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J Massons

Publications and source records attributed to J Massons.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Pigmented villonodular synovitis of the wrist. Apropos of a case].

The authors presented a case of pigmented villonodular synovitis of the wrist with extrinsic bony defects on opposing articular surfaces, seen after two recurrences following excision surgery. They performed a total synovectomy followed by curettage and autogenous bone grafting of the carpal and radiocubital bone lesions. Four years after the procedure, the patient-a woman aged 44-was symptom-free and there was no objectivable evidence of recurrence. Pigmented villonodular synovitis (PVNS) is an uncommon, benign, chronic process that causes synovial proliferation. Its etiology is unknown. The majority of patients is young to middle-aged adults. Especially the knee but other joints are involved including the hip, ankle, wrist, hand, and foot. Both soft tissue and bone abnormalities occur in PVNS. Magnetic resonance imaging (MRI) shows a heterogenous synovial mass with intermediate and low signal intensity areas on T1 and T2-weighted images, consistent with hemosiderin deposition. Computed tomography defines clearly the extrinsic bone erosions and excavations, which usually exhibit a sclerotic margin, produced by intraosseous invasion of the expanding synovia. After excision recurrence is common, leading eventually to arthrodesis, arthroplasty and even radiation therapy. The etiology of PVNS is controversial. First approach is conservative surgical treatment with total synovectomy and curettage of the osteolytic foyers. Bone grafts are employed for filling the sites of osteolysis. The sensitivity of MRI permits early detection of the process and may obviate the need for radical management options in PVNS.

Adult↗
PubMed1996

Relevance of early seizures for in-hospital mortality in acute cerebrovascular disease.

BACKGROUND: We studied the influence of early poststroke seizures (within the first 48 hours of onset of a first stroke or transient ischemic attack) on in-hospital mortality in 1,099 consecutive patients collected in a prospective stroke registry. METHODS: Differences in the frequency of demographic characteristics, clinical events, and outcome between patients with and those without epileptic seizures were assessed. To determine the independent predictive value of early seizures on in-hospital mortality, variables related to vital status at discharge (alive, dead) in the univariate analysis, plus age, were studied in two multiple linear regression models. The first predictive model was based on demographic, anamnestic, and clinical variables with a total of 13 variables, and the second model was based on clinical and neuroimaging variables with a total of 16 variables. RESULTS: A total of 27 patients (2.5%) had epileptic seizures during the first 48 hours of stroke. Advanced age, confusional syndrome, hemorrhagic stroke, large lesions, involvement of parietal and temporal lobes, and occurrence of neurologic and medical complications were significantly more frequent in seizure patients than in nonseizure patients. Overall in-hospital mortality rate was 33.3% in the seizure group and 14.2% in the nonseizure group (p = 0.02). The presence of early seizures was a significant predictive variable both in the model based on clinical variables (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.81 to 16.72) and in the model based on clinical and neuroimaging variables (OR, 6.1; 95% CI, 2.13 to 17.93). CONCLUSIONS: Seizures at the onset of a first-ever stroke is an independent prognostic factor for in-hospital mortality. Patients with the highest risk of developing epileptic seizures-aged persons with a large hemorrhagic infarction of a parietal lobe-may be candidates to be treated prophylactically against seizures for a few days.

Acute Disease↗
PubMed1994

[Mortality in the acute phase of cerebrovascular disease: the registry of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Few studies have been performed on mortality from acute cerebrovascular disease (ACVD) during hospital admission, particularly in Spain. METHODS: A prospective clinical analysis was performed in 1,356 consecutive patients with ACVD included in the Registry of Cerebrovascular Disease of the Central La Alianza-Hospital in Barcelona (1986-1992) with the aim of analyzing the causes of mortality during the acute phase of the disease and the time of hospital survival. RESULTS: The mortality of the series was 16% (13% from cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of mortality were not neurologic in 49%, neurologic in 42% and of unknown cause in 9%. The principal causes of death were: transtentorial herniation/compression of the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% and heart disease 11%. TH/CCT was more frequent on hemorrhage than on cerebral infarction (50% vs 27%; p < 0.001) while heart diseases were more frequent in cerebral infarction (14% vs 3%, p < 0.03). TH/CCT was the most common cause of death during the first seven days, with the pneumonia-sepsis-pulmonary thromboembolism being the most common after the third week. On the other hand, heart disease and sudden death showed homogeneous presentation with regard to frequency. CONCLUSIONS: The causes of death during the acute phase of acute cerebrovascular disease are principally non neurologic (49%) being potentially preventable with the most frequent causes of death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of these patients may be decreased on correct diagnosis and treatment.

Acute Disease↗
PubMed1994

Headache in acute cerebrovascular disease: a prospective clinical study in 240 patients.

