Search PubMed⌕ Search

Biomedical subjects

J Chiras

Publications and source records attributed to J Chiras.

At least 127 records · Page 7Linked to original sources
PubMed1987

Traumatic rupture of the thoracoabdominal aorta.

We report a case of traumatic rupture of the thoracoabdominal aorta that was successfully repaired 3 days following the accident. Associated lesions included rupture of the left renal and celiac arteries. This rare lesion should be suspected in the victims of violent hyperextension of the body with or without a fracture of the dorsolumbar spine. Aortography is diagnostic. Whenever possible preoperative angiographic visualisation of the spinal cord arterial supply should be performed.

Adult↗
PubMed1987

[Focal chronic ischemia and concomitant migraine: an atypical form of Sturge-Weber angiomatosis?].

A young man with a left hemifacial hemangioma had during a six months period about forty left hemispheric neurologic attacks suggestive of classic migraine. The neurologic examination was normal during the attack-free period. The CT scan (fig. 1) and the M.R.I. study (fig. 2) only showed a moderate interhemispheric asymmetry. The left internal carotid angiogram showed subtle anomalies of the venous system (fig. 3). All the neurologic manifestations ceased as soon as therapy by aspirin was initiated. A Positron Emission Tomography (PET) study with the oxygen 15 continuous inhalation technique was performed 7 months after the last attack in order to measure the regional Cerebral Blood Flow (rCBF), Oxygen Extraction Fraction (rOEF) and Oxygen Consumption (rCMRO2). Striking, statistically significant, alterations were observed in the left temporo-parieto-occipital area (fig. 4) consisting of a "misery perfusion" syndrome (rCBF = 28-38 ml/100 g/mn; rOEF = 0.64-0.80), without alteration in the rCMRO2 (Table). A repeated PET study 12 months later was unchanged. The association of local chronic oligemia and ipsilateral facial hemangioma, ipsilateral cerebral hypotrophy and venous anomalies suggested the diagnosis of atypical leptomeningeal angiomatosis of the Sturge-Weber type. The importance and persistence of the hemodynamic alterations suggest that chronic oligemia and, hence, tissue hypoxia may participate in the pathogenesis of the migraine-like attacks. Moreover, local circulatory stasis with thrombotic events may be implicated, as suggested by the apparent efficacy of aspirin.

Adolescent↗
PubMed1986

[Intracranial artery stenoses 44 years after craniofacial radiotherapy].

A 58 year-old patient experienced several ischemic strokes in the carotid arteries territories. History revealed a nasal epithelioma, for which he had received, at age 14, an irradiation through an anterior field (5500 rads), and two lateral fields (4550 rads each). He had a nasofacial atrophy as apparent sequellae. Angiograms showed stenoses of the cavernous portion of both internal carotid arteries and of the proximal portion of the left anterior cerebral artery. The ophthalmic arteries were narrowed and irregular. Despite the very long delay and the patient's age (that of common atherosclerosis) and the lack of specificity of the lesions, the relationship between the arterial lesions and radiotherapy was accepted: the site of the arterial lesions corresponded to that of irradiation; other carotid segments, and particularly the bifurcations of the common carotid arteries, appeared normal on angiograms. The X-rays dose delivered in the region of the Willis arterial circle had been very high. A review of the rare reported cases of intra-cranial post-irradiation arteriopathy is presented.

Brain Ischemia↗
PubMed1985

Spontaneous dissecting aneurysm of the extracranial vertebral artery (20 cases).

Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such as hypertension or fibromuscular dysplasia: on clinical findings they insist upon the diagnostic value of preliminary symptoms, cervical pain or posterior headaches; the most frequent angiographic appearance was a long and irregular stenosis of one or two segments of the vertebral artery. The prognosis of these aneurysms most often appears favourable in this group.

Adult↗
PubMed1985

CT in hemispheric ischaemic attacks.

The authors report the three principal characteristics of hemispheric ischaemic attacks on CT scan and their development over time: hypodensity, mass effect and contrast enhancement. Their pathophysiological mechanism and prognostic importance are discussed. The topography of the territories of the large arteries vascularising the brain and their main branches is described on the basis of twelve sections cut parallel to the cantho-meatal line. Finally, selected special aspects are described (misleading aspects, haemorrhagic infarcts, border zone infarcts).

Brain↗
PubMed1985

Cerebral angiography in ischemic strokes.

Angiography remains a very important means of evaluation of ischemic strokes: it confirms the diagnosis showing the occluded artery. It eventually shows the anastomotic pathways for cerebral circulation and it often finds the causes of stroke, among which the most frequent are atherosclerosis (70%) and fibromuscular hyperplasia (10%). The safer way to perform angiography is the retrograde route. Indications for angiography must be discussed according to the type of stroke, its onset, and the arterial territory involved.

Arteritis↗
PubMed1985

Ischemic strokes and migraine.

The coincidence of migraine and ischemic strokes is rare but unequivocal. Some of the cases described are recalled and the possible mechanisms discussed.

Brain↗
PubMed1985

Venous infarctions.

Strokes of venous origin are relatively infrequent. They usually cause venous infarcts which can be observed in 2 main circumstances: cerebral thrombophlebitis or dural arteriovenous (AV) fistulae draining into cerebral veins. The authors study the CT and angiographic aspects of these venous infarcts and their evolution. Conventional angiography remains indispensable to confirm the diagnosis.

Arteriovenous Fistula↗