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Biomedical subjects

Y Keravel

Publications and source records attributed to Y Keravel.

At least 55 records · Page 3Linked to original sources
PubMed1985

Extradural and hourglass cervical neurinomas: the vertebral artery problem.

Eleven cases of cervical neurinomas with an extradural component were operated on with control of the vertebral artery as the first step of the surgical procedure. The lateral anterior approach was used first in each case with excellent results. In the case of hourglass tumors (seven cases), a complementary posterior approach was performed to remove the intradural portion. Primary control of the vertebral artery in cases of extradural or hourglass neurinoma is a logical and safe procedure in the attempt to achieve complete and bloodless tumor removal.

Adult↗
PubMed1984

[Surgical treatment of naso-sinus tumors invading the anterior region of the base of the skull. Problems encountered during exploration, and repair of bone and dura mater].

Current limitations for surgical excision and solutions to problems of bone and dura mater repair of nasosinusal tumors invading the anterior region of the base of skull are discussed in relation to 14 cases. None of these patients had been operated upon by first intention using the upper approach Exploration of the median part of the anterior region is limited posteriorly by the posterior border of the jugum and the base of the anterior clinoid processes. Pre-operative discovery of invasion of the dura mater is a contraindication for surgery. Posterior and dural extension of the tumor is evaluated by combined CT Scan and tomography, but these examinations do not always confirm the absence of dura mater involvement before surgery. A double approach should be used when doubt as to invasion of the base exists. Dura mater repair involves suturing, a free periosteal flap, and a pediculated cranial periosteum flap anteriorly on the fronto-orbital region. Reconstruction of the base requires the use of the periosteal flap, alone or associated with bone grafts depending on the size and location of the bone breach. Short and long term postoperative complications were nor observed.

Bone Transplantation↗
PubMed1982

Failure of a Heifetz aneurysm clip.

A 16-year-old girl died from an acute subarachnoid hemorrhage following the fracture of a blade of a Heifetz aneurysm clip. The clip was manufactured from 17-7PH steel, which on metallurgical testing was found to be highly sensitive to intergranular corrosion. The fracture mechanism was stress corrosion, brought on by the combination of a stress load, an electrolytic environment, and a susceptible steel.

Adolescent↗
PubMed1981

[Removal of kidneys for transplantation. Experience in a French general teaching hospital (author's transl)].

A law issued on december 22, 1976 and aimed at increasing the number of kidney transplantations in France authorizes the removal of kidneys from deceased persons of full age provided they had not expressed refusal while still alive; for decreased persons under age, removal is subject to written consent of the legal representative. In a general teaching hospital of whose than 1 000 beds, 21 kidneys donors were operated upon between January 1, 1971 and December 31, 1975 (an average of 4.2 per year). A kidney transplantation team was developed in 1976. Between January 1, 1976 and August 31, 1979, 83 kidneys donors were operated, an average of 22.6 per year. Ninety-five per cent (59/62) of the kidneys removed and transplanted in the hospital began to function (diuresis greater than 2 ml/min) within minutes of releasing the clamp, no matter how long cold ischaemia had lasted. The increase in kidney removal and transplantation may be attributed to the fact that motivation was maintained among the various units concerned (anaesthesia and intensive care, neurosurgery, neuroradiology) by sustained information and teaching.

Cadaver↗
PubMed1981

[Effect of availability of computer tomography on activity in an emergency neuroradiological department (author's transl)].

Overall activity in an emergency neuroradiological department was altered when computed tomography facilities became available, as shown by comparative studies conducted during one year without and one year with the use of this investigational method. More examinations were conducted during the year the apparatus was available, and the diagnostic approach to patients with head or brain injuries was modified, computed tomography replacing the arteriography used as an initial examination during the first year. These findings can be related to the rapidity, safety, and diagnostic precision of computed tomography examinations.

Brain↗
PubMed1980

[Pain relief through transcutaneous electrical nerve stimulation (TENS). Results on painful neurological disorders in 180 cases (author's transl)].

