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Biomedical subjects

A Sévely

Publications and source records attributed to A Sévely.

12 recordsLinked to original sources
PubMed2004

[Spontaneous resolution of syringomyelia in a child with Chiari I malformation: a case report].

Cervicothoracic syringomyelia is a frequent feature in Chiari I malformation. It can be symptomatic or not, and is well demonstrated by magnetic resonance imaging (MRI). Its spontaneous resolution is uncommon. The authors report a case of spontaneous resolution of a thoracic syrinx in an 18-year-old patient with a Chiari I malformation. MRI study performed 6 years previously because of worsening headaches demonstrated a Chiari I malformation associated with a syrinx cavity. The cavity disappearance was noted after improvement of the symptoms.

Adolescent↗
PubMed2001

MRI in Lyme disease of the spinal cord.

We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case.

Adult↗
PubMed2001

In vivo geometrical evaluation of Cheneau-Toulouse-Munster brace effect on scoliotic spine using MRI method.

OBJECTIVES: The aim was to quantify the immediate effect of the Cheneau-Toulouse-Munster brace (worn at night) on scoliotic curvatures in vivo.Design. A three-dimensional geometrical model of the spine was developed using magnetic resonance images. BACKGROUND: Many corrective ortheses were proposed for the orthopaedic treatment of idiopathic scoliosis. Simple radiographs were not sufficient to analyse the three-dimensional spinal deformations. So, three-dimensional geometrical models were developed using stereoradiography and axial tomography. MRI has been only used clinically for investigation of intervertebral disc disorders. METHOD: MRI examination had been performed on 14 girls having an idiopathic scoliosis and wearing a first Cheneau-Toulouse-Munster brace. The protocol investigated was performed with and without brace. Using an in-house image processing software and the pre-post processing software Patran, two geometrical models of the spine (spine without brace and spine with brace correction) were obtained, respectively, for each patient, the models including the vertebral bodies. RESULTS: Our method reproducibility was found to be 0.5 mm on the displacements and 2.5 degrees on the rotations. The Cheneau-Toulouse-Munster brace decreased the coronal shift forward, the coronal tilt, the axial rotation, and increased the sagittal shift forward and the sagittal vertebral tilt. DISCUSSION: The results showed that the Cheneau-Toulouse-Munster brace had a three-dimensional and personalised action on vertebrae. This technique using MRI provides no irradiation and allows the soft tissue visualisation, but actually is not dedicated for clinical use and is limited to the lying position. RELEVANCE: The qualitative and quantitative data obtained allowed a better description of the Cheneau-Toulouse-Munster brace effect on scoliotic spine, and will help the orthopaedist in the brace design and the clinician in the scoliosis comprehension.

Adolescent↗
PubMed2001

Sensorineural hearing loss and otosclerosis: a clinical and radiologic survey of 437 cases.

The aim of this study was to determine if a relationship exists between bone level thresholds and the extension of otosclerotic foci within the otic capsule. The study consisted of a retrospective case review in a university hospital. We included patients who underwent surgery for otosclerosis in our department and who had a CT scan prior to surgery. We analyzed the data charts and CT scans of 437 cases (386 patients). On CT scan, we distinguished patients with fenestral otosclerosis and/or with a pericochlear focus. A pericochlear focus could be extended (Group 2) or not (Group 1) to the cochlear endosteum. Data for Groups 1 and 2 were compared with those for the control group of all patients for whom CT scan showed no cochlear focus (Group 3). Of the 437 CT scans, 399 were positive (91.3%). An anterior focus was reported in 305 cases (69.8%), a footplate thickening in 21 cases (4.8%) and both anomalies were encountered in 60 cases (13.7%). A pericochlear focus was reported in 53 examinations. This focus was extended to the endosteum in 14 cases (26.4% of the pericochlear foci). In Group 1, preoperative air conduction (AC) thresholds were significantly lower than in the control group (p < 0.05). The air--bone gap was also significantly larger in Group 1 (p < 0.05). Bone conduction (BC) thresholds were lower in Group 1 than in the control group but the difference was not significant. In Group 2, preoperative AC thresholds were significantly lower than in the control group (p < 0.05). BC thresholds were also lower in Group 2 than in the control group and the difference was significant (p < 0.05). As a result of this study, we assume that there may be a relationship between bone level thresholds and the radiological extension of otosclerosis within the otic capsule.

Adult↗
PubMed2001

[Septic arthritis of a lumbar facet joint associated with epidural and paravertebral soft tissue abscess].

Septic arthritis of the lumbar facet joint is rare, probably underdiagnosed, often associated with complications such as epidural abscess and paraspinal muscles abscess. Diagnosis is based on imaging evaluation. Plain radiographs of the lumbar spine are not helpful because often nomal. Bone scintigraphy is very sensitive but non-specific. CT scan can confirm the diagnosis and guide the needle biopsy. MRI is the preferred imaging modality for diagnosis. MRI shows early bone and joint involvement and it is helpful in detecting epidural and paravertebral soft tissue lesions.

