PubMed Health⌕ Search

Biomedical subjects

E Clavier

Publications and source records attributed to E Clavier.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Multiple cerebral aneurysms disclosed by subarachnoid hemorrhage. Apropos of 60 cases].

In a series of 60 consecutive patients, 137 multiple aneurysms (An) were discovered after subarachnoid hemorrhage. Multiple An were mostly double (83 % of the patients). The incidence of middle cerebral artery An was 42 %, internal carotid artery An 25.5 %, anterior communicating artery An 15 %. Both angiography (A degree) and CT scan could identify the ruptured An in 56 cases or at least the side of the ruptured An in the remaining 4 cases. Among the routine A degree criteria used to determine which one of the An had bled the most reliable ones appears to be: the existence of vasospasm of the parent artery, the bigger size of the sac, the irregular wall of the sac. The incidence of rupture is the highest in anterior communicating artery An (16/21). When an An located on the polygon of Willis is associated to a distal An, the former ruptures in 17 cases/18. All ruptured An were treated during the first operative session. In 47 patients (78.3%) all the An, ruptured and asymptomatic, were treated during the first procedure or in one or two additional surgical sessions. In 13 patients (22.7%) for several reasons only ruptured An and asymptomatic An that could be reached via the same craniotomy were treated. There was no morbidity or mortality related to the surgical treatment of asymptomatic An.

Aneurysm, Ruptured↗
PubMed1992

[Horton's disease with involvement of the arterial trunks of the arms. Pathogenic role of anticardiolipin antibodies? Report of two cases].

Diffuse arterial involvement in temporal arteritis is well known but the intimate mechanisms of vasculopathy is unknown. Recently the presence of anticardiolipin antibodies (aCL) has been recognized in giant cell arteritis. We report two cases of temporal arteritis with diffuse arterial involvement associated with aCL (axillary arteries in the two cases associated with femoral arteries in one). During corticosteroid and anticoagulant therapy, a rapid improvement was noted with regression of upper-limb ischemia. One month later, the aCL were absent. These cases confirm the presence of aCL in giant cell arteritis with diffuse arterial involvement. These antibodies might imply severe vascular damage and could play a role in pathogenesis of the vasculopathy of temporal arteritis. Their presence suggests the necessity of anticoagulant therapy at the beginning of corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1991

[Percutaneous retrieval of catheters migrated in the circulatory system].

The migration of catheter in the central venous system is a rare but serious iatrogenic complication. At short term this life threatening complication induces arythmias and then infectious, thrombotic and mechanical complications. Simple interventional procedures, rapidly achieved can prevent these complications.

Adult↗
PubMed1990

[Feasibility study of the Doppler exploration of the renal artery].

Using arteriography as a reference, the authors investigate the feasibility of pulsed doppler exploration of the normal or pathological renal arteries in 46 successive patients. The poor sensitivity of pulsed doppler, mainly due to the considerable anatomical variations of the renal pedicle, does not currently allow using this technique for the detection of renal arterial stenosis. When combined with angiography, pulsed doppler becomes a definite asset in therapeutic radiology to help in the choice of a treatment and in follow-up.

Adult↗
PubMed1990

[The value of a computer tomography scanner and controlled arteriography in the study of the results of aneurysm surgery. A series of 100 consecutive cases].

A total of 100 consecutive patients, (93 with ruptured aneurysms, 7 with asymptomatic aneurysms) were managed following a radio clinical investigation protocol. Preoperative evaluation included clinical grading (Hunt and Hess) (20 patients were GR I, 43 GR II, 19 GR III, 9 GR IV and 9 GR V) angiography and CTScan grading. The timing of surgery was determined according to angiographic, clinical and CTScan data: 73.2% of ruptured aneurysms were operated on between Day 0 and Day 3. Control angiography and control CT were performed 10-12 days after surgery (earlier in case of clinical deterioration). Post operative CTScan hypodensities were evaluated according to preoperative CT, preoperative angiography and post operative angiography: 32 hypodensities (8 without any symptom) were related to initial hemorrhage, vasospasm or post surgical thrombosis. In five cases the etiology was dobble. Angiographic control data showed 18 cases of vasospasm and 12 cases of post surgical thrombosis. We did not find any complication due to the control angiography. The outcome was classified according to the Glasgow Outcome Score (GOS): of 82 GR I.II.III (H & H) cases, the outcome was 73 GOS 1-2 cases, 3 GOS 3 Cases, 1 GOS 4 case and 5 GOS 5 cases. of 18 GR IV.V (H & H) cases, the outcome was 4 GOS 1-2 cases, 1 GOS 3 case, 1 GOS 4 case and 12 GOS 5 cases. In 28 GOS 2-3-4-5 cases, the cause of disability or death was under the main responsibility of the initial hemorrhage 13 times, of a thrombosis 11 times, of the vasospasm 4 times with associated non neurological problems in seven cases. When the control angiography is not performed and when the thrombosis is unrecognized sequellae or death can be erroneously attributed in many cases to the sole vasospasm or to the initial hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Pituitary adenoma treated with a somatostatin analog].

