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C Cioloca

Publications and source records attributed to C Cioloca.

32 records · Page 2Linked to original sources
PubMed1986

[Management of cranial-injured patients in the era of the Emergency Medical Service and the scanner. Comparative epidemiologic study with a 12-year interval in the same department of neurosurgery, in the Paris region].

The authors present an analysis of the different data concerning the emergencies admitted in the Neurosurgical department of Sainte-Anne Hospital in Paris, during the one year-period extending from 1st June 1983 to 1st June 1984. These data have been compared to the corresponding findings established during 1972 in the same department. Traumatology appears to be a more and more limited activity among neurosurgical emergencies: 55% of admissions in 1972, 43% in 1983-84. The main characteristics of injured patients on admission have not changed: 65% are in a coma, 1.25 are operated in emergency, age distribution and types of lesion are identical. The sorting of the patients has improved: 25% of them were operated upon in 1972, 37% in 1983-84. Conveyance of injured patients has undoubtedly improved in quality during the last years; yet the duration of transport is still important, too important, even in Paris: 2 h 30 as an average-time. Another favorable factor has been the coming out of CT-Scan; it is of course of great help for diagnosis, but it must not let forget basic and fundamental therapeutic decisions.

Adolescent↗
PubMed1986

[Real-time ultrasonography in neurosurgery. Puncture of an intracranial hypoechogenic cavity].

The authors have been using real time echography in neurosurgical procedures since 1981: either for detection of a small sub-cortical tumor during a surgical operation, either for biopsy-guidance, or for puncturing a cavity (abscess, cyst or hematoma). The imaging is performed with a CGR SONEL 100 apparatus and two different frequency transducer elements: 3.5 MHz and 5 MHz. 56 patients underwent this technique; 22 times the lesion was hypoechoic: abscess give homogeneous, round hypoechoic image, often surrounded by a fine hyperechoic line; intracerebral hematoma produces an hypoechoic image after a 10 to 15 days evolution: compared to an abscess it then has a more hyperechoic irregular wave-like limit; tumoral-cyst echogenicity is very low; it can even be anechoic. If a stereotaxic structure exists, indication of real time echography must be limited to such stereotaxy contraindications: threatening intracranial hypertension, suppurated lesion, fragile patient. The technique has its limit: that is the small volume of the target-lesion (inferior to 10 mm); advantages must be emphasized: light procedure, satisfying confidence when considering the probe progression, sometimes better information than that of a CT-Scan examination especially for tumoral and cystic lesions.

Brain Abscess↗
PubMed1985

[The CO2 laser: a new instrument for intracranial neurosurgery].

Since 1983 we have been using an 80 watts CO2 laser unit (Ercelas 80, Robert et Carrière Biomédical) routinely in some neurosurgical procedures. Fifty tumours (34 intracranial, 4 intraorbital and 12 intraspinal) have been operated upon with laser. The CO2 laser appears to be particularly useful to excise solid tumours, such as meningiomas and neurinomas. When these lesions are located in the posterior fossa or lying deeply near highly functional or vital supratentorial structures (e.g. carotid arteries, optic nerves, chiasma), the laser beam should be coupled with an operating microscope. Laser being a non-touch technique, the tumour can be removed with minimal trauma to healthy tissues. Depending on the output power, the laser beam coagulates, cuts or vaporizes the target lesion.

Brain Neoplasms↗
PubMed1985

[Physical and technical bases of tumor hemostasis with a CO2 laser in neurosurgery].

The particular thermal properties of CO2 laser make it an useful instrument for neurological surgery. Necrosis and carbonization zones, as well as its thermal diffusion in the nervous tissue are dramatically less important with a CO2-laser unit than with other lasers (Nd-Yag or Argon) and moreover with the electrical mono--or bipolar coagulator. That is why the authors chosed this instrumentation for achieving a good hemostasis. It was particularly useful during removal of intracranial tumors situated close to the functional structures of the basis of the brain and the brainstem. The authors present their experience with the french CO2-laser unit Ercelas 80 (Robert et Carrière Biomedical) that they have been using routinely since 1983 in 60 neurosurgical procedures. They present the technical standards necessary to perform such an hemostasis either with the hand-piece or using the micromanipulator. In all cases the output power must be much lower for hemostasis than for tumoral cutting or vaporization. Depending on the type of tumor, radiation power should vary from 2 to 10 watts if a linear emission is used, and from 10 to 30 watts in case of pulsed emission. On the other hand, CO2-laser beam must be unfocussed so as to avoid cutting the vessels less than 0.5 mm in diameter before coagulating them properly.

Carbon Dioxide↗
PubMed1984

[Value and limitations of the use of CO2 laser in neurosurgery. Reflexions from a French experience].

