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Biomedical subjects

P Castaigne

Publications and source records attributed to P Castaigne.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Necrotic myelopathies and neoplastic pathologie. Three clinico-pathological cases (author's transl)].

Three clinico-pathological cases of necrotic myelopathies with a distant malignancy are presented. Two cases had a lymphosarcoma and one case a prostatic carcinoma. They were compared to 13 well studied other cases collected in the literature. These myelopathies were related to solid visceral tumours in 8 cases and to lymphomas in 5 cases. The disease could be individualized on clinical grounds (flaccid paraplegia with bladder and bowell incontinence and sensory loss without clear-cut upper boundary developing over a few weeks with normal CSF and fast impairement of general condition), and, on pathological features. It is characterized by one or several spinal cord necrosis areas, often asymetrical, involving mostly white matter, without any vascular topography. Axons are involved as well as myelin sheats. There is mild inflammation and no specific vascular alteration. There is no metastases in the cord, meninges, vertebral column or nerve root. No vascular occlusion is found. The mechanism of the disease is unknown. The frequent occurence of lymphomas could suggest the presence of immunopathological factors.

Adenocarcinoma↗
PubMed1980

[Cerebral venous thrombosis in Behçet's disease (author's transl)].

Two patients with Behcet's disease and angiographically demonstrated cerebral venous thrombosis are described. Dural sinuses were involved in one patient and an internal cerebral vein in the other. Cerebral venous thrombosis was the first manifestation of the disease and occurred in the absence of other signs of "Neuro-Behçet". The outcome was favorable. The unusualness of such localisations, their unknown mechanism, and difficulties in their diagnostic and treatment are emphasized.

Adult↗
PubMed1980

[Neuropathological study of adult intracranial hemorrhage. III. Analysis of 107 meningeal hemorrhages due to rupture of arterial aneurysms].

The findings in 107 pathological studies of meningeal hemorrhages due to rupture of arterial saccular aneurysms are reported. There were 62 women (58 p. 100) and 45 men (42 p. 100). Mean age was 56, lower in men (53) than in women (58). 45 aneurysms of the Anterior Communicating Artery, 26 of the Middle Cerebral Artery, 15 of the Internal Carotid Artery, 10 of the Anterior Cerebral Artery, 1 of the Anterior Choroidal Artery and 10 of the Posterior System were studied. These ruptured aneurysms were compared to 31 non ruptured ones. Mean size of the ruptured aneurysms was 10, 62 mm, not statistically different from that of non ruptured aneurysms (9, 05 mm). Multiple aneurysms represent 10 p. 100 of the whole ruptured aneurysms population. They affected mostly the Middle Cerebral Artery. High blood pressure had been present in 56/107 cases of ruptured aneurysms (52 p. 100). The prevalence of high blood pressure in patients with ruptured aneurysms (men: 60 p. 100 between 35 and 49, 63 p. 100 between 50 and 64; women: 31 p. 100 between 35 and 49, 54 p. 100 between 50 and 64) was statistically higher than in the same age and sex ranges of the general French population. The other causes of bleeding were rare: 4 liver cirrhosis (2 of the patients were also hypertensive) and 5 anticoagulant therapies (2 of which were also associated with high blood pressure). Intracerebral hematomas were found in 43 cases (40 p. 100): 39 lobar, more frequent in the frontal (26) than in the temporal (13) lobes, due mainly to Anterior Communicating Artery and Anterior Cerebral Artery aneurysms; very few were in the basal ganglia (3) or brainstem (I). Intraventricular hemorrhage was found in 39 cases (36 p. 100). Forty (37 p. 100) cerebral infarcts had occurred. They were located in the territory of the same artery in 20 cases (19 p. 100), in a different territory in 11 cases (10 p. 100), in both in 9 cases (8. p. 100).

Adult↗
PubMed1979

[Diagnosis of cerebral hemorrhages. A report of 247 anatomo-pathological cases (author's transl)].

A series of 247 cases with simple and apparently primitive cerebral hemorrhages selected from the pathological records of Charles Foix laboratory from 1962 to 1977 is reviewed with regard to the accuracy of the premortem diagnosis as a function of the size, the location and the age of the bleeding, the patient's age, the practices of angiography or lumbar puncture and the considered period of death. The clinical diagnosis of cerebral vascular disease was made in 75% of the cases from that serie but the hemorrhagic mechanism was identified only in 50,6% of cases. The diagnosis accuracy was enhanced in large and recent hemorrhages occuring in patients under 70 years old. It seemed better in cerebellar and intermediate locations. It was enhanced in more recent observations (collected since 1974). The practice of cerebral angiography and lumbar puncture rose up (in a somewhat equivalent way) the proportion of accurate diagnoses. The lumbar puncture practice was not associated with a higher rate of cerebral herniae.

Adult↗
PubMed1979

[The treatment of organic pain of the peripheral nervous system using clomipramine. 30 cases (author's transl)].

Clomipramine used alone is an affective analgesic against organic pain due to a lesion of the peripheral nervous system, in particular post-herpetic pain. The quality of the result is related to the dose, and hence to tolerance. Fluohydrocortisone is the most powerful drug against orthostatic hypotension, the chief cause of limitation of treatment. No complications were seen, even in very elderly patients.

Adult↗
PubMed1979

[Creutzfeldt-Jacob disease in continental France. Retrospective study from 1968 to 1977].

