Merkel cell carcinoma of the central nervous system. Case report and review of the literature.
DE MARNEFFE, Mikaël ; DUBUISSON, Annie ; MARTIN, Didier
Poster (2013, March 30)Detailed reference viewed: 8 (3 ULg)
La hernie discale lombaire paralysante : une urgence chirurgicale ? Réflexion à propos d'une série de 24 patients et des données de la littérature.
DUBUISSON, Annie ; ; SCHOLTES, Félix et al
in Neuro-Chirurgie (2013), 59(2), 64-8
BACKGROUND AND PURPOSE: Paralysing lumbar disc herniation (LDH): what and when to do? Few studies have analyzed the optimal timing of surgery in case of paralysing LDH. METHODS: Twenty-four charts were ... [more ▼]
BACKGROUND AND PURPOSE: Paralysing lumbar disc herniation (LDH): what and when to do? Few studies have analyzed the optimal timing of surgery in case of paralysing LDH. METHODS: Twenty-four charts were retrospectively reviewed of patients suffering of LDH with severe motor deficit. RESULTS: There were 16 men and eight women. Mean age was 45.1 years. Seventeen patients suffered of lumbar pain, 15 of radicular pain and all of a severe motor deficit, implying mostly the ankle flexion (17 patients). LDH was most frequently located at L4/L5 or L5/S1 level. Surgery was proposed to all patients at the end of the consultation. Nine patients were operated within 48 hours. The mean interval between onset of motor deficit and operation was 20 days. The statistical analysis did not reveal any significant difference among different prognostic factors between the 17 patients with good motor recovery and the seven patients with poor motor recovery. In particular the operative delay did not appear to influence the degree of motor recovery. Literature review on paralysing LDH provides five published series since 1996, including 28 to 116 patients. Two series, including the single prospective one, conclude that the degree of recovery of motor function is inversely related to the degree and duration of motor deficit. CONCLUSIONS: Our retrospective series of 24 operated paralysing LDH did not reveal any prognostic factor for motor recovery. There is no evidence based medicine data in the literature about the optimal timing of decompressive surgery. A relative consensus exists among spine surgeons for paralysing LDH: since operative indication is obvious, surgery should be done as soon as possible. [less ▲]Detailed reference viewed: 24 (10 ULg)
Long-term evaluation of spinal cord stimulation for neuropathic/vascular pain
; Kaschten, Bruno ; DUBUISSON, Annie et al
Conference (2012, March 10)Detailed reference viewed: 33 (8 ULg)
Posterior cerebral artery duplication and plasty of the right third cranial nerve
SALADO, Anne-Laure ; SCHOLTES, Félix ; OTTO, Bernard et al
Conference (2012, March 10)Detailed reference viewed: 24 (3 ULg)
Is paralysing lumbar disc herniation a surgical emergency ?
DUBUISSON, Annie ; BORLON, Sarah ; NGUYEN KHAC, Minh-Tuan et al
Conference (2011, March 26)Detailed reference viewed: 53 (7 ULg)
La main de Gilliatt-Sumner ou le syndrome de défilé cervicothoracique neurogène vrai. A propos de sept cas opérés.
DUBUISSON, Annie ; NGUYEN KHAC, Minh-Tuan ; SCHOLTES, Félix et al
in Neuro-Chirurgie (2011), 57(1), 9-14
BACKGROUND AND PURPOSE: The clinical picture of hand atrophy related to a cervical rib or elongated C7 transverse process was well described in the modern literature by Gilliatt and Sumner; in 1970, they ... [more ▼]
BACKGROUND AND PURPOSE: The clinical picture of hand atrophy related to a cervical rib or elongated C7 transverse process was well described in the modern literature by Gilliatt and Sumner; in 1970, they reported a series of nine patients whose motor status was stabilized following brachial plexus decompression. We report here seven patients suffering from thoracic outlet syndrome (TOS), who developed hand atrophy, sometimes because of diagnostic delay. METHODS: The patient's charts were analysed retrospectively. RESULTS: The seven patients were all female; the mean age was 43 years. The first complaints were arm pain and paresthesias lasting six months to 5 years. Three patients were treated with C56/C67 discectomy plus disc prosthesis (one patient), ulnar neurolysis at the elbow (the same patient), carpal tunnel release (one patient), and intravenous immunoglobulins (one patient) before TOS diagnosis. Hand atrophy, severe in five patients, was present at presentation. All patients underwent brachial plexus decompression by the anterior (four), posterior (two), or transaxillary (one) approach. This last approach was completed 18 months later by brachial plexus neurolysis via the anterior approach. Postoperatively, motor deficit was improved in two patients and stabilized in five patients. CONCLUSIONS: Physicians' unfamiliarity with TOS diagnosis or their reluctance to accept the diagnosis without electrical confirmation can lead to hand atrophy. Brachial plexus decompression at this stage usually stabilizes the deficit. [less ▲]Detailed reference viewed: 5 (1 ULg)
Atrophie de la main sur syndrome de défilé cervicothoracique neurogène. A propos de 7 cas opérés.
