PubMed Health⌕ Search

Biomedical subjects

G Bourbotte

Publications and source records attributed to G Bourbotte.

At least 19 recordsLinked to original sources
PubMed2006

[Can multislice helical computed tomography replace conventional angiography in the diagnosis of non traumatic subarachnoid hemorrhage?].

AIM OF THE STUDY: To evaluate the reliability of CT angiography in the diagnosis of non traumatic subarachnoid hemorrhage. MATERIALS AND METHODS: We prospectively studied 57 patients presenting with non traumatic subarachnoid hemorrhage. In all cases, CT angiography of the circle of Willis was performed, followed by conventional angiography. We compared the results of both techniques, with conventional angiography considered as the gold standard. RESULTS: The specificity of CT angiography for diagnosing intracranial aneurysms was 100% with sensitivity and negative predictive values of 86% and 65% respectively. The aneurysms that were not diagnosed on CT angiography were located on the supra-cavernous internal carotid artery and their size was less than 5mm. Futhermore CT angiography failed to diagnose the other causes of subarachnoid hemorrhage. CONCLUSION: CT angiography can be considered as a first line imaging technique for diagnosis of non traumatic subarachnoid hemorrhage. However, conventional angiography including three dimensional acquisitions must be performed for all cases where the cause of hemorrhage remains undiagnosed at CT angiography.

Cerebral Angiography↗
PubMed2006

In vitro evaluation of 2D-digital subtraction angiography versus 3D-time-of-flight in assessment of intracranial cerebral aneurysm filling after endovascular therapy.

BACKGROUND AND PURPOSE: The aim of this study was to evaluate 2D-digital subtraction angiographic (DSA) and 3D-time-of-flight (TOF) MR imaging in assessment of aneurysmal residue by using a pulsating silicon aneurysm model. For each imaging system, we studied intra- and interobserver reproducibility and the agreement between interpretations and reference measurements. We also examined how each imaging technique affected the operator's therapeutic decision. METHODS: Two silicon aneurysm models depicting subarachnoidal aneurysms were used, one with a wide neck and one with a narrow neck. Each aneurysm model was placed in series on a pulsed flow circuit and was filled with Guglielmi detachable coils to simulate a clinical case. Each aneurysm was then gradually filled with silicon gel in increments of 10%, up to 100% to simulate different levels of occlusion (residual neck or dog ear, partial, complete) at each filling level. For each level of filling, we performed conventional 2D-DSA and 3D-TOF MR imaging. We submitted the images for examination by 2 senior medical staff with 2 readings per image. A combined reading of the 2 images was submitted to each expert to determine whether the 2 examinations were complementary. RESULTS: The 2D-DSA analysis showed good reproducibility (k = 0.8 and k = 0.57) and agreement (k = 0.71) in describing "complete" treatments. The distinction between a "residual neck" and "partial treatment," however, was not reliable. The 2D-DSA provided a good description of the coil and silicon protrusion into the parent artery. The 3D-TOF analysis of the residual aneurysm, however, was not reproducible, though it was more effective than the 2D-DSA in evaluation of partially wide-necked aneurysms (k = 0.68 MR imaging vs k = 0.041 2D-DSA; P = .018). At the same filling level, the 2D-DSA analysis indicated repeat treatment more often than 3D-TOF analysis (P = .059). CONCLUSION: The 2D-DSA remains the gold standard, but MR imaging is more effective in evaluating a "partial treatment." The 2D-DSA analysis indicated repeat treatment more often than the 3D-TOF for the same occlusion level. The distinction between "partial treatment" and a "residual neck" was not reliable with either method of evaluation.

Angiography, Digital Subtraction↗
PubMed2005

[Acutely ruptured intracranial aneurysms treated with GDC coils. Results from a single center over a period of 5 years].

