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Biomedical subjects

B Vallée

Publications and source records attributed to B Vallée.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Juxta- or trans-condylar lateral extension of the posterior suboccipital approach. Anatomical study, surgical aspects].

In order to improve the surgical approach to tumors and aneurysms of the anterior or antero-lateral aspect of the foramen magnum, some authors have proposed a lateral extension of the posterior sub-occipital approach to the occipital condyle including in some cases its partial or complete resection. The evaluation of this close medio-condylar or trans-condylar suboccipital approach has been performed on eight coloured-latex injected specimens in the conditions of a microsurgical operation. The extra- and intradural steps have been studied so as to define the optimal position of the patient's head and the surgeon and to precise the accessible anatomical structures: Vertebral artery (and its control), Cranial nerves IX, X, XI & XII, Posterior-inferior cerebellar artery and collaterals, Vertebro-basilar junction, antero-lateral aspect of the brain stem and spinal cord. Depending on the extent of the condylar resection, the lateral extension of the posterior sub-occipital approach may be defined as minimal, moderate or large. Based on anatomical and surgical constations it appears that a complete resection of the occipital condyle (resulting in occipito-cervical instability) should be reserved for those very extensive lesions. Yet a partial drilling of the condyle provides a better angle of approach, minimises the hazards of retraction of nervous structures and enables the surgeon to take the best advantage of the dissection and control of the vertebral artery.

Female↗
PubMed1992

[Contribution of ultrasonic cavitation--CO2 laser combination in the excision of panmedullary ependymoma].

The authors report an uncommon case of panmedullary ependymoma (C2 to T12), totally removed in one stage with the use of ultrasonic cavitation and CO2 laser. The preoperative topographical diagnosis without M.R.I. was very difficult. CO2 laser in addition with ultrasonic cavitation allows the removal of the tumor without any prohibitive tractions on the spinal cord. The stable course with a long follow-up period (seven years) confirms the good prognosis of such a pathology.

Adult↗
PubMed1991

[Intramedullary D12-L1 epidermoid tumor. Report of a case and review of the literature].

The authors report, after a follow-up period of two years, a case of intramedullary congenital epidermoid cyst treated surgically. The patient, a 21 year-old man, presented with a seven year history of motor disturbances of his left lower limb and more recent urinary incontinence. The diagnosis of an intramedullary tumor was provided by a myelogram and a post-myelogram CT. In the absence of a dermal sinus or vertebral dysraphic anomalies, the epidermoid nature of the mass was an operative and histological finding. The main data from the literature are commented: frequency, topography, clinical diagnosis, and radiologic or M.R.I. imaging. Intracapsular removal of the mass seems to result, as in the presently reported case, in a satisfactory outcome.

Adult↗
PubMed1984

Anatomical bases of transaxillary resection of the first rib.

Anatomical study of the costoclavicular space, with approach via inferolateral axillary route, allowing resection of the first rib. With the patient in the semisupine position, lifting the arm to the zenith allows the costoclavicular space to be opened widely and separation of the plane of the first rib from the neurovascular structures of the lateral wall of the axillary pyramid. In the first part of our work, we study successively the bony frame and its anatomical variations, the muscular frame and its anomalies, the cervical pleura and its associated fibromembranous complex. The second part is a succinct summary of the different stages of transaxillary resection of the first rib, with mention of the operative risks and landmarks in this approach.

Axilla↗
PubMed1982

Spontaneous spinal epidural hematoma in a 22-month-old girl.

The authors report the case of a 22-month-old girl who developed cervical pain, neck stiffness, and quadriparesis over 12 days. An epidural hematoma was removed, with complete recovery after 6 months. There was no history of trauma. A search of the literature revealed eight previous cases of spontaneous spinal epidural hematomas in children under the age of 10 years.

Female↗
PubMed1981

[Disabling segmental occlusion of the vertebral artery. Surgical treatment using a venous by pass from the external carotid to the C1-C2 portion if the vertebral artery (2 cases) (author's transl)].

The authors report the cases of two patients who were severely disabled due to signs and symptoms of vertebrobasilar insufficiency caused by unilateral segmental occlusion of one vertebral artery. The patency of the occluded vertebral artery beyond C3 was demonstrated by a faint angiographic injection through anastomic ascending cervical arteries which provided insufficient blood supply. The opposite vertebral artery was abnormal in both cases: a proximal kinking with intracranial atheromatous stenosis in the first and an atheromatous ostial stenosis in the second one. A venous by pass from the external carotid artery (end to end anastomosis) to the C1-C2 portion of the vertebral artery (en to side anastomosis) was performed through an incision from the tip of the mastoid process along the S.C.M. the division of which was unnecessary. Post operatively the signs and symptoms disappeared immediately. The stability of this result is attested by a follow up period of 13 months in the first case and 9 months in the second one. A control angiogram demonstrated a good supply to the vertebro-basilar system through the bypass, the excellent permeability of which was further confirmed by repeated Doppler ultrasound examinations. The indication of this technique is discussed.

Aged↗
PubMed1980

[A rare anomaly of the circle of Willis : infra-optic course of both anterior cerebral arteries: associated aneurysm of the basilar bifurcation (author's transl)].

A rare anomaly of the A1 portion of both ACA associated with a saccular aneurysm of the basilar bifudcation is presented. Based upon this case and eigth other cases in the literature, the anatomical and radiological features of the anomaly are precised : the anomalous artery comes from the internal carotid artery right over the cavernous sinus, very close to the origin of the ophtalmic artery; it rums medailly below the inferior aspect of the optic nerve, thus being projected under the plane of the optic canal on oblique angiograms; finally, it crosses the anterior edge of the optic chiasm up to the interhemispheric fissure. By itself the anomaly is asymptomatic but it should not be considered as a mere curiosity since it has most often been found associated with a variety of cerebral vasculature anomalies and in particular with encor more saccular aneurysms of the circle of Willis.

Brain↗
PubMed1978

Stereotaxic exploration in 200 supratentorial brain tumors. Its value in addition to computerized tomography.

The authors emphasize the advantages of stereotaxic methodology in the management of 200 brain tumors. Nowadays computerized tomography is the first stage of radiologic diagnosis. Both CT scan and stereotaxic examination have been carried out in more than 35% of these tumors. Rather than a comparison of the two examinations, the authors' purpose is to attempt to demonstrate their complementarity in the assessment of location, volume, and nature of the lesion and eventually in the choice of a therapeutic attitude. Analysis of topographic data and staged biopsies, gathered from the 'stereotaxic space,' provides the neurosurgeon with accurate information for planned surgical excision or interstitial irradiation.

Brain Neoplasms↗
PubMed1978

[Abnormal fusion of 2 primitive trigeminal arteries: apropos of an anatomo-radiological case].

Agenesis of the internal carotid artery was discovered during emergency cerebral angiography carried out on a comatose 28 year old man. The left cerebral hemisphere was supplied from the controlateral carotid artery, via a large vessel running through the sphenoid bone, between the intracavernous portions of the internal carotid arteries. Postmortem examination showed that death resulted from massive haemorrhagic infarction of the cerebellum and brain stem. Absence of the cervical and petrosal portions of the left internal carotid artery was confirmed. The anastomotic vessel was found to run through the spongiosa below the dorsum sellae. The heart, major vessels and circle of Willis were otherwise normal. An intercarotid anastomosis of this type has been reported on three previous occasions, in none of which was there anatomical confirmation.

Adult↗