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M Choux

Publications and source records attributed to M Choux.

At least 37 records · Page 2Linked to original sources

[A cerebral abscess due to Listeria monocytogenes in a 15-month-old infant].

We report a case of brain abscess due to Listeria monocytogenes in an infant. We recall that listeriosis is infrequent in pediatric patients beyond the neonatal period, that most cases occur in immunocompromised hosts, and that clinical features are non-specific in neuromeningeal forms. Management of brain abscesses is discussed. The role of the patient's general health condition seems to have a determinant influence on prognosis.

Brain Abscess

[Arteriovenous malformations in children. A series of 61 cases].

A series of 61 cases of cerebral arteriovenous malformations(AVM) was observed in children under 15 years of age during the last 18 years; 7 concern infants under 12 months and more than 50% are children between 10 and 15 years old. Intra-cerebral hemorrhage was revealing in 45 cases (7.7%) and 12 patients were in comatose state at presentation; 8 children (1.1%) only presented epilepsy alone; 53 cases (86.8%) were operated upon and only one has had a partial removal; 2 children were cured by stereotactic radiosurgery; one child must be embolize and 5 children were not treated; 50 cases (82%) have a good or an excellent result with normal life; 7 cases (11.5%) have sequellae and only 4 children (6.5%) died.

Adolescent

Extradural haematoma in infants.

The clinical and operative findings of 40 infants treated for Extradural Haematomas (EDH) between 1960 and 1988 are presented. This series represents 19% of the total number of children with EDH during this period. Twenty-five (63%) were male, fifteen (37%) female. They were divided into three groups according to age for comparison. Group A, less than 6 months (11 cases); group B, 7-12 months (16 cases); and group C, 13-24 months (13 cases). Sixteen (40%) resulted from falls less than 1 m. Seven (17.5%) fell whilst walking. Twelve (30%) fell more than 1 m. Two EDH followed obstetric trauma, three occurred as a result of a road traffic accident. A lucid interval was identified in 30 cases, and in 15 it was longer than 24 h. Drowsiness (60%), and delayed vomiting (45%), were the most important symptoms. Anaemia occurred in 19 (47.5%). Thirty-six (90%) had abnormal skull X-rays. Thirty (75%) EDH were parietal, temporal, or temporo-parietal. Two were located in the posterior fossa. There were no frontal EDH in this series in contrast to that found in older children. Twenty-seven (67.5%) EDH were larger than 75 cc in volume. The source of bleeding was identified in 31; in 17 (42.5%) it was from the middle meningeal artery; in 11 (27.5%) from the bone; and in three (7.5%) from the dural surface. The mortality was 12.5% with a 15% morbidity rate, three infants (7.5%), suffering motor deficits, and three requiring medical treatment for epilepsy.

Adolescent

[Intracranial arterial aneurysm in children. A cooperative study. Apropos of 43 cases].

This joint study describes 43 cases of intracranial arterial aneurysms in children diagnosed on the basis of clinical symptoms. In the pediatric age group, this malformation is notable because of the marked sex predilection in males (70%) and an unequal topographic incidence in the circle of Willis, where carotid artery (39.3%) and anterior communicating artery lesions (30%) predominate. The most frequent clinical sign was subarachnoid hemorrhage (81%), although symptoms caused by compression revealed the abnormality in 2.3% of patients. In this series, 11% of the patients suffered a head injury at the time of the hemorrhagic accident; this finding has been reported previously in the literature. Today, treatment is always surgical, consisting in removal of the aneurysmal sac. Surgical results are encouraging; all grade lesions considered together, 63.4% of the children were cured without any sequelae, 19.5% lost one school year but were able to lead a normal life, and 4.8% remained severely handicapped; overall postoperative mortality was 12.3%. Cerebral plasticity and tolerance of spasm in children are fundamental features of this aneurysmal pathology which partially explain the favorable results obtained with surgery.

Adolescent

[Aneurysms of the vein of Galen. Angiographic study and morphogenetic considerations].

