Search PubMed⌕ Search

Biomedical subjects

P Halimi

Publications and source records attributed to P Halimi.

At least 55 records · Page 3Linked to original sources

MRI features of craniopharyngiomas at 1.5 Tesla. A series of 13 cases.

Thirteen patients with craniopharyngioma were explored with a 1.5 Tesla magnetic resonance imager. The results were compared with those of CT and with operative findings. The MRI signals were correlated with the biochemical composition of the cysts (proteins, lipids, iron, LDH) in 5 cases; 2 patients were studied after an intravenous injection of gadolinium DOTA. MRI proved vastly superior to CT to evaluate the spread and identify the various components of craniopharyngiomas (cysts, fleshy parts, haemorrhages), except for calcifications. Gadolinium improved the detection of fleshy parts and "active" cysts. The signals emitted by cysts were extremely variable on T1-weighted sequences. The correlation between MRI and biochemical data was complex, but it appeared that protein, lipid and iron concentrations had a major influence on cyst signals. MRI with gadolinium may be envisaged as first-line examination to improve the evaluation of spread, determine the prognosis and detect recurrences of craniopharyngiomas. CT could be reserved to difficult cases with invasion of bones and sinuses.

Adolescent↗

Multifocal central nervous system lesions in three patients with trichinosis.

Three patients with trichinosis developed central nervous system complications. Cerebral computed tomography showed multifocal hypodense lesions in two patients. The lesions were associated with contrast enhancement and cortical gyral enhancement in the first case, suggesting hypoxia and infarction. In the second patient, magnetic resonance imaging showed multiple high-signal-intensity lesions. Early cerebral computed tomography was normal in the third patient. All patients recovered after treatment with antiparasitic drugs and corticosteroids. We suggest that neurologic complications of trichinosis should be treated by corticosteroids and flubendazole.

Adult↗

[Osteoarticular lesions in Whipple's disease. Apropos of a destructive form and review of the literature].

A patient with Whipple's disease was considered as cured after treatment for two years, but relapse occurred as the neurological form. Radiographic imaging showed destructive osteoarticular lesions, with few or no symptoms, affecting the peripheral skeleton but also the sacroiliac joints. The published literature is reviewed and the different osteoarticular radiologic forms of the affection described.

Bone Diseases↗

Radiological anatomy of the vascularization of cranial dural arteriovenous malformations.

Knowledge of the radiological anatomy of the cranial dural vascularization allows a flexible and appropriate approach to the pretherapeutic investigation of cranial dural arteriovenous malformations. The variability of the origin of these arteries requires that several possible sources of vascular supply be investigated - internal carotid, internal maxillary, ascending pharyngeal, occipital and vertebral - and that each of their meningeal branches be known in detail. Finally, familiarity with the radiological anatomy of these vessels allows one to identify on routine angiography those vessels that may be a source of risk when performing techniques of endovascular therapy (pedicles supplying the cranial nerves, internal carotid and vertebral anastomoses). Each foramen at the base and vault of the cranium contains an artery to the dura mater. Accordingly, very precise topographical study, in particular of the cavernous region, can be made.

Angiography↗

[Endovascular treatment of pure spontaneous dural vascular malformations. Review of 23 cases studied and treated between May 1980 and October 1983].

