http://hdl.handle.net/2268/106 Search this channel search http://orbi.ulg.ac.be/simple-search http://hdl.handle.net/2268/148595 Title: Apport de l’endoscopie pour la décompression microvasculaire dans l’angle ponto-cérébelleux : à propos de 27 cas <br/> <br/>Author, co-author: Duntze, J; Litré, Claude Fabien; Bazin, A; Noudel, R; Chays, A; Rousseaux, P <br/> <br/>Abstract: 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. Thu, 16 May 2013 13:44:54 GMT http://hdl.handle.net/2268/148593 Title: Primitive malignant rhabdoid tumor of the central nervous system in an adolescent. A case study <br/> <br/>Author, co-author: Eap, C; Litré, Claude Fabien; Noudel, R; Theret, E; Duntze, J; Collin, P; Rousseaux, P Thu, 16 May 2013 13:37:20 GMT http://hdl.handle.net/2268/148590 Title: Protocole de prise en charge neurochirurgicale des acouphènes invalidants : à propos de trois cas <br/> <br/>Author, co-author: Litré, Claude Fabien; Giersky, F; Theret, E; Leveque, M; Peruzzi, P; Rousseaux, P <br/> <br/>Abstract: 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. Thu, 16 May 2013 13:19:33 GMT http://hdl.handle.net/2268/148589 Title: Spinal cord compression caused by idiopathic dorsal epidural lipomatosis: Case report and critical review of the literature <br/> <br/>Author, co-author: Eap, C; Litré, Claude Fabien; Duntze, J; Theret, E; Noudel, R; Graftieaux, J-P; Rousseaux, P Thu, 16 May 2013 13:12:42 GMT http://hdl.handle.net/2268/148588 Title: Optic nerve sheath meningiomas <br/> <br/>Author, co-author: Litré, Claude Fabien; Colin, P; Rousseaux, P; Civit, T Thu, 16 May 2013 13:09:26 GMT http://hdl.handle.net/2268/148587 Title: Faut-il continuer à prendre en charge les accidents hémorragiques des AVK en neurochirurgie ? <br/> <br/>Author, co-author: Théret, E; Litré, Claude Fabien; Noudel, R; Duntze, J; Eap, C; Graftiaux, J-P; Gomis, P; Bazin, A; Peruzzi, P; Rousseaux, P <br/> <br/>Abstract: 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. Thu, 16 May 2013 13:05:06 GMT http://hdl.handle.net/2268/148586 Title: Clostridial brain abscess after glioblastoma resection: case report and critical review of the literature <br/> <br/>Author, co-author: Duntze, J; Litré, Claude Fabien; Bajolet, O; Theret, E; Eap, C; Peruzzi, P; Rousseaux, P <br/> <br/>Abstract: 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. Thu, 16 May 2013 13:04:37 GMT http://hdl.handle.net/2268/148585 Title: Intracranial hypotension with subdural hematoma following lumbar puncture: case report <br/> <br/>Author, co-author: Trunet, S; Litré, Claude Fabien; Tran, H; Marnet, D; Rousseaux, P Thu, 16 May 2013 13:03:34 GMT http://hdl.handle.net/2268/148584 Title: Tuberculose intramédullaire. À propos d’un cas <br/> <br/>Author, co-author: Litré, Claude Fabien; Pech Gourg, G; Acosta Diaz, U; Fuentes, S; Grisoli, B <br/> <br/>Abstract: 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. Thu, 16 May 2013 13:02:41 GMT http://hdl.handle.net/2268/148583 Title: Interest and feasibility of a modified supine position for posterior cranial fossa surgical procedures. <br/> <br/>Author, co-author: Graftieaux, J-P; Litré, Claude Fabien; Gomis, P; Malinovsky, J-M <br/> <br/>Abstract: The sitting position is considered as a gold standard for posterior fossa surgical procedures. However, in order to decrease the incidence rate of cerebral venous air embolisms, we presently described a modified supine position allowing performance of posterior fossa surgical procedures. Such position is easy and quickly performed with light variations of blood pressure: patients are placed supine with paddings inserted under ipsilateral shoulder and buttock, and head turned to other side of surgical site. Dural tension estimated by the surgeon was always considered as good. We performed more than 100 surgical procedures in this position without any complication for 10 years. Thu, 16 May 2013 12:53:32 GMT http://hdl.handle.net/2268/148582 Title: Minimally-invasive spinal surgery to remove a broken epidural catheter fragment <br/> <br/>Author, co-author: Eap, C; Frappart, M; Litré, Claude Fabien; Bourgeade, F; Gomis, P; Malinovsky, J-M; Rousseaux, P Thu, 16 May 2013 12:51:31 GMT http://hdl.handle.net/2268/148581 Title: Spinal cord compression due to C4 vertebral arch osteochondroma. <br/> <br/>Author, co-author: Eap, C; Litré, Claude Fabien; Noudel, R; Duntze, J; Theret, E; Rousseaux, P <br/> <br/>Abstract: Osteochondromas are usually benign bone tumors found on the metaphysis of long bones. These tumors are rarely located on the spine especially at cervical level. This report presents the case of a 23-year-old man who had previously developed tetraparesis at the age of 13 after infectious myelitis. Recent severe