebral arteries are often associated with a subarachnoid haemorrhage and most of them have a severe outcome. Lesions of the arterial wall such as cystic medial necrosis and fibromuscular dysplasia play a role in the extent, and presumably in the initiation, of the so-called spontaneous DA's at least in some cases. Minor trauma, high blood pressure (20 p. 100 of the cases), oral contraceptives and coughing have been as well suspected.

Adolescent↗
PubMed1983

[Dystonia musculorum deformans. Favorable effect of bromocriptine].

A 25 year-old woman suffered from a severe dystonia musculorum deformans since the age of 14. No similar cases were recorded in the family. Examination showed torsion spasm and a cogwheel phenomenon in both superior limbs. Signs disappeared on bromocriptine 22,5 mg/day then reappeared when dosages where progressively reduced. With 12.5 mg/day after 1 year of treatment, the patient leads a normal life including university studies.

Adult↗
PubMed1983

[Lasting focal signs in 2 cases of progressive multifocal leukoencephalopathy].

Two cases of progressive multifocal leukoencephalopathy, which occurred without a clinical setting of immune deficiency and developed as a unifocal brain lesion during 14 and 4 months, are reported. The diagnosis was established only by post mortem study in the first case and after five months by a brain biopsy in the second one. The difficulties of an early diagnosis in such cases should be now reduced with CT scan which may show a relatively specific picture, even when there is only one visible lesion.

Female↗
PubMed1983

[Carotid dysplasias].

Fibro-muscular dysplasia is the principal dysplasia of the internal carotid artery (ICA). It mainly affects women and is usually diagnosed at about the age of 50. The best known lesions are segmental medial defects. They are often associated with other local (aneurysm) or general (mainly renal) malformations. Congenital factors probably play a very important part in its genesis. Ischemic cerebrovascular accidents (transient or permanent), or cerebral haemorrhage are the usual modes of presentation. The diagnosis may be suspected on ultrasonic examination but can only be confirmed by arteriography. Therapy is not standardised as the natural history has not been definitely established. Megadolicho-carotid artery, hypoplasia and other dysplasias of the ICA are briefly described and illustrated.

Arterial Occlusive Diseases↗
PubMed1983

[Images of acute intracranial arterial occlusions obtained by CT scan].

In 1 case of occlusion of the basilar artery and 1 case of occlusion of the left middle cerebral artery a CT Scan performed within 24 hours of onset showed a high density area corresponding to the segmental arterial occlusion. In both cases on repeat CT Scans 5 and 9 days after the onset the high density area had disappeared.

Adult↗
PubMed1982

[Vascular attacks].

The present paper is aimed at presenting an overview of the studies on cerebrovascular diseases made by Charcot and his collaborators and later by the successive Professors in the Chair. The significance of studies from abroad is also briefly reviewed. Charcot's major interest in the field was cerebral haemorrhage and the evolution of the ideas about the aneurysms of Charcot-Bouchard is reviewed. During Charcot's Professorship, Henri Duret gave one of the first modern anatomical studies of the cerebral arteries. The study of lacunes was one among numerous important contributions of Pierre Marie to Neurology. Later the works of Charles Foix and his collaborators on cerebral infarction were prominent. Since the fifties, pathological, physiopathological and therapeutic studies have been one of the main flow of research in the Chair. Brief accounts of studies on hypertensive encephalopathy and vascular accidents of the spinal cord are given.

Brain↗
PubMed1982

[Giant aneurysm of both vertebral arteries. Drop-attacks (author's transl)].

A 79 year-old woman suffered from drop-attacks for 2 years. There were in addition disorders of swallowing. She then had a mild right hemiplegia. At age 81, she had a mild spastic quadriparesis with paresis of the right sterno-mastoid and trapezius muscles and of the right side of the tongue. She died from bronchopneumonia. At autopsy a giant aneurysm involving both vertebral arteries was present. This case exemplifies: 1) drop-attacks due to a lesion near the foramen magnum; 2) signs which may suggest an aneurysm of the posterior fossa; 3) an apparently very rare kind of aneurysm of the vertebral arteries.

Aged↗
PubMed1980

[Crossed plantar extension. A clinical and physiological study (author's transl)].

A 44 year-old man was examined for a slowly progressive left hemiplegia predominating on the lower limb. A left sign of Babinski was present. On the right side the plantar response was flexor. Stimulation of the right sole elicited a left extensor plantar response. CT Scan showed calcification sin the right paracentral lobule. The variations of the contralateral soleus H reflex when conditioned by a nociceptive stimulus applied on the right little toe were studied. No modification was seen. This contrasts with the facilitation observed in normal subjects and in patients with a lesion of the cerebral hemisphere not involving the paracentral lobule. It is suggested that this abnormality could contribute to the development of a crossed extensor plantar responses. Possible mechanisms of this phenomenon are briefly considered.

Adult↗
PubMed1978

Atherosclerotic lesions and mechanisms of cerebral ischaemia.

Main causes of cerebral infarction and focal transient cerebral attacks (TIAs) were evaluated. We distinguish between primary thrombosis, secondary thrombosis, and atherosclerotic embolism (platelet emboli-mixed emboli-atheromatous emboli). As to the haemodynamic significance of atherosclerotic lesions, the stenoses must be very tight, i.e., suppress 80--90% of the arterial lumen, for blood flow to be reduced. In clinical trials such a situation is not common and we rarely have found out that a stenosis has caused an infarct or focal TIA by reducing blood flow.

Cerebral Infarction↗
PubMed1977

[Treatment of parkinsonian syndromes by bromocriptin].

Nine patients suffering from Parkinson's disease and 2 cases of Parkinsonian syndrome were treated with bromocriptine, for 41 to 117 days, with a daily dose of 20 to 40 mg. The results were very good in 4 cases, satisfactory in 6 and nil in one case. Improvement concerned akinesias, rigidity and tremor, and was more marked in patients with more advanced signs. In 2 patients, amantadine was stopped. The dose of L-dopa was decreased by 2/3 without any change in clinical condition and L-dopa could be withdrawn in 5 cases out of 8. Bromocriptine appears to be an interesting development in the treatment of Parkinson's disease.

Aged↗
PubMed1977

[Pathogenesis of focal, transitory cerebral ischemic accidents].

Transient ischaemic focal cerebral attacks (TIA's) are due to: 1) atherosclerosis when embolism may take place or perhaps transient occlusion of the internal carotid artery or mural or transiently occlusive thrombus of an intracranial artery stenosis or transient systemic hypotension. In recent years embolism may have been overdiagnosed; 2) cardiac embolism due to dysrythmias, myocardial infarction, endocarditis, valvular prosthesis, etc.; 3) miscellaneous causes, often difficult to demonstrate such as tortuosity of the extracranial cerebral arteries, dissecting aneurysms, changes in cerebrovascular resistance; 4) not unfrequently no cause is found, especially in young patients.

Aortic Dissection↗