Biomedical subjects

A Ducolombier

Publications and source records attributed to A Ducolombier.

At least 19 recordsLinked to original sources

PubMed2001

Traumatic atlantoaxial rotatory dislocation with odontoid fracture: case report and review.

STUDY DESIGN: A case of traumatic rotatory dislocation associated with odontoid fracture is reported. OBJECTIVES: To report a rare case of traumatic rotatory dislocation associated with odontoid fracture, and to discuss the mechanism underlying spinal instability and management. SUMMARY OF BACKGROUND DATA: This case is a cross between traumatic rotatory fixation and atlantoaxial rotatory dislocation. Classification of rotatory subluxation change after osteosynthesis of the odontoid process was undertaken. METHODS: A 24-year-old man sustained head and cervical injury after jumping. A Type 2 odontoid fracture without displacement was noted. RESULTS: Without further traumatic event, 1 month after injury, computed tomography scan showed posterior displacement of the odontoid fracture and Type 4 or B atlantoaxial rotatory luxation. After surgical fixation and reduction of the odontoid fracture, the rotatory subluxation classification changed and became Type 1 or A. Posterior C1-C2 arthrodesis was performed. The patient wore a Philadelphia cervical collar for 3 months and underwent physiotherapy. CONCLUSIONS: As the pivot of rotatory subluxation changed after odontoid process osteosynthesis, posterior C1-C2 arthrodesis was performed. The patient probably could have been treated in a single-stage procedure using posterior C1-C2 transarticular fixation with bicortical interspinous graft.

Adult↗

PubMed1992

[Laser microsurgery of meningioma. An analysis of a consecutive series of 164 cases treated surgically by using different lasers].

Over a six years period, 224 laser procedures were performed in our clinic, of these 164 (72%) involved meningiomas of various intracranial and spinal locations; 82 (50%) tumors were located in the posterior fossa, 36 (32%) were suprasellar or parasellar meningiomas: a carbon dioxide laser was used in 56 cases, a double wave length YAG laser in 101 cases, and recently a simultaneous Nd YAG and CO2 combolaser in 7 cases. Complete tumor removal was accomplished in 83% of cases and overall mortality was 3%. We think that microscope guided laser techniques represents a significant advancement in the ability to remove deep situated meningiomas that might prove difficult to extirpate by conventional microsurgery. The advantages of these methods include: 1. reduced brain retraction; 2. the ability to operate with smaller and different exposures; 3. a reduced amount of mechanical manipulation by vaporizing in first the dural attachment; 4. improved operative precision and 5. decreased intra operative blood loss.

Adult↗

PubMed1991

[Disk highlighting after injection in MRI. Macroscopy and histology of 25 postoperative recurrences].

400 cases of failed back syndrome were examined with MRI in a prospective study (SE w Rho and T2, SE wT1 before and after injection of paramagnetic contrast agent in axial and sagittal planes). After second time surgery, 70 cases of herniated disks were found. 25 herniated disks were studied in microscopy and results correlated with enhanced herniated disks. Authors describe 4 types of enhancement: veinous plexus (5/24), inflammatory or granulomatous tissue (12/24), degenerative disc with fibrosis (5/24) and osteophytosis (2/24). The criterions of each pattern are described.

Adult↗

PubMed1989

[Materials for osteo-dural reconstruction in the cranium. An update].

Materials available for repair of a bony or dural defect at the cranial level are reviewed with particular attention stressed on their qualities and drawbacks for neurosurgical purposes. These materials include autologous or heterologous bone graft and biologically stable or biodegradable implants. No material can demonstrate ideal qualities of biocompatibility and biofunctionality. It should be either perfectly stable biologically and inert or perfectly biodegradable allowing simultaneous new bone reconstruction; moreover, it should be sterilizable, disposable, easy to handle and of low cost. Autologous grafts (iliac bone, split bone flap, pericranium...) have the best features but irradiated heterologous bone can be used instead; the latter needs a particular organization (bone graft bank) to fill the strict conditions of safety, especially regarding the risks of virus transmission. Implants have more recently been developed (acrylic, coral, B.O.P., ceramic, collagen-vicryl...) and present some drawbacks: generally high cost and not well established or insufficient biological properties. The experience of French neurosurgeons is reported from a questionnaire (102 answers) on the most frequently used materials. Autologous bone grafts, and acrylic as bone substitutes and pericranium for dural repair are preferentially used. Some materials, including coral, B.O.P. and collagen-vicryl, have a decreasing utilisation because of poor results especially with regards to bone incorporation and water tightness. Particular techniques (acrylic + teflon, acrylic with pre-op external casting and even non-repair of bone defects) are proposed by some neurosurgeons. New materials still under experimentation are finally presented (lyophilized bovine pericardium, collagen IV, polylactic acid).

