Search PubMed⌕ Search

Biomedical subjects

J Goffin

Publications and source records attributed to J Goffin.

At least 55 records · Page 3Linked to original sources
PubMed1994

Microdiscectomy for lumbar disc herniation.

Microscopical lumbar discectomy is nowadays a very common neurosurgical procedure. The technique has been introduced more than 15 years ago. For the present study a series of 100 consecutive patients, operated upon by one surgeon and with a follow-up period of at least 1 year, was reviewed. The importance of a clean surgical indication is stressed. At the latest follow-up examination 3 patients still complained of moderately intense sciatica and 1 of backache of an invalidating degree. Four patients needed a second operation for a recurrent herniation at the same or another level. Eventually, 96 patients were able to resume their previous, if available, professional activities.

Adult↗
PubMed1994

Simultaneous occurrence of developmental venous anomalies and cavernous angiomas.

PURPOSE: To study the clinical and radiologic findings in 15 patients presenting with both developmental venous anomalies and cavernous angiomas and to determine which lesions caused the acute clinical symptoms. METHODS: Lesions were infratentorial in 7 patients and supratentorial in 7 other patients. In one patient the developmental venous anomaly was infratentorial and the cavernous angioma supratentorial. In all 15 patients clinical examination and CT were performed. In 10 patients MR was performed at the time of the initial CT scan. In 5 patients only late MR is available. RESULTS: Acute clinical signs were present in 9 patients (epilepsy, hemiplegia, meningeal signs, cranial nerve deficit). On CT the cavernous angioma was missed in 9 patients, in 6 patients because of acute hemorrhage. On MR the cavernous angioma was missed in 1 of 2 cases with acute hemorrhage but seen in all other patients. On repeat MR all cavernous angiomas were correctly identified. On CT, 11 developmental venous anomalies were seen. On MR all developmental venous anomalies were seen. CONCLUSIONS: The frequent association of developmental venous anomalies and cavernous angiomas is confirmed. MR is superior to CT in the detection of both cavernous angiomas and developmental venous anomalies. Furthermore our data support the hypothesis that cavernous angiomas and not the developmental venous anomalies cause the acute clinical symptoms because of hemorrhage.

Adult↗
PubMed1993

Posterior fossa dermoid cyst associated with dermal fistula: report of 2 cases and review of the literature.

Two cases of dermoid cysts of the posterior fossa in association with a dermal fistula and with different clinical presentations are reported. The patient in case 1 is a 14-month-old girl with a history of recurrent bacterial meningitis. Case 2, a 7-year-old girl, presented with a skin "granuloma" at the inion. Both cases, and a review of the literature, demonstrate the need for a thorough exploration of the cranial and spinal midline skin areas in every newborn and argue for widespread use of nuclear magnetic resonance imaging whenever a suspected midline lesion is found.

Brain Neoplasms↗
PubMed1993

Controversies in the management of spontaneous cerebellar haemorrhage. A consecutive series of 49 cases and review of the literature.

We have reviewed our experience with a series of 49 consecutive patients with spontaneous cerebellar haematoma, treated according to a standardized management protocol. Seventeen patients were managed conservatively, 30 underwent ventricular drainage, and in six patients the haematoma was evacuated. The indications for the different modes of treatment are discussed. The most significant prognostic factors determining the outcome at one month were the grade of quadrigeminal cistern obliteration on the initial CT scan and the Glasgow Coma Scale on admission. Patients with normal cisterns had a good outcome, and only needed (temporary) ventricular drainage in case of hydrocephalus. Patients with totally obliterated cisterns had a bad outcome irrespective of treatment. In the patients with compressed cisterns, it is suggested that evacuation of the haematoma might improve outcome; treatment of hydrocephalus alone is insufficient in many cases in this group.

Adolescent↗
PubMed1993

Nonaneurysmal subarachnoid hemorrhage: prevalence of perimesencephalic hemorrhage in a consecutive series.

The perimesencephalic type of nonaneurysmal subarachnoid hemorrhage (SAH) is a recently described clinical and radiological entity, with a good outcome. We carried out a retrospective analysis of 294 patients with subarachnoid hemorrhage, of whom 62 had a negative four-vessel angiography. We identified 20 cases with the typical computed tomographic (CT) pattern of perimesencephalic hemorrhage, in whom the prognosis was invariably good. However, five cases of aneurysmal subarachnoid hemorrhage had a more or less similar CT appearance: the diagnosis cannot be made on the CT image only and angiography remains mandatory. The use of bed rest, antifibrinolytics, and calcium antagonists is discussed.

