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Biomedical subjects

C Christophe

Publications and source records attributed to C Christophe.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Value of brain MR imaging in infants with a severe idiopathic apparent life threatening event].

OBJECTIVE: Prognostic value of a magnetic resonance imaging (MRI) scoring system in infants with a severe apparent life threatening event (ALTE). METHODS: Ten infants with an ALTE (aged between 6 and 31 weeks) were clinically graded according to the PRISM score and evaluated with EEG, evoked potentials and MRI. The 18 MRIs obtained were distributed in 3 classes according to the delay after which they were obtained; class A (n=5): within the first 48 hours after the event, class B (n=7): between day 3 and 8 and class C (n=6): between day 9 and 50. The 18 MRIs were evaluated retrospectively using a scoring system based on 3 categories of lesions: edema, basal ganglia injury and watershed injuries. Five infants died between day 2 and day 15 after the event. The five surviving infants had follow up neurodevelopmental testing after 38 to 77 months. RESULTS: There was no correlation between the 5 MRIs of class A and the neurological outcome. For the MRIs of class B and C, the scoring system can be of great value when combined with the scores of EEG, EP and PRISM. CONCLUSIONS: The scoring system for MRI performed within 48 hours after the event is falsely reassuring. MRI can be helpful as early as 3 days after the event when combined with the score of the electrophysiological investigations and the PRISM.

Basal Ganglia Diseases↗
PubMed2000

S.P.I.C. pedagogical simulator for gynecologic laparoscopy.

Laparoscopic surgery has numerous advantages, but this technique is difficult and requires specific training. This paper presents a simulator for gynecologic laparoscopic surgery called S.P.I.C. (Pedagogical Simulator for Gynecologic Laparoscopic Surgery), specifically designed for teaching. It includes a rail with 3 trocars already in place, and a computer monitor. Training using the simulator is divided into tasks and steps in order of increasing difficulty. Each step consists of training exercises and evaluations. Learning with the simulator is guided by software that allows instructors to personalize their lessons. This prototype has allowed us to put into place training for spatial localization and manipulation of surgical instruments in the abdominal cavity. An evaluation at a clinical site has allowed us to determine the improvements to be made on this prototype. Training with a simulator is part of a resident's regular curriculum and is not meant to replace on site hospital experience. Some imperfections in imaging still exist, due to inevitable technical limitations. Our initial choice was to emphasize realism and "real time", rather than the "aesthetic quality" of the images. Furthermore, by limiting our graphic expectations, we have been able to create a simulator at a reasonable overall price. The S.P.I.C. training tool remains experimental and is still in the process of being developed.

Computer Simulation↗
PubMed1999

Magnetic resonance imaging cranial and cerebral dimensions: is there a relationship with Chiari I malformation? A preliminary report in children.

The pathogenesis of idiopathic Chiari I malformation (CM I) remains poorly understood, although it is thought to be due to disproportion between hindbrain structures and the posterior fossa (PF) dimensions. This study was undertaken to determine whether CM I and its possible complications are associated with disproportion between cranial and cerebral dimensions. Surface of the vermis, PF and supratentorial (ST) area were measured on magnetic resonance imaging midsagittal sections and were correlated with age in 19 children with CM I and 43 controls. The ratio of the PF/ST area and of the vermis/PF area were also plotted against age in the two groups and against length of the tonsils herniation in the CM I malformation group. Only the vermis midsagittal area and the vermis/PF ratio were found to be significantly higher in CM I malformation subjects. There was no correlation between the length of tonsils herniation and the vermis/PF area or the PF/ST area ratio in this group. The most severe complications (large syrinx and hydrocephalus) were not associated with particular measurements or calculated ratios in the children with CM I malformation except for the relatively small PF area in a neonate. We conclude that factors responsible for the appearance of clinical signs remain largely unknown. In particular, cranial and brain measurements alone do not seem to predict complications or unfavourable clinical evolution.

Age Factors↗
PubMed1999

Magnetic resonance imaging and angiography in cerebral fungal vasculitis.

