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F Turjman

Publications and source records attributed to F Turjman.

At least 55 records · Page 3Linked to original sources
PubMed1995

Correlation of the angioarchitectural features of cerebral arteriovenous malformations with clinical presentation of hemorrhage.

Superselective angiography is the most accurate technique in the analysis of brain arteriovenous malformation (AVM) angioarchitecture. Therefore, we reviewed the selective and superselective angiograms of 100 consecutive patients with intracerebral AVMs. Our purpose was to determine which parameters of angioarchitecture were significantly correlated with a clinical presentation of hemorrhage. The vascular characteristics evaluated on the angiograms were the size of the AVM, the location of the AVM, the type of nidus, the type of feeders, the characteristics of venous drainage, and the number and location of aneurysms. The parameters found to correlate with hemorrhage were deep venous drainage (P = 0.01), feeding by perforators (P = 0.01), intranidal aneurysm(s) (P = 0.004), multiple aneurysms (P = 0.001), feeding by the vertebrobasilar system (P = 0.002), and location in the basal ganglia (P = 0.04). Six parameters of AVM angioarchitecture were correlated with a clinical presentation of hemorrhage. Among these parameters, three (feeding by perforators, number of aneurysms, and presence of intranidal aneurysms) were well displayed by superselective angiogram.

Adolescent↗
PubMed1995

Collagen microbeads: experimental evaluation of an embolic agent in the rete mirabile of the swine.

PURPOSE: To evaluate the histologic and angiographic effects of collagen microbeads as an embolic agent in the swine rete mirabile. METHODS: Human collagen particles (380 +/- 100 microns) of spheroidal shape and smooth surface were used to embolize the rete mirabile in five swine. Control angiograms and pathologic examinations were obtained immediately and sequentially from 3 to 35 days after embolization. RESULTS: The collagen particles were easy to inject through microcatheters. Embolization was always angiographically complete and persistent for at least 5 weeks. Histologic studies showed occlusion of 25% to 50% of the rete vessels. After 3 and 5 weeks' follow-up, transmural and adventitial chronic inflammation was present. Inflammatory infiltrates included lymphohistiocytic cells and scattered eosinophils. The foreign-body giant-cell reaction was pronounced. No evidence of angionecrosis or focal hemorrhage was shown. CONCLUSIONS: Collagen microbeads are a promising experimental embolic agent, with potential future applications in humans.

Animals↗
PubMed1995

Epilepsy associated with cerebral arteriovenous malformations: a multivariate analysis of angioarchitectural characteristics.

PURPOSE: To identify the morphological vascular characteristics of cerebral arteriovenous malformations (AVMs) that predict a clinical presentation of epilepsy. METHOD: Fifteen angioarchitectural characteristics of brain AVMs were selected for assessment in 100 consecutive patients referred to our institution for endovascular treatment. In this population, 47% of the AVMs were diagnosed as a consequence of epilepsy. The angioarchitectural characteristics and population demographics were statistically analyzed by means of multivariate analysis. RESULTS: The following six parameters were found to be the most predictive of epilepsy: cortical location of the AVM, feeding by the middle cerebral artery, cortical location of the feeder, absence of aneurysms, presence of varix/varices in the venous drainage, and association of varix and absence of intranidal aneurysms. Three factors were not among the most predictive factors of epilepsy but were significantly associated with the onset of seizures: AVM feeding by the external carotid artery, a temporal cortical location, and a parietal cortical location. CONCLUSION: Detailed analysis of the angioarchitecture of intracranial AVMs has helped us identify features that strongly correlate with epilepsy. This may aid in future understanding of the physiopathologic mechanisms in epilepsy associated with AVMs, and in identifying goals of treatment for epileptogenic AVMs.

Adolescent↗
PubMed1994

Striatocapsular infarction: MRI and MR angiography.

We present a case of left striatocapsular infarction manifest clinically as a transient right hemiparesis. MRI showed a left striatocapsular infarct. Striatocapsular infarction, unlike lacunar infarction, is often associated with occlusive disease of the carotid artery. In order to screen the carotid vessels, cervical MR angiography (MRA) was performed during the same examination, demonstrating a left internal carotid artery occlusion, confirmed by contrast arteriography. MRA, a noninvasive modality, can be a useful adjunct to MRI, when diagnostic information concerning the cervical carotid artery is needed.

Adult↗
PubMed1994

Tectal plate gliomas. Part I: Microsurgery of the tectal plate gliomas.

