Strategical implications of aneurysmal cranial nerve compression

in Neuro-Chirurgie (2012)

Apport de l’endoscopie pour la décompression microvasculaire dans l’angle ponto-cérébelleux : à propos de 27 cas

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 ▲]

Protocole de prise en charge neurochirurgicale des acouphènes invalidants : à propos de trois cas

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 ▲]

Spinal cord compression caused by idiopathic dorsal epidural lipomatosis: Case report and critical review of the literature

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

Faut-il continuer à prendre en charge les accidents hémorragiques des AVK en neurochirurgie ?

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 ▲]

Intracranial hypotension with subdural hematoma following lumbar puncture: case report

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

Maladie de Cushing et adénome corticotrope: fonctions antéhypophysaires avant et après microchirurgie transsphénoidale

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 ▲]

Medullopathies cervicarthrosiques. Traitement et pronostic.

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 ▲]

Etude isoenzymatique de la creatine kinase chez les traumatises craniens en coma.

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 ▲]