Search PubMed⌕ Search

Biomedical subjects

P Gras

Publications and source records attributed to P Gras.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Mortality of cerebral infarction with auricular fibrillation. Results of a population study].

To evaluate the relationship between atrial fibrillation (AF) and mortality of the cerebral infarction, we have studied in a population survey, 540 cerebral infarctions, whose 162 were with AF (30%) and 378 without AF (70%). The group with AF differs significantly from that without AF, by the higher frequency of women (62% versus 35%), older subjects (75.4 +/- 10.2 years old versus 69.1 +/- 9.7 years old), a severe loss of consciousness, a more frequent subcortical infarction on CT-Scan. During a period of 24 months, 139 patients died, 64 among the 162 patients with AF (40%), 75 among the 378 patients without AF (20%). Rates of death are different in the 2 groups with, in the group with AF, at 1, 6, 18 and 24 months a rate of 20, 24, 37 and 40 percent. To the opposite, in the group without AF, the rates are 8, 12, 16 and 20 percent. The authors try to research the factors that may explain the mortality linked to AF, and they insist on the necessity to look for AF on admission for a stroke, to identify a subgroup of stroke patients with a high risk of death.

Aged↗
PubMed1992

Sphenoidal electrode insertion under local analgesia in children.

The indications for method and the results of sphenoidal electrode insertion under local analgesia are evaluated in children. This technique makes it possible to study the hippocampal area, which cannot be studied by other extracranial electrodes. It also localizes in a temporal lobe some complex seizures without electrical events on surface recordings, complex seizures with bilateral temporal spikes or a frontotemporal focus of spikes, as well as those with a temporal focus with bilateral synchronous spikes in standard EEG. Therefore, sphenoidal electrodes inserted without heavy general analgesia enable temporal seizures to be identified and localized, leading to more specific neuroradiological and neurophysiological explorations and helping in this way to select possible patients for epileptic surgery.

Adolescent↗
PubMed1992

[Investigation via electroencephalogram with sphenoidal electrodes of a case of reading epilepsy: role of the temporal lobe in the emotional evocation of seizures].

Reading epilepsy in a 20-year-old male. Electroencephalographic study with sphenoidal electrodes localized the onset of critical spikes in the temporal areas (especially the left). The frequency and diffusion of critical spikes were increased when material read had an emotional content. This case report supports the "communication" hypothesis as opposed to hypotheses that emphasize proprioceptive and other "lower order" stimuli in evoking seizures while reading. The authors discuss the role of the temporal lobe in reading: lexical function, treatment of visual information and emotional integration of stimuli.

Adult↗
PubMed1992

Plasma lipoproteins in cortical versus lacunar infarction with or without cardiac arrhythmia, and in transient ischaemic attacks: a case control study.

We investigated the relation of plasma lipids to the risk for cortical infarction with (22 cases) or without (38 cases) cardiac arrhythmias, for lacunar infarction (28 cases) and transient ischaemic attacks (TAI) (15 cases). In the group of cortical infarction with or without cardiac arrhythmias, we observed a maximum increase of total cholesterol, of very low density lipoprotein (VLDL) and low density lipoprotein (LDL), triglycerides, total Apolipoprotein (Apo) B, LDL-Apo B and Apo-A1. On the contrary, we observed a decrease of total ApoE, HDL-ApoE, a distribution of LDL in a single layer and the presence of LDL of small weight. TAI is different from the former group by a low level of HDL and the lack of abnormalities of Apo-A1, and on the distribution and the weight of LDL. Finally, lacunar infarction presents a normal plasma lipoprotein profile. These data suggest that previously demonstrated differences in LDL-cholesterol levels between patients with ischaemic stroke and control subjects may apply to patients with cortical but not lacunar infarction. The presence or not of a cardiac arrhythmia doesn't give a special lipoprotein profile, and TAI has no changes on the distribution and the weight of LDL. Therefore, separation of ischaemic strokes into types based on mechanism as large vessel atherosclerosis versus small vessel atherosclerosis may help clarify lipid-related risk factors in cerebrovascular disease.

Arrhythmias, Cardiac↗
PubMed1992

Frequency of transient ischaemic attacks in strokes: place for a preventive treatment.

Transient ischaemic attack (TIA) represents a neurological deficit during less than 24 hours, without any abnormality on CT scan. This symptom may have 2 risks: it may give place to a severe stroke, and it is not always linked to an ischaemic mechanism. This work rests on a population-based registry existing in Dijon since 1985 with a specific and exhaustive registration. CT scan allows the mechanisms of stroke to be identified: cortical infarct, lacunar infarct, cerebral haemorrhage, and TIA. TIA represent 15% of stroke. Survival rate of 80% is better than other strokes. A TIA may appear before a cerebral infarct in 48% of the cases, a lacunar infarct in 18% of the cases, another TIA in 28% of the cases, and a haematoma in 8% of the cases. Therefore TIA is an important symptom appearing before severe stroke, that may let place to a preventative action.

Aged↗
PubMed1992

[Acute anterior bi-opercular syndrome of critical origin in epilepsy with rolandic spikes].

We report the fifth case of a palsy of the lips, the tongue and the pharynx corresponding to an acute pseudo-bulbar syndrome causing speech arrest, and hyper-sialorrhea. The clinical examination and the electroencephalograms showed a partial motor status with spikes discharges in the two central regions, in a 10-year old boy known to have epilepsy with rolandic spikes. The status epilepticus ceased with phenytoin therapy. Although epilepsy with rolandic spikes is a benign one without any cerebral lesion, a partial motor status epilepticus is possible and does not change prognosis.

Brain Diseases↗
PubMed1992

[Difficulties in diagnosis of frontal syndrome in epileptic children: clinical, diagnostic, physiopathological aspects. Apropos of 6 cases].

