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Biomedical subjects

S Bracard

Publications and source records attributed to S Bracard.

At least 91 records · Page 5Linked to original sources
PubMed1990

Long term hemodialysis spondylarthropathy: an atlanto-occipital location.

A 41 years old patient on hemodialysis for 17 years with a clinical and radiological picture of osteoarticular beta 2 microglobulin amyloidosis, is presented. The patient had skeletal involvements, included cystic lesions of the left hip and both humeral heads and a C5/C6 spondylarthropathy. She had also associated carpal tunnel syndrome. Radiological exploration of the atlanto-occipital articulation demonstrated destructive changes. Histology documented osseous and periarticular deposition of beta 2 microglobulin derived amyloid. This is an unusual location of destructive spondylarthropathy in a patient on chronic hemodialysis.

Adult↗
PubMed1990

Mucoceles of the sphenoidal sinus. Report of six cases and review of the literature.

Six personal cases of mucocele of the sphenoidal sinus are reported, and 124 cases from the literature are reviewed. Sphenoidal sinus mucocele is a benign and rare lesion which has long been unrecognized. Clinical features include fronto-orbital pain, oculomotor palsies, loss of visual acuity, exophthalmos and anosmia. Our series is of particular interest since four of our six patients presented with endocrine disorders. Recent advances in neuroradiological methods should rapidly lead to the correct diagnosis. Treatment consists of aspiration and drainage of the mucocele via a trans-sphenoidal approach. The results are good, and ophthalmoplegia usually subsides. In our experience, endocrine disorders do not always respond to treatment. The prognosis of sphenoidal sinus mucocele depends on the preoperative duration of the loss of visual acuity.

Adult↗
PubMed1990

Dural fistulae of the tentorium cerebelli. Radioanatomical, clinical and therapeutic considerations.

Among the 84 intracranial dural fistulae treated in the Neuroradiology department of the University Hospital Centre of Nancy between August 1983 and April 1990, 10 (11.9%) were located on the tentorium cerebelli. The patients were 7 men and 3 women aged from 41 to 61 years at the time of diagnosis. All tentorial dural fistulae showed an exclusively cortical drainage, and only one of them was associated with probable thrombosis of a major sinus. Nine patients presented with at least one episode of neurological deficit (including 2 with progressive ascending myelopathy) associated with a cerebro-meningeal haemorrhage in 6 cases. In all patients the initial treatment was an endovascular one, subsequently reinforced by surgery in 2 patients. In every case the clinical condition was improved or stabilized and no recurrent haemorrhage was observed, but radioanatomical cure was obtained in only 3 patients: 1 treated by the endovascular route and 2 by embolization combined with surgery. The anatomical, physiopathological and clinical aspects of these particular fistulae and the different possible therapeutic approaches are discussed.

Adult↗
PubMed1989

[Embolization of vertebral hemangioma. Technic-indications-results].

A series of 19 cases of vertebral hemangiomas treated by hyperselective embolization is reported. Localization is thoracic in 12 cases and lumbar in 7. Patients were referred for back pain in 10 cases, neurological signs of spinal cord compression in 5 and of radicular compression in 4. The first step is a precise analysis of the vascular pattern of each case with identification of the feeders of the spinal cord. Embolization as the only treatment, was proposed in 12 cases with painful manifestations. In 5 cases with symptoms of spinal cord compression, it was associated with surgery. The last 2 cases were not treated because of the close proximity of an Adamkiewicz artery. Results on painful symptoms were excellent in 9 cases and good in 3. There was no complications in this series. Therefore, we consider embolization to be a safe tool in the treatment of vertebral hemangiomas, with good efficiency on painful symptom and pre-operatively in case of spinal cord compression.

Adolescent↗
PubMed1989

[Intracerebral cavernous angioma].

Thirty four cases (18 operated, 16 non-operated), of cavernous angioma are reported. The presenting symptoms and signs were epilepsy in 22 cases, neurologic deficit in 9 and cerebromeningeal hemorrhage without vigilance disorders in 3. In the operated group 15 angiomas were supratentorial, 3 were subtentorial. In the non-operated group symptoms and signs were epilepsy in 11 cases and a neurologic deficit related to a brain stem lesion in 4/5 cases. Follow-up of 2 to 39 years after the first fit episode and of 1 to 7 years after initial diagnosis suggested that the risk of hemorrhage is low. Indications for neurosurgery are discussed as a function of the site of the angiomas and of the operative hemorrhagic risk.

Adolescent↗
PubMed1988

[Immediate and severe epistaxis caused by traumatic rupture of the carotid siphon. Apropos of a case treated by intravascular approach].

