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Biomedical subjects

M G Bousser

Publications and source records attributed to M G Bousser.

At least 199 records · Page 11Linked to original sources
PubMed1990

Handedness, immune disorders and information bias.

In order to investigate the relations between handedness and migraine or immune disorders, we performed a case control study comparing the handedness of patients suffering from systemic lupus erythematosus (SLE), type I diabetes, Graves' disease, or migraine to that of a random sample of controls from the general population. A handedness index was measured from a 10-item questionnaire. No significant difference was observed. But when the controls who denied having ever suffered from migraine or any allergic disease were set apart from those who gave at least one positive answer to the same questions, the former were found more right-handed, i.e. with a lower handedness index than the latter (P less than 0.05) and than the SLE patients (P less than 0.05). More generally, the mean observed handedness index of controls giving a positive answer to any question about their health was found repeatedly higher than that of controls giving a negative answer: this was observed for 27 of the 32 questions. These results are highly suggestive of an information bias, the subjects saying they use the right hand for each of the 10 activities considered in the questionnaire being more likely to deny having suffered from a given disease or used, more or less recently, some drug or medical service. Our conviction is that previous observations dealing with the same topic are also more easily explained by the presence of an information bias than by Geschwind's theory. The implications for the design of further epidemiologic studies are discussed.

Adult↗
PubMed1990

Three cases of spontaneous extracranial vertebral artery dissection.

We describe three cases of extracranial vertebral artery dissection that are unusual in both their modes of presentation and their associations with other pathologic conditions. The first patient had Marfan's syndrome and migraine; his dissection was asymptomatic and was diagnosed by chance at the time of repeat angiography following a previous internal carotid artery dissection. The second patient had systemic lupus erythematosus and presented with a subarachnoid hemorrhage attributed to an intracranial vertebral artery dissection by the demonstration of an extracranial dissection. The third patient had a minor basilar artery stroke in which dissection had occurred beside a congenital hemivertebra deformity.

Adult↗
PubMed1990

Cerebral venous thrombosis in systemic lupus erythematosus.

We describe six cases of cerebral venous thrombosis in patients with systemic lupus erythematosus. In one patient, cerebral venous thrombosis was the initial manifestation of lupus; in the five others, it occurred 1-33 years after the diagnosis of lupus. The main clinical features of cerebral venous thrombosis were persistent headache in all six patients, focal symptoms in four, and seizures in three; papilledema was present in only one patient. Cerebral venous thrombosis was diagnosed based on angiography or magnetic resonance imaging. Both the transverse (in five patients) and the superior sagittal (in three) sinuses were involved. Extracranial arterial and/or venous thrombosis were present in three patients, abortion in two, thrombocytopenia in four, and lupus anticoagulant in three. The neurologic symptoms resolved rapidly in five patients treated with steroids and heparin. Cerebral venous thrombosis should be suspected in patients with lupus who complain of persistent headache, especially in the presence of neurologic symptoms.

Adult↗
PubMed1990

Magnetic resonance imaging in lateral sinus hypoplasia and thrombosis.

Lateral sinus thrombosis may be difficult to differentiate angiographically from lateral sinus hypoplasia, which mainly affects its proximal transverse portion. Using magnetic resonance imaging, we evaluated six patients who demonstrated poor filling or lack of filling of one or both lateral sinuses at angiography. In each patient, magnetic resonance imaging unambiguously demonstrated either lateral sinus thrombosis or lateral sinus hypoplasia. The latter was characterized by a frank asymmetry in size (surface of section) of the transverse portion of the lateral sinuses on parasagittal images without any abnormal signal in the course of the sinus. Lateral sinus thrombosis was indicated by increased intraluminal signal on all planes and with all pulse sequences. By virtue of its freedom from bone-related artifact, its multiplanar imaging capability, and its sensitivity to both blood flow and thrombus formation, magnetic resonance imaging is an excellent tool for the evaluation of lateral sinus thrombosis or hypoplasia.

Carotid Arteries↗
PubMed1990

[Opthalomoplegic migraine].

We report the case of a 24 year old man with a 22 year history of attacks of migraine without aura and attacks of ophthalmoplegic migraine. A persistent right 3rd nerve palsy appeared after the 17th attack. Although its existence has been debated, ophthalmoplegic migraine is recognized as such in the International Headache Society (IHS) classification. A review of published cases satisfying the IHS diagnostic criteria for ophthalmoplegic migraine is presented.

Adult↗
PubMed1990

Neurosarcoidosis: signs, course and treatment in 35 confirmed cases.

Thirty-five cases of biopsy-proven sarcoidosis with neurologic manifestations are reported. Neurosarcoidosis was the presenting symptom in 31% of cases and the only clinical manifestation in 17%. Mean follow-up time was 48 months. Central nervous system involvement was observed in 37% and meningitis in 40% of patients. Other manifestations were cranial nerve palsies (37%), peripheral neuropathy (40%), and myopathy (26%). Multiple neurologic manifestations were present in 51% of cases. All but 4 were treated with corticosteroids. Another immunosuppressive agent or cerebral irradiation was added in 6 and 2 patients, respectively. Complete recovery was observed in 46%, improvement in 46%, 4% remained stable, and 4% worsened. There were no deaths. We advocate treating neurosarcoidosis with corticosteroids as early as possible. If the patient's condition worsens, additional immunosuppressive agents or cerebral irradiation is warranted.

Adolescent↗
PubMed1989

[Platelet antiaggregants in cerebral ischemic pathology].

