Recruitment of preserved spinal cord parenchyma after spinal cord injury in order to increase locomotor recovery
Scholtes, Félix ; Franzen, Rachelle ; Poirrier, Anne-Lise et al
Poster (2008, March 08)Detailed reference viewed: 15 (5 ULg)
IRM interventionnelle : vers une neuronavigation en temps réel.
Martin, Didier ; Nguyen Khac, Minh-Tuan ; Scholtes, Félix et al
in Revue Médicale de Liège (2008), 63
La neuronavigation est un outil neurochirurgical qui peut être comparé au GPS. Elle sert à guider la procédure neurochirurgicale en visualisant les déplacements des instruments chirurgicaux sur les images ... [more ▼]
La neuronavigation est un outil neurochirurgical qui peut être comparé au GPS. Elle sert à guider la procédure neurochirurgicale en visualisant les déplacements des instruments chirurgicaux sur les images préopératoires. En augmentant la précision du geste, elle permet d’atteindre des lésions parfois très petites ou difficiles d’accès tout en réduisant la morbidité et en augmentant l’efficacité. Elle présente cependant un écueil majeur. L’image utilisée par le système de navigation est obtenue avant l’intervention et ne peut être corrigée durant celle-ci. En raison des modifications anatomiques inhérentes à l’opération (modification du volume du liquide céphalo-rachidien, résection de la tumeur,…), il apparaît progressivement une discordance entre la réalité chirurgicale et l’imagerie. Les informations pertinentes se périment ainsi peu à peu et la précision se perd. L’IRM interventionnelle est le moyen de réactualiser la neuronavigation par des images de haute définition. De plus, elle permet de réaliser des contrôles intra-opératoires de la qualité du geste chirurgical. [less ▲]Detailed reference viewed: 137 (2 ULg)
Rapid, postmortem 9.4 T MRI of spinal cord injury: correlation with histology and survival times.
Scholtes, Félix ; Phan-Ba, Rémy ; et al
in Journal of Neuroscience Methods (2008), 174(2), 157-67
High field magnetic resonance imaging (MRI) has been increasingly used to assess experimental spinal cord injury (SCI). In the present investigation, after partial spinal cord injury and excision of the ... [more ▼]
High field magnetic resonance imaging (MRI) has been increasingly used to assess experimental spinal cord injury (SCI). In the present investigation, after partial spinal cord injury and excision of the whole spine, pathological changes of the spinal cord were studied in spinal cord-spine blocks, from the acute to the chronic state (24 h to 5 months). Using proton density (PD) weighted imaging parameters at a magnetic field strength of 9.4 tesla (T), acquisition times ranging from <1 to 10 h per specimen were used. High in-plane pixel resolution (68 and 38 microm, respectively) was obtained, as well as high signal-to-noise ratio (SNR), which is important for optimal contrast settings. The quality of the resulting MR images was demonstrated by comparison with histology. The cord and the lesion were shown in their anatomical surroundings, detecting cord swelling in the acute phase (24 h to 1 week) and cord atrophy at the chronic stage. Haemorrhage was detected as hypo-intense signal. Oedema, necrosis and scarring were hyper-intense but could not be distinguished. Histology confirmed that the anatomical delimitation of the lesion extent by MRI was precise, both with high and moderate resolution. The present investigation thus demonstrates the precision of spinal cord MRI at different survival delays after compressive partial SCI and establishes efficient imaging parameters for postmortem PD MRI. [less ▲]Detailed reference viewed: 162 (13 ULg)
Cerebral subarachnoid blood migration consecutive to a lumbar haematoma after spinal anaesthesia
Hans, Grégory ; Senard, Marc ; Ledoux, Didier et al
in Acta Anaesthesiologica Scandinavica (2008), 52Detailed reference viewed: 24 (3 ULg)
Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single-institution experience.
