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Biomedical subjects

G Colnet

Publications and source records attributed to G Colnet.

At least 19 recordsLinked to original sources
PubMed1991

[Prevention of late post-traumatic epilepsy by phenytoin in severe brain injuries. 2 years' follow-up].

The high incidence rate and the invalidating nature of post-traumatic epilepsy after severe brain injury have encouraged the authors to review the prophylactic treatment of this type of epilepsy. Thirty-four out of 86 randomised patients with brain injuries admitted into a neurotraumatology intensive care unit were treated prophylactically, immediately after the injury, with an intravenous hydantoin injection in a dose sufficient to provide stable and effective blood levels. This was followed by dose-adjusted oral administration maintained for a minimum period of 3 months. After a 2 years' follow-up, there was a significant difference between treated and untreated patients, since only 6 per cent of the patients treated suffered from post-traumatic epilepsy, as against 42 percent in the untreated group.

Adolescent↗
PubMed1989

[Atlanto-occipital luxation and syringomyelia: 2 rare complications of cervical injury. Diagnostic and therapeutic effects. Apropos of a case].

The authors report the case of a 19 years old patient with an undiagnosed traumatic atlanto-occipital dislocation complicated after two years by a rapidly evolutive syringomyelia. This clinical case which associates two rare complications of cervical traumatology allows to discuss the problems of both pathologies especially on the following points: --The early diagnosis of the dislocation by tomography and CT scan is the only mean to treat totally these lesions and perhaps to avoid the complications like syringomyelia. --In case of delayed diagnosis, when the dislocation is "fixed" the complete decompressive surgery both by a posterior and a trans-oral way is for the authors the treatment of choice.

Adult↗
PubMed1988

[Diagnosis and surgical strategy in 3 cases of benign and unusual tumors of the occipito-cervical skeleton].

The authors report three cases of benign tumours of the occipito-cervical skeleton, remarkable for their rarity and especially by their unusual, even exceptional anatomic site: an osteoid osteoma, a pre-medullary chondroma and an extra-dural exostosis developing within a hereditary multiple disease. This presentation which allows to recall a few epidemiological and diagnostic problems is essentially focused on operative strategy and particularly on the choice of the best way to cope with surgical difficulties to be met. The osteoid osteoma whose diagnosis is difficult raises two surgical problems: the relation with the vertebral artery and the preservation of the atlanto-occipital joint. An approach through limited occipital craniotomy has allowed a perfect control of the vertebral artery and a complete removal without joint damage. Pre-medullary chondroma: a complete removal has been performed through the anterior way as described in rare observations of the literature. Post operatively, the patient had a complete neuro-orthopedic recovery. The antero-lateral exostosis has been removed through the posterior way by first resecting the basis of implantation, which has allowed the mobilization of the lesion without cord damage. Results have been good in the three cases both from neurological and orthopedic points of view.

Adult↗
PubMed1987

[Diagnostic and therapeutic problems of osteomeningeal defects and traumatic cerebrospinal fluid defects of the anterior floor of the base of the skull. Apropos of 95 cases].

The authors here report teaching drawn from the latest ninety five cases of osteo-dural defects in basilar skull fractures they have surgically treated. They particularly insist on the following points: Difficulties in establishing a clinical diagnosis when the traumatism is in its acute stage: initially 55% of patients do not show any symptom of rhinorrhea, so that the diagnosis is only based on X-ray data. Previous to any surgical treatment the number of serious septic meningitis is rather high in as much as it reaches 10.55% in this series. Risk of infection together with bone damages incite the authors to suggest a surgical treatment of dural defects in their acute stage, namely within the two weeks following the accident. The study of results shows that due to treatment complications, are not insignificant. The authors then tackle the problems of technics and osteo-dural restoration. They, at last, explain, in this series, the interest of preventive antiepileptic treatment by hydantoins during and after the operation. Despite complications due to treatment the results in this series appear to be significant enough to allow the authors to place the indication of the surgical treatment of traumatic osteo-dural defects in basilar skull at the acute stage of their evolution.

Bone Transplantation↗
PubMed1987

[Acute post-traumatic tetraparesis: a developmental complication of cervical arthrosis. Physiopathology, clinical study, prognosis. Apropos of 6 cases].

