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Biomedical subjects

C Manelfe

Publications and source records attributed to C Manelfe.

At least 19 recordsLinked to original sources
PubMed1992

Experimental focal cerebral ischaemia assessed with IVIM*-MRI in the acute phase at 0.5 tesla.

Intravoxel incoherent motion (IVIM*)-MRI has been performed on a clinical system at 0.5 tesla with a b gradient factor of 100 s/mm2, in a feline focal model of cerebral ischaemia. Images were obtained in 26 cats from less than 1 hour and up to 7-12 hours after stroke. The apparent diffusion coefficient (ADC) was decreased at the site of injury when compared to the contralateral normal side, by 30% in the first, 33% in 1-2 h and 27% in 2-4 h; it increased at 7-12 h, when vasogenic oedema occurred. IVIM*-MRI demonstrated early changes, due to cytotoxic oedema, during the acute phase of cerebral ischaemia to which conventional T2-weighted spin-echo imaging was not sensitive.

Animals↗
PubMed1992

[Neuro-imaging studies in migraine].

Neuroimaging studies in migraine patients are useful for three important reasons. 1) Brain imaging techniques and primarily CT-scan should be used in every patient with atypical or complicated migraine to rule out a vascular malformation or brain tumor; 2) angiography, which was extensively used in the 1960's and 1970's, discloses a number of arterial anomalies including spasm or occlusion, of unclear pathogenic significance; 3) T2-weighted magnetic resonance images in migraine often show increased signals generated by the white matter; this finding is as yet poorly understood but is undoubtedly related to factors very different from those seen in elderly patients or patients with vascular risk factors.

Adult↗
PubMed1992

[Dissection of the sylvian artery with resulting aneurysm in a 6 years old child].

BACKGROUND: Dissection of the walls of the cervical and cerebral arteries is rare in childhood. CASE REPORT: A 6 year-old girl suddenly suffered a loss of consciousness followed by a generalized tonic-clonic seizure 90 min after a non-traumatic fall. At admission, she had a massive right hemiplegia with aphasia. The CSF was not hemorrhagic. A CT-scan performed at H3 without infusion of radiopaque contrast material was normal, but a second CT-scan on day 4 showed a low density in the low area of the middle cerebral artery. An arteriogram taken on day 6 showed that the wall of the proximal part of this artery was irregular, with a discrete additive imaging. The child was treated with IV heparin for 3 weeks, then with aspirin. All investigations for the possible cause of thrombosis (protein C and S, antithrombin III, homocystinuria, etc...) were negative. Two further arteriograms, the last after a follow-up of 16 months, showed progressive disappearance of the wall irregularities and replacement of the additive imaging by a large aneurysm, suggesting a dissection. The hemiplegia persists under prolonged aspirin therapy. CONCLUSION: This case shows that dissection may occur in childhood without any apparent cause. It can result in the development of an aneurysm, a complication which is more frequent following dissection of the cervical rather the cerebral arteries.

Aortic Dissection↗
PubMed1992

Imaging of degenerative processes of the spine.

Because MR imaging provides accurate, clear, and noninvasive imaging for diseases of the spine and spinal cord, it has become the primary imaging modality in patients with spinal pathology. Degenerative processes of the spine are frequent, including disk degeneration and herniations, spondylosis, spinal canal stenoses, calcifications, and ossifications of the spinal ligaments. Several papers have been published recently on MR imaging in degenerative processes of the spine.

Humans↗
PubMed1991

[New imaging methods by nuclear magnetic resonance in multiple sclerosis].

Magnetic resonance imaging (MRI) has rapidly attained a major position among the examinations used in the diagnostic approach of multiple sclerosis because it is highly sensitive in demonstrating lesions. However, these lesional images may have several meanings, and there is the problem of distinguishing between oedema, which is said to reflect recent lesions, and gliosis which is thought to betray old lesions. The intrinsic MRI parameters studied (i.e. relaxation times) are unable to make this distinction, whereas it is provided by paramagnetic contrast media such as gadolinium. There is no correlation between the changes observed at MRI and the severity of the disease. Another problem is the accuracy of lesion localization, since visualization is predominantly macroscopic. This raises several questions about the demonstration of correlations between clinical signs and site of the lesion(s). At the moment, several teams of neuroradiologists are trying to find the most reliable method to determine the size of the lesion. The possible prognostic value of this size and its changes as time goes by are other parameters to be considered once the basic diagnosis has been made.

