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G Brassier

Publications and source records attributed to G Brassier.

At least 37 records · Page 2Linked to original sources
PubMed1999

Pituitary adenomas with infra-sellar extension into the nasopharynx.

Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.

Adenoma↗
PubMed1999

[A case of giant craniopharyngioma in an adult].

We report an unusual case of giant adamantinomatous craniopharyngioma in an adult who presented with impaired vision. The intra- and suprasellar tumor extended into the subfrontal, subtemporal and retroclival regions. CT and MRI allowed diagnosis and optimal surgical planning.

Adult↗
PubMed1999

Spontaneous chronic spinal epidural hematoma of the lumbar spine.

We report an exceptional description of a spontaneous chronic spinal epidural hematoma presenting as lumbar radiculitis. The computed tomographic, magnetic resonance imaging, and intraoperative findings are presented. We discuss anatomical and pathophysiological considerations that could lead to such a condition. We estimate that spontaneous spinal epidural hematomas located in the ventral space are in fact premembranous or posterior longitudinal ligament hematomas.

Aged↗
PubMed1999

[Spontaneous disappearance of a thoracic disc hernia].

We report a case of a 55-year-old man who experienced spontaneous resolution of a large herniated disc at T8-9. Spontaneous resolution of disc herniation is well known at the lumbar level. This case is a rare example of a large thoracic disc herniation diagnosed by CT and MRI which completely regressed six months after a medical treatment with complete disappearance of symptoms. The mechanism of resolution of a disc herniation is unclear and we discuss theoretical considerations. We emphasize the interest of conservative therapy in patients with thoracic disc herniation without neurological deficit.

Humans↗
PubMed1999

Rathke's cleft cysts: surgical-MRI correlation in 16 symptomatic cases.

Rathke's cleft cysts (RCCs) are non neoplastic epithelial lesions of the sellar region that have been rarely reported as a clinical entity. We retrospectively reviewed the magnetic resonance imaging (MRI), intraoperative, and pathological findings of a series of 16 cases of RCCs operated at our institution since 1992. Concurrently, we discussed the different hypotheses about their embryological origin. The patients included 12 females and 4 males, 11 to 73 years of age. Endocrine disturbance was the most common presentation, followed by headaches and visual impairment. The location of the cyst was intrasellar in 7 cases, intrasellar and suprasellar in 6 cases, and suprasellar in 3 cases. The size of the cyst ranged from 8 to 26 mm (mean 12 mm). MRI signal intensity was quite variable on T1-weighted images. The cyst appeared hyperintense in 6 cases, hypointense in 6 cases, isointence in 3 cases, and heterogeneous in one case. On T2-weighted images (available in 13 cases), the signal intensity was more constant and appeared hyperintense in 11 cases and hypointense in 2 cases. After Gd-DTPA, we did not observe enhancement either of the cyst contents or of the cyst wall, but only of the pituitary gland in all patient. Most often, the pituitary gland was displaced inferiorly by the cyst located above showing a typical image of "an egg in a cup". Fifteen patients were operated upon via the transsphenoidal approach and one upon a frontal craniotomy. Intraoperatively, the cyst contents were gelatinous or thick, and dark colored. In 2 cases, it was cerebrospinal fluid-like corresponding to the signal observed on MRI. The position of the pituitary gland confirmed by surgery in 15 cases coincided with enhancement seen and MR imaging. In 13 cases where biopsy of the cyst wall was performed, it confirmed focally ciliated columnar or cuboid epithelium. A coexistent adenoma was found in one case. In conclusion, we consider that RCCs have varied MRI characteristics so that no pathognomonic sign may be observed. Except in few cases, there were no correlation between MRI and intraoperative findings. Therefore, even with MRI studies, differential diagnoses with others cystic lesions of the sellar region remains extremely difficult. The most interesting findings on MRI studies of RCCs were to locate the pituitary gland to help the surgeon to preserve pituitary tissue during surgery.

Adolescent↗
PubMed1998

Unusual origin of the ophthalmic artery and occlusion of the central retinal artery.

Any variations in the origin of the ophthalmic a. are uncommon and well-explained by the comparative anatomy and human embryology. A unique case is reported of an ophthalmic a. arising from the middle meningeal a. associated with an occlusion of the central retinal a. Embryologic variations which can give such an unusual origin are discussed. Although this association may be fortuitous, we consider that an unusual origin of the ophthalmic a. could be a further factor for an occlusion of the central retinal a.

Adult↗
PubMed1998

Sensitivity of auditory brainstem response in acoustic neuroma screening.

Auditory brainstem response (ABR) is the reference screening technique for acoustic neuromas, but because of a few false negatives and the increasing performance of magnetic resonance imaging (MRI), its role as the standard method has been questioned. We assessed sensitivity of screening tests in 89 patients with surgically proven acoustic neuromas. Sensitivity of ABR was 92%; 94% for extracanalicular neuromas and 77% for intracanalicular neuromas. For stapedius reflex (SR), sensitivity was 84% and for caloric vestibular response (CVR) 86%. The combined sensitivity of ABR + SR was 97% and of ABR + RS + CVR 98%. For false negatives, the greatest diameter including the intracanalicular portion was always less than 18 mm, with a mean of 15 mm, and none of these tumours reached the brainstem. For patients with unilateral cochleo-vestibular deficit, we propose ABR and SR as first-line screening tests. These tests are repeated at 6 months and at 1 year in the case of normal results. MRI is ordered for patients whose auditory threshold is too low and for those whose ABR or SR results favour retrocochlear disease.

