References of "Neuro-Chirurgie"
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See detailLa hernie discale lombaire paralysante : une urgence chirurgicale ? Réflexion à propos d'une série de 24 patients et des données de la littérature.
DUBUISSON, Annie ULg; Borlon, S.; SCHOLTES, Félix ULg 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 ▲]

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See detailStrategical implications of aneurysmal cranial nerve compression
SCHOLTES, Félix ULg; Martin, Didier ULg

in Neuro-Chirurgie (2012)

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See detailLes anévrismes de très petite dimension : clip ou coil.
Signorelli, F; SCHOLTES, Félix ULg; Bojanowski, M. W.

in Neuro-Chirurgie (2012), 58(2-3), 156-9

INTRODUCTION: It is not unusual for very small aneurysms (</=3mm) to be responsible for subarachnoid haemorrhage. In addition, modern imaging has increased diagnosis of those that are asymptomatic ... [more ▼]

INTRODUCTION: It is not unusual for very small aneurysms (</=3mm) to be responsible for subarachnoid haemorrhage. In addition, modern imaging has increased diagnosis of those that are asymptomatic. Because of their spatial configuration and thin and fragile walls, very small aneurysms can be a sizeable challenge for both open surgical and endovascular treatment. Based on recent literature data, the present manuscript reviews treatment indications and the choice of treatment strategy to occlude these particular aneurysms. METHODS: Literature review concerning surgical and endovascular treatment of very small aneurysms (</=3mm). Arterial dissections and blister aneurysms were excluded. RESULTS: We found no study that systematically and specifically assessed surgical treatment of very small aneurysms. Investigations of endovascular treatment are almost exclusively retrospective, usually evaluating a small number of patients, and are limited by selection bias. Despite often contradictory results, it appears that very small aneurysms carry a higher risk of rupture during endovascular procedures and higher ensuing mortality, as compared to larger aneurysms. The use of more flexible coils and additional endovascular tools appears to reduce this risk. There is no study comparing surgical to endovascular treatment. CONCLUSION: Very small aneurysms carry higher treatment risks than larger aneurysms. A prospective randomised trial is justified for those very small aneurysms for which treatment is indicated. [less ▲]

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See detailApport de l’endoscopie pour la décompression microvasculaire dans l’angle ponto-cérébelleux : à propos de 27 cas
Duntze, J; Litré, Claude Fabien ULg; Bazin, A et al

in Neuro-Chirurgie (2011)

Microvascular decompression is an important procedure for the management of microvascular compression syndromes in the cerebellopontine angle (CPA) like trigeminal neuralgia or hemifacial spasm. The ... [more ▼]

Microvascular decompression is an important procedure for the management of microvascular compression syndromes in the cerebellopontine angle (CPA) like trigeminal neuralgia or hemifacial spasm. The ability to identify the offending vessel is the key to success. Can the endoscope help surgeons to identify and understand the responsible conflict in order to treat them? Our series concerns 27 consecutive patients who underwent microvascular decompression systematically using an endoscope with an angulation of 30° at the beginning and the end of the intervention. The decompression procedure was done under microscope. Endoscopic exploration was successful for all patients. Endoscopy improved visualization of the cranial nerves and allowed to see and understand the neurovascular conflicts, which were not able to be observed using the microscope alone for two of the 27 patients. The endoscope is a useful adjunct to microscopic exploration of the cranial nerves in the CPA avoiding significant cerebellar or brainstem retraction. [less ▲]

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See detailLa main de Gilliatt-Sumner ou le syndrome de défilé cervicothoracique neurogène vrai. A propos de sept cas opérés.
DUBUISSON, Annie ULg; NGUYEN KHAC, Minh-Tuan ULg; SCHOLTES, Félix ULg 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 ▲]

