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Biomedical subjects

J Pialat

Publications and source records attributed to J Pialat.

At least 37 records · Page 2Linked to original sources
PubMed1987

Spontaneous progressive thrombosis and surgical resection of a giant aneurysm of the posterior cerebral artery in an 18-year-old.

The rare case is reported of an 18-year-old boy with giant fusiform aneurysm of the P1 and P2 segments of the posterior cerebral artery. The symptoms were two episodes of sudden headache with transient third-nerve palsy. The aneurysm developed into almost complete thrombosis over five months. The posterior cerebral artery distal to the aneurysm was also thrombosed and reirrigated by collateral channels without visual field deficit. The aneurysm was treated by resection. The development of this giant aneurysm, the progressive thrombosis and the clinical characteristics are discussed.

Adolescent↗
PubMed1987

[Intra-spinal ganglioglioma. A case and review of the literature].

A case of intra medullary ganglioglioma is reported in a 25 year old woman, who had presented an acute poliomyelitis when she was 2 years old. Since 7 years, new neurological signs occurred with spastic paraplegia, sensitive and sphincter disturbances. Cervical and lumbar myelography showed an intra medullary tumor, extending from C2-C3 to T7-T8. Macroscopically, the lesion was well circumscribed, except on the cervico-dorsal junction where it engulfed the anterior spinal artery. Histologically, the tumor was a ganglioglioma, grade I. Two years after surgery, the patient remains paraplegic. This case is compared with the 13 other cases of the literature.

Adult↗
PubMed1986

Intra-operative embolization of cerebral arteriovenous malformations by means of isobutylcyanoacrylate (experience in 20 cases).

20 cases of cerebral arteriovenous malformations (AVM's) are reported, treated by direct intraoperative embolization. A 50% mixture of butyl-2-cyanoacrylate (IBC) and ethyl mono-iodostearate (Duroliopaque) was used. The clinical history of the patients was a long history of seizures in 10 cases, a haemorrhage in 9 cases, and a motor deficit in 1 case. In the immediate post-operative course, 1 patient died, 3 patients had a serious post-operative haemorrhage, 6 patients presented with a transient post-operative deficit, and in 10 patients the post-operative course was uneventful. During the following years, a late haemorrhage occurred after incomplete AVM eradication in 3 patients, leading to AVM resection. The AVM eradication was eventually complete in 3 cases with embolization only, and in 7 cases with embolization and AVM resection. The overall management of AVM in all 20 patients was: embolization only in 13 cases, embolization and resection in 7 cases. The long term results are: operative death 1, late death 3, long lasting deficit 1; uneventful 15. The authors discuss the technique of embolization, the effect of IBC on the vessel walls, the evolution of their general management of AVM's after this experience. Eventually the intra-operative embolization may be helpful after incomplete intra vascular embolization, to facilitate the AVM eradication.

Bucrylate↗
PubMed1986

[Study of the innervation of the spinal ligaments at the lumbar level].

The authors studied the innervation of the human lumbar spinal ligaments on cadaver or surgical specimens. In the ligaments annexed to the neural arch and in the posterior longitudinal ligament were found free-ending fibers and amyelinic perivascular fibers. In the anterior longitudinal ligament, coexisting with perivascular fibers were found encapsulated corpuscular formations on the ventrolateral aspect of the junction between the intervertebral disc and vertebral body. These findings comfort the role of the anterior longitudinal ligament in proprioception essential both in static and dynamic function of the spine.

Humans↗
PubMed1986

[Immunohistochemistry of thyroglobulin in the diagnosis of clear cell carcinomas of the cervical region].

6 thyroid gland and 3 cervical lymph node clear-cells carcinomas are investigated by means of indirect immunofluorescence detection of thyroglobulin. Immunofluorescence was positive only in 1 case, which was a primitive thyroid carcinoma. In 7 other cases, its negativity pointed at the metastatic nature of the lesion, from a clear cell carcinoma of kidney (in 4 cases, nephrectomy was very remote, and in 3 cases, the renal lesion was discovered after our examination of the thyroid tumour). One observation showed negative staining reaction, and was a propagation of a parathyroid carcinoma to the thyroid gland. It is concluded that thyroglobulin can be used as an immunohistochemical marker to establish whether a clear cell cervical tumour originates from thyroid gland, or is a metastatic neoplasm.

Adenocarcinoma↗
PubMed1986

[Brain toxoplasmosis: from a case disclosing AIDS. Recall of diagnostic, developmental and therapeutic elements].

