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Biomedical subjects

Y Guegan

Publications and source records attributed to Y Guegan.

At least 37 records · Page 2Linked to original sources
PubMed1986

[The place of arteriography in the etiologic diagnosis of spontaneous intracerebral hematomas].

456 cases of spontaneous cerebral hemorrhage have been referred at the Neurosurgical Department of the University of Rennes since the CT scan is available, i.e. from 1979 till 1984. Sixteen passed away at the time of admission itself. Among the remaining 440 cases a diagnosis of cerebro-vascular malformation was suspected in 189 according to some atypical features in clinical and/or scanographic presentation, but only 101 patients were actually submitted to an angiographic evaluation, 88 others presenting with a very deep comatose state leading to death in a few hours. We found 14 vascular anomalies (14 p. cent) amongst them eight arterial aneurysms, five arteriovenous malformations and one combining cerebellar AVM and arterial aneurysm of the basilar artery. We couldn't perform an autopsy in all lethal cases but the necropsy findings lead to discover eight additional cases (4 aneurysms and 4 AVM). Statistically it means that a gross vascular lesion is responsible of 5% of cases of cerebral hematomas (22 out of 440). We didn't take in account the cavernomas discovered at the pathological examination of the walls of several hematomas. We may conclude that a careful angiographic study is justified in following cases: young age of the patient (under 65); lack of risk factors, especially cardio-vascular or hematologic; relatively satisfactory clinical status of the patient; topographic criteria related to the CT scan (hematomas located in the fronto-basal area and near sylvian fissure).

Adult↗
PubMed1986

[Secondary hematoma of the brain stem. Apropos of 5 cases].

Five cases of brain-stem hematoma are described. The cause of these hematomas was identified as "cryptic angioma" (1 cavernous angioma, 1 telangiectasia, 3 arteriovenous malformations). So, they are so-called "secondary hematoma", as opposed to brain-stem hematoma in relation with hypertension. Such secondary hematomas are reported in the literature: 37 operated on cases and 22 untreated cases were found. The clinical picture does not seem to be typical. The presentation appears to be either with the acute onset of a stroke, or with a subacute onset including relapsing symptoms. A progressive deterioration suggesting a pontine glioma or mimicking demyelination is not rare. The CT scanner appearance is often characteristic showing a high density area in the brain-stem which enhanced after injection of contrast medium with an aspect of "halo". Angiography is usually negative. The natural history of brain-stem hematoma due to rupture of a cryptic angioma is not well documented, but it seems that prognosis is very poor. So, the authors insist on surgical evacuation which is effective and safe allowing the diagnosis of brain-stem hematoma and in some cases the identification of the malformation.

Adult↗
PubMed1985

Extracorporeal circulation with deep hypothermia and circulatory arrest in the treatment of intracranial arterial aneurysms.

Extracorporeal circulation with circulatory arrest and deep hypothermia in surgery on certain giant intracranial arterial aneurysms or on aneurysms difficult to access is described. The series includes a giant left carotid aneurysm, an aneurysm of the basilar artery bifurcation, a patient with two aneurysms, one on the right middle cerebral artery and the other at the end of the basilar artery, and a fourth patient with two aneurysms, one on the right middle cerebral and the other on the right carotid. Closed-thorax extracorporeal circulation with femoral cannulation was performed on all the patients. Surgical procedure is described and the advantages and disadvantages discussed. Results are encouraging. The authors suggest that the technique be used during surgical treatment of certain intracranial aneurysms that are in awkward positions or are very large in size. They emphasize that the procedure should be confined to exceptional cases.

Adult↗
PubMed1984

[Benign intracranial hypertension in polycythemia which had caused a lateral sinus thrombosis].

Report of a case of so called "benign" intracranial hypertension whose main characteristics are: the etiology attributed to a thrombosis of the venous transverse sinus in the course of a polycythemia; the clinical signs with a reinforcement during the course of the illness of a previous epilepsy; the prognosis with specially heavy visual impairment questioning the prefix "benign" applied to this condition.

Adult↗
PubMed1982

Spinal cord compression by extradural fat after prolonged corticosteroid therapy.

This young man was operated on twice for thoracic spinal cord compression. He had been on corticosteroid therapy for the last 2 years subsequent to a renal transplant. The only anomaly discovered during the operation was a large quantity of extradural fat that did not present the characteristics of lipoma. The remarkable postoperative clinical improvement suggested that the fat deposit was responsible for the spinal cord compression.

