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Biomedical subjects

J Philippon

Publications and source records attributed to J Philippon.

At least 91 records · Page 5Linked to original sources

[Significance and prognostic value of Parinaud's syndrome in hydrocephalus (author's transl)].

Eleven out of 260 cases of chronic hydrocephalus in adults were associated with mesencephalic symptoms, in particular Parinaud's ophthalmoplegia. Investigations aimed at detecting intracranial growth consistently gave negative results. In most cases, the midbrain symptoms were accompanied by intracranial hypertension and therefore reflected an aggravation of the hydrocephalus. They regressed when manoeuvres tending to reduce intracranial pressure were applied on time. On three occasions, they were followed by pontobulbar symptoms and treatment was ineffective. When brain stem symptoms (especially Parinaud's syndrome) occur in the course of hydrocephalus, one should always look for tumoral lesions, but they may also point to deterioration of the disease, which should be treated before it becomes irreversible. The mechanism of brain stem involvement in hydrocephalus is discussed in the light of electrophysiological recordings during experimentally-induced intracranial hypertension in the cat.

Adolescent↗

[Ependymoma of the cauda equina presenting as raised intracranial pressure without ventricular dilatation. One case (author's transl)].

Intracranial hypertension is a rare phenomenon in the development of intra-spinal neoplasm. In the present case, it occurred without ventricular dilatation raising the problem of the underlying mechanism. Perturbations in the CSF reabsorption would appear less likely than an increase in brain volume, where cerebral edema may play an important role.

Adult↗

[Gasserian differential thermocoagulation in trigeminal neuralgia: a medium-term follow up (author's transl)].

The results of thermo-coagulation have been evaluated in a series of 50 patients followed up from two to six years (average three years). Neuralgia disappeared in nearly 80 p. 100 of the cases (however this was obtained with a second operation in nine cases). The frequency of recurrences increase with time: 20 p. 100 during the first two years reaching 40 p. 100 after three years. They were more likely to occur if the post-operative sensory deficit is moderate. Complications directly related to the surgical technique were rare: some faded away relatively quickly (oculo-motor palsies less than 1 p. 100, masseter weakness 20 p. 100 in the first weeks). The only residual problems were related to sensory deficits: in general they were limited to a small cutaneous area and total anesthesia was never been observed. Although paresthesias were noted in 12 p. 100 of the cases, these usually were not really troublesome. Our conclusion, therefore, is that differential thermocoagulation appears to be the best surgical treatment for trigeminal neuralgia.

Aged↗

[Estrogen and progestin receptors in meningiomas: a study in 22 cases (author's transl)].

The authors have searched for oestrogene (RE) and progesterone (RP) receptors in 22 cases of meningiomas. Hormone receptors were determined on the cytosol and nuclear fractions of tumor tissues, using synthetic oestrogen R 2858 and progestin R 5020 in conditions where exchange was nearly achieved. The receptors were considered as present for values equal or higher than 100 femtomoles per gram of tumour tissue (fmol/gT). For the 22 studied cases the RE were present in 13 cases (59 p. 100) with values between 100 and 500 fmol/gT in 9 cases and higher than 500 fmol/gT in 4 cases. The RP were present in all cases (100 p. 100), with values between 100 and 500 fmol/gT in one case, between 500 et 5 000 fmol/gT in 13 cases and higher than 5 000 fmol/gT in 8 cases. The results were compared with neuropathologic data obtained by light microscopy. The clinical and biological significance of results are discussed.

Adult↗

Prolactin-secreting pituitary adenoma in a man with gigantism: a case report.

A prolactin-secreting pituitary adenoma was removed trans-sphenoidally from a 37 years old man with gigantism (218 cm). Serum levels of prolactin (PRL) were elevated pre-operatively and decreased after administration of L-Dopa with no increase after TRH as is usually observed in PRL-secreting adenomas. Growth hormone (GH) and somatomedin serum levels were normal with no modification of GH after insulin hypoglycemia, oral glucose loading or L-Dopa. Morphological examination of the tumour demonstrated the presence of lactotrophs by light and electron microscopy and by immunofluorescense staining. No somatotrophs were found. In this unique case, the relationship between a PRL-secreting adenoma and gigantism is discussed.

Adenoma↗

[Preoperative diagnosis of posterior fossa tumors (author's transl)].

The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.

Adult↗

[The treatment of trigeminal neuralgia by retro-gasserian differential electro-diathermy. One hundred cases (author's transl)].

Controlled thermocoagulation of Gasserian ganglion has been used in 100 patients presenting trigeminal neuralgia. Facial pain disappeared immediately in all cases, except four where it persisted at a minor degree during few days. Post-operative deficits are quite minimal and consist of hypoalgesia more or less marked; numbness to touch has never been observed except in a limited area in 12 patients. There have been no corneal problems. Paresthesias were noted immediately in 10 patients; they disappeared gradually and were troublesome only in four. The rate of recurrence (with a mean post-operative survey of 11 months is 13%). This technique of controlled thermocoagulation re presents the safest way of treating trigeminal neuralgia when it is uncontrollable with drugs.

Adolescent↗

[Treatment of chronic pain syndromes by transcutaneous stimulation. Preliminary results. A propos of 40 cases].

The study of the effect of transcutanous stimulations shows that 40% of the patients suffering of chronic pain can be relieved or greatly improved by this technic. The best results are obtained with peripheral nerves lesions. On the contrary no results are observed with malignancies or facial pain. This way of stimulation is easy to develop and does not imply any danger for the patient. It can be used as a test prior to percutanous stimulation or implantation of a direct stimulation, or can, by itself be an effective treatment.

Electric Stimulation Therapy↗

Cerebral pseudocysts following chemotherapy of glioblastomas.

Three cases of pseudocysts following surgery and chemotherapy for glioblastomas are reported. Their clinical picture was similar, consisting of intracranial hypertension without primary modification of focal signs. CT scanning has been able to detect the cystic aspect and to eliminate a true tumour recurrence. Medical treatment (steroids or Mannitol) seems inefficient. Evacuation of the cyst is the only efficient method of treatment.

Adult↗