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Biomedical subjects

B Alliez

Publications and source records attributed to B Alliez.

At least 19 recordsLinked to original sources
PubMed1995

[Unusual extra-axial infra-tentorial localization of a cavernoma in the cisterna magna].

A case of an extra-axial cavernous angioma of the cisterna magna is described. The clinical presentation, radiographic features, treatment of that unusual location in the posterior fossa are discussed. The patient is a 31 years old man admitted for the sudden onset of occipital headache and instability. A CT scan demonstrated a slightly calcified lesion, minimally enhanced after intravenous injection of a contrast agent, located within the posterior fossa. A T2-weighted MR image showed a well circumscribed mass, located between medulla oblongata and left cerebellar tonsil, of mixed signal intensity surrounded by a rim of decreased signal intensity related to the presence of hemosiderin. Cerebral arteriography was normal. A medial suboccipital craniectomy was performed, with the patient in the ventral position, in which a 1.5 x 1 cm solid dark-red mass was encountered arising from the cisterna magna and was easily removed "en bloc". The operative extra-axial aspect of that lesion was evident excluding a medulla oblongata tumor protruding into the cisterna magna. Histologically, the lesion was a cavernous angioma consisting of numerous vascular channels with collagen fibrous walls filled with fibrin thrombi and hemosiderin. Few elastic fibers were found in vascular walls. The patient's post-operative course was unremarkable.

Adult↗
PubMed1993

Sufentanil increases intracranial pressure in patients with head trauma.

BACKGROUND: Sufentanil is an intravenous opioid often used as a component of anesthesia during neurosurgical procedures. However, the effects of sufentanil on intracranial pressure in patients with diminished intracranial compliance are not well established, and remain controversial. METHODS: Ten patients with head trauma, in each of whom the trachea was intubated, were studied for the effects of sufentanil on intracranial pressure (ICP) and on cerebral perfusion pressure (CPP). In all patients, ICP monitoring was instituted before the study. Sedation was obtained using a propofol infusion, and paralysis was achieved with vecuronium. After obtaining control of ICP (between 15 and 25 mmHg) hemodynamic values and blood gas tensions (PaCO2 between 30 and 35 mmHg), the level of sedation was deepened with an intravenous injection of sufentanil (1 microgram/kg over 6 min), followed by an infusion of 0.005 microgram.kg-1min-1. Mean arterial pressure (MAP), ICP (fiberoptic intracranial pressure monitor), and end-tidal CO2 were continuously measured and recorded at 1-min intervals throughout the 30-min study period. RESULTS: Sufentanil injection was associated with a statistically significant increase in ICP of 9 +/- 7 mmHg (+ 53%), which peaked at 5 min. Then ICP gradually decreased and returned to baseline after 15 min. This was accompanied by a significant decrease in MAP (24% decrease) and, thus, CPP (38% decrease). After 5 min, MAP and CPP gradually increased, but remained significantly decreased throughout the study. CONCLUSIONS: The results of the current study indicate that caution should be exercised in the administration of sufentanil bolus to patients with abnormal intracranial elastance, particularly if ICP is significantly increased.

Adolescent↗
PubMed1992

[Distal aneurysm of the postero-inferior cerebellar artery. Anatomical and surgical considerations].

A patient with a rare peripheral aneurysm of the posterior inferior cerebellar artery (P.I.C.A.) was treated by microsurgery. Anatomical features and surgical procedures are discussed. The aneurysm was located in the retromedullary, tonsillomedullary segment of the right P.I.C.A. and formed a caudal or infratonsillar loop in the cisterna magna close to the inferior part of the tonsil. The operation was performed with the patient in the sitting position using a median suboccipital approach through a cervical 1 (C1) laminectomy. The widened neck of the aneurysm was clipped successfully and the post-operative course was completely asymptomatic. A vertebral angiogram control showed the P.I.C.A. to be patent. The surgical approach should be related to the site of the aneurysm. Those affecting the telovelotonsillar segment of a P.I.C.A., forming cranial or supratonsillar loops, and those involving its cortical segment can be effectively operated using the same median suboccipital approach. Aneurysms arising from the anterior or lateral medullary segment of a P.I.C.A. should be approached through a unilateral suboccipital craniectomy extending down to the foramen magnum. Although clipping the neck of the aneurysm is preferable, trapping is possible for lesions arising from or distal to the telovelotonsillar segment, this preserving the small arteries arising from the lateral and posterior medullary segments.

Adult↗
PubMed1990

[Extracranial aneurysm of the posterior inferior cerebellar artery. A case report].

A case is presented of an aneurysm arising in an extracranial loop of the left posterior inferior cerebellar artery (P.I.C.A.). Two similar cases can be found in a review of the literature. It is essential to obtain clear visualization of both P.I.C.A.s. in the evaluation of patients with subarachnoid hemorrhage. Surgical treatment of this aneurysm, located distal to the lateral medullary segment, involves a midline approach with retraction or subpial resection of the tonsillar tip.

Adult↗
PubMed1984

Primary lymphoma of the brain associated with AIDS. A study of one case.

A typical case of acquired immune deficiency syndrome (AIDS) has been clinically and morphologically studied. This homosexual man whose past history was significant for i.v. drug abuse and sexually transmitted infection presented several opportunistic infections with a profound impairment of cell-mediated immunity. Autopsy showed an intense lymphoid depletion, CMV-generalized infection, and a primary large cell immunoblastic lymphoma of the brain. The present case is discussed in the light of recent literature.

Acquired Immunodeficiency Syndrome↗