PubMed Health⌕ Search

Biomedical subjects

A Destée

Publications and source records attributed to A Destée.

At least 163 records · Page 9Linked to original sources
PubMed1986

[Benign intracranial hypertension and Marchiafava-Micheli disease].

A 35 year-old caucasian man suffered from paroxysmal nocturnal haemoglobinuria (PNH) or Marchiafava-Micheli's disease diagnosed in 1976 and complicated by several thrombotic episodes. He developed a benign intracranial hypertension. A digitalized intravenous angiography showed occlusion of both lateral sinuses. Partial improvement followed lombo-peritoneal shunting and steroid therapy. Cerebral venous thrombosis is a well-known complication of PNH but only a few cases have been radiologically and/or pathologically proven. It usually involves the superior longitudinal sinus and/or cortical veins resulting in hemorrhagic infarction of poor outcome. Benign intracranial hypertension due to a venous occlusion is rare. In 3 published cases, as in our own, the neurologic outcome was good. Steroid therapy seems useful. The risks of anticoagulant therapy are discussed.

Adult↗
PubMed1985

[Brain stem infarction, systemic lupus erythematosus and circulating lupus anticoagulant].

A 30 year old man admitted with a brain stem infarct presented with intellectual deterioration. A diagnosis of systemic lupus erythematosus (S.L.E.) was based on the presence of five A.R.A. criteria :photosensitivity, arthralgia, leukopenia and thrombopenia, false positive syphilitic serology, antinuclear factors on immunofluorescence. A lupus type circulating anticoagulant (L.C.A.) was no longer detected after corticotherapy. This appears to be a case of the "hematologic" form of S.L.E. in which the presence of L.C.A. predisposes towards thrombosis, not only of veins--which is typical--but also of arteries. These may be isolated and reveal the underlying disease as in the present case. The L.C.A. is an antibody possessing antiphospholipid specificity which explains the anticoagulant action in vitro and the thrombogenic effect in vivo. Some authors consider this to be sufficient justification for administration of anticoagulants and/or antiplatelet agents, but corticotherapy may be effective.

Adult↗
PubMed1985

[Acute transient Korsakoff's syndrome caused by hematoma of the floor of the 3rd ventricle].

A forty four year-old woman had had an amenorrhea-galactorrhea syndrome for 3 months when a Korsakoff's syndrome with headache suddenly appeared. Neuroradiological investigations revealed a hematoma involving the anterior part of the IIIrd ventricle. After a short period of neurogenic hypernatremia the lesion disappeared with the development of a spontaneous ventriculocisternostomy. Simultaneously, the Korsakoff's syndrome decreased until it went off almost completely, but a diabetes insipidus appeared and the hyperprolactinemia remained unchanged. Four years later, those are the only symptoms which are still present. This case, particular by its aetiology and evolution, illustrates well the possibility of functional Korsakoff's syndromes.

Acute Disease↗
PubMed1985

[Post-radiotherapy stenosis of the supraclinoid internal carotid artery. Moyamoya network].

A 36 year-old caucasian woman was operated and then irradiated for a pituitary adenoma. Two years later, a left anterior temporal lobectomy for a grade I astrocytoma was performed. Four years later, she experienced right hemiparesis and aphasia. CT scan showed a left temporo-occipital low density area. A left carotid angiogram showed a narrowing of the left carotid artery beginning in the lower part of the siphon and progressing to a complete supraclinoid occlusion. There was a collateral circulation of the Moyamoya type. Radiation-induced narrowing or occlusion of the intracranial internal carotid artery is an infrequent finding. Most cases appear in young subjects, several years after a high dose of radiation therapy (30 to 60 grays). Some cases may show a network of the Moyamoya type. Usually, the absence of vascular abnormalities prior to radiation cannot be demonstrated. In our case, as in 3 other cases of the literature, the intracranial vessels were of normal appearance before irradiation. The vascular lesions can thus be considered as acquired and secondary to radiation therapy.

Adult↗
PubMed1985

[Hematomas of the cerebellum and tumors. 3 cases].

