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Biomedical subjects

J M Fuentes

Publications and source records attributed to J M Fuentes.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Iatrogenic carotid-cavernous fistulas, complications of carotid thrombectomy].

The authors report four cases of carotid cavernous fistula at the C5 segment of the internal carotid artery following embolectomy by a 3F Fogarty Catheter. All patients were operated on a carotid bifurcation stenosis (pre-occlusive) and a thrombectomy with a 3F Fogarty Catheter was carried out in the same time in 3 patients and during re-operation in 1 patient who had post operative thrombosis. The carotid-cavernous fistula occurred the day after surgery in 2 cases, 1 week after in 1 case, and 2 months later in 1 case. Spontaneous recovery occurred in two patients (1 occlusion--1 re-stenosis), 1 patient died from controlateral carotid occlusion, and 1 patient was lost for investigation. There were no relationship between the number of "repeated passages" of the Fogarty Catheter and the interval time where the fistula occurred. However the location of fistula was constant. Overtension on the internal wall of the artery by the balloon could be advocated rather than a collateral torn of the intra cavernous internal carotid. Endoluminal treatment of various vascular lesion is increasingly used and iatrogenic problems as reported here should be kept in mind. Age and atheromatous lesion of carotid siphon appear to be the main risk factors.

Aged↗
PubMed1984

[Screwing into the pedicles of the lower lumbar spine (L3-L4-L5) and the lumbosacral joint].

In cases in which fixation of the lower lumbar vertebrae by plates is performed, the insertion of screws into the pedicles may be difficult. After an anatomical study the authors conclude that a partial resection of the articular facet of the superior vertebra allows improved insertion of antero-posterior screws in the pedicles. At the level of the fifth lumbar vertebra, the direction of the screws should be 10 degrees downwards. At the level of the sacrum it should be 30 degrees downwards. Screws of 15 mm length can be used in adults.

Adult↗
PubMed1984

[Brachial diplegia of traumatic origin as a result of injuries of the cervical cord].

Described by Dide and Lhermitte (1917) the brachial diplegia or bilateral paralysis of the upper limbs, is called since Schneider's data acute central spinal cord injury (1956). It is characterized by disproportionately more motor impairment of the upper than of the lower limbs, bladder dysfunction and variable sensory loss (pain and temperature) below the level of the cervical injury. For Richard C. Schneider the mechanism is a severe hyperextension injury and the anatomical finding indicate a central cord destruction with bleeding and hematomyelia. The pattern of the recovery is first return of the motor power in lower extremities; then bladder function and finally strength in the upper extremities reappears (finer finger movements coming back last). In our experience (28 cases) the incidence of the brachial diplegia is 20% of the cervical spinal cord injury and 31% of the incomplete cord lesions. The average age is 54 years. In the half of our cases hyperextension is the responsible mechanism and hyperflexion is present in one third of patients. Radiological findings indicate some vertebral displacement in 40% of cases and no patent loss of the bodies alignment in 28% of patients. Clinical investigations authorize the description of 4 clinical patterns: 1--Incomplete tetraplegia with more motor impairment of the upper extremities (57%), 2--Brachial diplegia (without loss of function of the lower limbs) 25%, 3--Brachial diparesis with total recovery (11%), 4--Incomplete cord lesions with Brown Sequard syndrome and brachial diplegia (7%). The review of the literature (Bohlman, Barraquer) and our anatomical findings show that central hematomyelia is not constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Description of an anterior cervical osteosynthesis plate].

Various authors have proposed the use of cervical osteosynthesis plates for traumatic and tumoral lesions of the cervical spine. The purpose of the plates was to maintain auto or allogenic grafts in position during biological fusion, or to act as a protection for non-biologic implants by constituting an inert framework. Among those described recently in the literature, the plates developed by Senegas, Orosco and Caspar unable osteosynthesis to occur under maximum safety conditions. The originality of the plate presented lies in its simplicity in use resulting from the oval shape of the intermediary holes this providing maximum flexibility of positioning as a function of the patient's morphology.

Bone Plates↗
PubMed1984

[Chance's fracture].

