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Biomedical subjects

P Derome

Publications and source records attributed to P Derome.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Trans-sphenoidal pituitary resections. Various problems in anesthesia and resuscitation. Study in 1,193 cases (author's transl)].

In the present study based on 1,193 cases of trans-sphenoidal pituitary resections, the various problems involved in anaesthesia and pre and post-operative care are discussed. The anaesthetic complications are few and should be avoided through adequate preparation and supervision. The procedure is a short one (75 +/- 16 minutes) and blood loss minimal. The patients are usually young (42 +/- 4 years old), in good condition (90% were in ASA group I or II). The pre and post-operative management must follow some well defined principles, based on hormonal substitution and diagnosis and early treatment of a possible diabetes insipidus.

Adolescent↗
PubMed1980

[Value of surgical approach to the vertebral artery in its extra-cranial segment. A case of aneurysm of the vertebral artery in C3 (author's transl)].

Long considered dangerous, surgical treatment of lesions of the vertebral artery in its extra-cranial course, may be viewed in parallel with angiographic techniques. Approach to the vertebral artery in its different segments, pre-operative arteriographic assessment, are discussed, and operative indications only mentioned. An aneurysm of the vertebral artery in C2-C3 was treated by exclusion and restoration of continuity by a sub-clavian vertebral vein graft in C1-C2.

Aneurysm↗
PubMed1979

[Anastomosis between subclavian artery and V. A. at C1-C2 level. Case report and reappraisal of surgical possibilities on the third portion of the vertebral artery (author's transl)].

A reappraisal of surgical possibilities on the third portion of the Vertebral Artery (V.A.) above C2, have been done from an anatomical study on 20 autopsied specimen. A route passing between the Internal Jugular Vein and the Sternocleido-mastoidian muscle allows a rather simple approach of the transverse process of C1. After dividing two muscles taking insertion on this process, 1,5 cm of the V.A. can be exposed. For larger exposure of the artery, the Foramen Transversaris of C1 must be unroofed and the artery dissected in the guttering of the posterior arch of Atlas. This surgical route was used in a case of aneurismal dysplasia at C3 level. An anastomosis between Subclavian Artery and V.A. at C1-C2 level was realized with an autologous saphenous vein graft. The keypoints are the highest possible freeing of the XI nerve and the head position. Rotation and extension move the transverse process and the posterior arch of Atlas superficially and anteriorly.

Humans↗
PubMed1979

[Double malformation discovered during investigations for hypertension; single pelvic kidney and occipitovertebral joint malformation (author's transl)].

A young Portuges eman with a spastic gait was found to have a kidney lying below the bladder. This was the only kidney present and its blood supply was derived from a renal artery which was also the only one present. This renal abnormality was associated with a major malformation of the occipitovertebral joint (occipitalization of the atlas, total occipito-atlanto-odontoid dissociation above the line of the digastric). The possible relationship between these two affections is discussed.

Abnormalities, Multiple↗
PubMed1978

Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control.

One hundred stereotactic thalamotomies performed for upper extremity tremor were reviewed and the spatial positions of the anterior limit of ventralis posterior (VP), the thalamic-internal capsular boundary and somatotopic areas within VP plotted with respect to the midline and the place of the anterior comissure. Considerable variability was noted as to the location of these points. The surgical results following 97 of the 100 thalamotomies were evaluated at least three months after the procedure. Fifty-six of 70 patients with Parkinsonian tremor had complete abolition of their upper extremity tremor, as did 20 out of 27 patients with intention tremon. Plotting the spatial positions of the lesions in those cases in which the tremor was abolished and those cases in which tremor continued revealed little difference. However, in all of the cases in which upper extremity tremor was totally abolished, the lesion site was situated in ventralis lateralis anterior to the VP representation of the buccal commissure, thumb, or index finger. This study not only demonstrates the wide range of individual spatial variability in thalamic structures, and the necessity for neurophysiologic corroboration of radiologic information during stereotactic surgery if optimal results are to be obtained, but also suggests a somatotopic organization within ventralis lateralis.

Adolescent↗
PubMed1977

Connections of latero-dorsal nucleus of the thalamus. II. Experimental study in Papio papio.

Modifications of the latero-dorsal (L.D.) nucleus of the thalamus have been observed earlier in man in relation to limbic lesion of various etiologies. Our proposal was to determine the role of L.D. in memory disturbances. We attempted to study the connections of L.D. in Papio papio baboon after surgical lesion using silver impregnations as well as traditional techniques. We found three afferent pathways: from the fornix, the posterior cingulate and the parietal cortex (area 7). The most important is the afferent system from the fornix, it terminates in the antero-dorso-medial part of L.D.; the other two afferent pathways have a postero-lateral projection in L.D. The three efferent systems to parietal cortex, cingulate and fornix were not delineated in this study. It was concluded that the antero-dorso-medial portion of L.D. is connected to the limbic system and the ventro-postero-lateral portion integrated into a large parieto-cingulo-parahippocampal circuit to which it is joined by direct and indirect projections with several relays. These connections have important implications, perhaps, in our understanding of memory disturbances.

Afferent Pathways↗