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Biomedical subjects

P Bret

Publications and source records attributed to P Bret.

At least 109 records · Page 6Linked to original sources
PubMed1981

[Intra operative embolization of unresectable cerebral arterio-venous malformations. Occlusion attempt by means of a delayed polymerization mixture. Report of two cases (author's transl)].

Two cases of unresectable intra-cranial arterio-venous malformation (AVM) are reported, treated by direct intra-operative embolization. A 50% mixture of Butyl-2-Cyano-Acrylate and Mono-Iodo-Stearate of Ethyle (Duroliopaque) was used after catheterization of some of the feeding cortical arteries. No intra-operative angiography was performed. The first patient, admitted after subarachnoid hemorrhage and presenting with a mild transient right hemiparesia and aphasia, showed evidence of a left temporal AVM with a left middle cerebral artery supply and contribution from the left cerebral posterior artery. The AVM was embolized with 3 cc of the mixture. A mild aphasia occurred after surgery and completely recovered after two weeks. Roughly half of the AVM was occluded on the postoperative angiograms. The second patient suffering from a long history of seizures had a huge right frontal AVM, with a right middle cerebral artery and right anterior cerebral artery supply, and contribution from a right lenticulostriate artery, the left anterior cerebral artery and the right posterior cerebral artery. The AVM was embolized with 7 cc of the mixture. A complete palsy of the left upper limb occurred after surgery, with complete recovery after two weeks. On the post-operative angiograms, more than three fourth of the AVM was occluded.

Adult↗
PubMed1981

[Lumbo-peritoneal CSF shunt (author's transl)].

In a preliminary technical report, the authors describe a procedure for lumbo-peritoneal shunt consisting of the percutaneous introduction of a sub-arachnoid proximal catheter. There would appear to be many advantages in the treatment of communicating hydrocephalus when compared with classical shunt methods taking the CSF from the ventricle.

Adolescent↗
PubMed1980

[An improved technique for radiological examination of the small intestine (author's transl)].

An improved technique for radiological examination of the small intestine by barium meal follow through is described, the method being based on an increase in amount of the volume of the meal: three glasses of 300 ml of a diluted 2/3 solution of micropaque. Opacification of the ileocecal region was obtained in 85 p. cent of 500 cases examined, in less than one hour. Intravenous injections of metoclopramide or neostigmine were given in 25 p. cent of cases.

Humans↗
PubMed1980

[Colonic complications of pancreatitis. A report on 39 cases (author's transl)].

Colonic complications of pancreatitis are not infrequent occurrences, as illustrated by the fact that the authors have personally treated 39 such cases. Lesions are found in the colon at sites which correspond perfectly to diffusion of pancreatic necrotic lesions along mesenteric pathways as described by Meyers. They occur mainly in the left colic flexure (17 cases) and transverse colon (10 cases) but may affect the ascending (6 cases) and descending (4 cases) colon by diffusion of the pancreatitis into the anterior extrarenal space. These topographical characteristics, associated with the extrinsic and inflammatory nature of the lesions, produce a very specific and typical radiological syndrome which should assist diagnosis.

Adult↗
PubMed1980

[Lacunar images and invagination in 25 patients with celiac disease (author's transl)].

A retrospective analysis of the results of barium meal with follow-through examinations of the small intestine was conducted in 25 patients with sprue. One or more images of invagination were present in 4 cases, and in 15 patients there were one or more central or marginal lacunar images, several centimetres in diameter, round or ovular in shape, and with irregular margins. These images are probably due, in varying degrees, to disorders of intestinal motility in hypotonic loops with edematous walls. Knowledge of these findings may be useful for assisting diagnosis of the disease.

Adult↗
PubMed1978

[Extra-intracranial artérial by-pass. A clinical experience based upon 40 cases (author's transl)].

UNLABELLED: Extra-intracranial by-pass between a branch of the external carotid artery and a branch of middle cerebral artery has been used since 1972 in the treatment of cerebral ischemia. MATERIAL AND METHODS: 40 patients have been operated on (34 men and 6 women) aged from 28 to 68. Clinical data were TIA's or PRIND in 11 patients and stroke in 29 patients. The left hemisphere was involved in 25 cases and the right one in 15 cases. No patient was operated on in emergency; operation was performed after 2 or 3 weeks in most cases. The branch of external carotid artery was the superficial temporal artery in 36 patients and the occipital artery in 4 patients. As for the cerebral artery, were used the anterior temporal artery (9), the middle temporal artery (2), the posterior temporal artery (15), the angular artery (6), a frontal artery (15) and a parietal artery (1). In 8 patients, two anastomosis were performed using both branches of STA. Patency of the by-pass was confirmed in most cases by means of angiography, performed early after operation, and if possible one year later.

