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Biomedical subjects

M Sindou

Publications and source records attributed to M Sindou.

At least 163 records · Page 9Linked to original sources

[Developmental ophthalmic ischemia. Regression after emergency extra-intracranial anastomosis].

Recently several publications have insisted on the ability of E.I.C.B. in reversing ocular manifestations due to chronic ophthalmic ischemia, when surgical carotid desobstruction is considered impossible or hazardous. Revascularization with E.I.C.B. can also be useful--on emergency --in case of "in evolution" ophthalmic ischemia, due to low pressure perfusion in the carotid-ophthalmic territory, to save vision. The authors report the case of a patient, presenting an optico-pyramidal syndrome "in evolution", secondary to occlusion of the left carotid artery associated with stenotic lesions in the ophthalmic artery, reversed by E.I.C.B. performed on emergency. Left visual acuity and diastolic retinian arterial pressure --respectively inferior to 1/10 and unmeasurable, before operation--raised up to 6/10 and 18 mmHg within the first twelve post-operative days and reached 8/10 and 38 mmHg after eleven weeks. This case report aims at pointing out the capacity of E.I.C.B. performed on emergency in reversing ophthalmic ischemia--"in evolution"--before constitution of irreversible lesions.

Aged↗

["Benign" intracranial hypertension due to bilateral thrombosis of the lateral sinuses treated with venous bypass (author's transl)].

The authors report on a case of "benign" intracranial hypertension due to bilateral thrombosis of the lateral sinuses and internal jugular veins of infectious origin (otitis). A venous by-pass was established between one of the lateral sinuses and an external jugular vein. As early as the first post-operative week, the intracranial pressure was reduced and the visual disorders regressed. Such venous by-passes, now made possible by micromicrosurgical techniques, can be suggested for treating occlusions of the intracranial sinuses due to thrombophlebitis, traumatisms or tumours.

Adolescent↗

[Pain relief through transcutaneous electrical nerve stimulation (TENS). Results on painful neurological disorders in 180 cases (author's transl)].

A series of 180 patients with painful neurological disorders were treated with TENS. The findings most frequently encountered when the treatment was successful are analyzed. Depending upon the etiology of the primary disorder, good results (i.e. pain relief of 20% or higher) were obtained as follows : -- Peripheral Nerve Involvement : Amputation - 35 cases; Traumatism - 13 cases ; Miscellaneous - 7 cases. (87 %). -- Radicular Syndromes : Epidural scar and/or Arachnoiditis - 19 cases; Miscellaneous - 9 cases. (60 %). -- Post Herpetic Pain : 34 cases. (67 %). -- Brachial Plexus Lesions (Avulsions) : 12 cases. (25 %). -- Spinal Cord Disorders : 17 cases. (11 %). --Thalamic Pain : 5 cases. (0 %). -- Post-Radiation Pain or Carcinomatous Pain : 16 cases. (30 %). Satisfactory long-term results (over 3 years) were maintained in 80 % of cases of peripheral nerve involvement. In all other cases the percentage of pain relief decreased with follow-up. In this series the likelyhood of good results was associated with the following objective data : 1) Pain is generally secondary to deafferentation. 2) Pain is localized. 3) TENS application in close contact with the nervous structure innervating the painful area is more productive. 4) A relative preservation of lemniscal fibers to superior centers must be present so that stimulation can be transmitted.

Analgesia↗

Bilateral thrombosis of the transverse sinuses: microsurgical revascularization with venous bypass.

The present paper reports a case of intracranial hypertension secondary to thrombophlebitis of the two transverse sinuses and internal jugular veins in which microsurgical revascularization was attempted. This was carried out by means of a bypass graft inserted between the right transverse sinus and the superficial jugular vein. As early as the first post-operative week, intracranial pressure improved and visual disorders regressed. This type of venous revascularization using microsurgical techniques should contribute to more successful and lasting results in cases of sinus occlusions of thrombophlebitic, traumatic or tumorous origins.

Adolescent↗

[Actinomycotic brain abscess. (about four observations) (author's transl)].

The authors report four observations of actinomycotic brain abcess. One patient with multiple hemispheric abcesses and with stomatologic and pulmonary lesions, one with seemingly primary cerebellar abcess, one with associated hemispheric abcess associated with pneumopathy. About these four cases, they discuss the role of actinomycosis in infectious diseases of the central nervous system, and the elements necessary for the diagnosis. The neurological syndrom is not specific, but the discovery of visceral lesions is an excellent argument. From the histological point of view, the discovery of "granules" containing the bacteria conforms the diagnosis by special colorations. From the bacteriological point of view, the isolation of the germ is easy but its specific identification necessitates special techniques. The diagnosis of actinomycosis is indispensible to begin a correct treatment. For the authors, this treatment must associate surgical excision of the most extensive lesions and adapted antibiotherapy for more than four months.

Actinomycosis↗

Revascularization of the spinal cord by micro-anastomoses in dogs.

The severity of ischemic lesions in the spinal cord justifies attempts at its surgical revascularization. The experiments consisted of: (1) creating devascularization of the conus medullaris by ligation of all the lumbo-sacral collaterals of the aorta, and (2) revascularizing the lumbo-sacral rachidian circulation by performing an end-to-side anastomosis between the caudal mesenteric artery and the 5th left lumbar artery (from which in the dog the Adamkiewicz artery generally arises). After two-months, the patency rate of the 20 cases was 85%. Such a procedure of revascularization could be useful in man in cases of interruption of the arterial supply of the spinal cord.

Angiography↗

[Trigeminal neuralgia. Percutaneous thermocoagulation of the trigeminal nerve (author's transl)].

200 cases of percutaneous thermocoagulation of the trigeminal nerve were studied in order to determine if the position of the thermolesion in the various parts of the trigeminal system modified the quality of the results and the frequency of post-operative complications. An anatomo-radiological study allowed the precise localisation in the sagittal plane of the position of the different parts of the trigeminal ganglion with respect to the neighbouring bony features. The quality of the results and the frequency of complications were studied according to the level of the thermolesion (ganglion, triangular plexus, posterior sensory root). This study permitted the observation that the more posterior the thermolesion, the less frequent the complication, and this confirmed results obtained in earlier procedures, c.g. gasserian or retro-gasserian neurotomy. Post-operative hypoaesthesia extending beyond the painful area, was the major side-effect of the radicular position of the thermolesion. There follows a discussion of the criteria, which permit the recognition of the point of the electrode at the level of the posterior root: the flow of CSF, vasodilatation, and radiological localisations. Of these three criteria, only radiological demonstration (point of the needle posterior to the clivus and above the petrous temporal bone) seemed reliable.

Adult↗