The authors are studying from a personal case revealing an AIDS, and from bibliographical cases, the treated evolution of toxoplasmic encephalitis in immuno-depressed patients and the elements of the diagnosis. They are insisting on the interest of the brain biopsy, and on the importance of the inflammatory brain oedema. The therapy consists on sulfamides and anti-oedematous drugs. They are thinking that the corticosteroids must be avoided. The evolution of cerebral lesions, seen on the repeated computed tomographies is often good but the prognosis remains bad according to the immuno-deficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Lumbar osteomyelitis of actinomycotic or atypical mycobacterial origin?].

A case of lumbar epiduro-vertebral actinomycosis is related, in a 45 years old man, who was immuno depressed by an evolutive pulmonary sarcoidosis. 72 similar cases are reported in the literature. 50 of them are autopsied++. Clinically our patient looked like a Pott disease. The infection began probably in the kidney. The smear's diagnosis was actinomycosis, confirmed by the routine examination. An atypical mycobacteria, Mycobacterium xenopi was bacteriologically isolated twice in the pus. It was considered as the pathogen agent for 14 months. Actinomycosis was never identified bacteriologically. The patient responded to surgery and penicillin therapy. In view of the pathologic constatations and the therapeutic response, the final diagnostic was epiduro-vertebral actinomycosis. Mycobacterium xenopi acted probably as an "accompaning " germ in this case.

Actinomycosis↗
PubMed1985

[Peroperative embolization of cerebral arteriovenous malformations with butylcyanoacrylate (18 cases)].

18 cases of cerebral Arterio-Venous malformations (AVM) are reported, treated by direct intra-operative embolisation. A 50% mixture of Butyl-2-Cyanoacrylate and Mono-Iodo-Stearate of Ethyl was used. The clinical history of the patients was a long history of seizures in 8 cases a sub-arachnoid or intra-cerebral hemorrhage in 9 cases, and a transient motor deficit in 1 case. The AVM site was supra-tentorial in 16 cases, and infra-tentorial in 2 cases. The AVM size was large with numerous feeders in 13 cases, and limited with a few feeders in 5 cases. Technically, after catheterisation of a cortical feeder, an intra-operative angiogram was performed (except for the first 6 cases) then the polymerizing mixture was pushed inside the feeder (from 1 cc to 3 cc routinely, depending of the AVM size; exceptionally 7 cc and 11 cc were used). In the immediate postoperative course, 1 patient died (case with the 11 cc embolization), 3 patients had a serious postoperative hemorrhage, 4 patients presented with a transient postoperative deficit, and in 10 patients the postoperative course was uneventful. The long term results are: 1 postoperative death, 1 death after recurrence of intra-cerebral hemorrhage (3 years postoperatively), 1 hemiplegia, 15 patients without long lasting complication. The embolization was performed as unique treatment in 14 cases, and was followed with the AVM removal in 4 cases (immediately in 1 case, delayed in 1 case, late after recurrence of intra-cerebral hemorrhage in 2 cases, respectively after 3 years and 2 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗
PubMed1984

[Epidermoid cysts of the cerebellopontile angle. 6 cases].

6 cases of cerebello-pontine angle (CPA) epidermoid cysts were encountered from 1970 up to 1983. This series accounts for 3,3% of 177 CPA tumours operated on during the same period. Epidermoid cysts result from heterotopia of ectoblastic tissue and CPA is their most frequent site of development. The wall of the cyst is composed of a stratified squamous epithelium. The inside of the cyst is filled with soft waxy material resulting from the desquamation of keratin of the cyst wall. Macroscopically, the cyst is extensive and usually closely attached to the brain stem, cranial nerves and vessels. The commonest clinical picture is that of a trigeminal neuralgia usually typical of tic douloureux. Plain x-ray films of the skull disclose no abnormalities. Air encephalography was performed in an early case: it showed an obliteration of the cerebello pontine cistern by the cyst mass, with no air injection of the tumor as mentioned elsewhere. Computerized tomography made other procedures obsolete in our 4 latest cases: it showed a non-enhancing low-density mass filling the CPA. Hypodensity characteristics can make differentiation from dermoïd and arachnoid cysts. In a patient, auditory evoked response were lengthened bilaterally and suggested a brain stem compression rather than a cochlear nerve involvement. Operative treatment was performed in all of our 6 patients through a suboccipital craniotomy with the aid of the operative microscope. The aim of surgery should be, whenever possible, total removal of the capsule. A partial section of the fifth nerve is not needed. No patient died postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Topographic and chemical study of the GABA synthetizing enzyme in Parkinsonian syndromes].