; Scholtes, Félix ; et al
in Neurosurgery (2008), 62(2), 463-9469-71
OBJECTIVE: The management of cerebrospinal fluid (CSF) fistulae after anterior cranial base fracture remains a surgical challenge. We reviewed our results in the repair of CSF fistulae complicating ... [more ▼]
OBJECTIVE: The management of cerebrospinal fluid (CSF) fistulae after anterior cranial base fracture remains a surgical challenge. We reviewed our results in the repair of CSF fistulae complicating multiple anterior cranial base fractures via a combined intracranial extradural and intradural approach and describe a treatment algorithm derived from this experience. METHODS: We retrospectively reviewed the files of 209 patients with an anterior cranial base fracture complicated by a CSF fistula who were admitted between 1980 and 2003 to Liege State University Hospital. Among those patients, 109 had a persistent CSF leak or radiological signs of an unhealed dural tear. All underwent the same surgical procedure, with combined extradural and intradural closure of the dural tear. RESULTS: Of the 109 patients, 98 patients (90%) were cured after the first operation. Persistent postoperative CSF rhinorrhea occurred in 11 patients (10%), necessitating an early complementary surgery via a transsphenoidal approach (7 patients) or a second-look intracranial approach (4 patients). No postoperative neurological deterioration attributable to increasing frontocerebral edema occurred. During the mean follow-up period of 36 months, recurrence of CSF fistula was observed in five patients and required an additional surgical repair procedure. CONCLUSION: The closure of CSF fistulae after an anterior cranial base fracture via a combined intracranial extradural and intradural approach, which allows the visualization and repair of the entire anterior base, is safe and effective. It is essentially indicated for patients with extensive bone defects in the cranial base, multiple fractures of the ethmoid bone and the posterior wall of the frontal sinus, cranial nerve involvement, associated lesions necessitating surgery such as intracranial hematomas, and post-traumatic intracranial infection. Rhinorrhea caused by a precisely located small tear may be treated with endoscopy. [less ▲]Detailed reference viewed: 50 (1 ULg)
Acquired tonsillar herniation and syringomyelia after pleural effusion aspiration: case report.
Scholsem, Martin ; Scholtes, Félix ; Belachew, Shibeshih et al
in Neurosurgery (2008), 62(5), 1172-31173
OBJECTIVE: We present a case of brachial plexus avulsion and reconstructive surgery with cerebrospinal fluid leak between the cervical subarachnoid space and the pleural cavity responsible for tonsillar ... [more ▼]
OBJECTIVE: We present a case of brachial plexus avulsion and reconstructive surgery with cerebrospinal fluid leak between the cervical subarachnoid space and the pleural cavity responsible for tonsillar herniation and syringomyelia. CLINICAL PRESENTATION: A 17-year-old man presented with headaches when he was positioned upright, simultaneously with a persistent right pleural effusion for about 4 months after reconstructive surgery for a right brachial plexus avulsion. In addition, the headaches had worsened considerably after two aspirations of the pleural effusion. Magnetic resonance imaging (MRI) demonstrated signs of chronic intracranial hypotension and tonsillar herniation with a presyrinx cavity from vertebral level C1 to C7. None of those abnormalities were seen on the MRI scan obtained a few days after the initial trauma 7 months previously. Plexus brachial MRI confirmed the presence of a cerebrospinal fluid leak between the avulsed root of C8 and the pulmonary apex. INTERVENTION: The leak was treated by surgical closure of the dural tear of the C8 root. Postoperatively, the patient's headaches immediately resolved, and MRI 4 months later showed resolution of cerebellar tonsil herniation and regression of the syrinx. CONCLUSION: Resolution of acquired tonsillar herniation and syringomyelia can be achieved by closure of the dural tear responsible of the cerebrospinal fluid leak. [less ▲]Detailed reference viewed: 219 (17 ULg)
Le cas clinique du mois. Le syndrome lissencephalique de Miller-Dieker.
