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Biomedical subjects

J L Mas

Publications and source records attributed to J L Mas.

At least 91 records · Page 5Linked to original sources

[Eclampsia in the late postpartum. Contribution of x-ray computed tomography and magnetic resonance imaging].

A 28-year-old woman developed late post-partum eclampsia. CT scan showed focal cortical hypodensities and diffuse and bilateral hypodensity of the hemispheric white matter. These lesions were hypointense on T1-weighted sequences and hyperintense on T2-weighted sequences. The CT and MRI abnormalities resolved completely within a few weeks. These changes are similar to those which occur with the more common prepartum eclampsia.

Adult↗

A comparative technetium 99m hexamethylpropylene amine oxime SPET study in different types of dementia.

Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPET) using technetium 99m hexamethylpropylene amine oxime (99mTc-HMPAO) as a tracer, in 13 control subjects and 44 age-matched patients suffering from dementia of the Alzheimer's type (DAT, n = 19), presumed Pick's disease (n = 5), idiopathic Parkinson's disease with dementia (DPD, n = 15) and progressive supranuclear palsy (PSP, n = 5). HMPAO uptake was measured in the superior frontal, inferior frontal, parietal, temporal and occipital cortices, and the perfusion values were expressed as cortical/cerebellar activity ratios. As compared with controls, tracer uptake ratios in the DAT group were significantly reduced over all cortical regions, with the largest defects in the parieto-temporal and superior frontal cortices. A marked hypoperfusion affecting the superior and inferior frontal cortices was found in Pick's disease, whereas a mild but significant hypoperfusion was observed only in the superior frontal cortex of patients with PSP. In the DPD group, HMPAO uptake was significantly reduced in the parietal, temporal and occipital cortices, but not in the frontal cortex. These results show that DAT and DPD share an opposite anteroposterior HMPAO uptake defect as compared with the Pick's and PSP groups.

Aged↗

Intravascular lymphomatosis (neoplastic angioendotheliosis) of the central nervous system: case report and literature review.

A 63-year-old woman developed gradual slowness, recurrent multifocal deficits, severe constitutional symptoms and hypopituitarism which progressed to death over 2.5 months. Elevation in lactico dehydrogenases was the main biological abnormality. Necropsy showed an intravascular malignant proliferation which proved to be a lymphoma of B-lineage. In order to better define diagnostic criteria, we reviewed previously reported cases of intravascular lymphomatosis of the central nervous system. A strategy for establishing the diagnosis is proposed.

Blood Vessels↗

Postradiation lower motor neuron syndrome presenting as monomelic amyotrophy.

Monomelic amyotrophy developed 16 months, nine and 12 years after irradiation of the lumbosacral spinal cord for seminoma in one patient and for Hodgkin's disease in two others. In two patients, involvement was clinically limited to one leg, with a subacute course followed by plateau in the first case and with progressive worsening in the second one. In the third patient, the course was progressive with involvement of the other lower limb occurring five years later. From clinical and electrophysiological data, it seems probable that the disease process was a result of a selective injury to the lower motor neuron in the lower spinal cord.

Adult↗

(99mTc)-HM-PAO SPECT and cognitive impairment in Parkinson's disease: a comparison with dementia of the Alzheimer type.

Regional cerebral perfusion was evaluated by single photon emission tomography (SPECT) using (99mTc)-HM-PAO as a tracer, in thirty Parkinsonian patients with (n = 15) or without (n = 15) dementia, nineteen patients with dementia of the Alzheimer type (DAT) and thirteen control subjects. HM-PAO uptake was measured in the frontal, parietal, temporal and occipital cortex and tracer perfusion was expressed as cortical/cerebellar activity ratios. Regional HM-PAO ratios in nondemented Parkinsonian patients did not differ from controls, whereas in demented patients with Parkinson's disease (DPD) a significant reduction was found in the parietal, temporal and occipital cortex. Tracer uptake ratios were significantly reduced in all regions in the DAT group. Thus DPD and DAT shared a common pattern of marked posterior hypoperfusion, although the perfusion defect was greater and more extensive in the DAT patients.

Aged↗

[Dissection of the extracranial internal carotid artery. 62 cases].