A series of 180 patients with painful neurological disorders were treated with TENS. The findings most frequently encountered when the treatment was successful are analyzed. Depending upon the etiology of the primary disorder, good results (i.e. pain relief of 20% or higher) were obtained as follows : -- Peripheral Nerve Involvement : Amputation - 35 cases; Traumatism - 13 cases ; Miscellaneous - 7 cases. (87 %). -- Radicular Syndromes : Epidural scar and/or Arachnoiditis - 19 cases; Miscellaneous - 9 cases. (60 %). -- Post Herpetic Pain : 34 cases. (67 %). -- Brachial Plexus Lesions (Avulsions) : 12 cases. (25 %). -- Spinal Cord Disorders : 17 cases. (11 %). --Thalamic Pain : 5 cases. (0 %). -- Post-Radiation Pain or Carcinomatous Pain : 16 cases. (30 %). Satisfactory long-term results (over 3 years) were maintained in 80 % of cases of peripheral nerve involvement. In all other cases the percentage of pain relief decreased with follow-up. In this series the likelyhood of good results was associated with the following objective data : 1) Pain is generally secondary to deafferentation. 2) Pain is localized. 3) TENS application in close contact with the nervous structure innervating the painful area is more productive. 4) A relative preservation of lemniscal fibers to superior centers must be present so that stimulation can be transmitted.

Analgesia↗
PubMed1979

[Trigeminal neuralgia. Percutaneous thermocoagulation of the trigeminal nerve (author's transl)].

200 cases of percutaneous thermocoagulation of the trigeminal nerve were studied in order to determine if the position of the thermolesion in the various parts of the trigeminal system modified the quality of the results and the frequency of post-operative complications. An anatomo-radiological study allowed the precise localisation in the sagittal plane of the position of the different parts of the trigeminal ganglion with respect to the neighbouring bony features. The quality of the results and the frequency of complications were studied according to the level of the thermolesion (ganglion, triangular plexus, posterior sensory root). This study permitted the observation that the more posterior the thermolesion, the less frequent the complication, and this confirmed results obtained in earlier procedures, c.g. gasserian or retro-gasserian neurotomy. Post-operative hypoaesthesia extending beyond the painful area, was the major side-effect of the radicular position of the thermolesion. There follows a discussion of the criteria, which permit the recognition of the point of the electrode at the level of the posterior root: the flow of CSF, vasodilatation, and radiological localisations. Of these three criteria, only radiological demonstration (point of the needle posterior to the clivus and above the petrous temporal bone) seemed reliable.

Adult↗
PubMed1978

Detachable balloon and calibrated-leak balloon techniques in the treatment of cerebral vascular lesions.

Of the cerebral vascular lesions that can be treated with intravascular detachable balloon techniques, carotid-cavernous sinus fistulas and vertebro-vertebral fistulas have the best results. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The authors report 17 postraumatic carotid-cavernous sinus fistulas successfully treated with preservation of the carotid blood flow in 12 cases. None of the patients died, and the morbidity was limited to one case of third nerve palsy. The treatment of aneurysms by this method is, however, much more difficult and dangerous. Of 14 cases treated, seven good results were obtained. Two patients died and two had a poor outcome. The embolization of certain brain angiomas with calibrated-leak balloons using bucrylate promises to be important in the future.

Adult↗
PubMed1976

[Technic for an inflatable and releasable balloon in neurology. Experimental study. Application in man].

We consider our method with an inflatable and releasable balloon to be trustworthy and now applicable to the treatment of carotido-cavernous fistulas; it may not be possible in all cases to pass the ballon on through the fistula and inflate it in the cavernous sinus, but it seems to us so very important to preserve the carotid flow that we think that this should be achieved whenever possible. Certain arterial aneurysms could profit from this technique. We have purposely omitted all diagnostic application of the method which serbinenko has described in his article: selective opacifcation of certain branches of the internal carotid, deliberate temporary occlusion of certain branches to enable the amount of tolerance to be assessed. All these exploratory methods which we are beginning to carry out will form the subject of a later paper.

Adult↗