The angiographic and/or anatomic study of a series of 30 cases of Vein of Galen aneurysm (which is defined as an arterio-venous fistula within the wall of the vein of Galen itself, therefore as a purely extra cerebral lesion) permits the analysis of the afferent arteries, of the efferent veins, and of the aneurysmal sac itself. The examination of the afferent arteries confirms the data from the literature, indicating that most often it consists of the abnormal hypertrophy of otherwise normally organized arteries, including the dural arteries. In particular, the involvement of distal subcallosal branches of the anterior cerebral arteries as well as the arterio-arterial maze extending above the collicular plate, fit well the normal anatomy. The venous side of the malformation nevertheless presents with more unusual features; the most striking is the non-opacification of the straight sinus and/or part of the transverse sinuses in half of the cases; also, an aberrant falcine sinus is frequently observed, which actually represents the persistence of a normal channel in the fetal anatomy. A more complex pattern was observed in two cases in which the aneurysmal sac drained into the straight sinus via a loop made of a falcine sinus, the superior sagittal sinus and then backward through a second falcine sinus. Finally, from the systematization of the afferents arteries, the aneurysmal sac appears to belong both to the (prosencephalic) velum interpositum and to the ambient cistern. Such a vessel cannot be either the true vein of Galen or an internal cerebral vein; therefore it has to be a persistent fetal vein, the median prosencephalic vein, which drains the choroid plexuses of the lateral and third ventricles between the 7th and 12th weeks, and disappears normally to be replaced by the internal cerebral veins, when the intrinsic vascularization of the neural tube develops. The adult pattern of the brain artery being attained during the 8th week, the event that led to the arterio venous fistula should have occurred some time during the 3rd month. Unfortunately, no clue was found to orient to a specific cause for the anomaly. The frequently observed venous occlusions are actually not seen in neonates but rather in older children. This, and the fact that spontaneous thromboses within the malformative veins have been observed in vivo, make likely the conclusion that venous occlusions are a secondary phenomenon only.

Adolescent

[Disk calcifications in children. Apropos of 17 cases].

Seventeen cases of calcification of the intervertebral discs in childhood have been seen. Only cervical lesions gave symptoms. In several cases the lesions were multifocal (cervical and thoracic) and there was a familial history in one case. Two cases were observed for 10 and 8 years respectively. It was noted that cervical calcifications tend to disappear while thoracic ones persist but are asymptomatic. The authors postulate that this is due to differences in the physiology of the nucleus and in the biomechanics at different levels of the spine. A high frequency of associated spinal deformities was noted. For this reason, the late prognosis must be guarded.

Calcinosis

Complex cerebral tumor with evidence of neuronal, glial and Schwann cell differentiation: a histologic, immunocytochemical and ultrastructural study.

An unusual cerebral tumor is reported in a ten-month-old boy. The tumor was large (10 cm x 6 cm), firm and included several cysts. Light and electron microscopy showed a striking cellular pleomorphism. Typical neurosecretory ganglion cells were observed, always surrounded by Schwann cells. Amyelinic neurites, clusters of Schwann cells, fibroblasts and numerous foci of GFA positive astrocytes composed the tumor. These features were compared with the rare previous electron microscopic reports of cerebral neuronal tumor of the central nervous system. A dysembryoplastic origin from the neural plate was retained to explain the growth of such a complex tumor.

Brain Neoplasms

[Medulloblastoma].

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Cerebellar Neoplasms

[Pre- and postoperative endocrine function in children with craniopharyngioma ].

17 children presenting with craniopharyngioma were studied from 1970 to 1980. Presenting symptoms were usually reflecting endocrine dysfunction (13 of 17 cases), such as growth retardation, weight abnormalities, diabetes insipidus and hypothyroidism. Unfortunately, these signs were most often misinterpreted (10 of 13 cases) so that when diagnosis was made dissociated hypopituitarism was present. Further impairment of endocrine function always followed surgical excision. In most children pituitary insufficiency becomes complete and permanent. These results are similar whatever the tumor site and surgical procedure. Growth goes on and puberty occurs without treatment in a few cases but in the majority of them substitutive therapy is necessary.

Adolescent