[Disk herniation in children and adolescents up to 18 years of age. Apropos of 9 surgically-treated cases].
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Biomedical subjects
Publications and source records attributed to R Steimle.
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An experimental study of nerve regeneration in rats was realized after sectioning 8 mm of the sciatic nerve and interpositioning a vein-graft to replace the portion of nerve which has been removed. The vein-graft was taken at the neck level, far away from the point of suture between vein and nerve, a procedure which seems to prevent the problems of scabbing. A histological and electrophysiological analysis was carried out on 16 grafts, over periods ranging from 4 weeks to 4 months. The nerve and venous dissections were realized under a stereoscopic microscope. A certain degree of amyotrophy appeared in the external-posterior region of the thigh, directly related to the muscular dissection and the partial paralysis caused by the section of the common peroneal nerve. The electrophysiological recordings in vivo provide proof of nerve regeneration but reveal the absence of any correlation between the time of recovery and the time of induction. Examination under the light microscope confirms the regeneration of the nerve inside of the vein-graft, with an augmentation of myelin sheaths, which increase with time both in number and in thickness. The vein-wall acts as a guide but the passage of a few nervous filaments outside of the graft itself is observed. Examination under the electron microscope furnishes important information on myelin sheaths. The results are of excellent quality, but to better appreciate and evaluate them, we envisage a further study, this time to be carried out on another animal species.
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The now nine years old girl with growth retardation, started to be ill with otitis and then diabetes insipidus of central origin at 1974. A treatment with lysin-vasopressin is prescribed. The PNEG in May 1976 shows a little, pea like, suspicious, supra-sellar nodule who is not surgically explored since they was no ophtalmologic symptoms and because a normal CT scan. Corticoid and thyroid substitutive therapy is added until September 1977 when the general status becomes impaired and vomiting starts. Also because some visual loss, a new neuroradiological study is performed showing a supra-sellar tumour and a fourth ventricle mass. The CT scan asserts the double intracranial expansive process and a posterior fossa craniotomy is done with subtotal resection of a vermian tumour and Torkildsen drainage. The histology is : Immature Dysembryoma (seminoma type) or germinoma. The follow-up was good under hormonal care. X Rays Therapy over the posterior fossa, the suprasellar region, the brain and the spinal channel was instaured. Four months later, the CT scan shows normal sized ventricles and no tumour mass at all. This case gives the authors opportunity for comments and to study the concerned literature.
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The present study compares the cicatrization of the dura by administration of I.M. hemocoagulase. This study was done on 6 rabbits and 6 control animals. The authors think that the cicatrization is a little slower but of better quality. The hemocoagulase seems to favorize the vasculo-exsudative process of cicatrization. The fibrinous deposits are more important too. Perhaps the occlusion of C.S. fluid fistulas could be favorized by means of the used product. Definitive conclusions are not possible for the moment but a work on a larger scale is projected.
The case of traumatic thrombosis of the vertebral artery in a 14 year old boy with quadriplegia is related. They were neither spinal fracture nor blockage at the Queckenstedt test and the spinal fluid was normal. The clinical recovery was poor but a partial revascularisation of the thrombosed vessel was observed. Physiopathological, clinical and therapeutic aspects of the traumatic thrombosis of the vertebral arteries and also literature data are under consideration.
Authors are reporting a case of a giant sylvian aneurism partially thrombosed which had given some tumor like symptoms. The Peumography performed, just before an angiography showed the exact size and the malformation's relations with the lateral ventricle. During the operation, the complete removal of the aneurismatic mass had been done. The follow up was good.
The authors present the case of a 43-years-old man who had suffered from back pain for 7 to 8 years followed by sciatic. X-rays showed an abnormal sacral cavity extending from S1 to S3. Wtih the suspicion of an occult sacral meningocoele, Dimer X radiculography showed a cystic formation at S2 which only partially filled the sacral cavity. There was also an L5-S1 disc protrusion. At operation, after exploration of the roots on both sides, it was possible to remove a disc herniation at L5-S1 on the right. Laminectomy of S1 and opening of the posterior wall of the sacral canal at S2 and S3 revealed a large cyst of epidural location, touching both S1 roots superiorly and situated behind the communicating cystic cavity seen at radiculography. Histological examination of the sacral cyst showed it to be a dura mater structure, in fact anon-communicating meningocoele.
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