After dealing with the anatomo-pathology of arthrosis, and then the physio-pathology of cervico-arthrotic myelopathy, the authors describe just now six cases of acute post-traumatic tetraplegia happening as a complication of cervical arthrosis. They do insist on the circumstances of that unexpected coming of such neurologic accidents, on their prognosis very often pejorative, on the necessity of a preventive surgical treatment at the stage of cervico-arthrosis myelopathy not very evolved, which is the only one accurate device to avoid the acute decompensation, insisting at last on the functional sequela most often severe of these complications.

Acute Disease↗
PubMed1984

[Bipedicular fractures of C2 and safety belts].

The authors have studied 10 cases of C2 bipedicular fractures which occur in automobilists having fastened safety-belt at time of collision. The description of the lesions presented by these patients and a literature review on the subject of safety-belt and cervical spine let them ask about the effectiveness of the safety-belt in prevention of cervical spine lesions.

Accidents, Traffic↗
PubMed1984

[Early per- and postoperative epileptic seizures during operations on osteomeningeal breaches. Value of preventive treatment with hydantoins].

The value of prophylactic anti-epileptic treatment in surgery of osteomeningeal breaches has been studied. This surgery exposes to a high risk of seizures, 20 to 25 of our cases after conventional surgery. 74 operated cases of osteomeningeal breaches, among then 38 under preventive anti-epileptic therapy are reviewed. The pre and postoperative epileptic fits up to 24 hours after the operation were taken in consideration.

Craniocerebral Trauma↗
PubMed1984

[Fractures of the posterior arch of C2. Apropos of 34 cases].

The authors preferred the term of "fracture of the posterior arch of the axis", rather than the restrictive terms of bipedicular or bi-isthmic fractures commonly referred to in the literature. It was possible, from 34 cases to joint out 4 different figures of fractures of the posterior arch of axis: isthmus, body and articular process, pedicle and lamina. From this classification it is possible to get indications for surgical treatment, as some of those fractures need internal fixation and others not. On completing Xrays study with research of instability between C2-C3 it's possible to fix a standard management for those fractures. --at first reduction for many patients, then --immobilisation by a minerva cart in mostly cases --or surgical approach and internal fixation in case of diastasis or of bad reduction --anterior arthrodesis if needed (anterior instability) --or both posterior fixation and anterior arthrodesis.

Adult↗
PubMed1982

Intracranial hypertension and prognosis of spontaneous intracerebral haematomas. A correlative study of 60 patients.

Intraventricular pressure was recorded in 60 patients with intracerebral haemorrhage, and correlated with their clinical conditions and prognosis. The results show that an evaluated intraventricular pressure is statistically linked with the most serious situations, and with the most severe prognosis. However, two thirds of the decreased patients had died with an almost normal pressure, suggesting that intracranial hypertension is not always the immediate cause of death, but only an aggravating factor. From these results, it is proposed that intracranial pressure should be monitored only in stuporous or comatose patients, and always compared with CT scan images, which give better information regarding the harmful effect of midline structure displacement.

Adult↗
PubMed1982

[Our experience with vertebral grafts in the surgery of recent severe fractures of the dorsolumbar spine].

The authors report their experience of spine fusion in the management of fracture dislocations of the thoracic and lumbar spine. In a series of over a hundred surgical stabilization, plate instrumentation alone was orthopedically unsuccessful in 20% of cases after plate removal. Instrumentation is but a tutor, whereas spine fusion is an element which brings definite spine stability. Clinical and roentgenographie results are given. Based on the different types of spine injuries, indication are discussed as well as surgical approach and technique with a possible association of several methods applied to the same patient.

Adolescent↗
PubMed1981

Benign intracranial hypertension and disorders of CSF absorption.

Sixteen patients suffering from benign intracranial hypertension were studied by a continuous measurement of intraventricular pressure, a simultaneous recording of intraventricular and sagittal sinus pressures, and a measurement of the cerebrospinal fluid (CSF) resistance to drainage. Isotope cisternography was performed and the patency of the dural sinuses verified by direct sinography or phlebography or both. The same procedure was used to study 6 other patients suffering from disorders leading to the same type of intracranial hypertension. In 16, our results confirm a defect in CSF absorption mechanisms linked to an abolition of the pressure gradient between CSF and sagittal sinus in 6 patients, as well as an important increase in CSF resistance to drainage in 10 others. Despite this defect, the CSF circulation was normal in most patients (10 of 12) as demonstrated by isotope cisternography.

Absorption↗
PubMed1981

[Acute arachnoid cysts in traumatic vertebro-medullary pathology (author's transl)].

