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Biomedical subjects

V Biousse

Publications and source records attributed to V Biousse.

At least 73 records · Page 4Linked to original sources

Frequency of the 20210 G-->A mutation in the 3'-untranslated region of the prothrombin gene in 35 cases of cerebral venous thrombosis.

BACKGROUND AND PURPOSE: A novel sequence variation in the 3'-untranslated region of the prothrombin (factor II) gene (nucleotide 20210 G-->A) has been recently described as a risk factor for deep vein thrombosis and pulmonary embolism. It is found in approximately 1% to 4% of healthy subjects. We studied the frequency of this factor II variant in patients with cerebral venous thrombosis. METHODS: The 20210A allele of the prothrombin gene was studied after DNA extraction, polymerase chain reaction amplification, and HindIII digestion in 35 patients with magnetic resonance imaging or angiographically confirmed cerebral venous thrombosis (23 women and 12 men, aged 11 to 71 years). RESULTS: Two patients (5.7%) had the 20210A allele of the prothrombin gene. Both had other risk factors for thrombosis (use of oral contraceptives and of intrathecal steroids). CONCLUSIONS: The 20210A allele of the prothrombin gene in association with other prothrombic factors may increase the risk of cerebral venous thrombosis, but case-control studies will be necessary to clarify these associations.

Adolescent↗

Visual fields in patients with posterior GPi pallidotomy.

The objective of this study was to describe the incidence and types of visual field defects after posterior globus pallidus internus (GPi) pallidotomy for Parkinson's disease. The creation of the pallidotomy lesion carries a risk of damaging neighboring structures such as the optic tract. The reported frequency of visual field defects in patients after pallidotomy varies from 0 to 40%. Goldmann visual field testing was performed on 40 patients who underwent microelectrode-guided posterior GPi pallidotomy. The optic tract was identified during the procedure by listening during microelectrode recording for the evoked responses to light flashes and by assessing stimulation-induced subjective responses. After the first 18 patients, lesioning thresholds were increased from 0.5 to > or =1.0 mA so that the lesion was placed more distant from the optic tract. The location of individual lesions was determined on postsurgical MRI. Three patients (7.5%) had visual field defects likely related to the pallidotomy. These were contralateral homonymous superior quadrantanopias, associated in two patients with small paracentral scotomas. The incidence of visual field defects with the early technique was 11% (2/18) and decreased to 4.5% (1/22) after thresholds for lesioning were increased. Except for the location of the lesion relative to the optic tract (more ventral, adjacent to or extending into the optic tract), no other variable correlated with a post-pallidotomy visual field defect. Microelectrode-guided GPi pallidotomy is a relatively safe procedure as regards visual function even when the optic tract is used as a guide for lesion placement.

Adult↗

Transient Horner's syndrome after lumbar epidural anesthesia.

Horner's syndrome as a complication of lumbar epidural anesthesia is a relatively benign and transient condition that usually does not warrant further extensive investigation. Its occurrence is unpredictable, although more frequently associated with epidural anesthesia performed for obstetric conditions. It may indicate high sympathetic blockade, and those patients should be monitored closely for autonomic complications. We report two new cases of iatrogenic Horner's syndrome from lumbar epidural anesthesia.

Adult↗

Intracranial Ewing's sarcoma.

Three patients with intracranial Ewing's sarcoma had neuro-ophthalmologic manifestations. In one patient, the primary tumor was in the skull and in two, it involved the long bones. Two patients complained of intermittent headache associated with bilateral, transient visual symptoms suggestive of migraine, which prompted imaging that showed occipital metastases. The third patient had an orbital syndrome.

Adolescent↗

Aortic root dilatation in patients with spontaneous cervical artery dissection.

BACKGROUND: Spontaneous cervical artery dissections are a relatively common cause of ischemic stroke in young adults. Their mechanism is unknown, though it is generally assumed that an underlying minor form of extracellular matrix defect could exist. The present study tested the hypothesis that aortic and cardiac morphological abnormalities usually seen in patients with heritable connective diseases are more frequent in patients with spontaneous cervical artery dissections than in patients without such dissections. METHODS AND RESULTS: We performed a case-control study of 28 case patients with spontaneous cervical artery dissection and 84 control subjects with an ischemic stroke not due to cervical artery dissection. Control subjects were matched to case patients for age (+/-5 years), sex, and year of hospitalization. The aortic root was more frequently enlarged (ie, diameter > 34 mm) in case patients (56%) than in control subjects (15%). Mitral valve prolapse, mitral valve dystrophy, and aortic valve dystrophy were more frequent in case patients than in control subjects. In multivariate analyses, aortic diameter > 34 mm was the only variable associated with an increased risk of spontaneous cervical artery dissection (odds ratio, 14.2; 95% CI, 3.2 to 63.6; P < .001). CONCLUSIONS: These results suggest that aortic root diameter enlargement is associated with an increased risk of spontaneous cervical artery dissection. This finding is consistent with the idea that a generalized defect of the extracellular matrix is present in patients with spontaneous cervical artery dissection.

Adult↗

Retinal vein occlusion and transient monocular visual loss associated with hyperhomocystinemia.

PURPOSE: To report a 24-year-old man with bilateral central retinal vein occlusions who had preceding episodes of prolonged transient monocular visual loss during which ophthalmoscopic findings were not suggestive of vein occlusion. METHOD: Case report. RESULT: Extensive hematologic studies for causes of vein occlusion were unremarkable with the exception of increased plasma homocysteine in the patient and in his asymptomatic father. CONCLUSIONS: Impending vein occlusion should be considered in the differential diagnosis of transient monocular visual loss regardless of ophthalmoscopic appearance, and hyperhomocystinemia should be considered as a possible cause of retinal vein occlusion.

Adult↗

Carotid disease and the eye.

Patients with carotid artery disease may present with monocular, ipsilateral ocular symptoms, and signs that can herald a devastating stroke. Asymptomatic retinal emboli, transient monocular visual loss, and central retinal artery occlusion are the most common. Venous stasis retinopathy and ocular ischemic syndrome are associated with severe hypoperfusion of the eye and usually reflect severe carotid occlusive disease. Embolic ischemic optic neuropathies and compression of the intracranial optic nerve by supraclinoid carotid arteries remain debated. Third-order Horner's syndrome and eye pain are common in carotid artery disease, particularly carotid dissection; carotid artery disease, however, is an uncommon cause of ocular motor nerve palsy. Several recent publications have highlighted the prognosis and management of patients with carotid artery occlusive disease, and have emphasized the role of the ophthalmologist in early diagnosis and prevention of further cerebral and systemic complications.

Animals↗

De novo 14484 mitochondrial DNA mutation in monozygotic twins discordant for Leber's hereditary optic neuropathy.

Monozygotic twin brothers, clinically discordant for Leber's hereditary optic neuropathy (LHON), had a heteroplasmic point mutation at position 14484 in the mitochondrial DNA that was not detected in their mother. Moreover, the mutation occurred on the rare European haplogroup X, rather than the haplogroup J commonly associated with the 14484 mutation. These data indicate that the 14484 mutation in this family was a new mutation, indicating that it was the de novo occurrence of a common, primary LHON mutation.

Adolescent↗

Pregnancy complicated by cerebral venous thrombosis in Behçet's disease.

Pregnancy and Behçet's disease are both disorders with increased risks of cerebral venous thrombosis. However, we describe the first case of central venous thrombosis during the pregnancy of a woman with Behçet's disease, revealed by headaches, visual obscuring, and a slight increase in cerebrospinal fluid opening pressure. Treatment with heparin and corticosteroids led to rapid amelioration.

Adrenal Cortex Hormones↗