PURPOSE: We prospectively reviewed the clinical results of acutely ruptured cerebral aneurysms treated with GDC over a 5 year period, in order to characterize death and dependency factors. METHODS: Between 1997 and 2002, 229 patients (254 aneurysms treated, 140 females, 89 males; mean age: 51 years) with aneurysmal subarachnoid hemorrhage were treated with GDC (Boston Scientific Neurovascular, Fremont, CA) once the anatomical conditions of feasibility had been achieved. Over 90% of the aneurysms treated (mean size: 5,8 mm) were located in the anterior circulation. The anterior communicating artery complex (87 cases), the posterior aspect of the internal carotid artery (65 cases), and the middle cerebral artery (49 cases) were most commonly treated. RESULTS: At the end of the initial hospitalization period, 14 patients (6.1%) died. Major procedural complications were associated with perforation of the aneurysmal sac in 9 patients (3.9%), thromboembolic events in 10 patients (4.3%) which resulted in 2 deaths (0.8%) and permanent neurologic morbidity in 7 patients (3%). The univariate analysis demonstrated no correlation between death and time-to-treatment, the topography of the aneurysm, or the occurrence of treatment related complications. The results of the logistical regression model demonstrated that the clinical score upon entry, and the occurrence of delayed ischemia were the only independent factors correlated with patient death. The prognostic factors affecting the degree of sequellae identified by the logistical regression model were the clinical score upon admission, age, treatment related complications, and pulmonary complications. CONCLUSIONS: Endovascular treatment of ruptured anterior circulation aneurysms with GDC, including MCA aneurysms, is associated with low morbidity and allows good overall outcomes in patients with subarachnoid hemorrhage. A better understanding of dependency factors associated with endovascular coiling will foster further technical advances in order to improve the treatment of small and medium sized ruptured aneurysms.

Analysis of Variance↗
PubMed2000

[Neurotrichinosis: a case report with MRI evaluation].

Neurological complications are rare in trichinosis. A case of trichinosis involving the central nervous system documented by MRI is presented. To our knowledge, only three cases of neurotrichinosis with MRI abnormalities have been already reported. The physiopathological mechanism are discussed (transport of the parasite through the blood-stream, immuno-allergic reaction or eosinophilic neurotoxic effect).

Adult↗
PubMed1995

Monitoring sodium methohexital distribution with [99mTc]HMPAO with single photon emission computed tomography during Wada test.

Twenty-five consecutive patients being considered for surgery for intractable epilepsy had intracarotid sodium methohexital procedures (ISM) as part of their evaluation. The lipophilic brain SPECT agent, [99mTc]hexamethylpropylene aminoxime (HMPAO), was administered intravenously during the procedure to determine the intracerebral distribution of methohexital. The validity of the ISM depends on consistent delivery of the anesthetizing agent to one hemisphere, including the mesial structures of the temporal lobe. To prevent postoperative language and memory deficits, correct interpretation of the test results supposes a reliable knowledge of which regions of the brain have been anesthetized. Currently, no absolute criteria allow determination of the level and topographical extent of the anesthesia. We compared results of HMPAO-SPECT with clinical and EEG video-monitoring data and with results of digital subtraction angiography (DSA) performed during the test. In all patients, the effect of SM was ipsilateral cerebral hypoperfusion on SPECT and crossed cerebellar diaschisis. The distribution of HMPAO varied from patient to patient. The delivery of SM to mesial temporal lobe structures was not constant. Using nonparametric tests, we demonstrated a statistically significant relationship between hypoperfusion on SPECT and duration of hemiplegia but not with the duration of aphasia. Hypoperfusion on SPECT was also related to the onset and duration of drug-induced delta activity on EEG. SPECT showed a statistically different distribution of SM in the brain from that predicted with DSA. We present our experience with HMPAO-SPECT use for mapping the distribution of methohexital's effects during the ISM (Wada test). We confirm the results of previous studies that SPECT assessment may be an excellent way of determining the distribution of barbiturate during the examination. It increases confidence in interpreting results of speech and memory testing by detecting either contralateral diffusion of the drug due to crossflow between hemispheres or insufficient quantitative delivery to the homolateral hemisphere.

Adult↗
PubMed1993

Lambdoid craniosynostosis. A 3D-computerized tomographic approach.

From a series of eleven children aged from 4 months to eight years presenting with a parieto-occipital flattening that was unilateral in nine and bilateral in two, we attempted to determine a 3D-CT semeiology able to demonstrate the presence of a lambdoid suture synostosis, as well as the participation of coronal and lambdoid sutures in the genesis of complex cranial malformations. Pure isolated forms of lambdoid synostosis are rare and justify a surgical treatment for cosmetic purposes if the deformation is severe and progressive.

Child↗
PubMed1992

[Diagnosis by Doppler color echography of dural carotid-cavernous fistula of ophthalmological manifestation].

