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Biomedical subjects

G Besson

Publications and source records attributed to G Besson.

At least 19 recordsLinked to original sources
PubMed1992

[Contribution of ultrasonic cavitation--CO2 laser combination in the excision of panmedullary ependymoma].

The authors report an uncommon case of panmedullary ependymoma (C2 to T12), totally removed in one stage with the use of ultrasonic cavitation and CO2 laser. The preoperative topographical diagnosis without M.R.I. was very difficult. CO2 laser in addition with ultrasonic cavitation allows the removal of the tumor without any prohibitive tractions on the spinal cord. The stable course with a long follow-up period (seven years) confirms the good prognosis of such a pathology.

Adult↗
PubMed1991

[Late neurological complications of heart transplantation].

To assess anomalies in these subjects, an ambulatory neurological examination was performed in 12 heart transplant patients and in 1 heart-lung transplant patient. The patients were examined between the 3rd and 51st month following the transplantation. Two had symptoms due to a previous neurological disease. Early postoperative complications were found in 6 patients (seizures in 3 cases, cerebral infarcts in 1 case, anoxia in 1 case and right ulnar nerve damage at the elbow in 1 case). Late postoperative complications included postural tremor (9 cases) or mild polyneuropathy (2 cases). Neurological examination was completely normal in 2 patients. The findings show that the most common late neurological abnormality found in heart transplant patients is postural tremor.

Adult↗
PubMed1991

Acute pseudobulbar or suprabulbar palsy.

We studied 13 patients with supranuclear lower cranial nerve ("pseudobulbar" or "suprabulbar") palsy of acute onset. While seven patients had had a prior stroke, six patients had no history of stroke. Eight patients experienced a complete bilateral supranuclear lower cranial nerve palsy, which was isolated in five patients and associated with hemiplegia and with hemiparesis in three patients. Pseudobulbar palsy was partial in five patients. Only one patient had neuropsychologic impairment. The pseudobulbar features improved or recovered within a few weeks in all patients. The common characteristic of the lesions on computed tomography or magnetic resonance imaging was the interruption of the corticonuclear pathways contrasting with marked sparing of the corticospinal pathways in both hemispheres. These lesions were either an opercular infarct, or a deep infarct in the corona radiata or internal capsule, or a lenticular hemorrhage. Hypertension was the most prevalent concomitant. Our findings suggest that acute pseudobulbar or suprabulbar palsy has rather stereotyped anatomic-vascular correlates and time course.

Acute Disease↗
PubMed1991

[Homonymous lateral hemianopsia as a presenting sign of intracranial extracerebral cavernous hemangioma].

A case of intracranial extracerebral cavernous hemangioma of the middle fossa in a woman who suffered from a multiple sclerosis, is reported. Appearance of a lateral hemianopia suggested an other disease than multiple sclerosis to explain this symptom. Intracranial extracerebral cavernous hemangioma is a rare tumor reported more often in the middle fossa than in other sites. It usually produces symptoms by compression of nearby structure. Diagnosis is based on neuroradiological examination and we describe the MRI aspect. It is difficult to remove because of massive hemorrhage.

Adult↗
PubMed1991

Medical treatment of acute ischemic stroke.

Progress in general symptomatic therapy such as avoidance of complications through nursing care, rehabilitation, and secondary prevention of stroke yield a better quality of life to stroke patients. Unfortunately, no specific drug therapy for acute stroke has been proven to be of benefit in controlled trials. However, new drugs and drug therapies such as thrombolytic therapy, 5-hydroxytryptamine agonists, NMDA receptor antagonists, and free radical scavengers are being studied.

Acute Disease↗
PubMed1990

[Vascular accidents of the brain stem].

Cerebrovascular accidents (CVA's) of the brain stem have the same causes and physiopathological mechanisms as CVA's of the hemispheres, but they are ten times less frequent. They correspond to ischaemic or haemorrhagic lesions in the territories of the vertebral arteries and the basilar artery, including their collateral, circumferential and perforating branches. Clinically, CVA's of the brain stem are characterized by the association of unilateral motor and/or somatosensory symptoms on the side opposite the lesion, and by involvement of the ipsilateral cranial nerves, which helps in evaluating the level of the CVA. Motor or somatosensory symptoms may be bilateral or on alternate sides. The complexity of these CVA's reflects the rich anatomical organization of the brain stem. Their severity in case of extensive lesions is due to the fact that they affect structures that are vital to consciousness and cardiorespiratory regulation. Patients with CVA's of the brain stem must be hospitalized in neurology departments.

Brain Stem↗
PubMed1990

Effects of passive tactile and auditory stimuli on left visual neglect.

Patients with left-sided visual neglect fail to copy the left part of drawings or the drawings on the left side of a sheet of paper. Our aim was to study the variations in copying drawings induced by passive stimulation in patients with left-sided visual neglect. No stimulation at all, tactile unilateral and bilateral, binaural auditory verbal, and nonverbal stimuli were randomly applied to 14 patients with right-hemisphere strokes. Only nonverbal stimuli decreased the neglect. As nonverbal stimuli mainly activate the right hemisphere, the decrease in neglect suggests right-hemispheric hypoactivity at rest in these patients. The absence of modification of neglect during verbal stimulation suggests a bilateral hemispheric activation and the persistence of interhemispheric imbalance. Our results showed that auditory pathways take part in the network involved with neglect. Passive nonverbal auditory stimuli may be of interest in the rehabilitation of patients with left visual neglect.

Acoustic Stimulation↗
PubMed1990

Prospective study of lacunar infarction using magnetic resonance imaging.