Adult↗
PubMed1978

[Diastematomyelia. About a series of 6 cases (author's transl)].

The authors report 6 cases of diastematomyelia in children. They stress the rarety of this spinal cord diformity whose pathogenesis is obviously of dysraphic origin. From the clinical point of view, "orthopedic syndrom" is the most common complaint (cypho-scoliosis and - or - malformation of the feet) in a child with dorsal or lumbar cutaneous dysplasia. Neurological disorders or sphincterian disturbance are less frequent. Radiologic examination shows the high frequency of spina occulta. The diagnosis is assessed when bony spur is demonstrated on films. Vertebral body diformities are not constant and often far seated from spur. Air myelography demonstrates site and length of spinal cord cleft and often the low position of conus medullaris. Surgery allows the liberation of bifid cord by resection of spur. It should be suitable to cut filum terminale when it is accessible by laminectomy. Exposure of results stress the preventive effect of surgery for diastematomyelia.

Adolescent↗
PubMed1976

[Subdural hematoma and anticoagulant therapy].

The authors report a series of 22 cases of subdural hematomas in patients submitted to anticoagulant therapy. A review of the literature finds 150 cases. Subdural hematomas occurs in about one third of the patients presenting hemorrhage of central nervous system related to anticoagulant therapy. Among subdural hematomas of any cause, the possible role of a previous anticoagulant therapy is stressed in 4,8 to 14% of cases. In most cases, long term anticoagulants were indicated for arterial or heart (ischemic) lesions (16/22 cases). In 6 cases, anticoagulants were indicated for prevention or treatment of pulmonary embolies. In 18 cases, anticoagulant drug is from the group of dicoumarol or phenylindanedione. In 3 cases, the only anticoagulant given to patient was heparin. Pathogenic study suggests that hypocoagulability might not always be the only factor of bleeding: high blood pressure, other drugs and head trauma (10 cases) are often associated. Clinical features, in our series, are similar to those encountered in cases of subdural hematoma of any cause. According to the existence of a cranial injury and to the chronology of anticoagulant therapy, the authors divide their 22 patients into 3 groups. The use of protamin sulfate or human plasma fraction PPSB provides in few minutes a normal coagulability. Neurosurgical treatment in all our cases evacuated in 11 patients a chronic subdural hematoma, in 2 cases an acute, and in 9 cases a subacute hematoma. Results were fair in 19 patients with no sequelae. 3 patients died during the immediate post-operative period. The authors conclude by stressing several preventive measures.

Anticoagulants↗
PubMed1976

[Intraspinal meningiomas. A series of 60 cases].

The authors present and compare two consecutive series of spinal meningioma, a total of 60 cases. From the aetiological point of view, the meningioma were more frequent than neurinoma. This study confirms its predominance in the female after the fifth decade. A traumatic factor was sometimes implicated. Anatomically, its localisation predominated in the dorsal region (78.3 p. cent), specially in the first three vertebral segments, and most commonly laterally placed. The strictly epidural meningioma, the multiplicity and the association with a neurinoma were less frequent. On the clinical level, the comparison between the two series illustrated a considerable diminution of the pre-operative evolution of the disease, taking into consideration the existence of spinal deficit less apparent in patients operated after 1963. 54.5 p. cent presented at diagnosis, a total or partial impotence against 81.5 p. cent in the old series. Among the laboratory examinations, the C.D.F. study confirmed slight or even absent cyto-albuminous dissociation, which contrasted markedly with the figures obtained in cases of neurinoma. Plain spinal radiography was usually negative. The radio-opaque myelography revealed a block, sometimes a partial one, very suggestive when bossulated, but which might sometimes mimic a neurinoma or even an epidural lesion. The presence of an arachnoid cyst may give a false level. Surgery was always indicated, regardless of the patients' age. The tumour should be completly removed in a piece-meal fashion with the preservation of the radiculo-medullary elements, which was facilitated by the use of the microscope. To prevent a recurrence, the base of the tumour should be well coagulated or resected followed by a plastic reconstruction of the dura mater. The mortality rate including the late mortality has diminished from 24 p. cent to 11 p. cent. This is essentially due to decubitus in patients who did not improve. The percentage of complete functional recovery rose from 40 p. cent to 66 p. cent of those who survived. The percentage of recovery with sequellae compatible with an autonomous physical activity was stable. The percentage of completly handicaped survivals fell from 28 p. cent to 5 p. cent. The authors conclude that the prognosis for patients with intraspinal menigioma has improved, however the diagnosis is still difficult in the old subject, and there is a serious risk to life when the lesion is in the cervical region.

Adult↗