Cremers, Julien ; ; Scholtes, Félix et al
in Revue Médicale de Liège (2007), 62(3), 139-43
We present the case of a 10-year-old boy who presents with a severe epilepsy resistant to medical treatment in the context of a Miller-Dieker syndrome. This patient underwent the implantation of a ... [more ▼]
We present the case of a 10-year-old boy who presents with a severe epilepsy resistant to medical treatment in the context of a Miller-Dieker syndrome. This patient underwent the implantation of a pneumogastric nerve stimulator. We describe the patient's clinical history and the main characteristics of lissencephaly syndrome. [less ▲]Detailed reference viewed: 158 (6 ULg)
Delayed GM-CSF treatment stimulates axonal regeneration and functional recovery in paraplegic rats via an increased BDNF expression by endogenous macrophages
; Malgrange, Brigitte ; Multon, Sylvie et al
in FASEB Journal (2006), 20(8), 12391241
Macrophages (monocytes/microglia) could play a critical role in central nervous system repair. We have previously found a synchronism between the regression of spontaneous axonal regeneration and the ... [more ▼]
Macrophages (monocytes/microglia) could play a critical role in central nervous system repair. We have previously found a synchronism between the regression of spontaneous axonal regeneration and the deactivation of macrophages 3-4 wk after a compression-injury of rat spinal cord. To explore whether reactivation of endogenous macrophages might be beneficial for spinal cord repair, we have studied the effects of granulocyte-macrophage colony stimulating factor (GM-CSF) in the same paraplegia model and in cell cultures. There was a significant, though transient, improvement of locomotor recovery after a single delayed intraperitoneal injection of 2 mu g GM-CSF, which also increased significantly the expression of Cr3 and brain-derived neurotrophic factor ( BDNF) by macrophages at the lesion site. At longer survival delays, axonal regeneration was significantly enhanced in GMCSF-treated rats. In vitro, BV2 microglial cells expressed higher levels of BDNF in the presence of GM-CSF and neurons cocultured with microglial cells activated by GM-CSF generated more neurites, an effect blocked by a BDNF antibody. These experiments suggest that GM-CSF could be an interesting treatment option for spinal cord injury and that its beneficial effects might be mediated by BDNF.-Bouhy, D., Malgrange, B., Multon, S., Poirrier, A. L., Scholtes, F., Schoenen, J., Franzen, R. Delayed GM-CSF treatment stimulates axonal regeneration and functional recovery in paraplegic rats via an increased BDNF expression by endogenous macrophages. [less ▲]Detailed reference viewed: 32 (6 ULg)
Extensive epidural and paraspinal follicular Non-Hodgkin lymphoma
Scholtes, Félix ; ; et al
Conference (2006, March)Detailed reference viewed: 31 (0 ULg)
Initial outcome and efficacy of kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures
Scholtes, Félix ; Martin, Didier ; et al
Conference (2006, March)Detailed reference viewed: 2 (0 ULg)
L'image du mois. Un cas de leucoencephalopathie rapidement progressive sur angiopathie amyloide
Wauters, Odile ; Scholtes, Félix ; Dive, Dominique et al
in Revue Médicale de Liège (2006), 61(1), 3-4Detailed reference viewed: 160 (14 ULg)
Correlation of postmortem 9.4 tesla magnetic resonance imaging and immunohistopathology of the human thoracic spinal cord 7 months after traumatic cervical spine injury.
Scholtes, Félix ; ; et al
in Neurosurgery (2006), 59(3), 671-8671-8
OBJECTIVE: To correlate high-resolution magnetic resonance imaging (MRI) with immunohistopathology in the injured human spinal cord. METHODS: Postmortem MRI scans at a field strength of 9.4 T, as well as ... [more ▼]
OBJECTIVE: To correlate high-resolution magnetic resonance imaging (MRI) with immunohistopathology in the injured human spinal cord. METHODS: Postmortem MRI scans at a field strength of 9.4 T, as well as standard histology and immunohistochemistry, were performed on an excised specimen of human high thoracic spinal cord, obtained 7 months after the initial trauma, several segments below a severe spinal cord lesion (C5). RESULTS: A precise correlation is described between MRI and immunohistochemistry of the long white matter tracts undergoing Wallerian degeneration and of an extension of the cervical lesion into the high thoracic cord. CONCLUSION: MRI, the only imaging technique that currently provides useful information on the spinal cord parenchyma after trauma, is rapidly evolving. High-field scanners of up to 9.4 T are being clinically tested. The present postmortem investigation of an isolated spinal cord specimen demonstrates the precise correlation that can be achieved between imaging and pathology. In future investigations, this type of technique can lead to a more precise description of spinal cord injuries and their consequences in remote tissue. Translation into the clinical setting will improve diagnosis and follow-up of spinal cord injured patients. [less ▲]Detailed reference viewed: 44 (11 ULg)
Two stages total vertebrectomy : about a series of 16 patients.
