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Biomedical subjects

M Jan

Publications and source records attributed to M Jan.

At least 55 records · Page 3Linked to original sources
PubMed1994

Granular cell tumor of the pituitary stalk. Case report.

The case is described of a granular cell tumor of the pituitary stalk in a 40-year-old woman with secondary amenorrhea. A computerized tomography scan showed a large contrast-enhancing mass, and T1-weighted magnetic resonance images demonstrated a tumor isointense to the brain parenchyma with nonhomogeneous enhancement after intravenous administration of gadolinium diethylenetriamine penta-acetic acid. Histopathological examination, especially immunocytochemical and electron microscopic studies, showed elements supporting an astrocytic origin for this type of tumor, a hypothesis advanced by many authors but still controversial.

Adult↗
PubMed1994

[An immunohistochemical and ultrastructural study of granular cell tumor of the neurohypophysis].

We describe the histopathological examination of a granular cell tumor of the neurohypophysis (GCTN). The immunohistochemical study revealed a focal positivity for GFAP within rare neoplastic cells. The electron microscopy study characterised two types of cells: some contained spindles of intermediate filaments and a few granules in their cytoplasm whereas others cells only contained granules. These findings are compatible with the astrocytic origin of the GCTN, which have been suggested by many authors but never proved up to day.

Glial Fibrillary Acidic Protein↗
PubMed1993

Postoperative assessment of cerebral blood flow in subarachnoid haemorrhage by means of 99mTc-HMPAO tomography.

Regional hypoperfusion is a very frequent complication of subarachnoid haemorrhage (SAH), being related to vasospasm in the majority of cases. Twenty-six patients who were admitted for SAH underwent follow-up with technetium-99m hexamethylpropylene amine oxime single photon emission tomography (SPECT) 3 and 8 days after surgery. Fifteen patients of these had one more examination 15 days after surgery. The degree of hypoperfusion was quantified using an index of asymmetry which allow the comparison of two symmetrical regions of interest (ROIs) on the transaxial slice which presented the greatest perfusion defect. Comparison of CT data, transcranial Doppler data and clinical signs with the perfusion as quantified by 99mTc-HMPAO SPECT indicates that a difference in counts of less than 10% between the two symmetrical ROIs is of no diagnostic value. Follow-up of the brain perfusion clearly shows that the most pronounced hypoperfusion was observed just after surgery, with progressive normalization at 8 and 15 days after surgery. 99mTc-HMPAO SPECT performed 8 days after surgery allows prediction of the clinical outcome. For these reasons, 99mTc-HMPAO SPECT, which is the only method for follow-up of cerebral perfusion in routine clinical practice, should be the first examination to be performed after surgery in patients with SAH.

Brain↗
PubMed1991

Multiple cerebral angiomas and Rendu-Osler-Weber disease: case report.

A 25-year-old man was hospitalized after suffering a subarachnoid hemorrhage. Arteriograms disclosed two arteriovenous malformations, one of which was asymptomatic. Rendu-Osler-Weber disease was suspected because of the concomitant existence of cutaneous telangiectases. Review of the literature shows that in 12 previously published cases involving multiple arteriovenous malformations, this diagnosis was established five times. The indications for surgical treatment are discussed.

Adult↗
PubMed1991

[Evaluation of cerebral hemodynamics by transcranial Doppler in anesthesia and reanimation].

Doppler technics are widely used for the investigation of the peripheral flows. The main objective of the method is to detect and quantify the vascular disease (stenosis, arterio-venous malformation) at the level of the carotid bifurcation or on the intracranial vessels. The spectral analysis provides informations on the velocity profile, and allows to quantify systolic, diastolic, and mean frequencies from which the usual haemodynamic parameters are determined. In case of vasospasm, the maximal frequency increases significantly (> 3 kHz). The amplitude of the diastolic flow is related to the vascular resistance. Vascular disease or distal vessel compression make the resistance increase; on the contrary vasodilation decreases the vascular resistance. The Doppler index R = S-D/S, with S and D the systolic and diastolic amplitude is generally accepted to change in proportion with the vascular resistance. The blood flow volume can be evaluated from the mean Doppler frequency, the vessel diameter, and the angle theta between the vessel and the Doppler beam. In case of intracranial arteries the diameter cannot be accurately measured by echography. Nevertheless if the diameter does not change and the angle theta remains constant, the variations of the mean frequency represent the blood flow volume changes. If there is a vasospasm, this method cannot be used, and the only possibility to evaluate the cerebral blood flow changes is to measure the variations of the common carotid blood flow or carotid mean frequency. The haemodynamic parameters are used in anesthesiology or in intensive care.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1991

[Hydrocephalus caused by obstruction of the foramina of Luschka and Magendie in adults. Report of a case. Etiopathogenic discussion].