Three cerebellar hematomas induced by a tumor are reported. A metastasis was present in two cases, but the lesion was unique on CT scan, vertebral angiography did not reveal abnormal vessels, and general investigations were normal. The third case was a medulloblastoma. The first two patients were treated medically or with ventricular shunting. In both cases the primary tumor was lately discovered. These cases show that a CT scan follow up is necessary when the patient is not operated, and a pathological examination of the hematoma must be done where there has been surgical intervention.

Adult↗
PubMed1985

[Acute choreic syndrome and psychotic state induced by an amphetaminic drug].

A twenty-nine year-old woman, with oral contraceptive medication over 10 years, was admitted with chorea and acute psychosis. Fourty-eight hours earlier she had initiated therapy with amphetamine. The mechanisms of these acute manifestations are discussed: oral contraceptives increase striatal post-synaptic dopaminergic sensitivity, while amphetamines facilitate the dopamine release in striatum.

Acute Disease↗
PubMed1984

[Posttraumatic neurogenic hyponatremia with late onset].

Ten months following a severe head injury, a 26-year-old man developed a syndrome of inappropriate secretion of antidiuretic hormone (ADH) with a grand mal seizure occurring after an increased intake of non alcoholic beverages. The water loading test was negative but the sorbitol infusion test was positive. In the basal state, plasma concentration of ADH was inappropriate to plasma osmolality. ADH has also been measured during dynamic tests (infusions of sorbitol and of normal saline; complete and partial water restriction; propranolol and diphenylhydantoin treatments). In spite of the poor sensitivity of these measurements when ADH concentrations are low, our results indicate that the plasma osmolality threshold at which ADH secretion is inhibited was probably reset at a level lower than normal.

Adult↗
PubMed1984

Effect of piracetam in Huntington's chorea.

Piracetam has been described to improve neuroleptic-induced acute extrapyramidal syndrome where a central dopaminergic hyperactivity is implicated. In Huntington's chorea, this abnormality is also generally admitted, at least functionally. Therefore the authors have utilized piracetam in this disease. The drug was administered intravenously in a double-blind study to 6 patients. Piracetam worsened choreic movements. This result is discussed in relation to the pharmacological properties of the drug.

Adult↗
PubMed1984

[Multiple sclerosis and lupus].

At 20 year-old a patient developed a paraplegia which regressed within several months, suggestive of an acute myelitis. Subsequently, several episodes of spastic paraplegia, posterior tracts lesions and retrobulbar optic neuritis, a transient cerebellar syndrome, modifications in cerebrospinal fluid (pleiocytosis, hypergammaglobulin levels, elevated Delpech's ratio) suggested multiple sclerosis. When aged 62 years, the patient developed articular lesions, Raynaud's phenomenon, and buccal ulcers attributed to lupus. LE cells, native DNA anti-antibodies, anti-Sm auto antibodies on immunofluorescence were present. The possibility of a collagen disease, expressed initially and for a long period in an exclusively neurological disorder is discussed. It was considered, however, to be more likely two distinct affections. This association has been reported very rarely, even though two immunity-mediated inflammatory affections are involved.

Adult↗
PubMed1984

[Uveitis and cerebral lymphoma].

A 57 year-old man developed a left posterior uveitis, without obvious aetiology and unresponsive to antibiotherapy and steroids. Nine months later, a lymphoma of the left parieto-occipital area was discovered. An immunological study detected a peripheral blood T lymphocytes deficiency, a B lymphocytes excess and a monoclonal gammopathy (IgM lambda). The latter abnormality disappeared one month after neurosurgery. Tumor cells were of the B lymphoid type with lambda light chain only. Brain irradiation and chemotherapy first improved neurological signs but right uveitis developed. The patient died 22 months after the first ophthalmological symptoms. The association of primary non Hodgkin brain lymphoma (PNHBL) (reticulum-cell sarcoma) with uveitis has already been described in 51 other cases in the literature. Two possibilities are considered: first, uveitis appears with or follows the neurological signs (NS): the prognosis is the same as that of PNHBL alone; second, uveitis appears before the NS: the prognosis is better and can be improved by brain and ocular irradiation. The immunological abnormalities are discussed. T lymphocytes deficiency and B lymphocytes excess have already been described but a monoclonal gammopathy is a more unusual finding.