Lenelle, Jacques ; ; Dubuisson, Annie et al
Conference (2005, March)Detailed reference viewed: 7 (0 ULg)
Ghreline et obesite
Garweg, Christophe ; Scholtes, Félix ; et al
in Revue Médicale de Liège (2005), 60(1), 35-40
Ghrelin is a peptide hormone secreted by the stomach. It was initially described as a stimulant of growth hormone secretion. Soon, however, it was discovered to play an important role in feeding behaviour ... [more ▼]
Ghrelin is a peptide hormone secreted by the stomach. It was initially described as a stimulant of growth hormone secretion. Soon, however, it was discovered to play an important role in feeding behaviour in animals and in appetite regulation in man: ghrelin stimulates appetite, and as such is an orexigenic peptide implicated in energy balance mechanisms and weight gain. Abnormal ghrelin activity leads to over- or underweight. Additionally, the efficacy of different treatment strategies against obesity seems to be related to modifications in plasma ghrelin levels. This review summarizes the current knowledge about ghrelin and its implications in obesity medicine. [less ▲]Detailed reference viewed: 88 (23 ULg)
Traumatisme médullaire - imagerie post-mortem par résonance magnétique 9,4T avec corrélation anatomo-pathologique.
Scholtes, Félix ; ; et al
Conference (2004, November 21)Detailed reference viewed: 19 (1 ULg)
Post-mortem, high resolution magnetic resonance imaging (9.4T) correlates with histopathology after traumatic spinal cord injury.
Scholtes, Félix ; ; et al
Conference (2004, October 08)Detailed reference viewed: 5 (0 ULg)
Correlation of post-mortem 9.4 tesla high resolution magnetic resonance imaging and immunohistopathology seven months after human spinal cord injury.
Scholtes, Félix ; ; et al
Conference (2004, April 27)Detailed reference viewed: 4 (0 ULg)
Repetitive transcranial magnetic stimulation improves open field locomotor recovery after low but not high thoracic spinal cord compression-injury in adult rats
Poirrier, Anne-Lise ; ; Scholtes, Félix et al
in Journal of Neuroscience Research (2004), 75(2), 253-261
Electromagnetic fields are able to promote axonal regeneration in vitro and in vivo. Repetitive transcranial magnetic stimulation (rTMS) is used routinely in neuropsychiatric conditions and as an ... [more ▼]
Electromagnetic fields are able to promote axonal regeneration in vitro and in vivo. Repetitive transcranial magnetic stimulation (rTMS) is used routinely in neuropsychiatric conditions and as an atraumatic method to activate descending motor pathways. After spinal cord injury, these pathways are disconnected from the spinal locomotor generator, resulting in most of the functional deficit. We have applied daily 10 Hz rTMS for 8 weeks immediately after an incomplete high (T4-5; n = 5) or low (T10-11; n = 6) thoracic closed spinal cord compression -injury in adult rats, using 6 high- and 6 low-lesioned non-stimulated animals as controls. Functional recovery of hindlimbs was assessed using the BBB locomotor rating scale. In the control group, the BBB score was significantly better from the 7th week post-injury in animals lesioned at T4-5 compared to those lesioned at T10-11. rTMS significantly improved locomotor recovery in T10-11-injured rats, but not in rats with a high thoracic injury. In rTMS-treated rats, there was significant positive correlation between final BBB score and grey matter density of serotonergic fibres in the spinal segment just caudal to the lesion. We propose that low thoracic lesions produce a greater functional deficit because they interfere with the locomotor centre and that rTMS is beneficial in such lesions because it activates this central pattern generator, presumably via descending serotonin pathways. The benefits of rTMS shown here suggest strongly that this non-invasive intervention strategy merits consideration for clinical trials in human paraplegics with low spinal cord lesions. (C) 2003 Wiley-Liss, Inc. [less ▲]Detailed reference viewed: 60 (12 ULg)
The effect of treadmill training on motor recovery after a partial spinal cord compression-injury in the adult rat
Multon, Sylvie ; Franzen, Rachelle ; Poirrier, Anne-Lise et al
in Journal of Neurotrauma (2003), 20(8), 699-706