Using computed tomography and magnetic resonance imaging, we prospectively studied 100 patients hospitalized with a lacunar infarct. Our aim was to evaluate the capabilities of magnetic resonance imaging in the detection and delineation of lacunes in a project of clinicotopographic correlations. Seventy-nine patients had a classic lacunar syndrome; 35 had pure motor stroke, 26 had ataxic hemiparesis, seven had sensorimotor stroke, and 11 had pure sensory stroke. A miscellaneous group of 21 patients had less typical lacunar syndromes, primarily with brainstem signs and symptoms. Among a total of 153 lacunes, magnetic resonance imaging detected at least one lacune appropriate to the symptoms in 89 patients. In 16 patients at least two lesions correlated with the clinical features, and precise clinicotopographic correlations were possible in 68 patients. Magnetic resonance imaging was more effective when it was performed a few days after the stroke. Lesions causing different types of lacunar syndromes had significantly different volumes, suggesting that the size of the lesion may influence clinical features. Magnetic resonance imaging may be the imaging technique of choice in the study of lacunar syndromes.

Aged↗
PubMed1990

Hemiplegia in posterior cerebral artery occlusion.

We report 4 patients with hemiplegia due to a posterior cerebral artery occlusion. Associated clinical signs were aphasia, alexia or a neglect syndrome, hemianopia, and hemisensory loss. Hemiplegia was due to infarction in the lateral midbrain. The level of the occlusion in the posterior cerebral artery may be located distal to the junction with the posterior communicating artery.

Aged↗
PubMed1989

Pure sensory stroke due to a pontine lacune.

A 53-year-old hypertensive man presented with the sudden onset of an isolated lemniscal sensory syndrome of the entire left side of his body. Magnetic resonance images showed a small lacune in the right paramedian pons corresponding to the location of the medial lemniscus.

Cerebral Infarction↗
PubMed1988

[Treatment of vasospasm in aneurysmal meningeal hemorrhage using intravenous nimodipine. Multicenter cooperative study].

We present a multicentric randomized double-blind study of the curative effect of intravenous Nimodipine on the post hemorrhagic vasospasm after aneurysmal rupture. On 122 validated cases out of 188 analyzed patients, the study demonstrates a significative effect on the mortality and severe morbidity related to vasospasm: the reduction of the risk is appreciated to 72%. The major effect is obtained on the mortality risk. A selective effect can be demonstrate on the isolated vasospasm.

Double-Blind Method↗
PubMed1988

[Magnetic resonance imaging in horizontal oculomotor paralysis caused by infarction].

Four patients with focal brainstem ischemic strokes and various types of horizontal oculomotor disturbances have been studied clinically and radiologically. One had a six nerve palsy, one a unilateral internuclear ophthalmoplegia, one a Fisher's one-and-a-half syndrome, and one a paramedian pontine reticular formation syndrome with a sixth nerve palsy. In all patients a C.T. Scan and a Magnetic Resonance Imaging (MRI) were obtained. The MRI study was performed on a CGR Magniscan 5000 with a superconducting magnet of 0.5 Tesla. In all patients a hypersignal in T2 weighted images was shown and corresponded to the brainstem infarct. MRI allowed accurate delineation of the lesion and clinico-radiologic correlations in three patients. But the low specificity of MRI does not permit to distinguish edema from necrosis, gliosis or demyelination in a region with a pathological MRI signal. In one patient this low specificity and perhaps partial volume effects decreased the accuracy of the clinico-topographic correlation.

Abducens Nerve↗
PubMed1988

[Magnetic resonance imaging and laterobulbar infarction].

Six patients with a clinical diagnosis of lateral medullary infarction have been studied by CT scan and Magnetic Resonance Imaging (MRI). The MRI study was performed on a CGR Magniscan 5000 with a superconducting magnet of 5 Tesla. In all patients T2 weighted images (TR = 2000, TE 60, 120) in joined section of 9 or 6 mm thickness were obtained in the axial plane. Three patients were also studied in T1 weighted sequences (TR = 500, TE = 28). A lateral medullary infarct was shown in 5 patients. MRI findings were consistent with a hemorrhagic infarct in one case. Occlusion of a vertebral artery was suggested in 2 cases and was confirmed by angiography. In 3 cases, an associated ipsilateral cerebellar infarct was demonstrated. The CT scan had only shown bleeding in the medulla oblongata in the hemorrhagic infarction case, and a cerebellar infarction in another case. Some clinical manifestations are discussed with regard to the results of MRI. MRI appears as the best current method to improve clinico-topographic correlations in medullary infarcts.

Aged↗
PubMed1987

[Syringomyelia and scoliosis in children and adolescents. Apropos of 14 cases].

The authors report their experience of 14 cases of scoliosis in children or young adults in association with syringomyelia. The neurological lesion was discovered at a variable time during the development of the scoliosis which may appear to be idiopathic for several years. There were 11 cases of syringomyelia or hydromyelia and three intramedullary tumours with cyst formation. The neurological lesion must be treated first and sufficiently early to avoid the development of muscle weakness and scoliosis. The scoliosis can be treated by normal without risk of additional complications.

Adolescent↗
PubMed1986

[Lateralized periodic activity and cerebral infarct].

A series of EEG recordings shows the evolution of a periodic activity (PA) in a 57-year-old man with acute cerebral infarction. The complexes ranged from 100 to 150 microV, the duration was 750 msec; the periodic occurrence repeated itself every 2 sec. PA is obliterated during the onset of electroclinical seizures. The CT scan shows temporal brain infarction.

Brain↗