We report on an 11-year old girl treated for leukemia who developed infarcts in the right lentiform nucleus and temporal lobe. Magnetic resonance angiography (MRA) showed mild intraluminal irregularities in the right carotid syphon and stenosis of the right proximal middle cerebral artery, suggesting vasculitis. Magnetic resonance imaging (MRI) follow-up showed evolution of the initial infarct into an abscess. Stereotactic biopsy disclosed filaments of aspergillus. This report emphasizes the fact that cerebral aspergillosis should be considered if MRA and MRI are indicative of vasculitis and cerebral infarction in immunosuppressed children.

Aspergillosis↗
PubMed1997

Acrocallosal syndrome in an Algerian boy born to consanguineous parents: review of the literature and further delineation of the syndrome.

We present a 17-month-old boy with the acrocallosal syndrome. He was born to consanguineous parents. Abnormal findings included agenesis of the corpus callosum, a ventricular septal defect (VSD), postaxial polydactyly of fingers, cleft soft palate, intestinal malrotation, large anterior fontanelle, prominent forehead, hypertelorism, epicanthic folds, short nose and mandible and preauricular skin tags, mixed hearing loss, laryngomalacia, and growth and severe motor and mental retardation. A review of previous reports on the acrocallosal syndrome shows considerable clinical variability; minimal diagnostic criteria are proposed. A developmental field defect with disturbance of midline development is suggested.

Abnormalities, Multiple↗
PubMed1997

Hemorrhage in the cavum septi pellucidi in a full-term neonate.

A case of hemorrhage in the cavum septi pellucidi presenting as macrocephaly secondary to hydrocephalus in a full-term neonate is described. This condition has only been reported previously in one premature infant. This unusual location of intracranial bleeding has been demonstrated by ultrasonography and MRI. We discuss the pathophysiology.

Cerebral Hemorrhage↗
PubMed1996

Anterior fontanelle pressure monitoring for the evaluation of asymptomatic infants with increased head growth rate.

We studied non-invasive intracranial pressure monitoring in 20 asymptomatic infants with increased head growth rate. Both basal anterior fontanelle pressure (AFP) traces and occurrence of pressure waves were analysed and compared with normal range values previously established. Eight recordings were classified as pathological; cerebral imaging showed subdural collections or ventricular dilatation in all cases. Five out of these eight infants further developed neurological deficits and/or increase of the ventricular size, and required neurosurgical procedures. Twelve infants had normal AFP traces; six of these had normal cerebral imaging and six showed enlargement of subarachnoid spaces with normal ventricles. All of these 12 patients normalised their head growth rate and remained asymptomatic. This observation suggests that AFP monitoring may be helpful in asymptomatic infants with increased head growth rate to identify a progressive intracranial process and the potential need for a neurosurgical procedure.

Child Development↗
PubMed1996

Clinical evaluation of gadodiamide injection in paediatric MR imaging.

The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82%). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children.

Adolescent↗
PubMed1994

Bilateral congenital absence of the internal carotid artery with a primitive transmaxillary arterial anastomosis.

We report a case of congenital, bilateral absence of the internal carotid artery accompanied by a complex anastomotic plexus arising from the right maxillary artery, a terminal branch of the external carotid artery. We present the clinical features and the radiological diagnostic evidence which consisted of ultrasonography, brain CT and MRI, conventional angiography and skull base CT scan. We review the literature pertaining to this congenital anomaly and correlate embryology of the carotid arteries to this unusual type of collateral circulation.

Adolescent↗
PubMed1994

Early MR detection of cortical and subcortical hypoxic-ischemic encephalopathy in full-term-infants.

Four observations illustrate the potential of MR imaging in the early depiction of multiple types of neuropathologic lesions which may coexist in the full-term newborn, upon severe hypoxic-ischemic encephalopathy (HIE). In particular, diffuse, postnatal involvement of cerebral cortex and subcortical white matter (WM) is demonstrated. Cortical hyperintensity on both proton-density- and T1-weighted images is probably related to cellular necrosis which is distributed diffusely or parasagittally. Hyperintense, frontal, subcortical WM edging on proton-density-weighted images results from the increase of water concentration, induced either by infarct or by edema. Diffuse WM areas of low intensity on T1-weighted images and of high intensity on T2-weighted images are presumably related to cytotoxic and/or vasogenic edema, proportional to the underlying damaged tissues. On follow-up MR examinations, several months later, the importance of cortical atrophy and of the myelination delay appeared related to the importance of the lesions detected during the postnatal period.