Locomotor training on a treadmill is a therapeutic strategy used for several years in human paraplegics in whom it was shown to improve functional recovery mainly after incomplete spinal cord lesions. The ... [more ▼]
Locomotor training on a treadmill is a therapeutic strategy used for several years in human paraplegics in whom it was shown to improve functional recovery mainly after incomplete spinal cord lesions. The precise mechanisms underlying its effects are not known. Experimental studies in adult animals were chiefly performed after complete spinal transections. The objective of this experiment was to assess the effects of early treadmill training on recovery of spontaneous walking capacity after a partial spinal cord lesion in adult rats. Following a compression-injury by a subdurally inflated microballoon, seven rats were trained daily on a treadmill with a body weight support system, whereas six other animals were used as controls and only handled. Spontaneous walking ability in an open field was compared weekly between both groups by two blinded observers, using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale. Mean BBB score during 12 weeks was globally significantly greater in the treadmill-trained animals than in the control group, the benefit of training appearing as early as the 2nd week. At week 7, locomotor recovery reached a plateau in both animal groups, but remained superior in trained rats. Daily treadmill training started early after a partial spinal cord lesion in adult rats, which accelerates recovery of locomotion and produces a long-term benefit. These findings in an animal model mimicking the closed spinal cord injury occurring in most human paraplegics are useful for future studies of optimal locomotor training programs, their neurobiologic mechanisms, and their combination with other treatment strategies. [less ▲]Detailed reference viewed: 51 (11 ULg)
Increased expression of the putative axon growth-repulsive extracellular matrix molecule, keratan sulphate proteoglycan, following traumatic injury of the adult rat spinal cord
; Scholtes, Félix ; Martin, Didier et al
in Acta Neuropathologica (2002), 104(6), 592-600
Keratan sulphate proteoglycan (KSPG) is a developmentally regulated barrier molecule, directing axonal growth during central nervous system (CNS) formation. The possible re-expression and functional ... [more ▼]
Keratan sulphate proteoglycan (KSPG) is a developmentally regulated barrier molecule, directing axonal growth during central nervous system (CNS) formation. The possible re-expression and functional significance of KSPG in preventing axon regeneration following spinal cord injury (SCI) is poorly understood. In the present investigation, the spatio-temporal expression of KSPG was studied following experimental SCI. There was no indication of sparing of axons at the lesion epicentre following severe compression injury. By 7 days post operation (p.o.) a diffuse increase of KSPG immunoreactivity (KSPG-IR) was observed in the parenchyma surrounding the lesion. This was followed by a delayed (21-28 days p.o.) and largely heterogeneous increase of KSPG-IR in the lesion epicentre, which revealed both cellular and extracellular matrix-like distribution patterns. Although no re-growth of anterogradely labelled corticospinal axons was observed, many 200-kDa neurofilament (NF)-positive axon could be detected growing into the connective tissue scar. This phase of spontaneous axonal re-growth was closely associated with a framework of glial cells (including Schwann cells from damaged local spinal nerve roots) that had migrated into the lesion site. The spontaneous nerve fibre re-growth could be detected in both KSPG-rich and KSPG-poor territories. The present data suggest that the lesion-induced up-regulation of KSPG-IR may have contributed to the lack of corticospinal axon re-growth. However, the lack of any direct spatio-temporal correlation between the distribution of raised KSPG-IR and spontaneous NF-positive axonal regeneration suggests that at least some populations of axons can resist the putative inhibitory effects of this extracellular matrix molecule. [less ▲]Detailed reference viewed: 38 (11 ULg)