After a classical neuropathological study assessing the diagnosis, the activity of the GABA synthetizing enzyme, glutamate decarboxylase (GAD), was assayed in 6 brain areas, in 8 cases of Parkinson's disease, 2 cases of idiopathic orthostatic hypotension and 9 control cases carefully matched. The activity of GAD is not impaired, as classically believed, in parkinsonian brains, particularly in substantia nigra and pallidum. This preservation would indicate the absence of lesion of GABAergic neurones in Parkinson's disease. In the cases of other Parkinsonian syndromes, the number of cases studied is too limited to allow any generality; but they are, however reported because of their rarity.

Aged↗
PubMed1982

[Primary non-Hodgkin's lymphoma of the brain, sarcoidosis, thyroid cancer and immunity cell deficiency (author's transl)].

A 66-year-old man presented with a primary malignant lymphoma of the cerebellum and brain stem. The lymphoma was of type V (Bryon's classification) with predominant B cells, and was associated, as in previously reported cases, with a peripheral blood T lymphocyte deficiency. This case was unusual, in that autopsy revealed an active multivisceral sarcoidosis (considered as being cured more than 10 years previously), a clear-cell renal adenoma demonstrating nearly all the characteristics of a Grawitz's tumor, and a papillary epithelioma of the thyroid gland. These findings lead to discuss the significance of immuno-surveillance lack in this particular case: was it dependent on the sarcoidosis (during which a reduction in T lymphocytes is known to occur), or was it primary and perhaps genetic, a son of the patient having Hodgkin's disease? Whatever the case may be, the encephalic proliferation of the B lymphocyte clone, the peripheral epitheliomas, the sarcoidosis, and the deficit in T lymphocytes in the peripheral blood constitute a group of factors singularly rich in questions, this being, apparently, the first case of this type reported in the published literature.

Aged↗
PubMed1982

Aneurysmal bone cyst of the cervical spine: report of a case investigated by computed tomographic scanning and treated by a two-stage surgical procedure.

The authors report the case of a 62-year-old woman with an aneurysmal bone cyst of the cervical spine. The patient presented with a progressive tetraparesis. Cervical computed tomographic scanning revealed a mass involving three contiguous vertebral bodies. The patient underwent two consecutive surgical procedures: (a) laminectomy and metallic plate osteosynthesis and (b) an anterior approach for curettage of the cyst and autologous grafting. Twelve months after operation, the patient was given a course of radiation therapy in the cervical area. She was found to be asymptomatic at the 20-month follow-up examination. The authors discuss the etiological, anatomical, and radiological features of vertebral aneurysmal bone cysts and evaluate treatment methods.

Bone Cysts↗
PubMed1982

[Reese's conjunctival melanosis. Two anatomicoclinical observations with ultrastructural study in one case].

Two cases of Reese's conjunctival melanosis are reported. Inflammatory signs revealed the presence of the lesion in a 58-year-old woman, examination demonstrating diffuse brown conjunctival, tarsal, and bulbar pigmentation in the right eye, raised above the surface at the sclerocorneal junction. Histology after exenteration demonstrated coexisting diffuse atypical melanocytic hyperplasia (precancerous melanosis), an intraepithelial melanoma (cancerous melanosis), and an invasive melanoma which was the object of an ultrastructural study. The second case, a 57-year-old woman, had a 20-year history of stable, diffuse black pigmentation of the bulbar conjunctiva of the right eye. Four months after biopsy, a pedunculated tumor of the internal canthus developed, corresponding to a poorly differentiated epithelioid cell malignant melanoma. These two cases are compared with similar observations reported in the literature.

Adult↗
PubMed1980

[Actinomycotic brain abscess. (about four observations) (author's transl)].

The authors report four observations of actinomycotic brain abcess. One patient with multiple hemispheric abcesses and with stomatologic and pulmonary lesions, one with seemingly primary cerebellar abcess, one with associated hemispheric abcess associated with pneumopathy. About these four cases, they discuss the role of actinomycosis in infectious diseases of the central nervous system, and the elements necessary for the diagnosis. The neurological syndrom is not specific, but the discovery of visceral lesions is an excellent argument. From the histological point of view, the discovery of "granules" containing the bacteria conforms the diagnosis by special colorations. From the bacteriological point of view, the isolation of the germ is easy but its specific identification necessitates special techniques. The diagnosis of actinomycosis is indispensible to begin a correct treatment. For the authors, this treatment must associate surgical excision of the most extensive lesions and adapted antibiotherapy for more than four months.

Actinomycosis↗