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Biomedical subjects

P Decq

Publications and source records attributed to P Decq.

43 records · Page 3Linked to original sources
PubMed1992

A technique for stereotactic aspiration of deep intracerebral hematomas under computed tomographic control using a new device.

A new device, modified from the Nucleotome (Surgical Dynamics, Alameda, CA), was used for stereotactic aspiration of deep brain hematomas. Real-time monitoring by computed tomography allows a very safe procedure, and the risk of aspirating the surrounding brain is avoided. The technique was applied in 13 cases of deep brain hematomas. The intraoperative computed tomographic scan demonstrated that the mass effect was always immediately improved. Aspiration was stopped when the midline shift disappeared or was dramatically reduced. For most of the cases, a total aspiration of the hematoma was not needed (mean value of the aspiration rate of 71, 5%). No rebleeding and no complication related to the technique was observed. This technique was easily performed in emergency conditions.

Activities of Daily Living↗
PubMed1991

[Treatment of chronic hydrocephalus in adults by flow-regulated shunt. Apropos of a series of 46 patients].

46 patients, 24 males and 22 females (mean age: 68.3 years), with chronic hydrocephalus were operated on by a variable-resistance, flow-regulated shunt. The selecting criteria before surgery were essentially clinical (association of gait disturbances, dementia and urinary incontinence, positive lumbar puncture withdrawal test) in consideration with the retrospective and cooperative study of this series. Hydrocephalus had an etiology in 23 cases (50%): 4 cases of trauma (8%), 9 cases of tumors (20%), 9 cases of subarachnoid haemorrhage (20%) and 1 case of infection (2%). The average follow-up is 17 months (median: 12 months). 20 patients (43.5%) have an excellent result (normal life), 16 patients (34.8%) have a good result (residual symptomatology compatible with a self-governing life), 5 patients (10.9%) have a poor result (residual symptomatology non compatible with a self-governing life), 2 patients (4.3%) have a bad result (unchanged symptomatology). 3 patients died after the surgical procedure. 3 patients had an infectious complication of their shunt (actuarial risk of infectious complication at one year and a half: 7%). 2 patients presented a non infectious complication, one chronic subdural hematoma and one bad insertion of the proximal catheter (actuarial risk of mechanical complication at one year and a half: 4.4%).

Actuarial Analysis↗
PubMed1991

[Intracerebral hematoma surgically treated under x-ray computed tomography with Backlund's needle. A series of 15 cases].

15 cases of supratentorial intracerebral hematomas (12 cases of primary hematomas and 3 post-traumatic cases) were operated under C.T. scan control, using the screw and suction technique (Backlund's needle). 10 cases of primary hematomas were operated early, before the 24th hour. The patients were selected for intervention on the following criteria: 1) Patients aged less than 70 years old; 2) initial Glasgow coma scale between 6 and 10; 3) cases with involvement of the mesencephalon by the hematoma were excluded. In the 3 cases of post-traumatic hematomas, intervention was decided in reference to the clinical course. The volume of the hematomas ranged from 40 to 160 cc. Putaminal or thalamic hematomas were observed in 9 cases. The percentage of aspirated hematoma volume ranged from 50 to 91%, the average being 70.5%. Dramatic improvement of the consciousness was observed in all cases. Improvement of the motor deficit was incomplete, for the most part. 1 patient rebled and 1 patient died (6.6% mortality). In 26% of the cases (4 patients) the development of a brain oedema, in the surrounding of the residual hematoma site, was observed during the post operative follow up. There was no post operative infection. Intervention under direct C.T. control allows an accurate guidance of the needle. Efficacity of the evacuation is attested by an immediate improvement of the mass effect on C.T. scan. Under C.T. control the risk to aspirate the adjacent brain is avoided. The technique proposed here has been easily performed in emergency condition.

Adult↗
PubMed1989

[Sciatica and nerve root anomalies. Apropos of a series of 20 cases].

We present 20 operative cases of lumbar nerve root anomalies, divided into 6 anatomical types: nerve roots with common dural emergence (4 cases), contiguous dural emergence (6 cases), with common dural sheath (4 cases), splited nerve roots (2 cases), anastomosis between roots (3 cases) and plexiform nerve roots (1 case). 14 cases are associated with a discal hernia. 10 cases presented with unilateral but biradicular sciatica. The asymmetry of emergence is the best symptom of the pre-operative radiological evaluation on the CT scan, moreover on the myelography. The management led to an enlargement of the surgical field by hemilaminectomy to recognize the anomaly and make easier the discectomy. In 3 cases, the anomaly was recognized in patients who had been previously operated on. There are only 53% of satisfactory final results. We present a review of the main publications concerning this subject.

Adult↗