The authors report the case of 30 years old patient presenting with an hydrocephalus responsible for high intracranial pressure and cerebellar ataxia. The fourth ventricle dilatation was predominant and there was no passage of the contrast media in the cisterna magna during ventriculography. For lack of neonatal antecedents and neurological pathology a congenital origin was evoked. The obstruction of the foramina of Luschka and Magendie with an hydraulic stability in the ventricles during the life before decompensation was likely. A ventriculo-peritoneal shunt, seemed to be the better treatment with regard to the permeability of the aqueduct.

Adult↗
PubMed1990

Hydrocephalus and cavernoma of the cauda equina.

The association of a tumor of the cauda equina and hydrocephalus is unusual. We report a case of hydrocephalus with normal pressure associated with an equally rare affliction, a cavernous angioma of the cauda equina, which regressed after surgical ablation. The physiological mechanism involved is discussed.

Aged↗
PubMed1989

Cerebellar hemangioblastoma and primary hyperparathyroidism.

The authors report the case of a 52-year-old woman presenting with cerebellar hemangioblastoma and primary hyperparathyroidism. It is the second reported case involving this new association. The relationship between these two tumors is discussed.

Cerebellar Neoplasms↗
PubMed1989

Ectopic prolactinoma within the sphenoid sinus.

A case of an ectopic prolactin-producing tumor located within the sphenoid sinus is reported. It was discovered in a girl who experienced secondary amenorrhea without galactorrhea. We discuss the different diagnoses proposed before immunocytochemical staining results were available. This case presented unusual radiological, surgical, and histopathological aspects.

Adolescent↗
PubMed1989

Colloid cyst of the fourth ventricle: diagnostic problems and pathogenic considerations.

The authors report the case history of a patient with a colloid cyst of the 4th ventricle. The clinical history of slow intracranial hypertension, homogeneous hyperdensity with contrast enhancement on computed tomographic, scan, and the gelatinous aspect of the cyst at surgery are characteristic of colloid cysts. The diagnosis was made, however, only at the time of histological examination. A common neuroepithelial origin with 3rd ventricle cysts would be explained by similar embryological developments of the prosencephalic and the rhombencephalic roofs.

Adult↗
PubMed1989

[Otoneurosurgery in the elderly].

An oto-neuro-surgical experience on patients older than 65 years is reported. 25 patients have been operated: 9 meningiomas, 5 trigeminal neuroglia, 2 vestibular neurectomies, 9 acoustic neuromas. The assessment, the indication, the surgical techniques are discussed. Are also evaluated the anesthetic technique, the patient drugs, position, and the post-operative survey.

Aged↗
PubMed1989

[Spinal osteoid osteomas. Apropos of 4 cases].

Spinal osteoid osteomas constitute a rare but perfectly curable cause of non-disc root pain. In discussing four cases (2 cervical and 2 lumbar), the authors stress that this disorder affects above all males under 30 and presents as vertebral column pain gradually becoming radicular in character; the pain, essentially nocturnal, is spectacularly but transiently relieved by salicylates and is accompanied by often frank stiffness of the spine. The diagnosis is based less on X rays and tomographs, than on isotope bone scanning, which reveals a focus of intense hyperfixation, and CAT scanning which shows a bony lacuna possibly with an opacity in the center producing a rosette shaped image. Block excision of the osteoid osteoma produces immediate relief for the patient and prevents recurrence which only occurs exceptionally.

Adult↗
PubMed1989

[Does nimodipine improve the outcome of perioperative complications of aneurysm rupture? Results of systematic treatment].

Morbidity after aneurysmal subarachnoid hemorrhages is proceeding from many factors; ischemic etiology is underestimated and frequently thought to be vasospasm related only. Other undoubted mechanisms are in the setting of ischemic disorders after ruptured aneurysms. The management of these disorders is relevant of new calcium blockers. Early administration of prophylactically oral nimodipine, with temporary intravenous administration of the therapy after surgery or in the setting of delayed ischemic deterioration, were assigned to 36 patients with aneurysm surgery. Efficacy was judged on prevention and outcome of ischemic disorders at discharge and three months later using the Glasgow Outcome Scale. On all, twenty-nine patients were disabled from any etiology; twenty made full or improved recoveries at discharge; twenty-eight get independent conditions of life at 3 months. Fourteen patients have return to their pre-rupture activity. Twenty-two surgical patients (61%) set an undoubtly ischemic disability during any time of their hospitalization, but many etiologies were identified in majority of cases. Spasm is the main factor of stroke in only 6 patients, and one of the ischemic factors in 15 cases. Among these ischemic deteriorations, twenty improved or made full recovery at discharge and get independent life at 3 months. No death with spasm. These data support the assumption that vasodilatating is not the only mode of nimodipine action. Hypervolemia must be adjunct with nimodipine to prevent regional hypoperfusion.

Adolescent↗