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Biomedical subjects

B Scherpereel

Publications and source records attributed to B Scherpereel.

At least 19 recordsLinked to original sources
PubMed1994

[Changes in systolic pressure and posture in the surgery of the lumbar spine].

Anesthetized patients for lumbar disk surgery can be placed in prone or knee chest position which may adversely affect circulation. Augmentation of the delta-down component of the systolic blood pressure variation in ventilated patient is a sensitive indicator of intra operative hypovolemia. According to results, cardiac filling pressure is more affected in the knee chest position than in prone position. Preload state variation between the two positions, evaluated with albumin fluid challenge, seems to be more important than 500 ml.

Blood Pressure↗
PubMed1993

[No hair shaving].

The author presents an experience with 4,655 operated on neurosurgical patients (except for shunt procedures) without any hair-shaving. He describes the precise technique used to prepare the scalp. Among these patients, twenty (0.43%) experienced infections complications.

Bacterial Infections↗
PubMed1989

Single brain metastasis of non-small cell lung carcinoma. Study of survival among 54 patients.

We studied 54 patients treated for non-small cell lung carcinoma with single brain metastasis presenting between 1980 and 1985. Better survival was obtained in cases of patients presenting a fair neurological condition who were treated by surgery. Histological condition and date of onet of metastasis had no significant influence on survival. Combined treatment of both primary lung tumour and brain metastasis was a favourable prognosis element, and surgical resection of both locations led to the best results in terms of duration and quality of survival.

Brain Neoplasms↗
PubMed1989

[Synovial cysts and synovialomas of the lumbar spine. Histo-pathologic and neuro-surgical aspects apropos of 8 cases].

Based on 8 personal cases and a 81-cases review of literature, it's authors' opinion that cystic or solid masses issued form posterior lumbar articular process and called according to the cases synovial cyst, ganglion cyst, benign synovialoma, pigmented villonodular synovitis, are a single variety of benign degeneration of soft articular tissues. The cystic or solid feature of these masses depends upon the extent of their histiocytic granulomatous proliferation. They may be asymptomatic, accompany chronic lumbar pain or cause sciatica, seldom cauda equina syndrome. In case of sciatica, clinical picture rather consists of a narrow lateral recess than a discal protrusion. CT scan is the best investigation to get a right preoperative diagnosis. Postoperative prognosis is excellent and no anatomical recurrence has been reported.

Adult↗
PubMed1989

[Myelopathies caused by dorsal spinal canal spondylotic stenosis. 3 cases and a review of the literature].

Thoracic spondylotic myelopathies are exceptional, only 29 observations could be found in the literature; we intend to describe three new cases here. The patients, two women and one man, 64, 69 and 72 years old, complained of weakness of the lower limbs, more marked on one side, which had been progressing slowly from several months to eight years. Examination revealed asymmetrical paraparesis with distal sensitivity deficits without thoracic sensory level. In the first case, the myelography remained virtually unchanged in front of T11, T12; in the second and third cases, there was slight extradural compression at T9 and T10 respectively. Magnetic Resonance Imaging (M.R.I.) performed in two patients was evocative of a thoracic disk herniation. A chest CT scan enabled us to establish correct diagnosis: in the three cases irregular hypertrophy of the posterior elements was evident at T11 and T12, T9 and T10, T10 and T11 respectively, with osteophytes originating in the articular process and deeply embedded in the spinal canal. Decompressive laminectomy associated with medial facetectomy resulted in the gradual improvement of walking in all three patients. Myelography and MRI are both useful in demonstrating the level compression, usually situated in the low thoracic spine, however only the CT allows differential diagnosis with other etiologies, especially anterior compression such as disk herniation.

Aged↗
PubMed1988

[Meningioma of the optic canal. Diagnostic aspects apropos of 3 surgically treated cases].

Three cases of meningiomas originated in the optic nerve sheath in its intra-canalicular portion, have been operated on in Reims since we dispose of the TDM; it gave us the opportunity to re-define the way how to explore an area always difficult to investigate; indeed it has been impossible for a long time to clearly isolate meningiomas in the optic canal through the classical neuro-radiologic technics. The anatomic study confirms that the optic canal orientation is fixed, constantly inclined downward and forward with an angle of minus forty degrees with regard to the horizontal line; our work establishes that it is possible to apply it to the CT scan; in this incidence, TDM perfectly allows to visualize the optic canal and the optic nerve, from the anterior clinoid process to the posterior orbital pole. This incidence seems us to be interesting, in addition to classical neuro-ophthalmic planes, for early diagnosis or supervision of tumors of the optic canal.

