Biomedical subjects
C Pheline
Publications and source records attributed to C Pheline.
[Man, environment and consciousness].
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[Introductive remarks on ICU team].
What makes a team efficient? Because the components which lead to its functioning as a whole have changed over recent years, the very concept of a team is to be analysed.
[Semiotic of awakening from coma].
One neurosurgeon and two semioticians compare their approaches on the awakening from deep coma. Successive stages of reorganization of possibilities of communication are analyzed. This new vision of coma seems pregnant of new issues.
[Suboccipital Pott's disease].
A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.
[One case of atypical craniopharyngioma located in sphenoïdal body and operated first by nasal then by maxillary sinus route (author's transl)].
This case of retro-pharyngeal craniopharyngioma was treated through an unusual combination of approaches first by naso septal then by the maxillary sinus route of Denker. This last exposure provided wide access and permitted a complete removal of this difficult tumor. It is usually meant for cancer of upper maxillary bone structures. In this indication, it is evidently followed by a very bad cosmetic result, but this did not happen with our patient.
Meningioma of the third ventricle.
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Sphenoidal chondroma. A comparison of the values of classical neuroradiology and computerized tomography.
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[Intrapetrous aneurysm of the carotis interna. 2. cases].
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[Intraventricular tumor and homolateral hemiplegia; Pathogenic considerations].
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[A different approach to the comatose patient].
To be comatose leads one to physical and psychological distresses which mean meeting an peak vital experience. The authors analyze how patient and family are concerned by the recovery of consciousness in Intensive Care Unit conditions. In order to get a quicker and better recovery, there is a need for interpersonal interaction. This type of approach in this specifical is analyzed.