Platelet aggregation inhibitors have been more extensively and better studied than all other treatments used in the prevention of cerebral ischaemia. It has been demonstrated that both aspirin (300 mg/day) and ticlopidine (500 mg/day) are effective in the secondary prevention of cerebral ischaemic accidents associated with atherosclerosis, with a 20 and 30 p. 100 respectively reduction of risk. At the moment, there is no evidence that these compounds are effective in the primary prevention or treatment of cerebral infarction in the acute phase. The best way of preventing thromboembolic stroke of cardiac origin is to treat the responsible heart disease and prescribe anticoagulants. However, several studies are in progress to evaluate the effectiveness of aspirin in the primary and secondary prevention of cerebral thromboembolism due to non-valvular atrial fibrillation.

Arteriosclerosis↗
PubMed1989

[Vasculitis of the central nervous system].

Vasculitis of the central nervous system (CNS) is a rare disease characterized inflammation and/or sclerosis of the vascular wall, usually due to an immunological mechanism. The positive diagnosis of CNS vasculitis is difficult owing to its protean clinical manifestations, to its variable course and to the nonspecificity of CT and MRI images. Angiography itself may be of no avail since the segmental narrowing images, although suggestive, are neither constant nor pathognomonic. The causes of CNS vasculitis are very numerous. The aetiological diagnosis is easy when the causal systemic disease is already known or when an inflammatory syndrome and other localizations are present, but it is difficult in those exceptional cases where the vasculitis is limited to the CNS. Biopsy of the cortex and leptomeninges may them be required. Treatment varies according to the cause; it rests essentially on corticosteroid therapy, sometimes combined with cyclophosphamide.

Brain↗
PubMed1989

Migraine--a risk factor for dissection of cervical arteries.

A case control study technique was employed to test for an association between non-traumatic cervical artery dissection and several possible risk factors. A significant positive association was shown with migraine, independent of type and treatment regimen. No such relationship was found with smoking history, hypertension or past oral contraceptive use. There was, however a significant and independent association with current oral contraceptive use.

Adult↗
PubMed1989

Epidural blood patch in the treatment of post dural puncture headache: a double blind study.

A randomised double blind controlled trial of 'epidural blood-patch' as treatment for post-dural puncture headache is presented. The method was successful in 11 out of 12 cases on its first application, the twelfth patient being relieved by a second procedure. None of six patients reported benefit from a 'sham' procedure. The rationale for the use of the technique is discussed.

Adolescent↗
PubMed1989

Dissecting aneurysm of the vertebral artery and cervical manipulation: a case report with autopsy.

A 35-year-old woman with 3 weeks of cervical pain developed ischemia in the basilar artery territory following cervical manipulation. At autopsy, there was a dissecting aneurysm within the third segment of the right vertebral artery. The pathologic changes in the lower and the upper part of the dissecting aneurysm were different, indicating recurring bleeding. Cervical manipulation could have accounted for one recent dissection, but not for another, which was a few weeks old. This suggests that cervical pain, which prompted the manipulation, may have been the first symptom of the dissection, and manipulation of the neck precipitated the stroke by inducing bleeding within the dissecting aneurysm.

Adult↗
PubMed1989

[AIDS in elderly patients. Apropos of 22 cases observed in the Paris region].

If geriatric AIDS is defined as the occurrence of this disease in individuals over 60 years old, it represents about 5% of the cases reported to the Direction Générale de la Santé by the end of 1988. We retrospectively analyzed 22 clinical cases of geriatric AIDS observed between 1985 and 1987, i.e. 21% of the cases reported at that time. In 55% of them, infection resulted from contaminated blood transfusions. Initially, hospitalization was indicated due to a significant deterioration of the patient's general condition, however, neuropsychiatric disorders and intellectual degeneration were present in 18% of the cases. Biological anomalies at the time of admission were classical with the exception of a high frequency of leukopenia often associated with anemia or thrombopenia. During the evolution of the disease, opportunistic infections were very common (90% of the cases). However, the major characteristic of this clinical form of AIDS is the high percentage (55%) of patients suffering from major neurological and psychiatric disorders, including subacute encephalitis in more than half of these patients. The prognosis is very bad, with an average survival time of 4.3 months from the time of diagnosis (median 2.5 months). The cumulative effect of the delay in diagnosing AIDS during the first hospitalization and the classical seriousness of encephalitis suffice to explain the very poor prognosis in patients whose age can play a role in altering the immune response.

AIDS Dementia Complex↗
PubMed1989

[Treatment of vascular pain of the face by methylprednisolone injection into the area of the greater occipital nerve: 16 cases].

Sixteen patients suffering from cluster headache received an injection of 160 mg methylprednisolone into the region of the greater occipital nerve ipsilateral to the pain, when free of headache. In episodic cluster (n = 8), attacks ceased in 2 cases and decreased in severity and frequency in one other. Three patients failed to respond at all. Two became headache-free, but the injection had possibly been performed towards the time when the episode might have been expected to end spontaneously. In chronic cluster (n = 8), four patients failed to respond at all. Four others improved, but only partially and transiently. On the whole, the present results are not as favourable as those obtained by Anthony, who advocated this technique.

Adult↗
PubMed1988

[Metoprolol, a new effective antimigraine agent].

The effectiveness of metoprolol as a prophylactic treatment of migraine was investigated in double-blind comparative trials involving more than 500 patients. In two trials using a slow-release preparation and a dose of 200 mg per day, metoprolol proved significantly better than a placebo and as effective as propranolol 160 mg/day or flunarizine 10 mg/day. At the dose of 100 mg per day metoprolol was significantly more effective than clonidine and clomipramine and not different from a placebo, propranolol 80 mg/day or pizotifen 1.5 mg/day. It is concluded that metoprolol is useful as prophylactic treatment of migraine and ranks among the main drugs used for the same purpose, such as propranolol and pizotifen.

Clinical Trials as Topic↗