The authors have been using routinely since February 1983 a french 80W. CO2 Laser unit. They discuss the advantages and limits of this technic in the light of the first 26 intracranial and intraspinal operations carried on with it. The main and wellknown qualities of CO2 Laser are: the easiness of the hemostasis of the tumor and of the surgical cavity; and the absence of traction on the same tissue. The coupling of CO2 Laser with the operating microscope appeared very useful and made safer deep tumor excision, particularly that of the posterior fossa such as neurinomas and meningiomas. It was also quite efficient for intra-orbital tumors. The maniability of the hand piece was increased by the use of oblique mirror (45 degrees and 60 degrees) fixed at its extremity. The incision of skin, subcutaneous and muscular layers was not simplified by CO2 Laser; indeed this apparatus increased the operatory duration and was responsible of a healing time extension.

Adolescent↗
PubMed1980

Control of dyskinesias due to sensory deafferentation by means of thalamic stimulation.

Intermittent stimulation of the parvocellular portion of the nucleus ventralis posterolateralis (V.P.L.) by means of chronically implanted electrodes and stimulus generator was performed in 124 patients for the control of chronic intractable pain. Among these, 11 showed spontaneous abnormal movements within the painful area: 6 post amputation "jumping stumps"; 4 pseudothalamic syndromes and 1 Von Benedikt's syndrome following a cerebrovascular accident. Electrical stimulation of the V.P.L. was able to control both pain and abnormal movements in all cases. The technique was applied with an equally good result in a case of choreoathetotic syndrome without pain but with severe sensory disturbances following a demyelinating process. Attempts made to control action tremor, parkinsonism and other dyskinesias not associated with sensory deafferentation in 12 cases failed. The same mechanism seems to be responsible for pain and dyskinesia in cases of sensory deafferentation, and thalamic stimulation might work as a substitute for sensory information delivered to the nucleus ventralis posterolateralis.

Amputation, Surgical↗
PubMed1976

[Present state of pain surgery].

This report presented to the Société de Neurochirurgie de Langue Française is based on 34 years of unique practice in neurosurgical management of pain; during that long period the author and his associates have collected an unusually large experience in almost every field of neurosurgical management of pain; they have improved or fully devised several new techniques which allow them to ground an appreciation of the procedures still worthy to be used in various pain syndromes. The first part of the report deals with "Cybernetics of pain". This rather long chapter is based both on classical data and personal observations on man during and following operations, meant to relieve pain. Though supporting HEAD and HOLMES, theory on Control of protopathic by epicritic Stimuli, the authors consider that the type of pain associated with noxious stimulation as representative of just one among other types of pain, not induced by nociception and not associated with protection reflexes. Sensory deafferentation as can be produced by amputations, herpes zoster, dorsal column or medullary lesions, cannot be included in Sherrington's scheme of psychical mechanisms associated with protection reflexes and yet is responsible for most of the chronic unbearable and often intractable pain. Moreover, an important modulation of pain as such depends on conditioning, on inherited and acquired patterns of behaviour and on a multiplicating factor which is provisionally named "algogenic neurosis". The fact that an intact nucleus ventralis posterolateralis is a necessity for a "no pain status" tends to prove that this thalamic nucleus acts as a major inhibiting relay on the pain integrating system and for several additional reasons is the level of integration of epicritic versus protopathic stimuli in case of true nociception...

Analgesia↗
PubMed1975

[Trial of experimental induction of cerebral metastasis in the rabbit carrying a VX2 tumor].

Numerous factors remain unknown as far as the mechanism of induction of cerebral metastases is concerned. Where as of cancer give metastases more readily than others, especially cerebral metastases, the neoplastic embolus can be either eliminated or remain in place in a state of quiescence. What is the role played by the blood brain barrier from a pathophysiological point of view? Is there a mechanism which prevents central nervous system metastases? What is the importance of individual variation? We attempted to induce cerebral metastases in VX2 carcinoma carrying rabbits to look for an approach to these problems and to create an experimental model of cerebral metastase. The VX2 carcinoma is easily transplantable and its biological characteristics are well known. The VX2 tumor is implanted in the thigh of the rabbits and is used in the experimentation starting two weeks following the take of the graft; the tumor is surgically resected and a solution containing approximatively 50,000 tumor cells for 0,1 ml is prepared. This solution is inoculated via the carotid artery to the same rabbit or to another rabbit of the same breed either or intrathecal way into the brain. Death occurred 6 to 20 days later and was followed by a complete pathological survey. The results were the following: --The inoculation via the carotid artery, even with very highly concentrated solution was never followed by any recognizable brain metastasis. --The inoculation intrathecaly produced only extraparenchymatous metastases where as the direct intracerebral inoculation was followed by the occurence of intracerebral metastases.

Animals↗