Brain Ischemia↗
PubMed1994

Fetal hypopituitarism: perinatal endocrine and morphological studies in two cases.

We report two infants with congenital absence of the anterior pituitary gland, documented by magnetic resonance imaging (MRI) or autopsy. In cord plasma obtained at birth from both infants, prolactin (PRL), pituitary growth hormone (hGH), placental growth hormone (hPGH) and thyrotropin (TSH) were undetectable; cortisol was low; thyroxine (T4) was 31 nmol/l in one infant and 85 nmol/l in the other infant who had been treated prenatally with intra-amniotic L-T4 administration. In maternal plasma at birth, PRL, hPGH and T4 were normal and hGH was undetectable. These observations suggest that plasma hGH and PRL in the fetus are exclusively of fetal pituitary origin, hPGH is secreted into the maternal circulation and is not transferred to the fetus and fetal growth can be normal in the absence of hGH, hPGH and PRL in fetal plasma.

Female↗
PubMed1993

MRI in seven cases of Rathke's cleft cyst in infants and children.

Seven MRI observations of presumed Rathke's cleft cysts in infants and children are reported. Age ranged between 6 months and 13 years. Size of the cysts ranged between 4 and 20 mm. While 3 small cysts were detected incidentally, 4 were large enough to cause symptoms secondary to compression of the pituitary gland and suprasellar components. The MRI appearance of the Rathke's cleft cysts varied according to their nature. MRI provides a major contribution to the diagnosis of these lesions; nevertheless, it often remains difficult to differentiate complex Rathke's cleft cysts from cystic craniopharyngiomas. The difficulties related to this differentiation are discussed.

Adolescent↗
PubMed1993

Achalasia-alacrima-ACTH insensitivity syndrome (Triple-A-syndrome).

Achalasia is a rare pathology in infancy. It is still more infrequent when associated with adrenal insufficiency and alacrima, a disorder known as Allgrove's syndrome, the etiology of which remains unclear. We describe a 9-year-old girl who presents with glucocorticoid insufficiency, partial mineralocorticoid deficiency, achalasia, and alacrima.

Adrenocorticotropic Hormone↗
PubMed1992

MRI of patients with cerebral palsy and normal CT scan.

Three children with clinical evidence of cerebral palsy (CP) and normal cerebral computed tomography (CT) scans were evaluated by magnetic resonance imaging (MRI) to identify CT-undetectable white matter lesions in the watershed zones of arterial territories. The two patients with spastic diplegia showed bilateral lesions either in the subcortical regions or in the occipital periventricular regions. The patient with congenital hemiplegia exhibited unilateral lesions in the periventricular region. We conclude that MRI is more informative than CT for the evaluation of patients with CP.

Brain↗
PubMed1992

Gaucher's disease. Plain radiography, US, CT and MR diagnosis of lungs, bone and liver lesions.

We report our observations made by conventional radiography, ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI) on a 3 1/2-year-old girl with Gaucher's disease. The interest of the case consists in the exceptional lungs involvement, the demonstration by MRI of the bone marrow involvement and the necrosis and fibrosis of the liver, as shown by CT. This liver complication has been previously reported only once.

Bone Diseases↗
PubMed1991

[Neonatal pilonidal sinuses and screening by medullary ultrasonography: preliminary results].

The authors report on their preliminary experience with ultrasound as a screening examination in neonates presenting pilonidal sinuses. Of the 100 patients examined over the 2 previous years, three pathological cases were found (1 tethered cord, 1 lipoma of the filum terminale and one localized hydromelia). Abnormal or doubtful cases were confirmed or further investigated by magnetic resonance. Ultrasound seems to be an accurate technique for the detection of malformation of spinal canal content in neonates under one month of age.

Humans↗