The results of a study of 62 patients with 69 dissections of the extracranial internal carotid artery are presented. Mean age at the time of diagnosis was 43 years, with a preponderance of men over women. The patients were followed up for a mean period of 41 months. In 6 cases regarded as being "traumatic" in origin, the outcome was similar to that of "spontaneous" dissection. The most significant associated factors seemed to be migraine (34 per cent), on-going treatment with oestrogens and progestogens (48 per cent of women) and fibromuscular dysplasia (21 per cent). The clinical features consisted of local signs (isolated in 8 cases), signs of ischaemia (isolated in 9 cases) or both together. There were 35 established cerebral vascular accidents and 2 cases of ischaemic optic neuritis with blindness, responsible for invalidating sequelae in 31 per cent of the patients. The most frequent local signs were suggestive hemicrania, cervical pain, Horner syndrome and tinnitus. The initial angiography showed occlusion in one quarter of the cases and stenosis in 70 per cent. Stenosis was usually located in the second infrapetrosal half of the artery and had the most favourable angiographic prognosis.

Adolescent↗

Magnetic resonance imaging in lateral sinus hypoplasia and thrombosis.

Lateral sinus thrombosis may be difficult to differentiate angiographically from lateral sinus hypoplasia, which mainly affects its proximal transverse portion. Using magnetic resonance imaging, we evaluated six patients who demonstrated poor filling or lack of filling of one or both lateral sinuses at angiography. In each patient, magnetic resonance imaging unambiguously demonstrated either lateral sinus thrombosis or lateral sinus hypoplasia. The latter was characterized by a frank asymmetry in size (surface of section) of the transverse portion of the lateral sinuses on parasagittal images without any abnormal signal in the course of the sinus. Lateral sinus thrombosis was indicated by increased intraluminal signal on all planes and with all pulse sequences. By virtue of its freedom from bone-related artifact, its multiplanar imaging capability, and its sensitivity to both blood flow and thrombus formation, magnetic resonance imaging is an excellent tool for the evaluation of lateral sinus thrombosis or hypoplasia.

Carotid Arteries↗

[Vasculitis of the central nervous system].

Vasculitis of the central nervous system (CNS) is a rare disease characterized inflammation and/or sclerosis of the vascular wall, usually due to an immunological mechanism. The positive diagnosis of CNS vasculitis is difficult owing to its protean clinical manifestations, to its variable course and to the nonspecificity of CT and MRI images. Angiography itself may be of no avail since the segmental narrowing images, although suggestive, are neither constant nor pathognomonic. The causes of CNS vasculitis are very numerous. The aetiological diagnosis is easy when the causal systemic disease is already known or when an inflammatory syndrome and other localizations are present, but it is difficult in those exceptional cases where the vasculitis is limited to the CNS. Biopsy of the cortex and leptomeninges may them be required. Treatment varies according to the cause; it rests essentially on corticosteroid therapy, sometimes combined with cyclophosphamide.

Brain↗

Migraine--a risk factor for dissection of cervical arteries.

A case control study technique was employed to test for an association between non-traumatic cervical artery dissection and several possible risk factors. A significant positive association was shown with migraine, independent of type and treatment regimen. No such relationship was found with smoking history, hypertension or past oral contraceptive use. There was, however a significant and independent association with current oral contraceptive use.

Adult↗

Risk factors in multiple sclerosis: a population-based case-control study in Hautes-Pyrénées, France.

A population-based study of the prevalence and risk factors of multiple sclerosis (MS) was conducted in the Hautes-Pyrénées, the southwestern region of France. The prevalence rate per 100,000 was equal to 40. Data on the past medical history of 63 MS patients and matched controls were collected. The frequency and age at occurrence of common childhood infections were similar for both the MS cases and controls. There was no difference between the frequency of vaccination for MS patients and for controls. However, the age at which MS patients were immunized against poliomyelitis was significantly higher than the corresponding age for controls (15.8 years versus 8.9 years, P less than 0.01). Antibody titers for various viruses were measured. The mumps antibody titer was significantly higher in the MS patients than in the controls. Also, MS patients tended to have higher titers for measles antibodies.