The case reported here, concerns a spontaneous low-flow fistula between the external carotid arterial network and the cavernous sinus, with ophthalmological symptoms (exophthalmos, red eye) in an old woman with cardiac failure. The shunt was diagnosed by color-Doppler-imaging, which showed a flow reversal with a systolic component in the superior and inferior enlarged ophthalmic veins. This finding led the authors to extend the arterial filling sequence since the shunt was not detectable on standard arterial views. Embolization was performed during angiography which remains necessary to localize the shunt and to treat the fistula. The clinical symptoms progressively returned to normal and the correction of the hemodynamic disturbances could be followed by color-Doppler imaging, a non-invasive technique which can be easily repeated.

Aged↗
PubMed1985

[Post-radiotherapy brain lesions].

Recurrent symptoms or signs during or after therapeutic brain irradiation may be due to the progression of the irradiated tumour, necrosis of normal brain tissue, necrosis of tumour, or all three of these. We have studied 12 patients with pathologically proven radiation-induced damage of normal brain tissue. All patients were exposed to a therapeutic range of radiation for an intra or extracranial tumour. Seven patients were exposed to 280 to 300 rads per day, three times weekly to a total dose of 4500 to 6000 rads (fractionated). Five patients received 750 to 850 rads per day, on days 1, 3, 21 and 23 (split-course). The diagnosis of radiation-induced brain lesions is difficult. CT scan is the most informative diagnostic procedure. The various patterns of radiation-induced brain lesions on CT are nonspecific. However where there is sufficient clinical data suggesting radiation-induced brain lesions, and a good correlation between CT abnormalities and the maximum delivered dose, on dose distribution maps of the brain exposed to a high cumulative radiation dose, the diagnosis may be accepted. The time interval between the end of radiation therapy and the occurrence of radiation-induced lesions was shorter in the patient group exposed to a split-course therapy (median time: 9.6 months) as opposed to the patient group exposed to a fractionated radiation (median time: 45 months). Pathologically the lesions corresponded to either a demyelinated area within the white matter with minimal vasculopathy or an area of coagulation necrosis with varying degrees of necrosis, delamination or hyalinosis of small blood vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Possible influence of cerebrospinal fluid pressure on the growth of a third ventricle choroid plexus papilloma.

A case of histologically proven benign choroid plexus papilloma of the third ventricle in a 4-month-old male child is reported. The clinical symptoms and the neuroradiologic findings were those of a supratentorial hydrocephalus. A shunting procedure was performed after refusal by the family of a direct surgical approach. Subsequently there was a four- to fivefold increase in volume of this tumor in less than 4 months under decreased cerebrospinal fluid pressure. The purpose of this report is first to add a case to 27 cases of papilloma of the choroid plexus of third ventricle reported in the medical literature. Secondly to underline a possible influence of intraventricular pressure on the growth of a histologically benign intraventricular papilloma. Subsequently, the question of radiation therapy may be raised, if total removal of the papilloma is not obtained, especially in view of decreased cerebrospinal fluid pressure provided by the previous shunting procedure.

Cerebral Ventricle Neoplasms↗
PubMed1984

[Chance's fracture].

Described by Chance (1948) this fracture is induced by a mechanism of flexion distraction (seat belt fracture). The injury is characterized by the following (W.S. Smith, 1969): A disruption of the vertebral body by an horizontal splitting of this formation and neural arches through the pedicles, nor, or a minimum decrease in the anterior height of the involved vertebral body, no forward or lateral displacements of the superior vertebra, location of the disruption between the first and third lumbar vertebra in the majority of cases. Four patterns of Chance's fracture are isolated in this paper: First pattern: The osseous disruption cross the posterior arches, pedicles and vertebra. The fracture is unstable. Second pattern: horizontal fracture involves both pedicles with extension anteriorly through inferior third of the vertebral body (unstable). Third pattern: Chance's fracture with anterior vertebral extension through superior third of vertebra (unstable). Fourth pattern: fracture with anterior horizontal vertebral disruption in the posterior half of the body (stable).

Adult↗
PubMed1977

[The 2nd saccoradiculography: changes in the post-radiculographic and postoperative radiological morphology (340 cases apropos of 2,292 files)].

A study was made of the files 2292 patients examined by sacco-radiculography with watersoluble contrast medium, of whom 340 had been subjected to a second examination. 284 of these had undergone surgery with good results during the interval between the two examinations. In 56 cases, repeat sacco-radiculography was carried out but no operation performed. In both groups of patients a semiological study was made of the radiological appearances to determine which were the effects of the contrast medium and which could be attributed to the operation. The paper concludes with a discussion of the problem of genuine and false albuminoachies of sacco-radiculography using meglumine locarmate (dimer-X).

Adrenal Cortex Hormones↗