clinical neurological deterioration revealed the diagnosis of osteochondroma arising in the C4 vertebral arch compressing the spinal cord and associated with syringomyelia. Of note in his past history was a treated hip localization. The patient underwent complete surgical excision of the osteochondroma. Postoperative outcome was good with slow clinical recovery from the spinal cord compression. We report this rare cause of spinal cord compression and other cases reported in the literature. Thu, 16 May 2013 12:50:56 GMT http://hdl.handle.net/2268/148580 Title: FRACTIONATED STEREOTACTIC RADIOTHERAPY TREATMENT OF CAVERNOUS SINUS MENINGIOMAS: A STUDY OF 100 CASES <br/> <br/>Author, co-author: Litré, Claude Fabien; COLIN, P; NOUDEL, R; PERUZZI, P; BAZIN, A; SHERPEREEL, S; BERNARD, M-H; ROUSSEAUX, P <br/> <br/>Abstract: Purpose:We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas. Methods and Materials: From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas; 84 female and 16 male patients were included. The mean patient age was 56 years. The most common symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia (34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed using a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator. Results: No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and a 50% improvement in type V neuropathy. Conclusions: FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery. In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional outcomes. Thu, 16 May 2013 12:50:20 GMT http://hdl.handle.net/2268/148579 Title: Intracranial teratomas in children: the role and timing of surgical removal <br/> <br/>Author, co-author: Noudel, R; Vinchon, M; Dhellemmes, P; Litré, Claude Fabien; Rousseaux, P <br/> <br/>Abstract: In this study, the authors report their experience with the surgical treatment of intracranial teratomas with an emphasis on the indications for delayed resection after oncological treatment. Methods. The authors retrospectively reviewed the cases of 14 children with intracranial teratomas. The mean age at diagnosis was 10.5 years (range 2 days–18 years), and 11 patients were male. The final histological analysis revealed pure mature teratoma in 5 cases, mixed teratoma with germinoma in 3 cases, and nongerminomatous malignant germ cell tumor in 6 cases. Thirteen patients underwent tumor resection, and these patients were divided into 2 subgroups according to the timing of surgery. In Group A, 10 patients underwent resection as the primary treatment because no tumor markers were detected in 4 patients, a teratomatous component was revealed on biopsy sampling in 3 patients, and a large tumor volume in 3 patients. In Group B, 3 patients underwent removal of residual pure mature teratoma after oncological treatment. Results. Seven of the 8 patients (87.5%) with pure mature teratomas or with mixed teratoma and germinoma are currently alive (mean follow-up of 9 years); the eighth patient died of postoperative meningitis. Two of the 6 patients (33%) with mixed nongerminomatous malignant germ cell tumors died of tumor progression regardless of the timing of surgery. Conclusions. The results of this study support the belief that microsurgical removal is the only effective treatment for intracranial teratomas. Surgery may be performed as the primary therapy when there is evidence of a noninvasive teratoma, and as a secondary therapy if there is only a partial response to neoadjuvant Thu, 16 May 2013 12:49:38 GMT http://hdl.handle.net/2268/148578 Title: Surgical treatment by electrical stimulation of the auditory cortex for intractable tinnitus <br/> <br/>Author, co-author: Litré, Claude Fabien; Theret, E; Tran, H; Lévèque, M; Portefaix, Ch; Gierski, F; Emeriau, S; Peruzzi, Ph <br/> <br/>Abstract: Tinnitus is a public health issue in France. Around 1% of the population is affected and 30,000 people are handicapped in their daily life. The treatments available for disabling tinnitus have until now been disappointing. We are reporting on the surgical treatment by electrical stimulation of the auditory cortex of a female patient affected by disabling tinnitus that resisted classical treatments. The tinnitus appeared suddenly 10 years ago after a left ear tympanoplasty. The acouphenometry measures revealed a bilateral tinnitus, predominant on the right side, constant, with high frequency (6000 Hz). Transcranial magnetic stimulation (TMS) was performed at first with several supraliminal and infraliminal protocols. This showed promising results. Anatomic and functional magnetic resonance imaging (fMRI) of the auditory cortex before and after repetitive TMS (rTMS) demonstrated a modification of the cortical activity