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J L Sautreaux

Publications and source records attributed to J L Sautreaux.

At least 19 recordsLinked to original sources
PubMed2000

Intracerebral hemorrhage survival: French register data.

Cerebral hemorrhages are subject to a heavy short- and long-term case fatality. A study of prognostic factors and of relative survival based on the data of a population registry is of great value to study patients having a hematoma of all ages, irrespective of the method of care. We have listed 183 patients having a cerebral hemorrhage between 1 January 1985 and 31 December 1996 and living in the city of Dijon, France. Eighteen clinical and CT-scanning variables have been studied. We have found four predictive factors of death at one month from cerebral hemorrhages. These are, in decreasing order: the existence of consciousness disorders at the initial clinical examination (OR = 5.80, p < 0.0001); an intraventricular hemorrhage (OR = 5.60, p < 0.0001); a hematoma volume over 11 cubic centimeters (OR = 3.53, p = 0.027); lastly, in male patients an age over 70 years (OR = 4.90, p = 0.039). With regard to long-term survival, the existence of consciousness disorders remains the principal predictive factor of case fatality in both crude and relative survival (OR = 5.52, p < 0.0001, in crude survival versus OR = 22.2 in relative survival, p < 0.0001), followed by age over 70 years (OR = 3.71, p < 0.0001 in crude survival and OR = 2.41 in relative survival, p = 0.086). The existence of consciousness disorders at the initial examination following a cerebral hemorrhage would seem to be the principal worst prognostic factor of short- and long-term survival and of relative survival, age and sex having less importance. Moreover, intraventricular hemorrhage and hematoma volume are short-term, pejorative factors. These data, based on a population-based registry, are an important consideration in the acute management of hemorrhagic therapy, and for the design of further therapeutic trials on this severe pathology.

Adolescent↗
PubMed1999

Survival rates of malignant gliomas in Burgundy from 1990 to 1995.

The aim of this study was to provide current data on case-fatality rates of malignant gliomas in the area of Burgundy (1,300,000 inhabitants). The ascertainment was specific according to imaging and histologic criteria, and was exhaustive because of the existence of a single University Hospital allowing both imaging and histologic diagnosis from stereotaxic cerebral biopsy. During six full years we collected 161 cases of malignant gliomas grades II to IV, 93 men (57.76%) and 68 women (42.23%). The mean age was 61 years. In all the age groups, there were a male predominance. Headache, epilepsy and motor deficit were the most frequent symptoms at onset. In most cases, the gliomas were localized within the frontal area. The post-surgical Karnofsky score was up to 70 in 40% of the cases. There were 89 glioblastomas with grade IV, 37 anaplastic astrocytomas, 13 gliomatous tumors with grade II and IV and six anaplastic oligodendrogliomas. This grading explains the very low survival rates, with a negative effect induced by age. Among the most relevant contributions of this study to the clinical features of malignant gliomas is an analysis of case-fatality rates, evaluation of health care services and therapeutic trials.

Adolescent↗
PubMed1995

[Lumbar canal stenosis. Retrospective study of 158 operated cases].

The authors report the results of a retrospective study of 158 lumbar spinal stenosis (LSS), all operated (111 degenerative, 26 congenital, 21 mixed). Eighty seven percent of the patients had a low-back pain and 81.6% a radicular pain. Only 57.6% of them had a polyradicular claudication. A neurological deficit (motor, sensitive, or involving sphincters) was present in 36.6% of cases. A myelographic block was noted in 23.4% of cases, and in 20.3% a spondylolisthesis with an intact neural arch was found. Surgery consisted of a posterior lateral spinal canal calibration, sometimes associated with a ventral canal calibration (via the posterior route) (6.3%), and/or excision of a disc herniation at one (47.5%) or two levels (3.8%). Mean follow-up after surgery was 7.8 months. The global result was good or excellent in 75.2% of cases. Radicular pain was relieved in 89.1% of cases, and polyradicular claudication in 90.1% of cases. Neurological deficit improved in 50.6% of cases. In only 59.8% of cases relief of low-back pain was achieved. Statistically low-back pain (lasting for over 2 years) improved less, but a preoperative spondylolisthesis didn't influence the quality of the result regarding this symptom. Semiology, pathophysiology, and surgery particularly regarding spine stability are discussed.

Adult↗
PubMed1992

MRI assessment of anterior callosotomy in the treatment of pharmacoresistant epilepsy.

