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Biomedical subjects

C Raftopoulos

Publications and source records attributed to C Raftopoulos.

At least 55 records · Page 3Linked to original sources
PubMed1992

Traumatic brain edema induced by ventricular puncture. A study by magnetic resonance imaging.

Magnetic resonance imaging demonstrates after ventricular catheterization a focal brain hypersignal corresponding to a parenchymal edema along the drain track. In the course of our daily clinical activity, this hypersignal extension seemed more pronounced when catheterizing the frontal area than the junctional parieto-temporo-occipital parenchyma (or trigonal area). In order to confirm this impression, we prospectively studied ten consecutive patients with normal pressure hydrocephalus in whom both of these brain regions were successively catheterized first by a frontal puncture for intracranial pressure monitoring and then by a trigonal one for a ventricular shunt. Each patient was evaluated by serial magnetic resonance imaging. The extension of the hypersignal induced by both catheterizations was estimated on a scale of five grades (0 to 4) of hypersignal extension. A statistically significant more important hypersignal extension was demonstrated at the level of frontal area when compared to the trigonal one. We discuss the likely underlying mechanisms of this phenomenon.

Adolescent↗
PubMed1992

Morphological quantitative analysis of intracranial pressure waves in normal pressure hydrocephalus.

This work presents a prospective morphological and quantitative analysis of 43 intracranial pressure recordings performed on normal pressure hydrocephalic patients. This analysis led us to separate Lundberg's B waves into different subtypes and to refine the definition of the 'Plateau' wave. Two B wave subtypes named Great Symmetrical wave and Intermediate wave appeared correlated with the surgical improvement. In addition, the degree of post-operative improvement was correlated with the frequency of Intermediate wave. An extended quantitative classification of intracranial pressure waves is proposed that can be used alone to determine which patients should undergo a shunting procedure and which one should the most improve.

Aged↗
PubMed1992

Endoscopic cure of a giant sacral meningocele associated with Marfan's syndrome: case report.

An unusual anterior sacral meningocele associated with Marfan's syndrome, with demonstrated dural anomalies related to Marfan's syndrome is reported. Endoscopy enabled complete exploration of the meningocele, its morphological description, and ultimate cure. The meningocele resembled an hourglass made up of intrasacral and anterior sacral components. The communication of this bilobed malformation with the dural sac was so small that only the intrathecal injection of a colored solution allowed its localization. The closure of this communication was accomplished under endoscopic view by a single stitch. The postoperative course of the patient was characterized by immediate disappearance of the preoperative clinical signs. Computed tomographic scans demonstrated progressive complete collapse of the anterior sacral meningocele and partial resolution of the intrasacral component. Dural anomalies of Marfan's syndrome are described, and their relationship to the formation of the meningocele is discussed.

Adult↗
PubMed1992

Variations of homovanillic acid levels in ventricular cerebrospinal fluid.

We studied the nycterohemeral variations of homovanillic acid (HVA) in ventricular cerebrospinal fluid (CSF) in 24 patients undergoing monitoring of intracranial pressure as part of the normotensive hydrocephalus (NTH) work-up. CSF samples were obtained every 4 h in each patient. The mean individual values of HVA in the ventricular CSF ranged from 133 to 421 ng/ml, and they could not be correlated to any clinical feature. The intraindividual levels of HVA were stable throughout 24 hours, with a variation coefficient inferior to 10% in 63% of cases, and inferior to 20% in all the patients.

Aged↗
PubMed1992

[Study of the turnover or the release of brain dopamine in rats after administration of N-linoleyl dopamine].

Wistar male rats received N-linoleyl dopamine (L-DA) at doses of 10, 50 or 100 mg/kg (i.p.). 2 h after these injections they were decapitated and dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), as well as the ratio DOPAC/DA, which could represent the DA turnover, were determined in the striatum, the frontal cortex or the hypothalamus, while homovanillic acid (HVA) as well as the ratio HVA/DA, which could represent the DA release, were determined in the striatum by high performance liquid chromatography (HPLC). Except a small rise of DA and DOPAC in the hypothalamus, at high L-DA doses, no significant modifications in DA, DOPAC, DOPAC/DA, HVA or HVA/DA were observed in the other brain areas studied. These results, in good agreement with the recent data obtained with other dopaminergic agonists, could show the absence of correlation between the hypomotility, on the one hand and the decreasing of the turnover or the release of the brain DA, on the other hand. Together with the data obtained recently by scandinavian and italian authors, they could raise questions about the position and the role of dopaminergic autoreceptors.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1991

Invading meningiomas of sphenoid wing. What must we know before surgery?

Sphenoid wing meningiomas are very invasive tumours. The only permanent treatment is total eradication. But quality of life should also be taken into account. Several surgical approaches have been proposed with more and more aggressivity. We have raised a list of 9 questions which is not exhaustive. We recommend solving them before surgery and to be sure to have an answer before a surgical decision is made. This would be of great benefit for more efficacious results with less sequelae.

Humans↗
PubMed1991

Three-quarter prone approach to the pineal-tentorial region. Report of seven cases.