During the decade 1968-1977, 170 cases of Creutzfeldt-Jakob disease were found in France. The clinical features of 124 neuropathologically-verified cases are summarized and a multi-factor analysis performed to obtain the most frequent combinations of signs and symptoms. Certain exceptional features are discussed. The annual mortality rate during this period was 0.32 cases per million for the whole of France, and 0.69 cases per million for the Paris metropolitan area. Preliminary totals for 1978 suggest that these figures may possibly be doubled, with 30-40 new cases occurring annually. No temporal-spatial clustering of cases was observed, and no contact between patients could be established, except for familial cases (9% of the total). No risk factors were identified; in particular, iatrogenic surgical or neurosurgical transmission did not occur, nor was any relationship apparent between CJD in man, and scrapie in sheep or goats. These data furnish a base of comparison for prospective studies in France, with a view towards discovering the natural mode of transmission of the virus of CJD.

Adult↗
PubMed1979

A study on sleep in amyotrophic lateral sclerosis.

A polygraphic study of sleep has been performed on 12 patients with ALS and 12 normal controls. Neither the total duration of sleep, nor the proportion of different stages of sleep differed significantly between the patient and control groups. A variety of morphologic peculiarities were observed in certain patients: frequent and repetitive blinking movements during the waking state (under quiet, dark conditions); persistence of EMG activity during both PS and SWS; and an early appearance of marked slow delta wave activity at the beginning of sleep. We observed in patients increased PS latency, and longer and more frequent awakenings. Certain patients also showed both qualitative and quantitative abnormalities of respiratory rhythm. A longitudinal study was performed on one patient. Results are discussed in relation to the existing literature.

Aged↗
PubMed1979

[Monocular circumduction nystagmus (author's transl)].

Monocular circumduction nystagmus is a very rare ocular movement. A type of circumduction movement, it is caused by successive movements of all the ocular muscles within the framework of a pendular nystagmus. As a monocular movement, it raises the question of the physiopathological mechanism of such a movement which is so complex and is also limited to one eye. The existence of a monocular form of circumduction nystagmus makes it necessary to revise the mechanism of pendular nystagmus.

Adult↗
PubMed1979

[Neuropathological study of adult intracranial hemorrhage. General data in 500 cases].

The systematic pathological study of 500 patients with intracranial hemorrhages (ICH) [341 (68 P. 100) CEREBRAL HEMORRHAGES (C.H.); 119 (24 p. 100) meningeal hemorrhages (M.H.); 39 (7,8 p. 100) subdural hematomas (S.H.) and, at last, one extradural hematoma] has been practiced. Those cases were issued primarily from neurological and, at a lesser degree, from neurosurgical departments. Etiological data, complications, associated findings and causes of death have been analysed. High blood pressure is the main etiological factor in C.H. This is confirmed by the statistical comparison between the incidence of this factor in our material and in the whole French population. However, nearly 50 p. 100 of ICH occuring in normotensive patients are C.H. The incidence of cirrhosis is much higher in our study than in other reports from the literature. The frequently associated high blood pressure does not seem to enhance the incidence of CH in patients with liver cirrhosis. Although this last factor can be found alone, its real etiological importance in CH cannot be assessed on account of the lack of data concerning the incidence of liver cirrhosis in the French population. The incidence of anticoagulant therapy is high in S.H. On the contrary, this factor does not seem to enhance the risk of high blood pressure induced C.H. The traumatic etiology of S.H. is significantly higher than the anticoagulant therapy etiology which, however, is very high in our study.

Adult↗
PubMed1979

[Multiple recurrent paralysis of the cranial nerves (author's transl)].

The authors describe three patients presenting several episodes of paralysis of the motor and sensory cranial nerves and discuss possible aetiological factors. The paralytic attacks were regressive and were repeated at irregular intervals over a period of several years. It was confirmed that no local or general cause for the symptoms existed and the conclusion was reached that they were part of an autonomous clinical syndrome of unknown aetiology. Other cases have been reported in the published literature in which a non-specific inflammatory mechanism is suggested but no biological or pathological basis exists to support this physiopathological hypothesis. The clinical syndrome follows a benign course, the paralysis being regressive and the affection remaining confined to the peripheral nervous system of mesencephalic origin.

Aged↗
PubMed1979

[Supranuclear lateral gaze palsy of pontine origin. Report of 2 clinicopathologic cases with electrooculographic and electromyographic data].

Electro-oculographic, electromyographic and pathological findings in two cases of supranuclear lateral gaze palsy of pontine origin have allowed us to define the clinical and physiopathologic features of the Pontine Reticular Formation (PRF) syndrome, and to formulate hypothesis about the terminal portion of the Occipito-Pontine Tract (OPT) involved in horizontal pursuit eye movements. The unilateral PRF syndrome is characterized by abnormal eye movements in the direction of the lesion. In the ipsilateral hemifield of movement there is paralysis of all movements from midline to extreme ipsilateral side, except oculo-cephalic reflex which remains intact (dissociated palsy); in the contralateral hemifield all saccades from extreme contralateral side to midline are suppressed, and this constitutes a specific abnormality of the PRF syndrome: quick phase of optokinetic and vestibular nystagmus are absent, while voluntary gaze is preserved but remarkably slow. It is suggested that this last fact is due to simple disfacilitation arising from undamaged PRF. Electromyographic findings suggest that the division between excitatory and inhibitory fibers of descending supranuclear oculomotor tracts ending in the abducens nuclei probably occurs in the lower pans. Anatomopathologic findings in the two cases show that the OPT runs in front of the Medial Longitudinal Fasciculus or in the lateral tegmentum and that it decussates, at least once, below the upper pons.

Abducens Nerve↗