Brain Neoplasms↗
PubMed1983

[Subarachnoid spinal metastases. Apropos of 2 cases].

Two cases of spinal subarachnoidal metastases are reported. From data from the literature, the authors review clinical manifestations and diagnostic difficulties. Etiopathological evidence which may explain this localization is discussed.

Aged↗
PubMed1983

[Intradural spinal arachnoid diverticula and cysts. 6 cases].

3 communicating diverticula and 3 arachnoid symptomatic cyst in intradural situation are presented. In two cases, this pathology is slowly developing, in patients with Von Recklinghausen neurofibromatosis. A congenital malformative process may be evoked. In two other cases, myelography and surgery favor a frank or discreet arachnoïditis. Those establishments show the diversity of mechanisms underlying intradural arachnoïd cysts. They are in most cases in a postero medullary and dorsal situation, but cervical as well as lumbar position are possible. One must insist on the frequency and importance of local and cordonal pain, accompanying in most cases sensory and motor deficits in inferior limbs. A rapid revelation or decompensation is most rare. Prognosis must be reserved, as post operative arachnoïditis and relapse are not rare.

Adolescent↗
PubMed1983

[Primacy of medical treatment of cerebral abscesses (19 cases)].

Therapy in 19 consecutive cases of cerebral abscess was limited to medical treatment whenever possible, using high doses of a combination of several antibiotics. Long-term follow up by serial computed tomography was performed. Antibiotic treatment alone was effective in 8 patients with multiple hemispheric abscesses of metastatic origin, though one patient seen late with three large abscesses die on the 4th day. In 8 cases with single abscesses, medical treatment alone was effective: 5 had lesions less than 4 cm in diameter; in 2 cases with lesions 4 to 5 cm in diameter, additional abscess puncture was carried out. One patient required early excision of an occipital abscess, and 2 cases of pontocerebellar angle abscesses were also treated surgically. Antibiotic therapy alone was effective in 1 patient with a large brain stem abscess. Treatment of cerebral abscess has largely changed since the availability of computed tomography, with a progressively more important place being accorded to antibiotic therapy alone. The stage of the abscess does not appear to be a decisive factor in the choice of treatment, medical therapy appearing to provide a definitive cure with a minimum of sequelae in the majority of cases. Abscess puncture may be an adjunct to antibiotic therapy in large abscesses with clinical signs.

Adolescent↗
PubMed1983

[Large listerial abscess of the brain stem. Favorable effect of antibiotic therapy].

A 52-year-old woman developed headache with fever followed after several days by a left hemiplegia, paralysis of the right IIIrd, Vth, and VIIth cranial nerves, and a right cerebellar syndrome. The CSF contained 48 white cells/mm3 and 0,80 g/l of proteins. Blood and CSF cultures were negative. In spite of an early massive antibiotic therapy, successive CT scans demonstrated the development of a voluminous rhombencephalic abscess. Clinical improvement occurred only after 1 month of treatment. The diagnosis of listeriosis, suggested clinically, was confirmed by elevated levels of antibodies to listeria Monocytogenes serotype 01 (1/80 to 1/1 280). Signs regressed slowly and hemiplegic sequelae persisted. A review of the literature demonstrated the rare nature of listerian abscesses in the CNS: in 6 of the 9 cases reported the patients were immunodepressed and the abscess was located in the cerebral hemispheres. The elective rhombencephalic lesion of listerian encephalitis may also apply to abscesses, which can develop in previously healthy subjects. The clinical picture is that of a solitary brain stem abscess with a fatal outcome whatever the nature of the germ. Van Gilder, Allen and Lesser (1974) published the first report of a case that recovered after surgical drainage. The present case is the only one of the 6 cases reported in the literature in which a favorable outcome was obtained by antibiotic therapy.

Ampicillin↗