Biomedical subjects
Publications and source records attributed to B Bouchez.
A case of hemangiopericytic meningioma of the pineal region is reported. We discuss the origin of meningiomas in this region and their histological nature. The rapid recurrence in situ of the tumor in this particular case seems to confirm the need to complement surgery with radiation therapy.
The authors describe a case of brachial plexus'lesion at axillary level in a patient under anticoagulation therapy. They underline the use of CT scan and digitalized angiography to establish the diagnosis and choice the treatment.
A previously healthy 24 year old woman presented a progressive paraplegia during the third trimester of her second pregnancy. Partial improvement occurred after caesarian. The neuroradiological study revealed spinal cord compression by an extensive corporeo-pedicular angioma of the T2 vertebrae. Almost total recovery occurred after selective embolization. The occurrence of neurological complications of vertebral angiomas during pregnancy is rarely reported in the literature. Mechanisms of the spinal cord compression and their relations with the pregnancy are discussed and difficulties for diagnosis and treatment are emphasized. When technically possible, the embolization appears to be the most adapted treatment, especially for these extensive types of vertebral angioma.
The cross-sectional study of patients with RA receiving LDGC, compared with those on NSAID alone (or patients with AS) showed that LDGC significantly affects bone mass at midshaft and even more so at the distal radius. The loss of bone seems to be brisk but continuous on the long run, at least at the distal scanning site, and thus increases the C/T ratio, especially in aged men. The loss of bone mass in the LDGC group correlates with the duration of the disease as well as with carpal destruction (especially at mid shaft radius), with both parameters being correlated with one another. At equal carpal destruction, LDGC still affects bone mass. Whether receiving NSAID alone or LDGC in addition, patients with RA, as compared with controls, are more liable to lose bone when they grow older. In a longitudinal study, premenopausal women were unaffected by the administration of LDGC at both scanning sites. In contrast, postmenopausal women receiving LDGC lost at least twice as much bone as did normal women after the menopause. Men of all ages on LDGC lost bone at a rate equal to that of normal women after the menopause. Men with RA or with AS on NSAID alone did not significantly lose bone. It is concluded that LDGC may be given to premenopausal women without harm to their bone mass. After the menopause, hormonal replacement therapy, if not contra-indicated, should be given in association with LDGC. Men fortunately have a higher peak bone mass and therefore can afford to lose bone during a decade before they attain the same situation as women at the time of their menopause. If treatment is then continued for another two decades, their bone mass might behave as does that of postmenopausal women if bone loss is continuous over such long periods of time. This latter assumption has yet to be verified.
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Peripheral nerves are rarely involved in Horton's disease, and when peripheral neuropathy predominates in the clinical complex it is sometimes a source of diagnostic errors. We report two cases of giant cell arteritis revealed by peripheral neuropathy.
Total lateral paralysis in a case of "One and half" Fisher's syndrome accompanied by paralytic pontine exotropia is described. Oculographic investigation indicates involvement of the nucleus of the VIth cranial nerve. Paralytic pontine exotropia, may therefore be encountered where the VIth nucleus is involved.
A case of femoral palsy associated with chronic pain sensible to Carbamazepine, secondary to iliacus haematoma during anticoagulant therapy is reported. Late femoral nerve decompression followed by transcutaneous neurostimulation permit the normalization of the sensory nerve conduction and a complete clinical recovery. The localizations of hemorrhage and nervous compression are discussed. The necessity of a nerve decompression when features of nervous conduction persist is emphasized. Clinical symptomatology, Carbamazepine and transcutaneous neurostimulation efficacity, electrophysiological features are correlated with a central deafferentation state caused by an incomplete and heterogeneous lesion of the sensory nerve conduction pathways.
A paravertebral ganglioneuroma was discovered in a 25 year-old woman presenting a transverse spinal syndrome at the same level. Exeresis necessitated sacrifice of the ninth left intercostal artery, but paraplegia regressed completely under corticotherapy. Additional exploration and subsequent clinical evolution revealed multiple sclerosis, of which the pavaplegia had been a manifestation. The authors discuss ganglioneuroma in the adult, a rare tumour, and the possibility of a link with multiple sclerosis. The association seems fortuitous despite the fact that the tumour and the transverse myelitis occurred at the same level.
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