The authors report seven cases of arachnoid cysts of the spinal cord discovered in the immediate post-traumatic period of spinal trauma. Five cases were dorso-lumbar traumas which often did note appear serious on roentgenograms. Similar groups of symptoms were encountered in the different cases, particularly the initial symptomfree period. Immediate surgery is mandatory and the subsequent prognosis is good. Two cases of cervical cysts have a less typical symptomatology and a less favorable operative outcome. The pathophysiology of this acute and evolutive affection is unclear.

Adolescent↗
PubMed1981

[Benign intracranial hypertension. A clinical, pathophysiological and diagnostic study (author's transl)].

Sixteen unpublished observations of Benign intracranial hypertension were reviewed from a clinical, aetiological and prognostic standpoint. The hypothesis that this affection could be caused by some disturbance of the C.S.F. resorption was assessed using an experimental tests battery allowing the measurement of the main factors involved in C.S.F. resorption. Our patients presented with a pure, solitary state of intra-cranial hypertension, of variable duration, capable of returning. The vital outcome was always favourable, but several severe and protracted cases were marked by a definitive visual damage. The visual risk, often underlined in the literature, requires a careful attention and eventually needs some effective treatment including C.S.F. diversion. A disorder of C.S.F. absorption could be demonstrated in most of our observations and appears to account for the principal features of Benign intracranial hypertension, including the lack of ventricular enlargement. The absorption disorder resulted either from the reversion of the pressure gradient between the C.S.F. and the venous sinuses when a dural sinus was obstructed, - or from an elevation of the resistance to flow when the sinuses were patent, thus suggesting some structural alteration of the arachnoid villi. However, for lack of histological control, such an alteration remains hypothetical, and a primary brain edema probably yield a similar a pathophysiological pattern. Finally, an attempt is made to classify the various aetiological factors encountered in Benign intracranial hypertension according to the previous pathogenic discussion.

Adolescent↗
PubMed1981

[Normal pressure hydrocephalus. Pre- and postoperative study of 56 cases (author's transl)].

56 patients considered to have a low pressure hydrocephalus were treated between 1973 and 1979 by a ventriculo-atrial shunting, using a medium pressure Holter valve. Apart from a standard clinical examination, these patients underwent a pneumoencephalography, an isotope cisternography, a measurement of ventricular pressure, and a determination of the C.S.F. resistance to flow by mean of an infusion test. A 6 months to 5 years follow up study showed that the operative result could be considered a success in 47%, a failure in 53%. No precise correlation could be found between any clinical sign or response to investigations, and the functional results. However, an early and really unsteady gait, an important ventricular enlargement without image of cortical atrophy, and the presence of pressure waves on I.C.P. recordings, seem to be frequently associated with good results.

Adolescent↗
PubMed1981

[Comparative trial of a new epidural transducer for intracranial pressure monitoring (author's translation)].

The measurement of intracranial pressure using a new epidural pressure transducer has been compared with the classical method of measuring intraventricular pressure. Comparative measures in vitro have been carried out with acid of an enclosure in which the hydrostatic pressure can be varied. Four positions of the epidural transducer with the respect to the dura mater have been studied; of these, only one, coplanarity between the epidural transducer and the dura, gives an excellent correlation between values of epidural pressure and hydrostatic pressure. Twenty-nine prolonged recordings have been carried out in vivo. Fifteen of these have given comparable recordings for E.D.P. and I.V.P. In the other fourteen cases the recordings were considered non comparable, either because of a significant difference between the average values of E.D.P. and P.I.V. or because the two curves were not parallel. It is considered that these differences are due to the problems of correctly positioning the epidural pressure transducer and hence an inability to achieve the condition of coplanarity. These problems should be resolved by a modification of the method of positioning the epidural pressure transducer. The use of this type of materiel is of interest for the monitoring of the I.C.P. of neurosurgical patients, as the epidural pressure follows the variations of I.C.P. and indicates pressures waves when they exist.

Epidural Space↗
PubMed1979

Intracranial pressure time course in primary intracerebral hemorrhage.

The course of intracranial pressure (ICP) over time was studied in 66 hypertensive and/or altherosclerotic patients harboring intracerebral hematomas. Patients with no disturbance of consciousness showed normal or only slightly elevated pressure. Conversely, most patients in deep coma exhibited high pressure with a tendency to rise further no matter what treatment was used. In the remaining patients with intermediate disturbances of consciousness, no definite correlation was found between ICP, clinical condition, and outcome. In all of the patients who underwent operation, the postoperative course of ICP over time was also studied and seemed to depend to a certain extent on the timing of the operation.

Adult↗