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Biomedical subjects

M Barge

Publications and source records attributed to M Barge.

At least 19 recordsLinked to original sources
PubMed1996

[Short-term change in sural venous thrombosis in patients in surgical intensive care when anticoagulants are contraindicated].

Venous thrombo-embolic disease in neurosurgical and surgical intensive care units is a frequent disorder (between 4.3 and 43 per cent of patients according to studies). The treatment is often difficult. We carried out a retrospective study from January 1994 to September 1995 of 57 patients in neurosurgical and surgical intensive care who developed thrombosis of a sural vein and in whom anticoagulant at therapeutic doses was contraindicated. After a median follow up 14 days echography showed proximal extension of the thrombosis in 4 patients and distal extension in 3 others. Five cases of pulmonary embolism occurred during the follow up period, one of which led to death. No complications (pulmonary embolism or proximal extension of venous thrombosis) occurred in those patients receiving heparin at prophylactic doses (0/11 versus 8/46 in the non-heparin group; p = 0.13). No case of pulmonary embolus occurred in those patients with partial or complete regression of the thrombosis (0/21 versus 5/36 in the group with stable or extending thrombi, p = 0,05). Echographic monitoring enabled therapeutic modification in 5 cases. These results indicate that sural venous thrombosis in the context of neurosurgical and surgical intensive care is a potentially grave situation and that the prescription of anticoagulant therapy even at preventive dose should always be considered. Further, we propose regular echographic monitoring until the patient is mobile.

Adult↗
PubMed1985

[Xanthoastrocytoma inf young subjects. Review of the literature apropos of 2 cases with discordant courses].

Two cases of pleomorphic xanthoastrocytoma (P X A) of young subjects (Kepes et al., 1979) are reported. Case 1 arose in 15-year-old boy admitted to the hospital with the complaint of severe headaches associated with nausea and vomiting of 1 month's duration. Computed tomographic scans showed a large well-defined low density area in the left temporo-parietal region of which an anterior portion was enhanced by contrast medium. Craniotomy revealed a large superficial and cystic tumor with a mural nodule. Histological and immunohistochemical features were those of a P X A confirmed by an electron microscopic study. No radiotherapy was given. The patient made a complete recovery, and 32 months later was asymptomatic. Case 2, a 17-year-old boy was admitted to the hospital in 1977. He presented with seizures that started 18 months prior to surgery. Carotid and humeral angiograms and air studies indicated the presence of a right, internal temporal mass with herniation. The craniotomy revealed a firm superficial tumor with an infratentorial, extraparenchymal extension. The histological diagnosis was giant cell glioblastoma or gliosarcoma. The patient received post-operative radiation of 5.500 rads and chemotherapy (CCNU and VM 26). He died on the 7th post-operative month. In this 2nd case, the diagnosis of P X A was made retrospectively based upon histological and immunohistochemical observations similar to case 1. We are aware of 24 P X A in the literature. In their clinical and histological features these neoplasms resemble closely each other. P X A are superficial, supratentorial astrocytomas occurring in youngs subjects (ages 3 to 32). Their typical microscopic structure include a marked cellular pleomorphism with bizarre giant cells, some mitotic figures and no necrosis. Many cells contain lipid and hyalin droplets in their cytoplasm. Characteristically, the tumoral stroma contain a very rich reticulin fiber network. Immunoperoxidase technique reveal glial fibrillary acidic protein in the tumor cells. Electron microscopic studies demonstrate abundant intracytoplasmic glial filaments. Individual cells or group of cells are surrounded by a prominent basal lamina. Some hemidesmosomes or primitive attachments are seen at the margins of the tumor cells. The biological behaviour of PXA with or without radiotherapy is relatively favorable. Long survival times (up to 25 years) are reported but in 5 cases, P X A follow a less favorable course with malignant transformation and death. Morphologic and immunohistochemical studies support the subpial astrocytic origin of P X A.

Adolescent↗
PubMed1984

[Cranial fasciitis in children. Apropos of a case in a neonate with duramateral involvement].