Adult↗

Dissecting aneurysm of the vertebral artery and cervical manipulation: a case report with autopsy.

A 35-year-old woman with 3 weeks of cervical pain developed ischemia in the basilar artery territory following cervical manipulation. At autopsy, there was a dissecting aneurysm within the third segment of the right vertebral artery. The pathologic changes in the lower and the upper part of the dissecting aneurysm were different, indicating recurring bleeding. Cervical manipulation could have accounted for one recent dissection, but not for another, which was a few weeks old. This suggests that cervical pain, which prompted the manipulation, may have been the first symptom of the dissection, and manipulation of the neck precipitated the stroke by inducing bleeding within the dissecting aneurysm.

Adult↗

[Prevalence of patent foramen ovale in young patients with ischemic cerebral complications].

We compared the prevalence of patent foramen ovale (PFO), detected by two-dimensional contrast echocardiography, in a group of 60 adults aged under 55 who had experienced a cerebral ischaemic accident and had normal standard examination of the heart, and in a control group of 100 patients. The prevalence of PFO was significantly higher in neurological patients (40 p. 100) than in controls (10 p. 100; p less than 0.001). Within the neurological group, the prevalence of PFO determined blindly, i.e. without any knowledge of the aetiological diagnosis, increased with the uncertainty of diagnosis: 21 p. 100 when a cause could be determined (n = 19), 40 p. 100 when a facilitating factor of cerebral accident, such as mitral valve prolapse, migraine or consumption of oral contraceptives, could be identified (n = 15), and 54 p. 100 when neither cause nor facilitating factor could be found (n = 26; p less than 0.10). In view of the very high prevalence of clinically silent venous thrombosis, these results suggest that paradoxical embolism through a PFO might be responsible for cerebral ischaemic accidents more frequently than is generally believed.

Adult↗

[Angina without involvement of large coronary trunks and precapillary pulmonary hypertension in a patient with periarteritis nodosa].

A patient affected with periarteritis nodosa and angina, presented a normal coronary angiography of the coronary trunks and an alteration of the left ventricular systolic function, improved by nicardipine, as well as a pre-capillary pulmonary hypertension with isolated, right cardiac repercussions, without pulmonary fibrosis nor thromboembolic disease. In addition, he presented three transient cerebral ischaemic accidents, with different localizations, which could not be related to a right aneurysm of the sylvian artery. Isolated precapillary pulmonary hypertension, without pulmonary fibrosis, which is not described in the course of periarteritis nodosa, seems related to an arteriolar involvement which is the known substratum of other visceral involvement in periarteritis nodosa. Improvement of the left ventricular function with nicardipine, administered acutely, suggest a partially reversible disorder of the coronary microcirculation.

Angina Pectoris↗

[X-ray computed tomography of lumbosacral roots and primary hypertrophic neuritis (Dejerine-Sottas disease)].

CT without contrast of lumbosacral nerve roots was performed in 13 patients with peroneal atrophy and 28 control subjects. Two series of 5 mm serial sections parallel to the plane of the disk were examined at the L4-L5 and L5-S1 levels, and the transverse diameter of the S1 nerve roots measured at the lower part of the lateral recess. Results showed frank bilateral, grossly symmetrical hypertrophy of lumbosacral roots in 8 of the 13 patients. This hypertrophy involved all roots examined (L4, L5, S1), except in one case where only S1 roots were involved. Hypertrophy was often more marked on the distal part of the roots and on spinal nerves, contrasting with the sometimes normal or only slightly altered appearance of the nerve roots emerging from the dural sac. In these 8 cases, the diameter of the S1 nerve roots was 8 to 18 mm, in contrast to a mean of 3.5 +/- 1 mm in the 28 controls. CT scan images were normal in the remaining 5 patients. The presence of a CT image of nerve hypertrophy was in all cases associated with a marked fall in nerve conduction rate (median nerve motor conduction rate less than 25 msec-1), and a decrease in number of myelinated fibers with numerous onion bulbs. In contrast, the absence of CT nerve hypertrophy could not predict the results of electrophysiological and histological examinations.

Adult↗