Brain↗
PubMed1991

Doppler ultrasound study of the anterior cerebral artery in neonates.

In neonates doppler ultrasound of the anterior cerebral artery (ACA) enables cerebral haemodynamics to be studied in a non-invasive manner at the patient's bedside. The signal of the pericallosal artery is recorded through the fontanelle with a 7.5 mHz real-time probe. Two parameters are monitored: Pourcelot's resistance index and mean velocity which reflects blood flow rate. Having established normal values according to the gestational and post-natal ages, the authors describe the changes in cerebral circulation observed in such pathological situations as intraventricular haemorrhage, apnoea, patent ductus arteriosus, hydrocephalus and post-asphyxia syndrome.

Apnea↗
PubMed1991

Imaging of the spine and spinal cord.

Recent technologic advances in MR imaging of the spine and spinal cord have been aimed at shortening examination time and suppressing artifacts. Gradient-recalled fast T2-weighted imaging is advocated for evaluating cervical radiculopathy. Better signal-to-noise ratios are achieved with three-dimensional Fourier transform gradient-recalled T2-weighted imaging and with decreased bandwidth acquisition. Obtaining high-contrast images of the spine is often complicated by the appearance of truncation artifacts. In outpatient radiculography, both iopamidol and iohexol appear safe, but iohexol seems better tolerated. In trauma, MR imaging is definitive, and signal abnormalities can help in evaluating neurologic recovery. Intraoperative spinal sonography may be helpful in evaluating acute injury. Enhancement with gadolinium diethylenetriamine penta-acetic acid is useful in the evaluation of disk space infections, osteomyelitis, and epidural abscess and in the study of spinal cord sarcoidosis. In patients with the acquired immunodeficiency syndrome, MR imaging may show hyperintense spine on T2-weighted images. MR imaging with gadolinium diethylenetriamine penta-acetic acid or gadolinium tetra-azacyclododecane tetra-acetic acid enhancement can be useful in evaluating intramedullary and intradural extramedullary tumors and for determining the extent of spinal leptomeningeal metastases. MR imaging can also be used to differentiate benign from pathologic fractures.

Humans↗
PubMed1991

[Severe neurologic course of galactosemia. Default of myelisation caused by deficient synthesis of UDP-galactose?].

We describe the unfavourable neurological outcome of a galactosemic patient who however received an appropriate diet from the neonatal period. The magnetic resonance imaging showed significantly abnormal myelinization of the brain. The biochemical hypotheses at the origin of this abnormal cerebral myelinization are discussed in our patient. The 1-14C incorporation in the TCA precipitable glycoproteins reached 21% of the average value observed in 6 controls; it ranged from 37% to 59% for galactosemic patients without neurological disturbances. These results, which have to be confirmed, suggest that some galactosemic patients have a very low UDP-galactose synthesis.

Galactosemias↗
PubMed1989

Epileptogenic cerebral vascular malformations and MRI.

The results of magnetic resonance imaging (MRI) performed in 67 patients with cerebral vascular malformations (35 arteriovenous malformations [AVM], 29 cryptic malformations, 11 venous angiomas and 2 associated lesions) were studied retrospectively after the patient population was divided into epileptics [25] and non-epileptics [42]. Several criteria were determined for each type of malformation in the two groups. They included patient's age, site of the malformation in relation to the cortex, size of the malformation, presence of a perilesional high-intensity signal on T2-weighted sequences and evidence of recent haemorrhage. Epileptogenic AVMs seemed to be more superficial and more often associated with a perilesional parenchymatous high-intensity signal on T2-weighted sequences than non-epileptogenic malformations. Epileptogenic cryptic malformations were closer to the cortex, larger, and specifically but rarely associated with changes in signal of the adjacent brain tissue on T2-weighted sequences. The few angiomas associated with epilepsy were, paradoxically, located in the cerebellum.

Adolescent↗
PubMed1987

[Cerebral localizations of non-Hodgkin's malignant lymphoma. Contribution of x-ray computed tomography].

