Biomedical subjects
Publications and source records attributed to Christophe Morel.
We report a case of a purely epidural capillary hemangioma of the thoracic spine with foraminal extension. Epidural hemangiomas are rare; only a few cases of dumbbell-shaped ones have been reported, and all were cavernous. MR imaging showed characteristic findings of a capillary hemangioma, which are also consistent with other epidural lesions such as neuromas or meningiomas.
PURPOSE: To analyze the features of retinal detachment (RD) occurring after cataract surgery performed by Kelman phacoemulsification (KPE) and to identify any potential correlations between KPE intraoperative complications and the features of RD (incidence apart) as well as the final visual outcome. DESIGN: Interventional consecutive case series. METHODS: Retrospective review of 114 eyes of 114 consecutive patients with RD occurring after KPE and followed for 6 months or more after surgery. RESULTS: Removal of posteriorly dislocated lens fragments during KPE by pars plana vitrectomy (PPV) was associated with a significantly shorter time interval between KPE and RD (3.89 vs. 15.7 months, P =.0044). Once RD occurred, no other statistically significant correlation between its features or the final visual outcome and KPE intraoperative complications (posterior capsular rupture, vitreous loss, posteriorly dislocated lens fragments) was detected. The overall anatomic reattachment rate was 94%. Only redetachment associated with the development of proliferative vitreoretinopathy (PVR) was significantly correlated with ultimate anatomic failure (P =.0036). A best-corrected visual acuity of 20/60 or better was achieved in 58 out of 114 eyes (51%). Three variables were independently correlated with visual results: more extensive RD (P =.0001), redetachment associated with the development of PVR (P =.0029), and failure to identify retinal breaks (P =.0114). CONCLUSIONS: Posterior capsular rupture and vitreous loss during KPE do not seem to affect the features (incidence apart) or the final visual outcome of RD occurring afterwards, except for a shorter time interval between KPE and RD in eyes that underwent PPV to remove posteriorly dislocated lens fragments.
The management of intracranial aneurysms has truly evolved after the introduction of the endovascular treatment. In this paper we compare patients that were operated or embolized for intracranial aneurysms. Between 1995 and 1999, 78 grade I to III ruptured aneurysms were treated in our service: 52 patients were operated, 21 were embolized and 5 were submitted to combinated endovascular and surgical treatment. In the surgical group, clinical outcome was very good in 80.8% of cases with 5% of mortality with 96.2% of total exclusion of the aneurysm. In the endovascular group, 95% of cases the clinical outcome was very good with only 42.8% of total exclusion of the aneurysm. By the endovascular method for treatment of aneurysms, we can obtain a good clinical outcome but a poor radiological outcome and sometimes need a complementary surgical procedure to treat residual aneurysm.