Cranial Nerve Neoplasms↗
PubMed1988

[Cerebral abscess and Osler-Rendu disease. Apropos of 4 cases].

The authors report 4 cases of cerebral abscesses (C.A.) complicating Rendu Osler disease (hereditary haemorrhagic telangiectasia: H.H.T.). These cases and 43 others comparable found in literature enable to assess C.A. complicates H.H.T. by the way of pulmonary arteriovenous fistulas (P.A.V.F.). C.A. appears during known H.H.T. in only a quarter of cases; in all other cases C.A. reveals the disease. When the etiological search for metastatic C.A. fails to find any classical cause: O.R.L., stomatologic, cardiac, it seems important to suspect H.H.T., and research P.A.V.F. by chest X ray and pulmonary angiography. Preventive treatment consists in excluding pulmonary fistulas without waiting neurological complications of known H.H.T.

Adolescent↗
PubMed1988

[Spondylodiscitis after surgery of lumbar disk hernia. Apropos of 12 cases in 1796 operations].

Discitis is a rare complication of disc operation. The incidence rate varies from 0.2 to 0.8% according to the series. During a 6 year period (1980-1986) 1,796 patients were operated for lumbar disc protrusion at our institution and twelve of them (0.66%) developed a post operative discitis. Bacteriologic verification due to the infection was ascertained in ten cases. Direct contamination during surgical time is likely far more frequent than hematogenous contamination because the liable germ was staphylococcus in 9 cases. Ascertaining the diagnosis is base upon clinical picture and some selected investigations. It may be earlier than it has been said before. Discitis may be suspected within a week after operation in two cases out of three. The most prominent clinical feature is back pain with muscle spasm but sometimes diagnosis may be misled to a psychiatric condition or a visceral disorder. Among conclusive investigations we range in the first place the needle aspiration of the disc which permitted to isolate a germ nine times out of eleven. Next the bone scan with H.M.D.P. Te 99 (8 Mbq/kg) which revealed a significant uptake pattern in eight cases out of eight. Finally the blood culture which grew five times out of ten. Risks of discitis, i.e septicemia, polysegmental infection or death justify in our opinion an appropriate antibiotherapy during at least 8 weeks. Moreover, in our experience, it is the best antalgic treatment that we can offer and back pain decreases as soon as the second day with antibiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Cervical spondylotic myelopathies. Apropos of 121 cases. Prognostic value of sensitive symptoms].

121 patients have been treated for cervical spondylotic myelopathy between 1972 and 1985; 88 patients have been operated on, most of them (84) by laminectomy and 4 cases by anterior approach; 33 patients have been treated conservatively in absence of evolution. We have used a clinical classification based on the different sensitive symptoms, the best predictive factor in our opinion; the typical form (2/3 of all cases) associates numbness and paresthesias of extremities of both hands, difficulties for manipulation, astereognosia, with a moderate pyramidal deficit of the lower limbs; this typical form obtains the best post-operative score with 75% of good results; the more the clinical sensitive form is far from the typical one, the poorest may be the evolution. Our results are similar with large series of literature, using either the posterior or the anterior approach; we have noted the frequency (1/4 of cases) of very late worsening, several years after initial good result, without residual compressive factor; it is supposed that organised intra-medullary lesions, may be of venous origin, continue to evolve for their own. 33 non operated patients have been treated conservatively, because of spontaneous stabilization of their disease, suggesting to try immobilization by cervical collar during few weeks before surgery.

Adult↗
PubMed1987

[Unilateral non-tumor hydrocephalus in children. Atresia of the foramen of Monro?].

The authors report 5 cases of an uncommon unilateral hydrocephalus due to non neoplastic obstruction of the foramen of Monro. Clinically, it is an early hydrocephalus, and usual absence of neurological deficit contrasts with large unilateral ventricular dilatation. CT Scan made diagnosis easier, confirming non neoplastic etiology. The authors compare their own 5 cases with 14 cases alike in the literature and emphasize the usual post shunting good prognosis of these hydrocephalus. Etiology remains uncertain.

Cerebral Ventricles↗