The authors present 23 cases of pure dural spontaneous vascular malformations (DVM) between 1980 and 1983; among the 23 patients, presented with a sellar DVM, 10 with a torcular DVM and adjacent sinuses, 1 DVM was located at the lamina cribriformis. The history of the patients can be classified into 3 groups: - trauma history (9 patients); - vascular disease (15 patients); - infections history (1 patient). Certain remarkable associations were encountered: 2 cases of multifocal DVM, 3 cases with intracranial aneurysms, 1 case with a brain AVM in an other territory, 1 maxillo-facial AVM. Certain aspects of the symptomatology can be noted: 1 case was in a child of 3 years of age, 2 cases presented during pregnancy, 1 case with premenstrual changes, 2 cases with acute choroidal detachment. Of the 11 patients which had a DVM with cortical venous drainage, 9 were complaining of CNS symptoms and 3 were explored in emergency: 2 for SAH, 1 for acute spontaneous SDH. In this series, following a multidisciplinary decision, the treatment chosen was always endovascular a priori. However it was preceded in one case by surgery at the anterior base of the skull in order to develop a collateral circulation from a reachable artery (for embolization); in an other case, it was followed by surgery to evacuate a compressive SDH, and in an other it was completed by surgery to improve a too proximal embolization. Only once had the internal carotid artery to be occluded to obtain a satisfactory clinical result. One slowly regressive complication was noted following active heparin therapy. No patient has been excluded from this series during that period. With the exception of 1 spontaneous cure, following embolization (s) 13 cases are asymptomatic among which 9 have an anatomical "cure"; 4 cases have an incomplete but significant improvement; 1 patient after a initial good result had recurrent symptoms were stabilized with medical treatment; 2 cases were not embolized for technical reasons, but are asymptomatic. Finally, one died a few days after surgery for evacuation of his SDH. Details of embolic agents and vessels embolized are specified. 5 observations can be made: - The angiographic screening must be complete and must not overlook dangerous vessels which could limit the embolization. - All the vascular compartments of the lesion must be visualized, as all of them do not have to be embolized; the embolic agent has to be radio-opaque and the nidus of the malformation must be reached.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Value and limits of arthrography in the study of pathological mediopatellar plicae of the knee; a comparison with arthroscopy.

The results from arthroscopy and arthrography were compared in a prospective study of the mediopatellar plicae in 100 knees with internal disorders. With reference to arthroscopy, the sensitivity and specificity of arthrography for the detection of mediopatellar plicae were, respectively, 83.6 and 88.8%. The arthrographic signs of pathological plicae were: a thick plica, thicker than the internal condylar cartilage (sensitivity: 72%; specificity: 84%) and an interposed plica (sensitivity: 85%; specificity: 81.8%). Statistically the arthrographic signs agreed with the arthroscopic signs. The two methods did not differ significantly in their contribution to the diagnosis of pathological plicae.

Adolescent↗

Estimating anesthetic depth by electroencephalography during anesthetic induction and intubation in patients undergoing cardiac surgery.

Intravenous (IV) anesthesia titrated to continuous computer-processed electroencephalograms (EEGs) was studied in 32 consecutive patients undergoing cardiac surgery. Anesthesia was induced with fentanyl 50 micrograms/kg with no EEG monitoring (n = 16) or 25 to 50 micrograms depending on changes in EEG (n = 16). EEG, oxygen saturation by pulse oximeter, intra-arterial blood pressure (BP), central venous pressure (CVP), and pulmonary artery pressure (PAP) (n = 18) were monitored continuously. Cardiac output (CO), CVP, PAP, spectral-edge frequency for each hemisphere, and BP were recorded before induction, immediately before intubation, and 1 and 5 minutes after intubation. With EEG monitoring, intubation was performed when spectral-edge frequency decreased to 10 Hz or less. Recall and pain were investigated 2 to 12 weeks postoperatively. With EEG, the amount of fentanyl used before intubation was significantly lower (39.7 +/- 2 micrograms/kg; p less than 0.005) than without EEG (50 micrograms/kg). The decrease in BP (% change) was less with than without EEG; mean changes in BP between preinduction and preintubation were -7.4% +/- 3.8% and -16.5% +/- 3.1% and between preinduction and 1 minute after intubation 0.3% +/- 3.4% and -12.5% +/- 3.5%, respectively. Percent changes in mean BP between intubation and 1 minute after were 9.6% +/- 4.0% with EEG and 5.2% +/- 3.0% without EEG. No patient in either group had recall. The authors conclude that using EEG monitoring to estimate depth of anesthesia during induction and laryngoscopy may increase safety in high-risk patients undergoing cardiac surgery.

Adult↗