Adipose Tissue↗
PubMed1981

Extra-intracranial anastomosis using a venous graft.

The authors describe a patient with ischaemic neurological incidents due to bilateral hypoplasia of the carotids. Because the use of the superficial temporal artery or the occipital artery was impossible, the extra-intracranial anastomosis was performed by a direct venous graft between the external carotid artery and the posterior temporal artery. The authors describe and illustrate the operation, emphasizing the particular difficulties due to differences in diameter of the arteries and the graft. Because postoperative control angiography demonstrated perfect permeability of the anastomosis, this technique is suggested for when a normal branch of sufficient diameter of the external carotid artery cannot be used.

Arteriovenous Shunt, Surgical↗
PubMed1980

[Lateral interscalenic approach for tumors of the cervical intervertebral foramina (author's transl)].

The authors report six cases of tumours limited to the cervical inter-vertebral foramen. The patients presented with cervico-brachial neuralgias occasionally accompanied by radicular sensitivo-motor impairment. Radiographs and tomographs of the cervical spine demonstrated enlargement of the intervertebral foramen with bone proliferation depending on the etiology and provided in easy diagnosis in all the cases. A myelogram showed the absence of extension into the spinal canal thus allowing distinction from the group of dumbell tumors. In the six cases vertebral angiography gave information regarding the vascularisation and relationships of the tumour. The histological diagnosis was different in each case : neurofibroma, chordoma, osteochondroma, osteoma, osteoblastoma and an aneurysmal bone cyst. The same surgical approach was used in the six cases. Neither a laminectomy with facettectomy, nor a classical antero-lateral approach allow for a satisfactory exposition of the tumor. On the contrary a lateral interscalenic approach including dissection of the brachial plexus lead to a trouble free excision. This approach was precised by anatomical dissections.

Adolescent↗
PubMed1979

[Nerve grafts. Experimental study. Importance of number of suture points (author's transl)].

An experimental study about 36 nervous grafts on laboratory rats is reported. This study emphasizes the interest of microsurgical technique and, further more, the role of the number of stitches improving the results of each anastomosis and, thus, the quality of neural regeneration. In each animal, after sectioning tibial nerve, a graft (sciatic nerve same side) is interposed and sutured in three different ways; in a first lot of animals 6 stitches at the level of each anastomosis; in a 2nd lot: 2 stitches and in a 3d one a single stitch. The animals are tested at the end of the 20th week, with an electrophysiological control before being sacrified. The pathological controls take in account the number of regenerated nervous fibers below the graft. Our study confirm the superiority of results in the 6 stitches lot. The authors emphasize the role played by a watertight suture to prevent an anarchic growth of regenerating axones outside the graft.

Animals↗
PubMed1976

Role of the pneumo-encephalogram in the diagnosis of spontaneous subarachnoid haemorrhage.

The authors have collected eighteen cases of primary intraventricular lesions revealed by a subarachnoid haemorrhage. Among these cases, the most important are the choroid plexus papillomas followed by ependymomas; some cases have no precise histological interpretation. Generally speaking, cerebral arteriography gives only indirect evidence of ventricular dilation and thus does not confirm the presence of a lesion. On the contrary, the pneumoencephalogram is consistantly positive, but does not give the differential diagnosis between intraventricular tumours and primary intraventricular haemorrhages. This test should therefore be given the same importance as spinal cord arteriography in the exploration of subarachnoid haemorrhages with negative cerebral angiograms.

Adolescent↗
PubMed1975

[Spontaneous rhinorrhea of unusual etiology].

Authors report on the case of one patient exhibiting, since three months, a spontaneous thinorrhea and directed to them with the diagnosis of pituitary tumor. The neuro-roentgenologic inquiry discovers a ventricular dilatation and an evagination of the III rd. ventricle into the pituitary fossa ; it also puts in evidence a tumor of the posterior cerebral fossa. We are dealing here with a meningioma of the posterior aspect of temporal pyramid (petrosal bone). If tumoral hydrocephalus is common, its complication with a spontaneous rhinorrhea is, on the contrary, exceptional. We are therefore obliged to consider the pre-existing in this female patient of a deficiency of the pituitary diaphragm that has favoured the intra-sellar diverticle of the III rd ventricle, in the same manner as it makes possible, in other circumstances the arachnoidocele in the syndrome of empty pituitary fossa. Exeresis of the tumor, by suppressing the intracranial hypertension, stopped the rhinorrhea and has considerably improved the visual signs.

Brain Diseases↗