A series of 12 patients with tectal plate gliomas, is presented treated by direct surgery. Mean age was 19 years. All patients presented with signs of raised intracranial pressure and supratentorial hydrocephalus on CT scan. Diplopia was the most common local sign. CT scan and MR imaging showed 4 intrinsic, 6 exophytic, and 2 ventrally infiltrating tectal tumours. The histological diagnosis was low-grade astrocytoma in 7, high-grade astrocytoma in 2, oligodendroglioma in one, oligo-astrocytoma in one, and ependymoma in one case. The suboccipital supra- and transtentorial approach was used in every cases. Tumour resection was generous at the level of the superior colliculi, but on the contrary, resection was limited at the level of inferior colliculi due to the auditory risk. Tumour removal was total (macroscopically) in 9 cases and partial in 3 cases. There were 4 surgical complications and one death related to surgery. Parinaud's syndrome was the most-common postoperative sequelae. Auditory hallucinations and the acoustic neglect syndrome were seen once. In three cases additional radiotherapy and chemotherapy were given once with severe sequelae. The treatment of tectal plate gliomas is controversial. The role of different therapeutic options remains open. We consider the tectal plate as a relatively safer territory for surgery than the ventral part of the midbrain. The brain stem auditory evoked potentials (BAEPs) and middle latency potentials (MLPs) monitoring can help to determine the appropriate limit of surgery.

Adolescent↗
PubMed1994

Tectal plate gliomas. Part II: CT scans and MR imaging of tectal gliomas.

CT scans and MR images were analyzed in 12 patients with histologically proved tectal plate gliomas. In an attempt to identify the nature of these lesions, their radiological characteristics were correlated with the histological results. In four of our patients CT scan failed to show the tumour. MR imaging demonstrated the tectal distortion in all cases. Contrast enhancement, calcification, cystic portions, exophytic nature were observed in both high and low-grade gliomas. We conclude that in the case of intrinsic tectal tumours, the most probable diagnosis is that of low-grade astrocytoma while in the case of exophytic tectal tumours, the differential diagnosis from pineal region tumour is required and a histological verification is necessary.

Adolescent↗
PubMed1994

Tectal plate gliomas. Part III: Apparent lack of auditory consequences of unilateral inferior collicular lesion due to localized glioma surgery.

The authors present one of their cases operated on for intrinsic tectal plate glioma. The complete resection of the right inferior colliculus (I.C.) had no apparent auditory consequences. The pre- and post-operative tonal and vocal auditory tests were normal. The brain-stem auditory evoked potentials (BAEPs) and middle latency potentials (MLPs) were recorded pre-, post- and intraoperatively. At the end of surgery all waves were present with a marked delay of wave V and a slight delay of the Pa component. The dichotic test showed a significant right ear extinction but admittedly much less important than expected. The role of inferior colliculus (I.C.) in hearing is discussed.

Astrocytoma↗
PubMed1994

Auditory early- and middle-latency evoked potentials in patients with quadrigeminal plate tumors.

Both early auditory evoked potentials (BAEPs) and middle-latency auditory evoked potentials (MLAEPs), were recorded in nine patients suffering from a quadrigeminal plate tumor. These recordings were performed before surgery in six cases and after surgery in three cases. The results of these examinations were correlated with impairments of the midbrain auditory pathways as shown by magnetic resonance imaging. BAEPs and MLAEPs were abnormal in five of nine cases and eight of nine cases, respectively. The two examinations yielded normal results in only one case. These data show that the functional evaluation of the midbrain should not be limited to the recording of BAEPs, routinely performed for brain stem functional evaluation, but should also include recording of MLAEPs, although the technique is a little more delicate. In the five patients with abnormal BAEPs, I-V conduction time was increased unilaterally (three patients) and bilaterally (two patients), and the I/V amplitude ratio was abnormal in two patients. In one of these two patients, isolated destruction of the right inferior colliculus was responsible for an abnormality affecting Wave V of the BAEP that was visible only after left ear stimulation. The most frequently observed MLAEP abnormality was a delay in the peaking of the Pa component, assumed to be of cortical origin. Therefore, a limited impairment of the midbrain may delay the peaking latency of Pa. Unilateral hypovoltage of Na-Pa was also observed. In only one case were Na and Pa components unilaterally abolished, in a patient suffering from a postoperative lesion extending from the right inferior colliculus to the right medial geniculate body.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Aneurysms related to cerebral arteriovenous malformations: superselective angiographic assessment in 58 patients.

PURPOSE: To report the comprehensive superselective angiographic characteristics of aneurysms associated with cerebral arteriovenous malformations. METHOD: One hundred consecutive patients referred for cerebral arteriovenous malformation embolization underwent preembolization superselective angiography. Superselective angiograms were obtained after microcatheterization of arteriovenous malformation pedicles, and assessed for number and location of aneurysms related to the malformation. A chi 2 test was conducted to correlate these parameters with the onset of intracranial hemorrhage. RESULTS: Aneurysms were demonstrated in 58 of 100 patients. Single aneurysms were found in 24 patients and multiple aneurysms in 34. Presence and number of aneurysms were found to correlate significantly with a clinical presentation of hemorrhage. CONCLUSION: Superselective angiography was found to be of paramount importance in elucidating the precise and detailed angioarchitecture of brain arteriovenous malformations.