The authors report 6 cases of acute frontal syndrome following severe seizures of frontal origin. The study of the 6 cases shows the place of disorders in affectivity, behavior, judgement and motor activity; such features changing over time. The relationship between the frontal syndrome and epilepsy is suggested by the fact that the frontal syndrome appears after an increased frequency of frontal seizures, with prolonged discharges of generalized or frontal spikes. The frontal syndrome disappears slowly with the epileptic discharges, and no frontal lesion is found on CT-Scan. Such cases suggest that the frontal syndrome is functional, linked to the localization of the epileptic discharges; it may be regarded as a post-critic deficit, and must be differentiated from a post-critic delirium or a psychotic state.

Adolescent↗
PubMed1992

[Prognosis of transient ischemic accidents disclosing infarction].

In a prospective study, thirty six out of 175 consecutive patients (21%) with transient ischemic attack (TIA), had cerebral infarction on CT-scan. This group of patients differed from the group without cerebral infarction by a higher age, a longer duration of neurological deficit, a greater frequency of neurological history, vertebro-basilar TIAs, cephalagia and, cardiac arrhythmia, and by a higher 2-year mortality rate. Due to their difference in etiological factors and prognosis, TIAs with cerebral infarction on CT-scan should be differentiated from those without cerebral infarction.

Cerebral Infarction↗
PubMed1992

[Multiple cerebral embolism in acute alcoholic intoxication. A pathological case].

A 37 year-old man sustained 2 ischemic strokes during acute alcohol intoxication. One month after the onset of strokes, a spontaneous atrial flutter occurred. Autopsy revealed an embolic rostral occlusion of the basilar artery. Cardiac verification did not show myocardiopathy or coronary disease. The relations between acute alcoholic intoxication and paroxystic cardiac rhythm disorders are discussed.

Adult↗
PubMed1992

[Dopa-sensitive muscular dystonia. Segawa's syndrome. A case report].

A four-year-old girl developed difficulty in walking due to dystonia of the right then left foot, rest tremor in both hands, and rigidity. These symptoms worsened upon exertion and in the evening and were remarkably responsive to L. dopa, suggesting the diagnosis of fluctuating muscular dystonia or Segawa syndrome.

Child, Preschool↗
PubMed1991

[EEG periodic lateralized activities associated with ischemic cerebro-vascular strokes: physiopathologic significance and localizing value].

Eleven cases of periodic lateralized epileptiform discharges (PLED) with stroke (9 cases) or transient ischemic attacks are reported. PLEDs are often associated with depression of conscience (81%) or partial pure motor epileptic seizures (90%). PLEDs and seizures seem independent on EEG. Ischemic strokes associated with PLEDs have some characteristic features: old age, vascular risk factors, parieto-occipital areas infarcts and frequent association with TIAs. PLEDs seem to be often associated with watershed infarcts. The relations between PLEDs and cerebral ischemia are discussed.

Aged↗
PubMed1991

[Electrophysiologic investigation of the anterior temporal and frontal lobes: sphenoidal and intraorbital electrodes].

The authors have evaluated the interest of sphenoidal electrodes in detection of internal temporal spikes, and intra-orbital electrodes in the detection of orbito-frontal spikes. From a study of 26 patients, 21 with sphenoidal electrodes, 3 with intra-orbital electrodes and 2 with both electrodes, they observed the sensitivity and specificity of such electrodes in detecting spikes with no traduction upon extra-cranial electrodes, or with an unsuspected traduction as spikes at a distance from deep electrodes, or spikes on 2 foci, or bisynchronous discharges. Sphenoidal and intra-oribital electrodes constitute a non-invasive method that provides excellent information in the exploration of the mesiobasal cerebral face. Indications for the use of such a method are complex absences without EEG traduction or with an unsuspected traduction and without abnormalities on CT scan, in the context of functional surgery of epilepsy.

Adolescent↗
PubMed1991

Incidence and survival rates during a two-year period of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks. The Stroke Registry of Dijon: 1985-1989.

The age- and sex-specific incidence and survival rates over two years of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks (TIA) in a town of 140,000 inhabitants, are reported. During the five years, (1985 to 1989), 984 patients suffering from first stroke were registered by the Dijon Stroke Registry. The diagnosis was established by a CT-Scan in 88% of cases. Intracerebral haemorrhages (ICH) account for 8.8% of strokes, subarachnoid haemorrhages (SH) for 1.5%, cortical infarcts (CI) for 45.6%, lacunes for 16.7%, TIA for 15.8%, and 11% were undetermined. The annual average incidence rates per 100,000 are 13.4 for ICH, 2.0 for SH, 69.0 for Cl, 30.0 for lacunes and 25.5 for TIA. The survival rates for the acute stage (up to four weeks) differ between ICH and SH (46% and 67%), and the other types of strokes: 77% for Cl, 90% for lacunes and 98% for TIA. The survival rates of unclassified stroke are similar to ICH rates. At two years, survival rates of lacune and TIA are the highest. The divergences between public hospital based data and population-registry data are discussed. A population registry is necessary for studying the natural history of stroke.

Adult↗
PubMed1991

Cerebral haemorrhage in a French prospective population study.

The incidence of cerebral haemorrhage was studied from a population-based stroke registry. The incidence was 12.3 per 100,000 per year in women and 13.9 per 100,000 per year in men, with a peak in the eighth decade and a male preponderance. Haemorrhages were deep seated and mostly due to hypertension. Recognised clinical characteristics of haemorrhage are acute onset, convulsion, vomiting, and disturbed consciousness. This study showed that cerebral haemorrhage may present with pure motor deficit or transient deficit preceding the stroke. The mortality was 51% in the first month, and 61% by two years.

Adolescent↗