Female↗
PubMed1993

Cerebellar hemorrhage complicating supratentorial craniotomy: report of two cases.

One of the rare complications of supratentorial craniotomy is the occurrence of a hematoma in the cerebellum. Only seven previous cases have been published, and these have been ascribed to disturbed blood coagulation or decreased intracranial pressure. We present two similar patients, in whom, however, the pathogenetic role of these factors seems improbable.

Cerebellar Diseases↗
PubMed1993

Catecholamine response to a gradual increase of intracranial pressure.

To determine the catecholamine response to progressive intracranial hypertension, intracranial pressure (ICP) was raised gradually by continuous expansion of an epidural balloon in seven dogs. Hemodynamic parameters, ICP, and cerebral perfusion pressure (CPP) were monitored continuously and serum catecholamine levels began to rise when CPP was in the low-positive range (20 to 30 mm Hg), reaching a peak just after brain death (CPP < or = o mm Hg). There was no correlation between ICP and the catecholamine peak. Compared to control values, the mean increase was 286-fold for epinephrine and 78-fold for norepinephrine. Temporally, the catecholamine peak corresponded well with the observed hemodynamic changes. These results suggest that ischemia in certain parts of the brain stem is responsible for the hemodynamic changes observed in intracranial hypertension (such as the Cushing response), and they show that catecholamines play an important role in these hemodynamic changes.

Animals↗
PubMed1993

Embolization of arteriovenous malformations of the brain: preliminary experience.

Transcatheter embolization was performed in 8 young patients (mean age 24.5 years) with intracerebral arteriovenous malformations. In total 12 arteries were embolized in 10 sessions. Clinical complaints of the patients included epilepsy in 4, sudden coma in 3 and severe sudden neurological deficit in 1. Intracerebral hemorrhage was documented in 4 patients and subarachnoid hemorrhage in 1. In all patients, prior to embolization a superselective Wada-test was performed under wake-up anesthesia. Embolization was performed with a mixture of acrylic glue and lipiodol. In one patient a detachable balloon was added. In 6 patients embolization of all the feeding arteries was possible, with total obliteration of the arteriovenous malformations in 4 and subtotal embolization (> 90%) in 2. In 2 patients reduction of the size of the arteriovenous malformation by one third was followed by total surgical removal of the lesion. In 1 patient reflux of the embolization material in the anterior choroidal artery caused severe neurological deficit with good clinical recuperation.

Adolescent↗
PubMed1992

Posterior fossa venous anomaly and ipsilateral acoustic neuroma: two cases.

The association of an acoustic neuroma with an ipsilateral venous anomaly or angioma is reported in two patients. In the first, the venous angioma was situated low in the posterior fossa, and was of no significance surgically. In the second, the angioma was strongly attached to the capsule of the tumour. On MRI and angiography the lesion appeared as a large draining vein, encircling the tumour. At operation, extensive dissection of the angioma from the neuroma appeared necessary to prevent venous infarction of the brain stem.

Adult↗
PubMed1992

Isodense subdural haematomas on CT:MRI findings.

MRI findings are described in two patients with subdural haematomas isodense on CT. In one patient, admitted 6 weeks after trauma, a chronic subdural haematoma showed extreme hypointensity on T2-weighted images, suggesting acute trauma, and therefore acute rebleeding. In the second patient with severe anaemia, an acute subdural haematoma was hyperintense on T2-weighted images, suggesting chronic trauma; this may be explained by the low haematocrit and a possible mixture of blood with cerebrospinal fluid. The MRI features of subdural haematomas and hygromas have to be kept in mind, in order not to misjudge the age of the haematoma.

Female↗
PubMed1992

Intraspinal juxta-facet cysts: a case of bilateral ganglion cysts.

Juxta-facet cysts are relatively uncommon intraspinal lesions, causing radiculopathy, neurogenic claudication or myelopathy. To the best of our knowledge, only 4 cases of bilateral synovial or ganglioncysts were described. We report the 5th case of bilateral ganglioncysts of the lumbar spine. Generally, juxta-facet cysts should be differentiated from other intraspinal lesions, such as herniated discs, meningiomas and neurinomas. Correct preoperative diagnosis is necessary for adequate treatment, namely the (microscopic) resection of the cyst. After adequate treatment, complete recovery may be expected.

Aged↗
PubMed1992

Subcortical aphasia from a thalamic abscess.