At the present time, CT scan imaging occupies an essential place in the diagnostic approach and course of cerebral non-Hodgkin's malignant lymphoma. Results of CT scan investigations are reported in 17 patients, 8 with primary and 9 with secondary lymphoma. The lesions observed, hypo-, iso- or faintly hyper-dense, took-up contrast almost constantly in an intense and well limited homogeneous manner. The subependymal infiltration noted was suggestive of the disease particularly since it was often associated with a paraventricular localization in the white substance, corpus callosum or central gray nuclei. However, no correlation existed with the primary or secondary nature or histologic type of lymphoma, and histopathologic confirmation was necessary from surgical biopsy specimen. Appearances of primary and secondary lymphoma are superimposable, apart from certain cases with co-existing secondary lymphoma and bone lysis or a contiguous endocranial tumor. Follow-up CT scan imaging confirms clinical remission, or recurrence raising the problem of radionecrosis.

Adult↗
PubMed1987

[Dilatation of the vein of Galen. Anatomoclinical forms and endovascular treatment apropos of 14 cases explored and/or treated between 1983 and 1986].

The authors report 14 cases of vein of Galen dilatation explored and/or treated between 1983 and 1986. Three anatomic types have been individualized: the vein of Galen arterio-venous malformation (AVM) (7 cases); the cerebral AVM with vein of Galen ectasia (6 cases); the varix of the vein of Galen without AV shunt (1 case). When an AVM is present the shunt is located either in the venous wall (vein of Galen AVM) or in the brain parenchyma; in the latter the AVM drains into a tributary of the vein of Galen (cerebral AVM with vein of Galen ectasia). However in all the 14 cases downstream to the draining vein, a venous (dural) anomaly could be demonstrated. This anomaly suggests the secondary nature of the dilatation proximal to a developmental obstacle. Clinically the vein of Galen AVM reveals early in neonates by cardiac complications; the other types are usually seen later following hydrocephalic or bleeding episodes. As far as therapeutic aspect, we can technically stabilize the hemodynamic problem, by occluding most if not all the shunts by endovascular approach, and make most of the neonates survive. However the quality of survivance and the future neurological development is impossible to predict yet. Nevertheless the short term follow-up is very encouraging. The combined per operative embolization through the vein must be exclusively reserved to vein of Galen AVM. The torcular approach is contraindicated in brain AVM with Vein of Galen ectasia. The vein of Galen varix do not require any type of morphological correction.

Adolescent↗
PubMed1986

Angiographic architecture of intracranial vascular malformations and fistulas--pretherapeutic aspects.

The authors describe the angio-architecture of intracranial vascular malformations. Several patterns can be identified thanks to the intracranial superselective angiograms that can now be performed. Schematically, the following features can be seen: direct arterial supply, indirect arterial supply, flow-related arterial ectasia (aneurysm), dysplastic aneurysm, direct arteriovenous fistula, intralesional arterial ectasia (aneurysm), intralesional venous ectasia (aneurysm), venous ectasia. Each of these elementary arrangements are illustrated and their clinical significance outlined whenever possible. Finally, the dural AVM drainage into the cortical venous system serves as an almost experimental model for the appreciation of the role played by the venous congestive phenomenon in brain AVM symptoms.

Arteriovenous Fistula↗
PubMed1986

Endovascular treatment of cerebral arteriovenous malformations.

The authors report their experience with the endovascular approach of AVMs. Although the follow-up is short, the approach to the lesion and the morbidity related to the technique is low. 41 patients are reviewed. The most important feature of this series is that only 17 patients had previously bled. 27 had seizures and the remaining intractable headaches or progressive deficits. Only 4 patients were operated on following embolization. Clinical results are good, although few "anatomic" cures have been obtained by embolization alone (5 cases). However, the morbidity was moderately important (19%) per patient, 2/3 of which were totally regressive within a month. One death occurred during the procedure for a young male with a non-surgical posterior fossa brain AVM which had bled two times prior to the endovascular treatment. Topographic presentation of our results is the following: Pure cortical (13 cases), cortico-ventricular (17 cases), deep-seated (without vein of Galen) (2 patient), Posterior fossa (3 cases).

Embolization, Therapeutic↗