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See detailPrimitive malignant rhabdoid tumor of the central nervous system in an adolescent. A case study
Eap, C; Litré, Claude Fabien ULg; Noudel, R et al

in Neuro-Chirurgie (2010), 56(5), 404-7

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See detailProtocole de prise en charge neurochirurgicale des acouphènes invalidants : à propos de trois cas
Litré, Claude Fabien ULg; Giersky, F; Theret, E et al

in Neuro-Chirurgie (2010), 56(4), 303-8

Les acouphènes invalidants représentent 1 % de la population. Les différents traitements proposés jusqu’à présent ont des résultats très décevants. L’avènement de la stimulation corticale entrouvre un ... [more ▼]

Les acouphènes invalidants représentent 1 % de la population. Les différents traitements proposés jusqu’à présent ont des résultats très décevants. L’avènement de la stimulation corticale entrouvre un nouvel espoir thérapeutique pour ces patients. Nous rapportons ici notre expérience sur la prise en charge et le traitement chirurgical pour ces patients. [less ▲]

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See detailOptic nerve sheath meningiomas
Litré, Claude Fabien ULg; Colin, P; Rousseaux, P et al

in Neuro-Chirurgie (2010), 56(2-3),

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See detailSpinal cord compression caused by idiopathic dorsal epidural lipomatosis: Case report and critical review of the literature
Eap, C; Litré, Claude Fabien ULg; Duntze, J et al

in Neuro-Chirurgie (2010), 56(1), 55-8

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See detailClostridial brain abscess after glioblastoma resection: case report and critical review of the literature
Duntze, J; Litré, Claude Fabien ULg; Bajolet, O et al

in Neuro-Chirurgie (2009), 55(6), 569-72

Clostridium perfringens is rare in neurosurgery. The source of clostridial brain abscess is usually a penetrating head injury. We report the case of a 57-year-old man who had parietal glioblastoma ... [more ▼]

Clostridium perfringens is rare in neurosurgery. The source of clostridial brain abscess is usually a penetrating head injury. We report the case of a 57-year-old man who had parietal glioblastoma resection with local carmustine chemotherapy and who presented a clostridial brain abscess three weeks later. Progression was especially brutal, leading to patient's death in few hours. We discuss the etiology and progression of this case compared to the data reported in the literature. [less ▲]

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See detailFaut-il continuer à prendre en charge les accidents hémorragiques des AVK en neurochirurgie ?
Théret, E; Litré, Claude Fabien ULg; Noudel, R et al

in Neuro-Chirurgie (2009), 55(6 - supp 1), 3-10

Les complications hémorragiques des AVK sont en augmentation, surtout chez les personnes âgées. Nous cherchons à évaluer l’intérêt d’un traitement neurochirurgical versus traitement médical bien conduit ... [more ▼]

Les complications hémorragiques des AVK sont en augmentation, surtout chez les personnes âgées. Nous cherchons à évaluer l’intérêt d’un traitement neurochirurgical versus traitement médical bien conduit, en fonction des différents types de localisation. [less ▲]

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See detailTuberculose intramédullaire. À propos d’un cas
Litré, Claude Fabien ULg; Pech Gourg, G; Acosta Diaz, U et al

in Neuro-Chirurgie (2008), 54(4), 545-7

Les manifestations neurologiques de la tuberculose restent rares, même si ces dernières années ont été marquées par une augmentation de ces pathologies, du fait, notamment, de la pandémie du VIH. Le ... [more ▼]

Les manifestations neurologiques de la tuberculose restent rares, même si ces dernières années ont été marquées par une augmentation de ces pathologies, du fait, notamment, de la pandémie du VIH. Le tuberculome intramédullaire reste une localisation exceptionnelle. Nous rapportons ici le cas d’un patient adulte non séropositif pour le virus VIH et non immunodéprimé présentant un tuberculome intramédullaire, découvert devant un tableau de compression médullaire lente. Nous discuterons le diagnostic radiologique, la nécessité ou non d’un traitement chirurgical, ainsi que les suites cliniques et, notamment, fonctionnelles. Notre expérience nous porte à croire que l’approche combinée de la chirurgie et de l’antibiothérapie paraît être la meilleure alternative. [less ▲]