Section of the anterior two-thirds of the corpus callosum is a well-known treatment of some forms of epilepsy of long duration resistant to anti-epileptic drugs and dangerous for the patient (tonic and atonic seizures). The aim of this functional surgery is to obtain the most complete rostral and caudal section of the corpus callosum without risk of disconnection syndrome. Callosotomy is seldom performed in Europe. We present our experience of magnetic resonance imaging (MRI) in the pre- and postoperative assessment of 6 patients who underwent anterior callosotomy and were followed up for more than six months. Our results were encouraging with considerable improvement of the patients' social life.

Adolescent↗
PubMed1991

[Dumbbell-shaped nerve-tissue tumors of the posterior mediastinum. Apropos of 5 cases].

The authors present 5 cases of dumbbell neurogenic tumors with intraspinal extension. There were 4 neurilemmomas in four adults and 1 ganglioneuroma in one child. These tumors were benign. Neurological signs were observed in two cases. Widening of the intervertebral foramen at the level of the tumor is a very suggestive sign of dumbbell tumor confirmed by CT-Scan or MRI. Precise morphologic features must be assessed before embarking on the operation. The procedures used were: thoracotomy only in two cases, laminectomy then thoracotomy because of neurological signs in two cases, thoracotomy then laminectomy to fully remove tumor remnants in one case. No major morbidity was noted. The neurological symptoms resolved in two cases. A combined two-team approach with thoracic and neurosurgeons working together has not been used so far, but this possibility is probably the best choice for the future.

Adult↗
PubMed1991

[Spontaneous intracerebral hemorrhages in young patients. Study of 33 cases].

We report 33 cases of intracerebral hemorrhage (ICH) in patients aged from to 9/44 years (male: 20, female: 13, mean age: 32.5 years). ICH was due to vascular malformations in 39 p. 100 of cases, to arterial hypertension in 30% and to various causes in 18% no cause could be found in 13% of the cases. ICH was lobar in 64%, deep in 33% and infratentorial in 3% of the cases. The diagnosis was assessed by arteriography in 9 patients. The vascular malformations were arterial angiomas, saccular aneurysms and cavernous angiomas. Death rate was 24%. There was a fast ICH handicap in 40% of cases. Only 36% of the patients were not disabled.

Cerebral Hemorrhage↗
PubMed1991

[Dumbbell neurogenic tumors of the posterior mediastinum. Apropos of five cases].

The authors present 5 cases of dumbbell neurogenic tumors with intraspinal extension. There were 4 neurilemmomas in four adults and 1 ganglioneuroma in one child. These tumors were benign. Neurological signs were observed in two cases. Widening of the intervertebral foramen at the level of the tumor is a very suggestive sign of dumbbell tumor confirmed by CT-Scan or MRI. Precise morphologic features must be assessed before embarking on the operation. The procedures used were: thoracotomy only in two cases, laminectomy then thoracotomy because of neurological signs in two cases, thoracotomy then laminectomy to fully remove tumor remnants in one case. No major morbidity was noted. The neurological symptoms resolved in two cases. A combined two-team approach with thoracic and neurosurgeons working together has not been used so far, but this possibility is probably the best choice for the future.

Adult↗
PubMed1991

[Aneurysm rupture and cocaine addiction].

We describe a new case in which cocaine use was related to stroke and review the literature. Cocaine is increasingly used by drug addicts. The neurological complications are unpredictable. They include generalized or partial epileptic seizures, ischaemic or haemorrhagic cerebral vascular accident. In this case, stroke after intravenous drug injection is associated with rupture of an intra-cranial aneurysm. We put the accent on the difficulties to diagnose the cerebral stroke in cocaine abusers.

Adult↗
PubMed1990

[Epidural hematoma of the posterior cranial fossa].

The use of CT scans has entirely modified the prognosis of epidural hematomas of the posterior cranial fossa. The analysis of a personal series of 20 cases diagnosed and treated over a 10 year period, that is 6.5% of E.D.H. cases seen in this hospital, has enabled us: to propose an anatomical study regrouping the different topographic forms observed in the literature as well as in the present series. to check the deceptive radiological appearance of these hematomas. The main sign remains the existence of a cranial fracture at the level of the occipital bone. Repeated CT scans should attempt to localize this lesion. In 15% of our cases, the lesion was only detected on the second CT scan. to recommend a simple and rapid surgical procedure in the ventral decubitus position, which does not involve the foramen magnum approach. This is performed away from the occipital junction of the venous sinus. to underline the progressive decrease in the mortality rate (10%) and the good subsequent prognosis of these apparently serious forms which have left no sequelae.