Biocompatible Materials↗

PubMed1987

[Acute staphylococcal epidural inflammation. Apropos of 2 cases].

Two cases of staphylococcal infection of the epidural space are presented and on this purpose a review of literature is done to remind of this pathology and to plead for early diagnosis.

Acute Disease↗

PubMed1987

[Early syringomyelia following benign cervical injury. Contribution of postoperative MRI].

The authors show an observation of a post traumatic syringomyelia syndrome which gradually developed a few months after a cervical sprain. The diagnosis has been mentioned after the discovery of a "big medulla" with myelography and computed tomography. The presence of a cervical cystic cavity with viscous liquid has been confirmed by surgery. A syringosubarachnoïd shunt has been carried out with excellent post operative results as the patient has recovered all his sensory and motor functions. For the pathogenic hypothesis mention is made of a small subclinic early hematomyelia which then develops on its own to form a genuine syringomyelic cavity. The authors emphasize the future interest of M.R.I. for the pathogenic diagnosis as well for the post operative effects.

Adult↗

PubMed1987

[Combination of traumatic vascular and neural lesions of the limbs. Surgical approach. Apropos of 10 cases].

Ten cases of limb injuries including vascular and nervous lesions are reported. After pointing out the modalities of diagnosis, the authors describe the surgical technic: vascular management first, and then nervous repair. After a six months to three years follow-up, among eight cases, the vascular repair is successful every time, and the nervous repair five times. Although each technic is usually easy, the association of both lesions needs the collaboration of multidisciplinary surgical teams.

Adult↗

PubMed1987

[Inter-apophyseal articular synovial cyst of the lumbar spine. X-ray computed tomographic and magnetic resonance imaging correlation. Apropos of 2 cases].

Two patients presenting with L5 radiculagia were investigated by CT scan imaging. The origin of the pain was determined with certitude as arising from intraspinal development of an interapophyseal synovial cyst. Examination of the two cases by MR imaging provided conflicting results: in one patient images obtained by MR were not contributive and the synovial cyst would probably have been missed while in the other patient images were specific and very sensitive for diagnosis of interapophyseal synovial lesions. Treatment was surgical in both cases.

Female↗

PubMed1986

[Nosocomial Candida albicans septicemia in parenteral alimentation through a peripheral vein].

Fungal septicaemias during total parenteral nutrition are frequent, but their occurrence during parenteral nutrition via a peripheral vein is uncommon. A case of disseminated candidemia with ocular and renal localizations during parenteral nutrition via a peripheral vein is reported in a 24 year old patient hospitalized for primary cerebellar haemorrhage. The case history showed the importance of early ophthalmologic examination in all septicaemic cases. The diagnosis was confirmed by nine positive blood cultures and immunological tests, but the dosage of soluble antigens remained negative. The part played by a contaminated perfusion bottle out-of-date was suggested, but could not be proved absolutely. The assessment of the immune state could wrongly suggest an acquired immunodeficiency syndrome, for it has been demonstrated that Candida albicans itself had an immunosuppressive activity.

Adult↗

PubMed1986

[Blue tympanic membrane. Apropos of 3 cases].

A CT scan allowed simple diagnosis of the affection in three patients with the blue tympanic membrane syndrome. Lesions included prolapse of the internal jugular vein sinus into the tympanic cavity, an aberrant trajectory of the internal carotid artery in the middle ear and a tympano-jugular glomus tumor. Angiographic investigation of the latter lesion was performed more as a pre-treatment procedure rather than for diagnostic purposes, since it served as a guide to surgery, consisting usually of embolization.

Adult↗

PubMed1986

[Cerebral venous angioma. Angiographic and x-ray computed tomographic aspects. Apropos of a case].

Cerebral venous angioma is a vascular malformation, rarely recognized before use of C.T. It remains an angiographic diagnosis and prescribes, except when hemorrhage, quite uncommon, the surgical abstention.

Angiography↗

PubMed1986

[Surgery of acoustic neurinoma in the elderly].

Eleven patients, between 70 and 85 years old, with acoustic neurinoma, were operated by translabyrinthic approach. The size of the tumor was between 2 and 4 cm in five cases, 4 cm or more in six cases. Complete tumor removal was possible in six cases (55%), in five cases (45%) residual tumor was left behind. Complications included cerebrospinal fluid leakage (2 cases), meningitis (1 case), and hemorrhage (1 case, fatal four days later). Anesthetic management is described.

Aged↗

PubMed1985