Described by Chance (1948) this fracture is induced by a mechanism of flexion distraction (seat belt fracture). The injury is characterized by the following (W.S. Smith, 1969): A disruption of the vertebral body by an horizontal splitting of this formation and neural arches through the pedicles, nor, or a minimum decrease in the anterior height of the involved vertebral body, no forward or lateral displacements of the superior vertebra, location of the disruption between the first and third lumbar vertebra in the majority of cases. Four patterns of Chance's fracture are isolated in this paper: First pattern: The osseous disruption cross the posterior arches, pedicles and vertebra. The fracture is unstable. Second pattern: horizontal fracture involves both pedicles with extension anteriorly through inferior third of the vertebral body (unstable). Third pattern: Chance's fracture with anterior vertebral extension through superior third of vertebra (unstable). Fourth pattern: fracture with anterior horizontal vertebral disruption in the posterior half of the body (stable).

Adult↗
PubMed1983

[Optochiasmatic diastasis in tumors with suprasellar extension and duplication of the chiasma].

The opto chiasmatic diastasis whose extreme form is a duplication of the chiasma, corresponds to a longitudinal cleavage, using the well known fasciculation of the optic fibres. It has been noticed four times in the sellar and para sellar expanding processes (two adenomas, one craniopharyngioma and one metastasis). Generally, this lesion of the chiasma goes with big tumors (grade II); it has been detected four times in frontal approaches (15%) while the rhinoseptal approach represents 85% of our cases. The diastasis of the optic fibers with tendency to form double chiasma, instead of being an exception, happens in 4% of sellars tumors. It is perfectly identified by the frontal surgical approach, but is really hard or impossible to be recognized by the rhinoseptal surgical way. The mechanisms and the prognosis of this lesion are discussed.

Adenoma, Chromophobe↗
PubMed1983

[Tear drop fractures. Contribution to the study of the mechanism of osteo-disco-ligamentous lesions].

Since the original description by Schneider (1956), the tear drop fracture is designated as a flexion fracture. The C.A.T. investigation proves the coexistence of two lines of fractures: a frontal fracture (by mechanism of flexion), a sagittal fracture (by compression). The sagittal fracture affects the body and the posterior arch in 48% of Lee's cases (1982) as Jefferson's fracture. The tear drop fracture is a fracture by mechanism of flexion-compression with sagittal sprain of the inter vertebral cervical disk. --In our experiences C5 is the level of the most frequent lesion. --4 types of tear drop fractures are described: an occult form (C.A.T. diagnosis), tear drop without displacement, tear drop with moderate displacement, tear drop with posterior dislocation and kyphosis greater than 20 degrees. --The spinal cord damage corresponds to displacement of the two half vertebral bodies and posterior dislocation. --In case with posterior dislocation and kyphosis greater than 20 degrees complete tetraplegia or anterior spinal cord injury are often presents. --In case with asymmetrical posterior displacement of an half vertebral body the syndrom of Brown Sequard is constant. --The tear drop fracture is unstable and cervical spine fusion necessary.

Biomechanical Phenomena↗
PubMed1983

[Intrapetrous neurinomas of the facial nerve and its branches. Apropos of 2 cases].

The complete removal and conservation of the facial function in neurinoma of VIIth nerve in the petrous bone, are the goals of this surgery. In 2 cases, the authors emphasize the difficulty of the diagnosis and the means of making an accurate recognition of this lesion before performing a surgical approach. In the first case, neurinoma was carried by the left nervus intermedius at the level of the genu of VII with extension in the internal auditory meatus. Prior surgery had been a suboccipital craniotomy and a second operation by sus petrosal approach was necessary. In the second case, neurinoma of the right chorda tympani was removed by the retro auricular approach. In these two cases, the facial nerve had been spared.

Adult↗
PubMed1982

[Contribution of Doppler angiography to the study of sub-millimeter cortical arteries].

Intra operative Doppler has been already used especially during cerebral vascular malformations surgery. The systematic practice of this method, in 15 cases, for the blood flow study of the sub millimetric cortical vessels is helpful, very simple, and harmless. The investigation has been achieved by the direct application of a sterilized 8 MHZ, 5 mm Doppler probe on a small cortical artery. As the diameter has been exactly measured (0,8 mm +/- 0,2 in 15 cases) it is easy to calculate the blood flow from the recorded curve diagrams. The normal cortical flow of the sub millimetric arteries is about 2,52 cm3/mn +/- 1,16 confirming the previous data obtained with other methods of approach. The study of contused brains, points out, the disastrous effect of edema on cerebral blood flow, which before a complete arrest, looses its continuous diastolic pattern. Deep seated angiomas can be accurately located together with the flow direction in their feeding vessels. This method is also of fair interest for extra intra-crânial anastomosis, the choice of the cortical artery for bypass and its functional appreciation.

Adult↗