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Biomedical subjects

P Frerebeau

Publications and source records attributed to P Frerebeau.

At least 73 records · Page 4Linked to original sources
PubMed1978

Cerebellar gangliocytoma dysplasticum in an infant.

A boy, 25 months old, presented a cerebellar syndrome with increased intracranial pressure. Despite a ventriculo-peritoneal bypass, death occurred at the age of 4 1/2 years. Autopsy revealed a very large cerebellum, presenting a "glossy" appearance, with swelling of the brain stem. Histologically, there was a very unusual lesion with a diffuse disorganization of the cortex, a neuronoglial mixed proliferation, a large number of calcospherites, small tumour-like nodules and many leptomeningeal glial bridges. The authors consider that their case is not related to L'Hermitte-Duclo's disease, nor to gangliogliomas, and they discuss the hypothesis of hamartoma.

Autopsy↗
PubMed1978

[The value of the study of brain stem reflexes in coma (author's transl)].

A better clinical assessment of the comatose state is obtained by the study of brain stem reflexes. Systematic research of the fronto orbicular, pupillar, corneal, masseteric, vestibulo-ocular, oculo-cardiac, palmo-mental and cornéo mandibular reflexes has enabled characterization of functional levels. Degree of comatose stade and other usual physical symptoms have been correlated. Hence brain stem injury and course is followed in acute coma. Six functional levels permit assessment of cranio-caudal disintegration of brain stem functions. According to our opinion, diencéphalo-mesencephalic level is of bad prognosis in the course of follow-up.

Adolescent↗
PubMed1978

[Direct surgery of traumatic injuries of the radial nerve (author's transl)].

33 cases of traumatic lesions of the radial nerve are reported. Etiological features, prognosis, surgical treatment including micro-surgical techniques, leading to a larger indication of direct nerve repair are discussed. Recent nerve wounds must be repaired early. Surgical exploration will be carried out on unopened lesions when no recovery occurs within two months. According to the lesion, peri-fascicular neurolysis or fascicular resection-graft will be achieved. Tendon transfer techniques will be proposed only after one or two years without recovering, according to the level of the injury.

Adolescent↗
PubMed1977

[Value of brain metabolic studies in post-traumatic coma].

In 34 comatose patients in the acute phase, the mean hemispheric CBF is lowered as well as the CMRO2, with a quite good relation between these values and the coma level and prognostic so. The cerebral response to a PaCO2 range indicates a quite good relation with the coma level (the lowest value in the most severe comas). The cerebral autoregulation study, using Aramine induced hypertension, can separate the cases with a present autoregulation and the cases with a loss of autoregulation (the most severe and the poorest prognosis). In dynamic conditions (variation of the PaCO2 or Aramine induced hypertension), the change in CMRO2 is interesting : rather good prognosis among the patients with a normal metabolic autoregulation - poor prognosis among those whose metabolic autoregulation is lost.

Brain↗
PubMed1977

[The arthritic narrow lumbar canal. Anatomoradiologic study - technical considerations].

The Narrowing of the lumbar canal by spondylosis appears as a frequent factor of cauda equina compression. There is a wide range of symptomatology : common low back pain and sciatalgia; neurogenic claudication with sensitive, motor or sphincter disturbance; radicular deficit at one or several levels. Radiological measurement of the anterior-posterior diameter of the lumbar canal does not give a good evaluation of the lesion. Qualitative analysis of spondylosis must be performed by special radiological investigation : plain X ray film and tomography shows the osteophytics spurs and articular hypertrophy; sacco-radiculography (Dimer X) with tomography and flexion-extension films shows the changes on the dural sac. Three types of lesions can be distinguish on anatomical and radiological grounds which carry a special operative management : the anterior type should be treated by discectomy, at one or more level; the posterior type needs facetectomy with or without laminectomy; the mixed type must be treated by combined operative procedures. Laminectomy only does not permit the cure of lateral radicular entrapment. Our results seem much better in our series since this diagnostic and therapeutic attitude is considered.

Aged↗
PubMed1976

Sectorial posterior rhizotomy, a new technique of surgical treatment for spasticity.

After their experience of Foerster's operation and its technical modifications in 80 cases the authors report a new concept of analysis and treatment of spasticity in lower limbs. Spasticity of the different muscle groups is classified either as "useful spasticity" or "handicapping spasticity". The first has to be preserved, the second must be reduced. In order to achieve this purpose a new technique is presented, based on operative sectorial identification of the posterior rootlets subserving the "handicapping spasticity" by electrophysiological stimulation, muscle testing, and E.M.G. studies. The conus medullaris and cauda equina are exposed by T 11-L 1 laminectomy, performed in the lateral position. The clinical and E.M.G. evaluation of responses to stimulation enables the surgeon to establish a map of rootlet groups which are marked with coloured threads. Selective resection of "handicapping posterior rootlets" is then performed after several tests of the mapping. The rootlets subserving useful spasticity are carefully preserved. Ten cases are reported, comprising five cases of cerebral palsy operated upon since 1974 and five cases of posttraumatic spastic paraplegia from the same period. Pre and postoperative findings are summarized. The technical features of this procedure are discussed and compared with other surgical procedures. The problem of the rootlet reflex arch is considered in the light of the effects of stimulation of anterior and posterior rootlets at the same level.

Adolescent↗
PubMed1976

Long term results of stereotaxic surgery for infantile dystonia and dyskinesia.

Our experience is based on a series of 25 patients suffering from infantile dyskinesias and dystonias who underwent stereotaxic surgery of basal ganglia. We first note the immediate good results (77%) obtained by thalamo-sub-thalamotomy. Concerning dyskinesia this type of surgery enjoys in an opinion a place of choice. Secondly we have been able to estimate secondary deterioration on long term results in patients examined 2 to 15 years post-operatively. In contrast to various results reported in the literature good long term results are not superior to 50%. Some deterioration is noted in patients operated on for choreo-athetosis over the age of 20. A pallido-subthalamic lesion is efficient at the beginning of the disease course since it improves motor performance and thereby helps possibilities of intellectual acquirement. Bilateral lesions have after improved I.Q. Effects of this treatment specially on spasticity must be discussed among other types of surgery.

Adolescent↗