Adolescent↗
PubMed1994

Combined stent implantation and endosaccular coil placement for treatment of experimental wide-necked aneurysms: a feasibility study in swine.

PURPOSE: To assess the feasibility of combining stent implantation in the parent artery with endosaccular coil placement for the treatment of experimentally created wide-necked aneurysms. METHODS: Wide-necked aneurysms were surgically created on the common carotid artery in 12 swine. A metal stent was endovascularly implanted across each aneurysm neck and its effect documented anigiographically. If the aneurysm remained patent, a microcatheter was introduced into the aneurysm through the stent mesh. Electrically detachable coils were delivered into the aneurysm sac to produce thrombosis. RESULTS: After stent implantation, one carotid artery thrombosed and two aneurysms spontaneously occluded. In the other 9 cases, coils were deposited through the stent to occlude the aneurysm. Complete aneurysm packing was possible in all 9 cases. The presence of the stent allowed placement of small coils near the aneurysm neck, thus contributing to the safe occlusion of small remnants in the final stages of aneurysm packing. CONCLUSION: The combination of stent implantation and coil placement is feasible in the treatment of experimental wide-necked saccular aneurysms. The stent maintains patency of the parent artery while allowing aneurysm occlusion by endosaccular coil placement through the stent's mesh. Occlusion of small aneurysm remnants is possible with no fear of coil hernation or migration into the parent artery. Long-term studies will be necessary before application to treatment of selected intracranial aneurysms.

Aneurysm↗
PubMed1993

Treatment of experimental carotid aneurysms by endoprosthesis implantation: preliminary report.

Four experimental aneurysms were treated by implantation of an endoprosthetic stent. The aneurysms were surgically created by grafting a venous pouch on the carotid artery of mongrel dogs. Aneurysm patency was assessed angiographically. Under systemic heparinization and via a transfemoral approach, the stent measuring 20 mm in length and 5 mm in diameter, was implanted in the lumen of the parent artery at the level of the aneurysmal neck. Good angiographic results were obtained immediately following implantation, showing exclusion of the aneurysm from the circulation. Patency of the parent vessel was preserved in all the experimental aneurysms treated. In one case an angiogram performed 30 days later showed the same findings with excellent tolerance of the device. The technique of endovascular treatment of experimental aneurysms by stent implantation appears feasible and safe in vivo. Further investigations are still necessary before clinical applications.

Aneurysm↗
PubMed1992

Fenestration of the middle cerebral artery and aneurysm at the site of the fenestration.

The authors report the case of a patient who presented a ruptured aneurysm of the anterior communicating artery and an unruptured aneurysm of the middle cerebral artery arising at the site of a fenestration of the MCA. The fenestration was undiagnosed on the preoperative angiogram but discovered during the surgery carried out for clipping of the aneurysms. In the literature, cases of fenestration of the MCA are sporadically reported and are incidental findings; an aneurysm may be associated on an artery other than the fenestrated MCA; an aneurysm arising at the site of the MCA fenestration is a very rare occurrence.

Aneurysm, Ruptured↗
PubMed1992

Vertigo and upside down vision due to an infarct in the territory of the medial branch of the posterior inferior cerebellar artery caused by dissection of a vertebral artery.

A 48 year old woman developed an acute vestibular syndrome associated with upside down vision a few hours after minor cervical trauma. Magnetic resonance imaging showed an ischaemic lesion in the territory of the medial branch of the posterior inferior cerebellar artery. An arteriogram showed a dissection of the left extracranial vertebral artery.

Aortic Dissection↗
PubMed1992

Dural fistulae of the cavernous sinus treated by embolization. Ten cases.

We report ten cases of dural fistulae of the cavernous sinus treated by the endovascular route. The fistulae were fed by the internal and external carotid arteries. All patients presented with ophthalmic symptoms and/or headache and/or intracranial murmur. Embolization was decided on the ground of all in visual acuity, exophthalmos, ophthalmoplegia or sudden exacerbation of clinical symptoms. It was performed after selective catheterization of external carotid feeders with non-resorbable particles. The shunt was totally occluded in 7 cases, and local signs were improved in all patients: the intracranial murmur disappeared in 2 out of 4 cases and headache was relieved in 2 out of 3 cases. No permanent complication was observed. Among the various possible treatments of these dural fistulae, embolization of branches of the external carotid artery is a simple, effective and safe method, provided its principles and indications are respected.

Adult↗
PubMed1992

MRI in Sturge-Weber syndrome.

Five children (3 girls, 2 boys, aged from 1 to 18 years) presenting with Sturge-Weber syndrome were explored by MRI with contrast injection in 2 cases. The respective positions of CT and MRI are discussed: CT is the method of choice to display leptomeningeal calcifications. MRI seems to be more accurate than CT to determine the location of the lesions and to demonstrate the enhancement of the angioma after contrast injection.

Adolescent↗