A patient is reported who was treated successfully for a left thalamic abscess that resulted in subcortical aphasia. A SPECT scan showed large areas of hypoperfusion in the cortex of the left hemisphere. At follow up after seven months there was marked improvement in the language disorder and the cortical hypoperfusion. It is suggested that aphasia in patients with subcortical lesions results from secondary cortical dysfunctions. The evidence is confined to patients with stroke lesions. The possible implications of this case on current theories of pathophysiological mechanisms, in particular the ischaemic penumbra theory and the cortical diaschisis theory, are briefly discussed. Cortical diaschisis may be the appropriate explanation in this patient.

Adult↗
PubMed1992

The radiological differentiation of acoustic neurinoma and meningioma occurring together in the cerebellopontine angle.

A patient with right hearing loss, in whom computed tomographic scanning demonstrated a mass in the right cerebellopontine angle with widening of and extension into the internal auditory canal, but with important posterior extension and broad implantation on the surface of the petrous bone, is reported. On both T2-weighted and gadolinium-enhanced T1-weighted magnetic resonance images, there were clearly two separate tumoral lesions: an acoustic neurinoma extending into the internal auditory canal and a meningioma with broad implantation on the petrous apex. These findings were confirmed at surgery.

Cerebellar Neoplasms↗
PubMed1992

MR features of intracranial hemangioblastomas.

The contribution of MR in 10 patients with surgically proven intracranial hemangioblastomas was retrospectively evaluated and correlated with the computed tomographic findings. Angiography was obtained in eight cases. Multiple lesions were shown in only two patients, but none proved to have von Hippel-Lindau disease. In six patients the tumor typically appeared as a cystic lesion with an intensely enhancing mural nodule at the pial surface of the cyst; three patients presented with a solid lesion with a central cyst and one with a solid lesion only. Thirteen tumors were located in the posterior fossa, with one in the brain stem extending towards the spinal cord. A supratentorial localization was found in two patients. Abnormal serpiginous vessels supplying or draining the mural nodule or solid lesion were not visualized on contrast-enhanced computed tomography, but were easily identified as flow voids on MR in five patients. Calcification or hemorrhage were not seen in the entire series. Because of the multiplanar imaging capability and the lack of streak artifacts from the petrous bone, MR provides better localization than CT. MR is more accurate in predicting the number, extension and vascularity of hemangioblastomas, and provides a sound basis for further diagnostic and therapeutic procedures.

Adult↗
PubMed1992

Synovial cyst at the C1-C2 junction.

Intraspinal synovial or ganglion cysts of the cervical spine are rare. We present the third reported case of a degenerative articular cyst of the upper cervical spine, involving the quadrate ligament of the odontoid process. Magnetic resonance examination reveals typical images. A new, more general terminology is proposed.

Aged↗
PubMed1992

Osteoarthritis of the facet joints and its role in low-back pain: evaluation with conventional tomography.

Thirty-seven patients with chronic low-back pain and an atypical irradiation to one or both legs were examined by conventional tomography of the facet joints. A disc herniation was excluded by computed tomography (CT) in 31 patients. The facet joints were considered normal in 4 patients. Four grades of facet joint disease were used to classify the pathological changes. Correlation of the radiological findings with the facet joint block by injection of a local anesthetic was obtained in 12 patients. It appears that conventional tomography is a very sensitive technique as it is possible to detect even discrete abnormalities of the facet joints. However, as it is time consuming and high in radiation dose, the examinations should be reserved for patients with a normal CT examination of the lumbar spine in whom there still remains a high suspicion of facet joint disease.

Adult↗
PubMed1991

Craniofacial resection for anterior skull base tumours.

This study presents a series of 10 patients with anterior skull base tumours, treated by a team of neurosurgeons and head- and neck surgeons. The series included 7 malignant tumours of the nose and paranasal sinuses and 1 retinoblastoma, all with intracranial extension through the lamina cribrosa. There were also 2 patients with an anterior base meningioma, growing into the ethmoid sinus and the nasal cavity. 8 tumours were resected by a combined bifrontal craniotomy and uni- or bilateral rhinotomy. In 2 cases a bifrontal craniotomy alone without facial incision sufficed. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of wound infection, CSF-leakage or meningitis. Recurrent tumour growth or systemic metastasis occurred in 5 out of 7 patients with malignant tumours, 6 months to 2 years postoperatively. The related literature and especially questions of operative indications and technique, including different possibilities of closure and reconstruction of the skull base, are discussed.

Adenocarcinoma↗