Aged↗
PubMed2001

[Reliability of CT scan in the diagnosis of conductive hearing loss with normal tympanic membrane].

The goal of this study was to assess the reliability of CT-Scan in the cases of conductive hearing losses with normal tympanic membrane. A computed tomography of the temporal bone (CT-Scan) has been performed in a prospective manner in all patients who underwent surgery for a conductive hearing loss with a normal tympanic membrane in our department. Out of 474 cases, 437 cases (92.2%) presented with otosclerosis. In 25 cases a minor malformation (5.3%) was found at surgery, and in 12 cases (2.5%), another diagnosis was made. Sensitivity of CT-Scan was 91.3% in otosclerosis and 57% in minor malformations. In 8.7% of cases, a superficial and beginning surgical focus was put in evidence whereas CT-Scan was normal. Theses cases represent infra-radiological cases of otosclerosis. In case of radiological otosclerosis, fenestral otosclerosis was found in 83.5% of the cases. CT-Scan was found specific on the operated and deaf side, but in 11.3% of the cases, a radiologic focus did not have a clinical consequence on the controlateral side. A radiological focus is not systematically responsible for a hearing loss. Finally, CT-Scan remains a reliable, sensitive and specific exam in the diagnosis of cases of conductive hearing losses with normal tympanic membrane.

Audiometry↗
PubMed2000

Cervicofacial angioma and the Kasabach-Merritt syndrome.

We present a neonate with a cervicofacial haemangioma complicated by the Kasabach-Merritt syndrome, respiratory distress due to airway compression and high-output heart failure. This haemangioma and intravascular disseminated coagulation, treated initially by aspirin, ticlopidine and corticosteroids, required more invasive treatment with superselective embolisation and interferon alpha-2a. The clinical outcome was good.

Blood Coagulation Disorders↗
PubMed1998

Clear-cell meningioma of the cauda equina.

Meningiomas are rare tumours in children and lumbar lesions are exceptional. We report a clear-cell meningioma (CCM) of the cauda equina in a 10-year-old girl. The tumour was diagnosed by MRI, showing an enhancing intradural mass extending from L1 to L4. Pathology and immunohistochemical study demonstrated a CCM. The patient had a recurrence 6 months after the operation requiring further surgery. CCM are rare lesions, characterised by abundant cytoplasmic glycogen particles. Complete surgical removal is necessary because, despite their benign histological appearance, CCM are potentially aggressive and may recur, spread locally and even metastasize.

Back Pain↗
PubMed1998

Intracranial vascular involvement of brain pathologies and venous occlusions.

In this paper, the authors present the contribution of CT and MRI to the diagnosis of acute stroke caused by arterial or venous occlusion. The term "early" used in this context means within 6 h of the onset of symptoms. Signs of early ischemic edema are subtle and sometimes difficult to detect by CT or MRI. The purpose of this presentation is to familiarize the clinician and the radiologist with the subtle brain parenchymal changes seen within the first 6 h after onset of symptoms, in order to improve detection of early ischemic infarction and to improve patient care.

Acute Disease↗
PubMed1998

[Clear cell meningioma: recurrent intraspinal tumor in a child].

BACKGROUND: Meningiomas represent 1.5% to 4.3% of cerebral and medullar primary tumors in children. CASE REPORT: A 9-year-old girl had a history of thoracolumbar scoliosis. An intracanalar and extramedullar tumor was confined to the lumbar region. Resection identified a clear cell meningioma. A symptomatic and tumoral recurrence occurred 5 months later in the same region. After a second resection, the patient received radiotherapy. At 8 months follow-up, no recurrence was documented. CONCLUSIONS: A stiff and painful scoliosis can be predictive of expansive intracanalar tumor. The recurrent or multifocal evolution of clear cell meningioma show the "aggressive behavior" of this histological type. A preventive radiotherapy could be proposed, depending on the age of the patient and the localization of the tumor.

Child↗
PubMed1996

[Dissection of the intracranial arteries. Apropos of 10 cases].

Ten cases of spontaneous dissection of the cerebral arteries are reported. 3 males and 7 females aged 6 to 60 years (mean age 30 years) were investigated in the Department of Neuroradiology of Toulouse between 1989 and 1994 with CT, angiography and MRI. In 5 cases the dissection involved the carotid artery, in 5 cases the vertebro-basilar system. The clinical presentation was of two types: ischaemic stroke (7 cases) or subarachnoid haemorrhage (3 cases). Their evolution is never lethal, contrary to the classical descriptions of the literature. In all cases an initial angiography then follow up has been performed showing an irregular located arterial stenosis. The diagnosis of intracranial dissection is sometimes made in front of a dissequant aneurysm. In case of doubt, magnetic resonance (MR) imaging is helpful showing a linear hypersignal parallel to an arterial segmental stenosis, and angiography MR an irregular aspect and stenosis of the endoluminal artery.

Adolescent↗