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See detailIntracranial hypotension with subdural hematoma following lumbar puncture: case report
Trunet, S; Litré, Claude Fabien ULg; Tran, H et al

in Neuro-Chirurgie (2008), 54(2), 858

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See detailMaladie de Cushing et adénome corticotrope: résultats de la microchirurgie hypophysaire
Stevenaert, Achille ULg; Perrin, G.; Martin, Didier ULg et al

in Neuro-Chirurgie (2002), 48(2-3, Pt 2), 234-265

Between November 1994 and June 2001, 194 patients with Cushing's disease underwent transsphenoidal surgery: 167 patients had adenomectomy, 14 had ante hypophysectomy, 5 had subtotal hypophysectomy, 4 had ... [more ▼]

Between November 1994 and June 2001, 194 patients with Cushing's disease underwent transsphenoidal surgery: 167 patients had adenomectomy, 14 had ante hypophysectomy, 5 had subtotal hypophysectomy, 4 had hemihypophysectomy 4 had central hypophysectomy. Complications occurred in 18 patients (9.3%), including 4 deaths (three were apparently not related to surgery). Remission of disease was achieved in 162 of 190 (85.3%) patients analyzed. Surgical failures were associated with lack of pituitary adenoma, size of the tumor and invasiveness. Among patients with confirmed adenomas, the rate of remission was significantly higher (p<0.01) in patients with microadenomas (92.6%) than in patients with macroadenomas (66.7%). Reoperation in 6 failures was followed by remission in 4 cases. The overall remission rate was 87.4%. In the 162 patients with immediate success, duration of follow-up was 10.0 +/- 5.9 years (m +/- DS; median=10.0). Recurrence of the disease occurred in 24 (14.8%) of 162 patients at a mean 4.8 years (range: 0.8-12.0 years). Our longest sustained remission is 25.6 years. Actuarial analysis indicates that the probability of a patient remaining well 12 years after surgery is 80.0%. It is 86.2% in microadenomas versus 52.5% in macroadenomas and 94.5% in the patients with postoperative hypocortisolism versus 59.2% in the others. [less ▲]

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See detailMaladie de Cushing et adénome corticotrope: fonctions antéhypophysaires avant et après microchirurgie transsphénoidale
Martin, Didier ULg; Valdes Socin, Hernan Gonzalo ULg; Beckers, Albert ULg et al

in Neuro-Chirurgie (2002), 48(2-3, Pt 2), 226-233

Background and purpose. - Cushing's disease is characterized by an overproduction of ACTH inducing an hypersecretion of corticosteroids. We assessed the non-corticotrophic pituitary functions before and ... [more ▼]

Background and purpose. - Cushing's disease is characterized by an overproduction of ACTH inducing an hypersecretion of corticosteroids. We assessed the non-corticotrophic pituitary functions before and after microsurgical resection of the corticotrophic adenoma. Methods. - We reviewed retrospectively a series of 98 patients (19 males, 79 females) undergoing transsphenoidal surgery between 1974 and 2001. Prolactin levels, somatrotrophic, gonadotrophic and thyroidotrophic functions were assessed and compared before and after resection of the adenoma. Results. - Before surgery, we observed an elevation of prolactin and a reduction of the GH, TSH, LH and FSH levels. These modifications were not linked to the volume of the adenoma but depended on the systemic effect of the hypercorticism or on local paracrine mechanisms. Selective adenomectomy usually restored altered corticotrophic and also, unlike (partial or total) hypophysectomy, the non-corticotrophic functions. Conclusions. - Non-corticotrophic functions are often altered in Cushing's disease but can be restored after selective adenomectomy. [less ▲]

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See detailDiagnostic differentiel et traitement medical dans la maladie de Cushing.
Beckers, Albert ULg; Valdes Socin, Hernan Gonzalo ULg; Betea, Daniela ULg et al

in Neuro-Chirurgie (2002), 48(2-3 Pt 2), 163-172

Cushing's disease remains a difficult diagnosis in spite of new technical procedures such as pituitary MRI, selective bilateral petrosal or cavernous sampling, (111)In pentreotide scan and 18 ... [more ▼]