A case of cranial fasciitis in the skull of a male child is described. At the age of a few weeks was noted a "lump" beneath the scalp of the right parietal region. Physical examination was otherwise normal. Radiographs showed erosion of the skull deep to the palpable mass. At operation, a firm, 2,5 X 2 X 2 cm nodule was found, which had destroyed the underlying bone and invaded the dura matter. This nodule both extra and intracranial was excised en bloc with the surrounding bone. Histological features were those of a fibroblastic proliferation closely resembling nodular fasciitis. The child is well and symptom-free a year after treatment. The authors also include diagnostic, prognostic and histogenetic comments about cranial fasciitis of childhood, new entity described by Lauer and Enzinger in 1980.

Dura Mater↗
PubMed1979

Correlative study between computerized transverse scanning and stereoimpedoencephalography in space-occupying lesions of the brain.

Stereoimpedoencephalography (SIEG) is routinely used by the authors during stereotactic investigations of glial brain tumours prior to stereotactic implantation of isotopes or prior to conventional surgery: the brain tissue impedance is measured along a probe track according to the four electrodes impedance technique. The correlation between the tissue structures and the corresponding impedance values has been studied by comparison with the CATScan data reported on the stereotactic schedules; impedance values are influenced by changes in arterial pCO2 and also by other unknown factors; in order to avoid these uninterpretable changes of the impedance, the recorded values have been normalized with respect to the average impedance along a control track in the normal hemisphere. As a rule, the impedance profile exhibits a "hole" at the site of the pathological processes like tumours as well as surrounding oedema, and the delimitation of the pathological area is very similar to that obtained by the CATScan. There is a good linear correlation between the values of normalized impedance and the x-ray absorption as given by the computer listing of the CATScan. Lastly, statistical values of normalized impedances are determined for the main structures of the brain, showing that the tumour tissue has an impedance equal to half the impedance of the normal tissue.

Brain Neoplasms↗
PubMed1978

[Delineation of brain tumors by stereo-impedo-encephalography (SIEG) (author's transl)].

Authors describe the SEEG technique which is routinely used during stereotactic investigations of brain tumors. By the way of the Talairach's stereoencephalographic electrodes, the brain tissue impedance is measured along the probe trajectory with a four electrode impedancemeter (0.25 mA; 5 KHz). The impedance profile provides a good pattern of the brain structures which are crossed; in pathological areas, the impedance significantly decreases as well in gliomas as in edema; cysts and CSF spaces also decrease the recorded impedance. As a contrary, metastases and meningiomas increase the impedance. SEEG appears to be a sharp method for stereotactic delineation of the brain tumors; a larger series as well as the real-imaginary decomposition of the impedance are needed for a best selectivity of the method.

Adult↗
PubMed1978

[Mesodiencephalic level of severe head injuries (author's transl)].

From the study of 65 severe traumatic comas, the authors describe the syndrome of mesodiencephalic dysfunction, because of its frequency and its particular clinical signs. This peculiar level of loss of consciousness is characterized by a coma without mimic and without awakening after painful stimulation, by a stereotyped motor pattern in extension, by a perseverance of the photomotor reflex, while fronto-orbicular and vertical oculo-vestibular reflexes are lacking. This level of deterioration appears to be a critical point in the natural history of comatose patients. If this level is not surpassed, the probability of early death due to evolutive neurological lesion is low (18%). One half of these patients have a good prognosis, more than 75% have an excellent recovery. This high probability of recovery is decreased by a half when the level of mesencephalic dysfunction is reached.

Brain Injuries↗
PubMed1978

[Two cases of pericranial sinuses (author's transl)].

The authors report two cases of "sinus pericranii" a rare vascular tumor of the skull, communicating with the meningeal veins or with the dural sinuses. The partial reduction in size of the tumor in the sitting position may aid the clinical diagnosis. The X ray diagnosis is highly enhanced by the direct injection of contrast medium into the tumor, leading to the visualization of the outflow in the miningeal veins, while external carotid angiography is normal. Step by step coagulation of the verious supply coming through the skull allows a non-bleeding surgical excision.