The authors report a recent case of massive and immediate epistaxis resulting from a rupture of the internal intracavernous carotid artery caused by closed head injury. The point out the unusualness and the extreme severity of such lesions. The pathogenesis of these epistaxis can be explained by an immediate arterial rupture proceeding from a sphenoidal fracture. The emergency bilateral carotid angiography states precisely the diagnosis and the level of the rupture, allowing in the same time the intravascular treatment by detachable balloon.

Carotid Artery Injuries↗
PubMed1988

[Neurological manifestations of alveolar echinococcosis].

Among 78 cases of alveolar echinococcosis reported in Lorraine, France, 5 had neurologic complications which in 3 cases revealed the disease. Results of parasitic tests are discussed and emphasis is placed on differences between this disease and hydatidosis. Encephalic localizations (3 cases) were multiple making neurosurgery impossible. The outcome was fatal in 2 cases: 1 month after the initial neurologic signs in the absence of treatment (case 1) and 4 months after treatment with flubendazole (case 2). This drug was however effective in the 3rd case (hepatic, pulmonary and cerebral form) with follow-up now at 4 years. Epidemiologic, histopathologic, clinical, diagnostic characteristics and course of these encephalic localizations are reviewed. Spinal localizations (2 cases) presented with a picture of spinal cord compression. After laminectomy and flubendazole, the course was marked by relapse with death in one case and a satisfactory neurologic course with a 4 year follow-up in the other one.

Aged↗
PubMed1987

Microvascularization of the intracranial dura mater.

The authors have studied the microvascularization of the intracranial dura mater by microradiographic and histologic examination of 73 injected anatomic specimens. There exists a very abundant superficial arterial plexus which also serves to supply the inner table of the cranial vault. This plexus is continuous, even at the walls of the venous sinuses and the dural septa. The arteries are for the most part tortuous. The veins may be satellites of the arteries or, on the contrary, from a plexiform network passing through crevices in the interior of the dural layer. The walls of these veins consist only of an endothelium to be seen within the fibrous layer of the dura. Often, the arteries compress the venous lumen; this dangerous situation probably explains the frequent occurrence of arteriovenous fistulae of the dura mater, known by the name of dural fistulae.

Adult↗
PubMed1987

Spinal involvement in alveolar echinococcosis: assessment of two cases.

Two cases of spinal involvement in alveolar echinococcosis are reported. Conventional radiographs showed bone lysis and spondylitis; computed tomographic scans showed detail of local spread to the ribs, other vertebrae, and soft tissues. Differential diagnosis, which includes other infections and hydatidosis, is difficult, and the diagnosis may be suggested by evidence of a primary hepatic focus, geographic propensity to the infection, and laboratory findings.

Aged↗
PubMed1987

[Effects of intracranial pressure on frontal sinus development].

Through a study of some syndromes of intra-cranial high and low pressure, the authors try to find out the relations between the intra-cranial stresses and the development of frontal sinuses. They account for the choice of frontal sinuses and the various factors determining this pneumatization. They study the morphology of the frontal sinuses in 20 cases of old and chronic hydrocephaly, in 13 cases of oxycephaly with a late diagnosis, and in 20 cases of adults suffering with infantile cerebral hemiatrophy. They show that in these syndromes, the development of frontal sinuses is an inverse ratio to the intracranial pressure. However, they point out that in standard people, the extreme differences in the morphology of their frontal pneumatization can be explained not only by various causes--a number of which is as yet not known--but also by an aleatory distribution.

Atrophy↗
PubMed1987

[Aneurysm of the ampulla of Galen. Nosologic reflections and endovascular therapy].

Nosologic concepts distinguish three types of aneurysm of Galen's ampulla: true aneurysms, related aneurysms, false aneurysms, whatever the type the majority of these malformations can be treated by the endovascular approach, frequently the most effective alternative therapy. Experience acquired during treatment of intracerebral arteriovenous angioma allows perfect control of direct, high output arteriovenous fistula by injection of pure isobutyl cyanoacrylate. Occlusion of shunts should be combined with prevention of consequences, that is to say extensive venous thrombosis. Two cases are reported that demonstrate the value of post-embolization heparin therapy.

Adult↗
PubMed1985

[Arteriovenous fistulas of the cranial dura mater. Apropos of 3 cases].

Three cases of arteriovenous fistulas (A.V.F.) of the cranial dura mater are reported. The authors point out that the first symptom is often in the O.R.L. field: vascular tinnitus with sometimes headaches. Diagnosis can be perform by selective arteriography. In the same time, embolization is possible.

Adult↗