We report our preliminary results (seven cases) with a three-quarter prone approach to the pineal-tentorial region using an opening beneath the midline. The technique we have used eliminates the risk of air embolism because the head is just over the right atrium, the table remaining in an horizontal plane. Using the natural effect of gravity, it is no more necessary to use retraction on the occipital lobe. So, hemianopsia is eliminated. We confirm the results of other teams who have used this approach which seems to us to be the best way to treat any lesion in the pineal-tentorial area.

Adult↗
PubMed1991

[Dopamine amides with essential or fundamental fatty acids. Synthesis and pharmacological study].

Dopamine amides with palmitic, stearic and linoleic acid, their diacetates and carbonates were synthesized and their action on mice and rats was studied. The experimental results which are obtained from these derivatives (antagonized or non antagonized hypomotility by neuroleptics in low doses on mice, potentiation of the haloperidol catalepsy or not, on rats) could be compatible with a selective action of these amides on the autoreceptors of the cerebral dopaminergic neurons and with a preferential activity of some derivatives on certain cerebral areas (mesencephalon or striatum).

Animals↗
PubMed1991

[Lesions of the pineal and tentorial region. Occipito-parietal approach in three-quarter prone position with infrasagittal craniotomy].

Surgical treatment of pineal-tentorial region lesions remains a challenge. The difficulty in approaching the pineal region can be verified with the number of operative plans that have been proposed to reach this area: transcallosal, occipital transtentorial, infratentorial supracerebellar approaches and sitting, prone or Concorde positions. This emphasizes the surgeon's dissatisfaction with the surgical techniques described. Recently, a three-quarter prone position with the bone flap placed under the midline has been described (1, 3, 8). We have decided to test this approach that we have slightly modified and we report our results on 13 cases: 2 arachnoid cysts, 3 vascular malformations and 8 tumors (3 brainstem gliomas, 2 dysgerminomas, 1 quadrigeminal plate metastasis and 1 meningioma plus 1 metastasis of the falx). Keeping the table in a horizontal plane, risks of air embolus are eliminated. Using the natural effect of gravity, traction on the occipital lobe is no more necessary and hemianopsia no more occurs. We recommand the parieto-occipital route which is the shortest way to reach epiphysis and falco-tentorial notch. We confirm the results of american colleagues (1, 3, 8, 15) and we advise to use this approach which seems to us the best way to treat pineal-tentorial lesions.

Adult↗
PubMed1991

A survey of 65 tumors within the spinal cord: surgical results and the importance of preoperative magnetic resonance imaging.

Between January 1984 and December 1990, 65 intramedullary spinal cord tumors were diagnosed and operated on. In this series, all patients underwent magnetic resonance imaging investigations and were operated on with the Cavitron ultrasonic surgical aspirator whenever necessary. Major surgical difficulties have been found in patients previously treated by radiotherapy with or without biopsy. We found magnetic resonance imaging to be a highly sensitive imaging procedure and the method of choice for visualizing tumors within the spinal cord. Nevertheless, accurate diagnosis may only be suggested by magnetic resonance imaging, rather than made definitively. Surgery is necessary in every case in order to obtain a definite diagnosis. Radical surgery can be performed when a plane exists between the tumor and the normal spinal cord: biopsy or debulking with the Cavitron ultrasonic surgical aspirator should be performed when the tumor is infiltrative. We have performed 33 so-called total resections, 22 partial resections, and 10 biopsies, among which 5 were performed on lipomas. Surgical results were assessed at 3 months after surgery, showing 35 improvements (53%), 24 stabilizations (37%), and 6 deteriorations (10%).

Adolescent↗
PubMed1990

Paraganglioma of the cauda equina. Report of 2 cases and review of 59 cases from the literature.

Paragangliomas of the cauda equina are not so rare as said in the literature. Two additional cases are presented with a global analysis of the 59 cases from the literature. The diagnosis of this pathology greatly benefit of the use of immunostainings as the cells are often neuron-specific enolase, neurofilament protein and somatostatin positive so that electron microscopy is thus no longer mandatory for establishing the diagnosis. In addition, we report the first magnetic resonance images of this tumor at this location.

Adult↗
PubMed1989

Vertebrobasilar insufficiency revealed by xenon-133 inhalation SPECT.

A study of cerebral and cerebellar blood flow reactivity to acetazolamide by xenon-133-inhalation single photon emission computed tomography (133Xe SPECT) was carried out in a patient with bouts of transient basilar ischemia, whose neurological examination, computed tomographic scan, and auditory evoked potentials were normal. Though the patient was symptom-free at the time of the study, 133Xe SPECT demonstrated vertebrobasilar insufficiency by showing an impaired vasodilatory response in both the occipital lobes and the right cerebellar hemisphere. Three weeks later, the patient suffered an extensive stroke in these same areas. We therefore suggest that this method could be of great value in the assessment of vertebrobasilar insufficiency.

Acetazolamide↗
PubMed1988

The traumatic aspect of ventricular catheterization demonstrated by magnetic resonance imaging.

Five patients who underwent ventricular catheterization for increased intracranial pressure, were studied shortly after operation by two different radiological modalities: Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). MRI showed an important brain edema surrounding the site of ventricular catheterization especially in the frontal area, whereas CT did not demonstrate any anomaly or only a very slight one. This report outlines the traumatic aspect of ventricular puncture and the need for a proper setting at the first essay.

Brain Diseases↗