Dubuisson, Annie ; Nguyen Khac, Minh-Tuan ; Scholtes, Félix et al
Poster (2010, December)Detailed reference viewed: 67 (2 ULg)
Postoperative sialadenitis with chronic brachial plexopathy
; Racaru, Tudor ; et al
Poster (2010, March 20)Detailed reference viewed: 12 (1 ULg)
Cement-augmented pedicular screws in treatment of osteoporotic pathology. Technical aspects and preliminary results
Racaru, Tudor ; Nguyen-Khac, Minh-Tuan ; Pellegrini, Nicolas et al
Poster (2010, March 20)Detailed reference viewed: 47 (2 ULg)
Propianibactrium acnes in neurosurgery : weak in cultures, stronger under scalp.
Nguyen Khac, Minh-Tuan ; Racaru, Tudor ; Pellegrini, Nicolas et al
Conference (2010, March 20)Detailed reference viewed: 20 (5 ULg)
Encéphalocèle orbitaire post-traumatique bilatéral
Racaru, Tudor ; Nguyen Khac, Minh-Tuan ; Scholtes, Félix et al
in Revue Médicale de Liège (2010), 65
L'encéphalocèle orbitaire aigu traumatique est une entité rare. Selon Pubmed moins de 25 cas ont été raportés. Nous présentons le premier cas d'encéphalocèle post-traumatique bilatéral provoqué par une ... [more ▼]
L'encéphalocèle orbitaire aigu traumatique est une entité rare. Selon Pubmed moins de 25 cas ont été raportés. Nous présentons le premier cas d'encéphalocèle post-traumatique bilatéral provoqué par une fracture enfoncement du toit de l'orbite. Un traitement rapide est nécessaire pour éviter l'hypertension intra-orbitaire qui peut être responsable de lésions dégénératives du nerf optique. La réparation du toit de l'orbite nécessite une reconstruction rigide pour éviter la transmission de variations de la pression intra-crânienne. Dans le cas rapporté, la reconstruction du toit de l'orbite a été effectuée par voie crânienne sous-frontale à l'aide d'un mélange de poudre d'os à la colle biologique soutenu par un treillis en titane fixé avec des vis [less ▲]Detailed reference viewed: 183 (4 ULg)
Does radiation treatment delay affect survival in glioblastoma
Robe, Pierre ; Nguyen-Khac, Minh-Tuan ; Lenelle, Jacques et al
in Surgical Neurology (2009), 72(5), 519Detailed reference viewed: 56 (9 ULg)
Does radiation treatment delay affect survival in glioblastoma ?
Robe, Pierre ; Nguyen Khac, Minh-Tuan ; Lenelle, Jacques et al
Conference (2009, March 21)Detailed reference viewed: 32 (7 ULg)
The Gilliatt-Sumner hand: an ill-known clinical picture from cervical ribs. Report of 5 operated cases.
Dubuisson, Annie ; ; et al
Conference (2009, March 21)Detailed reference viewed: 121 (0 ULg)
The Gilliatt-Summer hand: an ill-know clinical picture from cervical ribs. Report of 5 operated cases
Dubuisson, Annie ; ; et al
Conference (2009, March)Detailed reference viewed: 16 (1 ULg)
Preliminary observations after discectomy plus fusion with the use of bioresorbable cages
Nguyen Khac, Minh-Tuan ; ; Racaru, Tudor et al
Poster (2008, March 08)Detailed reference viewed: 35 (1 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: 48 (1 ULg)
Classical pituitary tumour apoplexy: clinical features, management and outcomes in a series of 24 patients.