Cushing's disease remains a difficult diagnosis in spite of new technical procedures such as pituitary MRI, selective bilateral petrosal or cavernous sampling, (111)In pentreotide scan and 18 Flurodeoxyglucose pituitary PET scan. In this article, we review biological diagnostic procedures of Cushing's disease and corticotroph adenomas. According to our experience and the literature, we summarize the approach in medical treatment of Cushing's disease. [less ▲]

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See detailMedullopathies cervicarthrosiques. Traitement et pronostic.
Milbouw, G; Born, J D; Collignon, J et al

in Neuro-Chirurgie (1987), 33(1), 44-50

The authors present 50 cases of cervical spondylotic myelopathy treated by anterior or posterior approach. To assess the severity of the pre- and postoperative neurological symptoms, they define an ... [more ▼]

The authors present 50 cases of cervical spondylotic myelopathy treated by anterior or posterior approach. To assess the severity of the pre- and postoperative neurological symptoms, they define an original ten-point classification scale taking into account gait and urinary disturbance, ability to manipulate objects and pain. With C2-C7 laminectomy, 60% of the patients are improved, essentially for walk. A few cases only (14%) are upgraded for upper limbs function. The authors conclude that this surgical treatment should be applied only when there is a multi-level narrowed canal and predominant lower limbs deficits. The efficacy of the anterior approach depends on complete removal of osteophytes. In cases with complete osteophytectomy, this surgical treatment can improve both the upper and lower limbs function and 77.8% good results are obtained. In a few cases it may be necessary to use both approach successively. Discriminant analysis applied to 12 factors shows that pre-operative scores of upper and lower limbs and sagittal diameter of spinal canal are the most important factors for neurological prognosis. [less ▲]

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See detailCorrelation entre l'echelle de Liege et un marqueur biochimique de la lesion cerebrale.
Born, J. D.; Hans, Pol ULg; Chapelle, Jean-Paul ULg et al

in Neuro-Chirurgie (1984), 30(5), 319-23

Brain type creatine kinase isoenzyme (CK.-1) was measured in the ventricular cerebrospinal fluid in a series of 42 patients within 7 +/- 3,4 hours following severe head injury (GCS less than or equal to 7 ... [more ▼]

Brain type creatine kinase isoenzyme (CK.-1) was measured in the ventricular cerebrospinal fluid in a series of 42 patients within 7 +/- 3,4 hours following severe head injury (GCS less than or equal to 7, LCS less than or equal to 12). The presence of the CK.-1 isoenzyme correlated with the degree of head injury as indexed by the Glasgow coma scale and the Liege coma scale. There was a significant logarithmic correlation between CK.-1 activity in the C.S.F. and the coma scores. However, the correlation with the Liege coma scale score (r = -0,84) is significantly better (Z = 1,97; p less than 0,05) than with the Glasgow coma scale score (r = -0,65). Thus, the Liege coma scale is a better index of neurological trauma. [less ▲]

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See detailEtude isoenzymatique de la creatine kinase chez les traumatises craniens en coma.
Hans, Pol ULg; Born, J. D.; Chapelle, Jean-Paul ULg et al

in Neuro-Chirurgie (1982), 28(1), 9-12

We measured the c.s.f. and serum creatine kinase activities in the first hours following the trauma, for 24 severe head injury patients. We found a good correlation between total CK and CKBB isoenzymes ... [more ▼]

We measured the c.s.f. and serum creatine kinase activities in the first hours following the trauma, for 24 severe head injury patients. We found a good correlation between total CK and CKBB isoenzymes levels in the c.s.f. only. The c.s.f. values are a quantitative index of brain dysfunction assessed by the Liege coma scale, associating the Glasgow coma scale and the study of the brain stem reflexes. There is no relationship between CK activity and intracranial pressure. [less ▲]

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