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Biomedical subjects

C Marsault

Publications and source records attributed to C Marsault.

At least 109 records · Page 6Linked to original sources

Gadolinium-DTPA enhanced MR imaging in tuberous sclerosis.

Ten patients with clinical tuberous sclerosis were examined with CT and MR imaging, before and after IV contrast in order to determine the role of Gd-DTPA. Gd-DTPA enhancement occurred in eleven subependymal nodules which did not enhance on CT after IV contrast. As illustrated by previous CT and pathologic observations and related to the histologic similarity of the subependymal nodules and giant-cell astrocytomas, these hyperintense nodules could represent active lesions with the potential to evolve. Four giant-cell astrocytomas were detected both with CT and Gd-DTPA-enhanced MRI; tumor conspicuity and size assessment were improved by postcontrast MRI in two cases. No cortical tuber or heterotopic cluster enhanced; T2-weighted sequences therefore remain necessary for their detection. If pre and post-Gd-DTPA T1- and T2-weighted imaging is negative, CT is clearly the most sensitive modality in the detection of the small calcified subependymal nodules.

Adolescent↗

[The new imaging technics: theoretical principles, limitations and some ideas on costs].

The new imaging techniques modify the diagnostic, or even sometimes therapeutic, decision lines. Their efficiency is much greater than that of the old techniques, while pretium doloris and side-effects are considerably reduced. Such advances are not without a major disadvantage: the ever increasing cost of imaging explorations. Radiological guidance (with conventional radiology, ultrasounds and computerized tomography) facilitates percutaneous procedures for diagnostic (biopsy) or therapeutic purposes (emptying of abscesses, chemonucleolysis of herniated lumbar disc, etc.).

Angiography↗

Magnetic resonance imaging in the exploration of dissection of the internal carotid artery.

Five patients with recent spontaneous or post-traumatic dissection of the internal carotid artery (ICA) were explored by magnetic resonance imaging (MRI), using T1-weighted axial sections in all cases. In four patients examined during the subacute phase (after 7 days) the diagnosis of ICA dissection was strongly suspected on the association of a very high intensity signal produced by the parietal haematoma with a contiguous signal void area corresponding to the lumen of the ICA. A control MRI examination performed in two patients 2 months after the onset of dissection showed that it had regressed and that the carotid arteries were patent, which was confirmed by angiography. In the fifth patient MRI provided evidence for the evolution of a post-traumatic dissection towards thrombosis. The MRI image of carotid dissection at the subacute phase seems to be characteristic. MRI is also useful to follow up dissections under treatment and to postpone angiography. The latter, however, remains necessary to investigate for associated arterial dysplasia and to evaluate the sequelae of dissection.

Adult↗

MRI evaluation of tuberous sclerosis.

The authors present four cases of tuberous sclerosis examined with MRI. The patho-anatomic aspects are reviewed and analysed with respect to MRI data. MRI appears superior to the CT particularly for imaging of cortical tubers, cystic lesions, and heterotopic clusters; these last two features were never described with MRI before. Here is also presented the second progressive case of giant intracranial aneurysm associated with tuberous sclerosis.

Adult↗

Diffuse subependymal periventricular metastases. Report of three cases.

Three clinicopathologic cases with a remarkable pattern of extensive diffuse subependymal periventricular spread of cerebral metastases from solid systemic cancer are reported. Two patients had a small cell carcinoma of the lung. In the third case, the histologic features of the brain metastases were consistent with a neuron-specific enolase-positive, small cell anaplastic carcinoma. Involvement of the choroid plexus and leptomeninges was moderate or absent. Intraparenchymatous nodular metastases were not found except in one case in which rare nodular superficial cortical metastases were present. The clinical data were nonspecific except for orthostatic hypotension, in one patient, which was probably due to the infiltration of the floor of the third and fourth ventricles. Results of the cerebrospinal fluid examination, available in two cases, were normal. The only diagnostic investigation was contrast-enhanced computed tomography scanning.

Carcinoma↗

[Non-traumatic vertebro-epidural radiculo-spinal cord compressions: value of x-ray computed tomography coupled with myelography for lesion evaluation and therapeutic indications].

About 37 cases of non-traumatic spinal cord and cauda-equina compression, the authors emphasize the value of CT-scan study after intra-thecal injection of water-soluble contrast-medium. This exploration gives accurate informations about the involvement of both spinal and para-spinal spaces. These data are helpful diagnosis purpose and for the choice of therapeutic especially when surgical procedure is decided.

Adult↗

Adult form of Leigh's disease: a clinico pathological case with CT scan examination.

The clinical and pathological findings of a 31-year-old woman, in whom the diagnosis of Leigh's disease was made, are reported. CT scan examination with contrast enhancement showed symmetrical areas of low density, in both thalami, anterior limbs of internal capsules and corpus callosum. Longstanding chronic lesions involved the optic chiasma and the cerebral peduncles and consisted of myelin loss, status spongiosus, astrocytic gliosis and marked capillary proliferation. The neurons were spared. In the basal ganglia, internal capsules and corpus callosum, these lesions were more recent and consisted of focal necrosis, perivascular oedema and few lymphocytic perivascular cuffings.

Adult↗

Cytomegalovirus encephalitis occurring after bone marrow transplantation.

4 months after a bone marrow transplantation performed for acute lymphocytic leukaemia, a 28-year-old man had encephalitis. A brain CT scan revealed bilateral and symmetrical temporal hypodense areas. Serological studies revealed a recent CMV conversion in serum and a higher conversion in cerebral spinal fluid. All other viral antibodies remained at low levels, especially for herpes simplex virus. Because of a high incidence of CMV infection after bone marrow transplantation, the responsibility of CMV as the cause of the encephalitis is discussed.

Adult↗

[Dysautonomia and behavioural disorders from periventricular metastasis (author's transl)].

In a patient presenting dysautonomia a severe orthostatic hypotension revealed the presence of a subependymal metastatic infiltration from a large cell anaplastic bronchial carcinoma. Clinical pharmacological studies were conducted. A paradoxical sinus bradycardia during orthostatism, and an absence of bradycardia after clonidine injection, were suggestive of a central origin of the dysautonomia. At post-mortem, metastatic infiltration involved the walls of the lateral ventricles, and the floor of the IIIrd and IVth ventricles, from where it invaded structures responsible for cardiovascular control. Correlations could be established between the results of the clinical pharmacological tests and the pathological findings. Also present were a) anterograde amnesia dating from the onset of the orthostatic hypotension, probably due to compression of the anterior pillars of the trigone by tumour invasion of the septum; b) behavioural disorders with absence of spontaneous movement and speech, indifference and docility, probably arising from destruction of the septum.

Autonomic Nervous System Diseases↗