We studied for over 7 months the use of SMS 201-995, in 1 woman with pituitary adenoma. Eight years after surgical and irradiation therapy, adenoma relapsed with hyperthyroidism (T4 L = 71pmol/l, TSH = 5.3 mU/l, subunit: 309 micrograms/l) and was complicated by meningitis. It was invasive and removed only partly. SMS therapy, 100 micrograms SC q 8 h, allowed partial reduction of clinical hyperthyroidism and decreased TSH and alpha subunit of 47%. Increased dosage and changing route of administration did not increase efficacy. A modest decrease of adenoma was probably caused by several reasons. In summary in an adenoma unusual by the extremely high value of alpha subunit in contrast with modest value of TSH, SMS therapy allowed partial control only.

Adenoma↗
PubMed1988

Intracranial aneurysmal bone cyst: a rare CT appearance.

Aneurysmal bone cyst occurring within the calvarium is uncommon. We report a case presenting as an intracranial space-occupying lesion. Fluid levels within a lesion on CT is very suggestive but inconstant. The theory of a pre-existing lesion is noted.

Bone Cysts↗
PubMed1988

Antidepressant side effects in the medically ill: the value of psychiatric consultation.

In this study we evaluated the side effects of antidepressant use in medically ill patients. The authors evaluated fifty-one general hospital inpatients who were later prescribed antidepressant medications by their primary care physicians. These patients' medical records were reviewed one year later for evidence of serious complications. The overall complication rate was 43 percent. When the psychiatrist recommended antidepressant therapy, there was a 30 percent incidence of major complications. When the psychiatrist did not recommend antidepressants, but the patient was treated anyway, the incidence of treatment-limiting side effects was 67 percent. These results suggest that psychiatrists can predict which medically ill patients are at risk for complications. Since most antidepressants are prescribed by non-psychiatrists, an important role for consultants is to identify those patients at high risk for significant complications.

Adult↗
PubMed1988

[Optochiasmatic tuberculoma and MRI. 2 cases].

Two cases are reported of optochiasmatic tuberculoma, an exceptional complication difficult to diagnose in the absence of any tuberculous context. Although diagnosis of the optochiasmatic occupying process is simple by scan or NMR imaging, it is generally difficult to identify the chiasma in a process of this type. It is therefore impossible to recognize the two forms of these tuberculomas: intra- and peri-chiasmatic histologic types, and yet these have an incidence on therapy and prognosis. Surgical exploration is justified when the diagnosis remains in doubt or when the functional prognosis is implicated.

Adult↗
PubMed1987

[Intracranial hematoma in ruptured aneurysms. Apropos of 57 cases].

In 200 consecutive cases of ruptured aneurysms volume of resulting hematomas exceeded 5 ml in 57 patients (28.5%) and 50 ml in 25 patients (12.5%). We have studied the radio anatomical and clinical datas of these 57 cases: In most of them (90%) the aneurysm situation appears to determine hematomas characteristic features. Fatal issues are related to hematoma volume when above 50 ml and to vasospasm in other cases. Results in the 48 operated cases lead to advise neurosurgeons against surgical procedure when volume is greater than 60 ml in grade V patients (unless operation could take place immediately after rupture onset), and when severe intra ventricular hemorrhage is present. Death in ruptured aneurysms is a consequence of hematomas volume in at least 10% cases. Hematomas or vasospasm are responsible for sequellae or fatal issues which still occurs in 15-20% of overall population of patients with ruptured aneurysms, despite improvement in management and timing. Cases finding and preventive surgery of non incidental aneurysms should be a matter of concern.

Adolescent↗