Dubuisson, Annie ; Beckers, Albert ; Stevenaert, Achille
in Clinical Neurology & Neurosurgery (2007), 109(1), 63-70
We retrospectively analysed the incidence, clinical presentation, endocrinological and radiological findings, medical and surgical management of pituitary apoplexy in our department (single-centre study ... [more ▼]
We retrospectively analysed the incidence, clinical presentation, endocrinological and radiological findings, medical and surgical management of pituitary apoplexy in our department (single-centre study), having a large experience in pituitary surgery. Among 1540 pituitary lesions, 24 patients presented with pituitary apoplexy. Their charts were retrospectively reviewed. The symptoms included headache (92%), nausea and vomiting (54%), visual deficit (50%), oculomotor paresis (54%) and/or an altered mental state (42%). Skull X-rays (n = 14) demonstrated an enlarged sella turcica in all cases; CT-scan and/or MRI always revealed a sellar and suprasellar expanding lesion. Panhypopituitarism was present on admission in 70% of the patients. Urgent therapeutic management included high-dose cortisone treatment in all but one patients and CSF drainage in three. Three patients were treated conservatively. Nine patients were operated on rapidly, within hours or a few days because of severe visual deficit and/or altered level of consciousness. Nineteen patients were operated by the trans-sphenoidal approach; one of them required a second operation by craniotomy. There were two deaths related to the illness and one to an ill-defined reason at 4 months. Among the other patients 95% made a good recovery. All but two patients required a substitutive treatment with adrenal (83%), thyroid (68%), gonadal (42%) and/or growth (16%) hormones. The preoperative visual deficits recovered in all but one patients (92%) whereas the oculomotor pareses improved in all but two patients (85%). In conclusion, pituitary tumour apoplexy is a rare event, complicating in our series 1.6% of 1540 pituitary adenomas. Even in severe cases, complete recovery is possible if the diagnosis is rapidly obtained and adequate management is initiated in time. Surgical results after trans-sphenoidal approach are in the majority of cases very satisfactory. [less ▲]Detailed reference viewed: 23 (0 ULg)
Intrasellar arachnoid cysts.
Dubuisson, Annie ; Stevenaert, Achille ; Martin, Didier et al
in Neurosurgery (2007), 61(3), 505-13513
OBJECTIVE: To evaluate the clinical, endocrinological, and radiological presentation of nine cases of surgically verified intrasellar arachnoid cysts and to discuss the physiopathological mechanisms of ... [more ▼]
OBJECTIVE: To evaluate the clinical, endocrinological, and radiological presentation of nine cases of surgically verified intrasellar arachnoid cysts and to discuss the physiopathological mechanisms of formation of these cysts. METHODS: Among 1540 patients presenting with pituitary lesions, nine presented with an intrasellar arachnoid cyst. Their charts were retrospectively reviewed. RESULTS: Presenting symptoms included headache (n = 2), visual symptoms (n = 3), menstrual irregularities (n = 2), rapid weight gain (n = 1), vertigo (n = 1), and/or confusion (n = 1). Two cysts were discovered incidentally. T1-weighted magnetic resonance imaging scans showed an intrasellar cystic lesion in all cases, with a huge suprasellar extension in six cases. The cyst was of the same intensity as the cerebrospinal fluid (CSF) in only two patients. A transsphenoidal approach allowed the transdural aspiration of fluid and injection of a water-soluble contrast agent under mild pressure. In three patients, the contrast infiltrated along the pituitary stalk toward the subarachnoid spaces; in the other patients, it remained in the intrasellar compartment. Cyst membranes were removed as completely as possible with fenestration toward the subarachnoid spaces in communicating cysts. In spite of tight packing of the sella and sphenoid sinus, CSF fistulae requiring reoperation developed in two patients. CONCLUSION: The clinical picture of an intrasellar arachnoid cyst resembles that of a nonfunctional pituitary adenoma. Magnetic resonance imaging scans typically show a cystic intrasellar lesion with suprasellar extension, containing isointense or, more often, hyperintense fluid on T1-weighted sequences. In spite of the risk of CSF fistulae, the preferred surgical approach is transsphenoidal. A physiopathological mechanism is proposed according to anatomic variations of the sellar diaphragma allowing penetration of subarachnoid spaces into the sellar compartment and their enlargement by a ball-valve mechanism. [less ▲]Detailed reference viewed: 48 (5 ULg)