Adolescent↗
PubMed1989

[Dumbbell neurogenic tumors. 5 cases (4 thoracic, 1 lumbar)].

Benign in more than 90% cases, dumbbell neurogenic tumors are rare. It was 3 thoracic schwannome and 1 thoracic ganglioneuroma and 1 lumbar schwannoma are reported. In 2 cases complete removal was performed by thoracotomy, in another case thoracic removal was incomplete with leateag of spinal fluid, laminectomy was necessary 3 months later and in a third case laminectomy was performed first because of paraplagia and thoracotomy one month later. In lumbar case a two ways procedure in 3 weetes space permitted complete removal, a monoparesia and sphincters troubles, regressive spontaneously in 5 months, complicated first performed laminectomy. Schwannome and benign neurofibroma are the most frequent tumors. Latero vertebral situation in chest radio or in abdominal ultrasonography must induce neurogenic tumors diagnosis. Myelography or tomodensitometry confirms intraspinal extension when osseous signs are present on vertebral radiographies. In thoracic localization a one stage combined resection gives the lowest morbidity. In lumbo-sacral localization tumoral large size requires a combined approach, which can be performed in a single stage. Recklinghausen's association in neurofibroma (4 to 16%) exposes to malign evolution risk (12 to 13%).

Adult↗
PubMed1989

[Multiple and recurrent extradural hematomas].

Among 130 patients with post traumatic extradural haematomas treated during the 1979-1984 period, there were 11 patients with multiple extradural haematomas, generally visualized at the first C.T. examination and 5 patients with recurring haematomas. The patients who have just been operated upon must be clinically watched and a new C.T. examination must be made if a deterioration of the patient's condition appeared or if the post operative condition is not that expected after the first C.T.

Hematoma, Epidural, Cranial↗
PubMed1988

Diencephalic epilepsy with congenital suprasellar arachnoid cyst in an infant.

The authors report the case of a 2-year-old infant who presented with paroxysm and short changes characterized by acute drowsiness, cold sweats, ocular reversion, facial cyanosis, and bradycardia. Between these attacks, the condition was normal, suggesting diencephalic seizures. Over 2 months five fits were observed by the parents when some to-and-fro bobbing of the head onto the trunk appeared during drowsiness. One electroencephalogram was normal without a slow background or spikes discharges. As the skull radiographs showed erosion of the jugum and chronic intracranial hypertension features, a CT scan was performed and showed hydrocephalus associated with a congenital suprasellar cyst. The cyst was opened into basal cisterns with cystoperitoneal shunt. The histological examination revealed that it was an arachnoid cyst. Six months later, the infant was free of diencephalic seizures and head bobbing. Thus, we can assert that there was a direct relationship between this cyst and the diencephalic seizures. From this case, the authors make a review of the clinical features of diencephalic epilepsy, and their different causes and show that both diencephalic epilepsy and suprasellar arachnoid cysts are not common.

Child, Preschool↗
PubMed1988

[Intracranial arterial aneurysm in children. A cooperative study. Apropos of 43 cases].

This joint study describes 43 cases of intracranial arterial aneurysms in children diagnosed on the basis of clinical symptoms. In the pediatric age group, this malformation is notable because of the marked sex predilection in males (70%) and an unequal topographic incidence in the circle of Willis, where carotid artery (39.3%) and anterior communicating artery lesions (30%) predominate. The most frequent clinical sign was subarachnoid hemorrhage (81%), although symptoms caused by compression revealed the abnormality in 2.3% of patients. In this series, 11% of the patients suffered a head injury at the time of the hemorrhagic accident; this finding has been reported previously in the literature. Today, treatment is always surgical, consisting in removal of the aneurysmal sac. Surgical results are encouraging; all grade lesions considered together, 63.4% of the children were cured without any sequelae, 19.5% lost one school year but were able to lead a normal life, and 4.8% remained severely handicapped; overall postoperative mortality was 12.3%. Cerebral plasticity and tolerance of spasm in children are fundamental features of this aneurysmal pathology which partially explain the favorable results obtained with surgery.

Adolescent↗
PubMed1987

[Complications observed in the surgery of aneurysms of the circle of Willis in a perspective of early operation].

This report concern a series of 100 consecutive patients operated by direct attack for intracranial ruptured aneurysms (mortality: 14%, complete removal: 70%). 35% of this patients have been early operated before the 96e hour. In this series, only one case of spasm was observed. But we have observed other neurosurgical complications, analysed and compared to the postoperative course of the patients who had delayed operations.

Circle of Willis↗