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Biomedical subjects

M Giroud

Publications and source records attributed to M Giroud.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Moyamoya disease in children. A review of the clinical and radiological features and current treatment.

Two cases of moyamoya disease observed in two children are reported. The two cases recall the frequency of ischemic strokes, transient ischemic attacks, and seizures revealing the disease. Diagnosis is made by cerebral arteriography showing carotid stenosis and the dense deep arterial collateral as seen in these two cases. Magnetic resonance imaging makes it possible to identify this vascular disease as it reveals vascular varicosities in the basal ganglia, as in case 1. Strokes can sometimes be prevented by constructing an anastomosis between the superficial temporal artery and the middle cerebral artery, as demonstrated in case 1. Thus, the diagnosis of moyamoya disease has been improved by magnetic resonance imaging and there is now a surgical treatment to prevent ischemic stroke.

Brain↗
PubMedDate not supplied

[Ischemic cerebrovascular accident and sport activity. 6 cases].

Six cases of ischaemic stroke which occurred during sporting activities are reported. The authors insist on the unusual features of the ischaemic events which had the same characteristics as other ischaemic strokes in young subjects: frequent involvement of the main cerebral arteries, good vital and functional prognosis in short--and mid-term. They consider that three factors might have concurred in precipitating the ischaemic accident, viz.: fibromuscular dysplasia (observed in 3 patients), warm summer weather encouraging haemoconcentration and poor physical training in 5 out of 6 cases.

Adult↗
PubMedDate not supplied

[Multiple sclerosis associated with biological symptoms of systemic lupus erythematosus. A case with anatomical study].

A clinical history typical of multisclerosis began in a 20-year old man with transient, then permanent manifestations involving the optic tract and the pyramidal, extrapyramidal and cerebellar systems. The patient died at the age of 62, at the end-stage of a complex clinical situation which included paraplegia, bilateral cerebellar syndrome, optic nerve atrophy, epileptic seizures and dementia. When the patient was 54 years old, laboratory findings suggestive of systemic lupus erythematosus (SLE) were discovered, namely: antinuclear, native anti-DNA, anti-Sm antibodies, circulating anticoagulant, cryoglobulinaemia and low complement level. These abnormalities persisted up to the patient's death, 8 years later, without any non-neurological sign of SLE. Post-mortem examination showed lesions of focal demyelination characteristic of multiple sclerosis, but no evidence of cerebral or extracerebral SLE. This case raises the problem of borderlines or associations between systemic lupus erythematosus and multiple sclerosis. In our case, as in other cases of "lupoid sclerosis" reported in the literature, there was a frank and isolated elevation of serum IgM levels.

Adult↗
PubMedDate not supplied

Early seizures after acute stroke: a study of 1,640 cases.

We evaluated prospectively the occurrence of seizures within 15 days of a first stroke or transient ischemic episode in 1,640 patients to study relation between seizures and type of stroke. Seizures occurred in 90 patients (5.4%), including 36 (4.4%) of 814 with infarct owing to atheroma, 21 (16.6%) of 126 with infarct owing to cardiogenic embolus, 3 (1%) of 273 owing to lacunar infarct, 5 (1.9%) of 259 owing to transient ischemic attack (TIA), 21 (16.2%) of 129 owing to supratentorial hematoma, and 4 (16.6%) of 24 owing to subarachnoid hemorrhage. Thirteen (14.6%) of 89 subcortical infarcts were associated with seizures. Seizures were the initial sign of stroke in 80 (89%) of 90 cases and were usually single and partial. Seizure symptoms were most often motor, sensory, or visual.

Aged↗
PubMedDate not supplied

5-Hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluid of children with febrile convulsions.

5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured by high-performance liquid chromatography (HPLC) in lumbar cerebrospinal fluid (CSF) obtained from febrile children subdivided according to the presence or absence of convulsions. Lumbar puncture was made either early (mean time 2 h) or late (3-6 days) after the febrile convulsion. The level of 5-HIAA was significantly decreased in children early and late after the febrile convulsion as compared with the convulsion-free group, but the HVA level was reduced only early after the febrile convulsion. These results support the hypothesis that a decrease in CSF 5-HIAA may be a biologic marker of susceptibility to convulsions and indicate that the transient decrease in HVA is a secondary phenomenon related to occurrence of convulsions.

Child, Preschool↗
PubMedDate not supplied

[Effects of callosotomy in the treatment of intractable epilepsies in children on psychiatric disorders].

Two children, 13 and 14 years old, presented an intractable epilepsy of Lennox-Gastaut. In front of dangerous tonic and atonic epileptic crisis, a corpus callosotomy was performed. Corpus callosotomy is becoming a more widely used procedure in the treatment of intractable epilepsy as Lennox-Gastaut syndrome, or frontal epilepsy. However, there have been very few series that have reported results in children. It is not a complete but a partial, callosal section including approximately the anterior two thirds of the callosum. After this surgery the two children improved dramatically because the dangerous tonic and atonic crisis disappeared. Secondly we observed improvement of pre-surgical psychiatric troubles, that is a data not developed in the literature. Before surgery, the two children had a frontal syndrome with hyperkinesia, distractibility, aggressiveness, alexithymia, loss of the program of ideas. During the two months after the section of the anterior two thirds of the corpus callosum, we observed a progressive improvement of the frontal syndrome, with possibility to learn new praxies. The intellectual quotient was not altered and associative functions, depending of the posterior third of the corpus callosum were spared. Anti-epileptic medications were not stopped. We think that the improvement of the frontal syndrome is due to reduction of seizures. Therefore, we insist on the interest of the section of the anterior two thirds of the corpus callosum as treatment of tonic and atonic seizures but also as treatment of psychiatric symptoms depending of a frontal syndrome.

Adolescent↗
PubMedDate not supplied

[Erythema multiforme induced by the combination of phenytoin and cerebral irradiation].

The authors report the case of erythema multiforme characterized by its cephalic onset and its rise after association phenytoin and cranial irradiation, for glioblastoma with epileptic fits. Eight similar cases are observed in literature with the same timing. Benign outcome is not always the rule because 2 patients died. This type of reaction being not forseeing, and outcome very varying, we suggest to avoid phenytoin in patients having a cerebral tumor revealed by epilepsy and needing a cranial irradiation.

Brain↗
PubMedDate not supplied

[Epilepsy and endocrine modifications].

From a few personal works and from a review of the literature, the authors discuss the current date of the endocrinological involvement of epileptic seizures, epileptic diseases, and anticonvulsants. Generalized epileptic seizures are followed by a constant, specific and significant rise of ACTH and Prolactin during the hour after the fit. That is a very good biological marker of the epileptic cause of a loss of consciousness. The duration and the repetition of the seizures involve the pituitary-gonadotropic+ axis that explains the anovulatory cycles and hypofertility in women, and the decrease of libido in men. Then, the anticonvulsants involve the hormonal balance, either by a direct action upon the hypothalamo-pituitary axis (ACTH, Prolactin) or by a direct action upon peripheral hormones (Testosterone, Thyroxine). These problems must be known for the follow-up of the epileptic patients, and for the interpretation of the hormonal dosage of these patients.

Adrenocorticotropic Hormone↗