Child, Preschool↗
PubMed1978

[Intracranial pressure. IV - Relationships with post capillary vascular pressures (author's transl)].

The authors have demonstrated experimentally in dogs that, in all cases, the cortical venous pressure (Pvco) is higher than the intracranial pressure (PIC), which always remains higher than the sagittal sinus venous pressure (PSLS). The difference between Pvco and PIC remains statistically equal to 8 mm Hg and can be explained by the "Vascular Waterfall" phenomenon; during Queckenstedt's test, the intracranial venous volume does not change, and is not the cause for the increase of PIC; this increase is due to the constancy of the difference between PIC and PSLS, which is induced by the resorption of CSF through the arachnoïd villi. Increases in Pvco and PIC are shown to be equal to 70% and &2% respectively of the change in PSLS. Any other factor that increases PIC (injections in the cisterna magna, pharmacological effects) does not change PSLS, which remains equal to zero. As long as the cerebral blood flow is constant, the increase in cerebro-vascular resistance of the veins at the site of their junction to the sagittal sinus must be compensated upstream by a vasodilatation, which leads to a new distribution of the pressures along the cerebro-vascular bed.

Animals↗
PubMed1977

[Primary "muscle" tumors or tumors with a myosarcomatous component of the central nervous system. General review and attempt at classification based on 2 anatomo-clinical observations].

The authors report the first two French cases of primary rabdomyosarcoma of the central nervous system. They then review the literature on muscle tumours or primary myosarcomas of the nervous system of which 29 cases have now been published. From the point of view of morphology and classification, one should distinguish firstly, purely mesenchymatous tumours (rhabdomyosarcomas, leiosarcoma, mesenchymoma) and secondly, composite tumours of connective tissue or spino-epithelial tumours (medullomyoblastomas, neuromyoblastomas, gliomyosarcomas). Their histogenesis occurs from the ectomesenchyme of the neural crests.

Age Factors↗
PubMed1976

Rheographic assessment of cerebral blood volume and correlations with changes in intracranial pressure.

The authors present a four electrode rheographic technique for simiquantitative continuous measurement of CBV, by examining changes in cerebral tissue impedance induced by changes in blood content of the brain parenchyma. Correlation between the data obtained and ICP measurements permits conclusions regarding the behaviour of the cerebral blood bed. pCO2 regulates CBV, and the phenomenon is reversible according to a hystereris shaped time course in acute experiments. The rebound of ICP after sudden injections of CSF into the cisterna magna is of a vasogenic nature. Changes in CSF volume induce contrary changes in CBV. Pharmacological effects can be studied. The validity of the method is discussed.

Animals↗
PubMed1976

[Hyperproduction of CSF in choroid plexus papillomas in children].

Two cases of papilloma of the choroid plexus in children, one in the fourth ventricle and the other in the central part of the left lateral ventricle, are reported. Hyperproduction of CSF could be suspected in the first case by the productive character of pre-operative external ventricular drainage and demonstrated in the second by measurement of pre and post-operative flow rates through a ventriculo-peritoneal bypass which had been installed previously. The origin of this over-production of CSF is discussed, in the pathogenesis of hydrocephalus, in comparison with other factors such as subarachnoid haemorrhage, hyperproteinorachia impairing the resorption of CSF.

Cerebellar Ataxia↗
PubMed1975

[Intracranial pressure. II. Experimental verification of a mathematical model].

The authors report the results of experiments (performed on the dog in vitro and in vivo) which were designed to verify hypotheses made concerning vascular elasticity and characteristics of CSF resorption, as well as to test the validity of a mathematical model that was described in a previous paper. The authors concluded that the equations of the model account for most of the phenomena satisfactorily, but fail to predict a rebound phenomena which occurs after sudden injections in the cisterna magna. The elasticity coefficient S appears to be constant over a range of 200 mm Hg. On the other hand, the filtration coefficient K depends upon pressure, probably due to morphological changes in the size and shape of the CSF valves. These discrepancies are taken into account in a more general model that is presented in the following paper.

Animals↗