To evaluate the clinical features of headache in stroke, a prospective study was carried out in 240 consecutive patients with acute stroke who had intact expressive function. Headache occurred in 38%: 32% of 195 patients with ischemic stroke and 64.5% of 45 patients with hemorrhagic stroke (p < 0.0001). Headache patients were younger (mean age 62 +/- 15 vs 67 +/- 11.5 years) than non-headache patients (p < 0.01). A history of previous vascular or tension-type headache was found in 40.5% of the headache group, but in only 23.5% of the non-headache group (p < 0.01). In ischemic stroke, headache was observed in 41% of thrombotic infarcts, in 39% of cardioembolic infarcts, in 23% of lacunar infarcts and in 26% of TIA. Headache was significantly more common in thrombotic than lacunar infarcts (p < 0.05). In hemorrhagic stroke, headache was observed in all subarachnoid hemorrhages and in 58% of intraparenchymal hemorrhages. In ischemic stroke, the mean duration of the headache was 25 +/- 28 h and in hemorrhagic stroke 64.5 +/- 36.5 h (p < 0.00001). In ischemic stroke the headache was focal in 74% and mild or moderate in intensity in 74%. In hemorrhagic stroke, it was diffuse in 52% and the pain intensity was incapacitating in 70%. Headache was more common in vertebrobasilar stroke (59%), in comparison with carotid stroke (26%) or stroke of unclear vascular topography (33%) (p < 0.00001). Fifty-six and a half percent of patients with cortical stroke had headaches, as opposed to only 26.5% of patients with subcortical stroke (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1994

Achilles tendon ossification.

The authors describe the case of a patient who had an ossified Achilles tendon without fracture. Such ossification is uncommon, occurring most often after trauma or surgery.

Achilles Tendon↗
PubMed1993

[An analysis of 1000 consecutive patients with acute cerebrovascular disease. The registry of cerebrovascular disease of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Registries of cerebral vascular disease (CVD) are useful in the study of the natural history of acute cerebrovascular disease (ACBD). Nonetheless there are few series which analyze the different stroke subtypes (SS) of CVD. METHODS: A descriptive and comparative clinical analysis was performed of the different SS of CVD from the registry of CVD of the La Alianza-Central Hospital of Barcelona (Spain). A prospective study of 1,000 consecutive patients with ACVD admitted in the Neurology Department from 1986-1991 was carried out. The registry recommended by the Study Group of Cerebrovascular Diseases of the Sociedad Española de Neurología (SEN) were used and the stroke subtypes classified in agreement with the Glossary of Neurology of the SEN. RESULTS: The mean age of the series was of 71 +/- 13 years with 537 patients being males. The frequency of the stroke subtypes in focal cerebral ischemia (FCI) was: thrombotic infarction 26%, lacunar infarction 16.9%, essential infarction 14.8%, cardioembolic infarction 12.4%, transient ischemic attacks 9% and infarction of unusual cause 3.5%. The frequency of the SS in cerebral hemorrhage (CH) was: intraparenchymatous hemorrhage 14.1%, subarachnoid hemorrhage 2.0%, subdural hematoma 1.2% and epidural hematoma 0.1%. Mortality of the series was 16.7% predominating in CH (28%) versus FCI (14%) (p < 0.00001). This was found to be greatest in cases of intraparenchymatous hemorrhage (31%) and in the cardioembolic infarction (28%) and lowest in the lacunar infarctions (0.6%). CONCLUSIONS: The most common stroke subtypes were those of thrombotic infarctions, lacunar infarctions and intraparenchymal hemorrhages. Essential infarctions constitute 14.8% of acute cerebral vascular disease. The classification of cerebral vascular disease in its different subtypes is recommendable since this has prognostic and therapeutic implications.

Acute Disease↗
PubMed1993

[Headache in acute cerebrovascular ischemic disease: a prospective clinical study of 195 patients].

BACKGROUND: Headache is a little known aspect in the study of acute ischemic cerebrovascular disease (AICVD). METHODS: To contribute to the knowledge of the clinical characteristics of headache in the different nosologic entities of AICVD a prospective study was performed in 195 patients consecutively studied by CT scan and/or cerebral MRI. RESULTS: There was headache in 32% of the total and in 41% of the thrombotic infarctions, 39% of the cardioembolisms, 26% of the transient ischemic attacks (TIA) and 23% of the lacunar infarcts. The mean duration was 25 +/- 28 hours. Headache was focal in 74% of the cases and of slight or moderate intensity in 74%. Headache was significantly more common in thrombotic infarctions than in lacunar ones (p < 0.05). It was more frequent when the topography is vertebrobasilar (57.5%), in comparison with carotid (21%) or undetermined (17.5%) (p < 0.0001). Headache was more common when topography was cortical (56.5%) in comparison with subcortical (26.5%) (p < 0.005). Eight per cent of the patients presented sentinel headache: 22% of the cardioembolic infarctions, 7% of the lacunars, 6.5% of the TIA and 5.5% of the thrombotic. CONCLUSIONS: Headache in acute ischemic cerebrovascular disease is not uncommon predominating in thrombotic infarctions and cardioembolisms of cortical topography and of vertebrobasilar vascular territory.

Acute Disease↗
PubMed1993

[Pure motor hemiparesis secondary to chronic subdural hematoma with total recovery through medical treatment].

We discuss in this paper the cases of two patients with pure motor hemiparesis which were secondary to chronic subdural hematoma who evolved satisfactorily only with medical treatment. Of 1,000 consecutive patients with cerebro-vascular pathology admitted in our Neurology Department in the last 5 years, said two patients were the only ones (0.2%) in whom the lacunar syndrome "pure motor hemiparesis" was secondary to a chronic subdural hematoma. Such cases show that a subdural hematoma can manifest itself as a lacunar syndrome and that in selected cases the medical treatment of chronic subdural hematoma can yield goods results.

Aged↗