and where the ideal location for a cortical electrode might be, to straddle primary and secondary auditory cortex.After these investigations, two quadra polar electrodes (Resume, Medtronic Ltd, Hertfordshire, UK), connected to a stimulating device implanted under the skin (Synergy, Medtronic Ltd), were extradurally implanted. The surgical procedurewas similar to the one performed for analgesic cortical stimulation. No surgical complications were reported. The activation of the stimulator provided a reduction of 65%of the tinnitus impact, with a persistent effect on the right side. The feasibility of the cortical stimulation in symptomatic treatment of tinnitus was proven by this preparatory work. The middle- and long-term therapeutic Thu, 16 May 2013 12:47:25 GMT http://hdl.handle.net/2268/148577 Title: Intramedullary spinal cord cavernous angioma in children: case report and literature review <br/> <br/>Author, co-author: Noudel, R; Litré, Claude Fabien; Vinchon, M; Patey, M; Rousseaux, P <br/> <br/>Abstract: Introduction Intramedullary cavernous angiomas (ImCA) of the spinal cord are very uncommon malformations especially in the pediatric population where only ten cases have yet been reported within the available literature. Case report In this paper, the authors report the case of a 12- year-old girl presenting with a T11 level hematomyelia because of a cavernous angioma. Microsurgical excision was performed with good clinical outcome and no magnetic resonance imaging evidence of residual cavernoma 30months later. Discussion Despite the small number of cases reported in children, this one contributes to the literature identifying special features of presentation and management of ImCA for pediatric patients. Because a higher risk of recurrent bleeding has been demonstrated for ImCA, with dramatic clinical consequences, microsurgical removal remains the only definitive treatment. Thu, 16 May 2013 12:45:53 GMT http://hdl.handle.net/2268/148576 Title: Cervical tumoral calcium pyrophosphate dihydrate deposition disease 28 years after suboccipital craniotomy: case report. <br/> <br/>Author, co-author: Scavarda, D; Litré, Claude Fabien; Froelich, S; Srour, R; Rousseaux, P <br/> <br/>Abstract: To describe a rare case of tumoral cervical chondrocalcinosis that appeared 28 years after the patient had undergone suboccipital craniotomy Thu, 16 May 2013 12:45:10 GMT http://hdl.handle.net/2268/148575 Title: Gamma knife surgery for facial nerve schwannomas. <br/> <br/>Author, co-author: Litré, Claude Fabien; Gourg, GP; Tamura, M; Mdarhri, D; Touzani, A; Roche, PH; Régis, J <br/> <br/>Abstract: Radical resection of facial nerve schwannomas classically implies a high risk of severe facial palsy. Owing to the rarity of facial palsy after gamma knife surgery (GKS) of vestibular schwannomas, functional evaluation after GKS seems rational in this specific group of patients. To our knowledge, no previous similar evaluation exists in the literature. Thu, 16 May 2013 12:44:22 GMT http://hdl.handle.net/2268/148573 Title: Acquired aqueductal stenosis in preterm infants: an indication for neuroendoscopic third ventriculostomy <br/> <br/>Author, co-author: Scavarda, D; Bednarek, N; Litré, Claude Fabien; Koch, C; Lena, G; Morville, P; Rousseaux, P <br/> <br/>Abstract: Abstract Object: The object of this study is to demonstrate the delayed occurrence of aqueductal stenosis in preterm infants who have suffered from intraventricular hemorrhage (IVH) and to try to explain the mechanisms of this stenosis. Method: From January 1996 to June 2002, 1,046 premature infants were admitted to our institution. Thirty-six neonates suffered from grade 3 or 4 intraventricular hemorrhage (Papile grading), of whom 16 died. Twenty patients survived and a ventriculoperitoneal shunt was inserted in 7 infants. Four patients underwent a neuroendoscopic third ventriculostomy. Follow-up was carried out, twice a month during the first 2 months and subsequently twice a year. Conclusion: In 2 children NTV was an effective treatment for hydrocephalus with an average follow-up of 29 months. The specific pattern concerning these patients is the long delay before obstructive hydrocephalus and the visualization of de novo obstruction with MRI. The biological explanation must be investigated. Keywords Premature newborn · Intraventricular hemorrhage · Hydrocephalus · Neuroendoscopy · Aqueductal stenosis · Acquired obstructive hydrocephalus · Transforming growth factor b1 Thu, 16 May 2013 12:35:53 GMT http://hdl.handle.net/2268/148512 Title: "Ceci n'est pas une migraine." Cas cliniques de céphalées de diagnostic difficile. <br/> <br/>Author, co-author: MAGIS, Delphine Wed, 15 May 2013 11:01:20 GMT