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J Lecuire

Publications and source records attributed to J Lecuire.

At least 19 recordsLinked to original sources
PubMed1978

[Extra-intracranial artérial by-pass. A clinical experience based upon 40 cases (author's transl)].

UNLABELLED: Extra-intracranial by-pass between a branch of the external carotid artery and a branch of middle cerebral artery has been used since 1972 in the treatment of cerebral ischemia. MATERIAL AND METHODS: 40 patients have been operated on (34 men and 6 women) aged from 28 to 68. Clinical data were TIA's or PRIND in 11 patients and stroke in 29 patients. The left hemisphere was involved in 25 cases and the right one in 15 cases. No patient was operated on in emergency; operation was performed after 2 or 3 weeks in most cases. The branch of external carotid artery was the superficial temporal artery in 36 patients and the occipital artery in 4 patients. As for the cerebral artery, were used the anterior temporal artery (9), the middle temporal artery (2), the posterior temporal artery (15), the angular artery (6), a frontal artery (15) and a parietal artery (1). In 8 patients, two anastomosis were performed using both branches of STA. Patency of the by-pass was confirmed in most cases by means of angiography, performed early after operation, and if possible one year later.

Adult↗
PubMed1976

[Subdural hematoma and anticoagulant therapy].

The authors report a series of 22 cases of subdural hematomas in patients submitted to anticoagulant therapy. A review of the literature finds 150 cases. Subdural hematomas occurs in about one third of the patients presenting hemorrhage of central nervous system related to anticoagulant therapy. Among subdural hematomas of any cause, the possible role of a previous anticoagulant therapy is stressed in 4,8 to 14% of cases. In most cases, long term anticoagulants were indicated for arterial or heart (ischemic) lesions (16/22 cases). In 6 cases, anticoagulants were indicated for prevention or treatment of pulmonary embolies. In 18 cases, anticoagulant drug is from the group of dicoumarol or phenylindanedione. In 3 cases, the only anticoagulant given to patient was heparin. Pathogenic study suggests that hypocoagulability might not always be the only factor of bleeding: high blood pressure, other drugs and head trauma (10 cases) are often associated. Clinical features, in our series, are similar to those encountered in cases of subdural hematoma of any cause. According to the existence of a cranial injury and to the chronology of anticoagulant therapy, the authors divide their 22 patients into 3 groups. The use of protamin sulfate or human plasma fraction PPSB provides in few minutes a normal coagulability. Neurosurgical treatment in all our cases evacuated in 11 patients a chronic subdural hematoma, in 2 cases an acute, and in 9 cases a subacute hematoma. Results were fair in 19 patients with no sequelae. 3 patients died during the immediate post-operative period. The authors conclude by stressing several preventive measures.

Anticoagulants↗
PubMed1976

[Intraspinal meningiomas. A series of 60 cases].

The authors present and compare two consecutive series of spinal meningioma, a total of 60 cases. From the aetiological point of view, the meningioma were more frequent than neurinoma. This study confirms its predominance in the female after the fifth decade. A traumatic factor was sometimes implicated. Anatomically, its localisation predominated in the dorsal region (78.3 p. cent), specially in the first three vertebral segments, and most commonly laterally placed. The strictly epidural meningioma, the multiplicity and the association with a neurinoma were less frequent. On the clinical level, the comparison between the two series illustrated a considerable diminution of the pre-operative evolution of the disease, taking into consideration the existence of spinal deficit less apparent in patients operated after 1963. 54.5 p. cent presented at diagnosis, a total or partial impotence against 81.5 p. cent in the old series. Among the laboratory examinations, the C.D.F. study confirmed slight or even absent cyto-albuminous dissociation, which contrasted markedly with the figures obtained in cases of neurinoma. Plain spinal radiography was usually negative. The radio-opaque myelography revealed a block, sometimes a partial one, very suggestive when bossulated, but which might sometimes mimic a neurinoma or even an epidural lesion. The presence of an arachnoid cyst may give a false level. Surgery was always indicated, regardless of the patients' age. The tumour should be completly removed in a piece-meal fashion with the preservation of the radiculo-medullary elements, which was facilitated by the use of the microscope. To prevent a recurrence, the base of the tumour should be well coagulated or resected followed by a plastic reconstruction of the dura mater. The mortality rate including the late mortality has diminished from 24 p. cent to 11 p. cent. This is essentially due to decubitus in patients who did not improve. The percentage of complete functional recovery rose from 40 p. cent to 66 p. cent of those who survived. The percentage of recovery with sequellae compatible with an autonomous physical activity was stable. The percentage of completly handicaped survivals fell from 28 p. cent to 5 p. cent. The authors conclude that the prognosis for patients with intraspinal menigioma has improved, however the diagnosis is still difficult in the old subject, and there is a serious risk to life when the lesion is in the cervical region.

Adult↗