Caloric Tests↗
PubMed1998

MR demonstration of spontaneous acute spinal subdural hematoma.

We report an unusual case of spontaneous acute spinal subdural hematoma. To date, only a few cases of magnetic resonance imaging (MRI) demonstration of such a pathology have been reported in the medical literature. We analyse the pathogenesis, clinical presentation, magnetic resonance imaging results, intraoperative findings and prognosis of this rare condition. We would like to stress that prompt and non-invasive diagnosis by MRI sagittal sections leads to efficient surgical treatment.

Hematoma, Subdural↗
PubMed1996

Microsurgical anatomy of the anterior choroidal artery.

In this study, the authors present the results of 50 dissections of the anterior choroidal a. in man. Fifty cerebral hemispheres were prepared with the classic techniques of preservation and vascular injection. An ectopic origin was observed in 4% of cases. The intracisternal segment of the anterior choroidal a. forms a neurovascular bundle with the optic tract and basal v. Most of its intraparenchymatous branches arise from the cisternal segment, while branches supplying the optic tract, lateral geniculate body and thalamus arise from the intraplexual segment. Constant anastomoses exist with the vertebrobasilar system, specially the postero-lateral choroidal and posterior cerebral aa. We discuss the importance of an adequate knowledge of the anatomy of the anterior choroidal a. and its relations in the surgical approach to arterial aneurysms and arteriovenous malformations of the region.

Arteriovenous Anastomosis↗
PubMed1990

Contribution of MRI to the diagnosis of ACTH-secreting pituitary adenomas. Exploration of 9 patients with Cushing's disease.

Between June 1987 and October 1989, nine patients with suspected Cushing's disease were explored by magnetic resonance imaging (MRI), using an 0.35 or 0.5 Tesla magnet. All these patients underwent transsphenoidal surgery and radio-surgical correlations could be established. MRI showed a lesion in 5 cases; it was negative in 2 cases and doubtful in 2 cases. Surgery was positive for pituitary adenoma in 7 cases and negative in 2 cases (including 1 patient with subsequently discovered paraneoplastic syndrome). Using sagittal and coronal planes and combined with gadolinium enhancement, MRI proved to be the most sensitive and specific of all exploratory methods for the diagnosis of ACTH-secreting pituitary adenomas.

Adenoma↗
PubMed1990

Contribution of MRI to the diagnosis and post-therapeutic monitoring of brain stem tumours.

MRI has become indispensable to the positive diagnosis of brain stem tumours which develop preferentially in young people. The prognosis of these tumours, especially infiltrating gliomas, being relatively sombre, it is important to make a precise morphological diagnosis of the lesions (increase in size, signal abnormalities) which will help both neurosurgeons and radiotherapists. As regards post-therapeutic monitoring, MRI with gadolinium contrast injection is harmless and will make it possible to follow these patients regularly and to detect recurrences.

Adolescent↗
PubMed1986

[The place of arteriography in the etiologic diagnosis of spontaneous intracerebral hematomas].

456 cases of spontaneous cerebral hemorrhage have been referred at the Neurosurgical Department of the University of Rennes since the CT scan is available, i.e. from 1979 till 1984. Sixteen passed away at the time of admission itself. Among the remaining 440 cases a diagnosis of cerebro-vascular malformation was suspected in 189 according to some atypical features in clinical and/or scanographic presentation, but only 101 patients were actually submitted to an angiographic evaluation, 88 others presenting with a very deep comatose state leading to death in a few hours. We found 14 vascular anomalies (14 p. cent) amongst them eight arterial aneurysms, five arteriovenous malformations and one combining cerebellar AVM and arterial aneurysm of the basilar artery. We couldn't perform an autopsy in all lethal cases but the necropsy findings lead to discover eight additional cases (4 aneurysms and 4 AVM). Statistically it means that a gross vascular lesion is responsible of 5% of cases of cerebral hematomas (22 out of 440). We didn't take in account the cavernomas discovered at the pathological examination of the walls of several hematomas. We may conclude that a careful angiographic study is justified in following cases: young age of the patient (under 65); lack of risk factors, especially cardio-vascular or hematologic; relatively satisfactory clinical status of the patient; topographic criteria related to the CT scan (hematomas located in the fronto-basal area and near sylvian fissure).

Adult↗
PubMed1986

[Secondary hematoma of the brain stem. Apropos of 5 cases].

Five cases of brain-stem hematoma are described. The cause of these hematomas was identified as "cryptic angioma" (1 cavernous angioma, 1 telangiectasia, 3 arteriovenous malformations). So, they are so-called "secondary hematoma", as opposed to brain-stem hematoma in relation with hypertension. Such secondary hematomas are reported in the literature: 37 operated on cases and 22 untreated cases were found. The clinical picture does not seem to be typical. The presentation appears to be either with the acute onset of a stroke, or with a subacute onset including relapsing symptoms. A progressive deterioration suggesting a pontine glioma or mimicking demyelination is not rare. The CT scanner appearance is often characteristic showing a high density area in the brain-stem which enhanced after injection of contrast medium with an aspect of "halo". Angiography is usually negative. The natural history of brain-stem hematoma due to rupture of a cryptic angioma is not well documented, but it seems that prognosis is very poor. So, the authors insist on surgical evacuation which is effective and safe allowing the diagnosis of brain-stem hematoma and in some cases the identification of the malformation.

Adult↗