Biomedical subjects
Publications and source records attributed to J Vignaud.
A technique of reconstruction of angiograms in any projection, by stereogrammetry and computer, is described. Sections of the vessels may be obtained and superimposed on CT sections.
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The results obtained in 145 cases of space-occupying lesions in the sellar and suprasellar structures, after exploration with computer assisted tomography, were used to assess the technical and diagnostic value of this procedure. Precise details of the localization and extent of the lesion can be obtained, but not the nature of the lesion in many cases.
52 metrizamide myelographies practiced with tomodensitometry were studies (23 normal cases); 6 cervicarthrosic myelopathies; 2 intra medullar tumors; 1 extra medullar tumor; 19 syringomyelias). The technical procedures are discussed for the different diseases. This test has proven highly interesting for the study of syringomyelias and tumors. It allows the presence of narrow canals to be demonstrated, but does not yet indicate discal hernias. The role of tomodensitometry, in relation to other exams, is demonstrated.
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The normal development of the hyoidostapedial system and its branches and anastomosis are outlined. The intrapetrous facial nerve receives its arterial suplly from the network. The arterial arch of the facial nerve is seen more frequently in angiograms of infants than in those of adults. The fact that the same vessel supplies the VIIth and the Vth nerves suggests that an ischemic mechanism may frequently be involved in Bell's palsy. The facial nerve from the point of view of its arterial supply must be considered as a nerve of the middle fossa and represent the major risk of embolization in the propinal middle meningeal artery.
Since Parkinson's original description, the C5 collaterals are always presented as originating from a common trunk (meningo-hypophyseal). This is the least frequent anatomical variation. In fact, the posterior (C5) group of collaterals corresponds to the remnant of two transient embryonic vessels (primitive maxillary and trigeminal arteries), branches of which will give rise to the two main groups of collaterals originating from this area: medially, the inferior hypophyseal and the medial clival arteries; laterally, the basal tentorial and lateral clival arteries, which are constantly anastomosed with the ascending pharyngeal artery. Only in some cases (10%) do these two groups arise in common from the C5 carotid siphon. Apart from these branches the so-called Bernasconi's artery may originate from eight different pedicles, the C5 siphon representing only one of them.
The middle meningeal artery can sometimes supply the complete vascularisation of the posterior fossa, i.e., the dura mater of the cerebellar fossa and the tentorium cerebelli. The authors present an anatomic and radiologic correlative study based upon an unusual case where the middle meningeal artery arose from the ascending pharyngeal artery and vascularised the entire posterior cerebellar fossa.
Many arguments lead us to think that a possible etiologic factor in idiopathic Bell's palsy is the ischemia of the facial nerve and that angiography could help in diagnosis: (1) the rapid progress of the paralysis; (2) the correlation between Bell's palsy occurring after embolization of the internal maxillary artery, the middle meningeal artery, the occipital or posterior auricular artery, and their participation in the blood supply of the facial nerve; (3) the already known ischemic third nerve paralysis reported in diabetes and extending further to the facial nerve. Even if it is technically impossible to study Bell's palsy by angiography, it is interesting to understand and consider some complications of embolization and perhaps to envisage a new kind of treatment.
The usefulness of CT of the eye in diagnosis is discussed, and comparison with ultrasonography is made. The authors draw on experience with 62 patients, including, in particular, cases of tumor, eyeball malformtion, and intraocular foreign bodies. CT is not very useful for study of the eyeball itself, but can be indispensable in the diagnosis of malformations and tumors.
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