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G Combelles

Publications and source records attributed to G Combelles.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Intracranial subdural empyema. 3 cases].

With reference to three cases the main features of subdural empyema are recalled. These collected suppurations are often secondary to frontal or maxillary sinusitis due to a streptococcus. Clinical features are those of meningo-encephalitis but signs of cortical damage are more prevalent. Many cases of subdural empyema which would have been unrecognized by conventional procedures are now diagnosed by CT scan. CT scan has also improved monitoring; thus, two of the three patients could be given medical treatment alone. The authors believe that non-surgical treatment would ensure recovery in many cases of subdural empyema. Surgery should be restricted to patients with severe intracranial hypertension or persistence of a large mass after several weeks of antibiotic treatment. Non-surgical treatment may improve prognosis.

Adult↗
PubMed1983

An intramedullary ependymal cyst in a 71-year-old woman.

An intraspinal ependymal cyst of the thoracolumbar spinal cord was found in a 71-year-old woman with a history of right side abdominal pain since the age of 18. The late discovery of the cyst is related to the extremely slow evolution of this type of cyst in the absence of spinal trauma. Etiopathogenic problems are discussed after a review of the literature.

Cysts↗
PubMed1983

[Intradural spinal arachnoid diverticula and cysts. 6 cases].

3 communicating diverticula and 3 arachnoid symptomatic cyst in intradural situation are presented. In two cases, this pathology is slowly developing, in patients with Von Recklinghausen neurofibromatosis. A congenital malformative process may be evoked. In two other cases, myelography and surgery favor a frank or discreet arachnoïditis. Those establishments show the diversity of mechanisms underlying intradural arachnoïd cysts. They are in most cases in a postero medullary and dorsal situation, but cervical as well as lumbar position are possible. One must insist on the frequency and importance of local and cordonal pain, accompanying in most cases sensory and motor deficits in inferior limbs. A rapid revelation or decompensation is most rare. Prognosis must be reserved, as post operative arachnoïditis and relapse are not rare.

Adolescent↗
PubMed1983

[Familial forms of intracranial cavernous hemangioma. Apropos of 5 cases in 2 families].

The authors report five cases of cavernous hemangioma belonging to two families. In the first family, an 8 year old child was operated on in 1970 for a left frontal location. His mother, aged 39, was operated on in december, 1981, with stereotaxic approach, for two locations: one was frontal location, the other one was in the pineal region. Among the second family, a 21 year old woman was operated on in december 1976, for a cerebellar cavernous hemangioma. Her sister, aged 18, presented with subarachnoid hemorrhage in january 1980. C.T. scan showed a right temporal high attenuation area. This patient was not operated on. The aunt to those two sisters was operated on in october, 1981, for a left temporal cavernous hemangioma. Those five cases represent about half of the intracranial cavernous hemangiomas operated on in the Lille Neurosurgery Department since 1967. Even, unusual, the familial occurrence of this affection must be admitted. It shows a nosological interest, but also allows prevention by searching and surveying the asymptomatic cases, or genetic evaluation of disease risk.

Adult↗
PubMed1983

[Extradural spinal hematoma without traumatic bone lesion. Apropos of 9 cases].

Extradural spinal hematomas observed in 9 cases over a period of 11 years developed in the absence of blood coagulation disorders in 3 cases, during anticoagulant therapy in 5 cases, and during the course of a megaloblastic anemia in one patient. The presence of marked associated myelomalacia was confirmed at postmortem in one case. Etiopathogenic factors remain obscure, particularly in spontaneously developing forms, and careful histologic examination of all clots is necessary to determine possible vascular malformations at the origin of the hematoma.

Adult↗
PubMed1982

[Bifocal excision in the treatment of bronchial carcinoma revealed by cerebral metastasis (author's transl)].

Between 1964 and 1980, 17 patients operated upon for cerebral metastasis as initial presentation of bronchial cancer underwent excision of the thoracic tumour 24 to 131 days later. One patient died post-operatively of acute pneumopathy. Nine patients showed signs of recurrent cerebral malignancy after a 55 to 904 days' delay. Increase in life expectancy and regression of neurological symptoms justify this bifocal surgical strategy. Using cerebral and thoracic radiotherapy as well as chemotherapy as supplementary measures seems rational and likely to improve the present results.

Adult↗
PubMed1981

[Arteriovenous malformations in deep cerebral area. Topographic classification. Therapeutic possibilities and results about 46 cases (authors' translation)].

The authors study the clinical dispositions of 46 arteriovenous malformations developed in deep cerebral area and detected in 41 cases by an haemorrhagic accident and after make a radiological classification. They class the M.A.V. of nucleus centralis with the localizations of the nucleus caudate's head, the insula and lentiformis nucleus and the capsulo thalamic area; the ventriculo-cisternalis M.A.V., the corpus callosum M.A.V. and complicated forms. With this classification they analyse the different operative technics that permit to obtain a complete extirpation in 26 cases about 39 operated patients. The results are excellent in 19 cases, good for 8 cases and mediocre in 4 cases. Eight patients are died during post operative time. The most important factors for the final result are the disturbance of consciousness before operative time and the malformations developed about several anatomical area. At last the authors insist on the fact that, if during next years, the embolism technics are not effective, the operation will be indicate in spite of the technical difficulties because the spontaneous evolution is always dangerous.

Adolescent↗
PubMed1980

[Treatment of arterio-venous aneurysms (AVA) in language areas. About 18 cases (author's transl)].

This study, about 18 cases of AVA strictly in language areas (posterior end of the inferior frontal gyrus (Broca), posterior third of T1 and T2, supra-marginalis and angularis gyri), prepose to specify the possibilities and the legitimacy of surgical management as well as the technical parts of removal. Malformations may divided in to : 1 arterio-venous fistula, 3 medium AVAS, 8 important AVA, 6 cirsoïdum aneurysms. 15 patients presented one or several intracranial hemorrhage (ICH). 3 others were admitted before this complication : 2 epileptic seizures, 1 left hemicrania. 2 patients died because of important ICH before any surgical treatment. The 16 others were operated. Two died during post-operative course : one because of prior ICH with deep coma, the other third month after a good period. In one case upon 14, a disabling handicap concerning language is noted after an important ICH. Except an ethylic patient with post-operative acalculia, minor language handicaps were observed only in patients with hemorrhagic seizure, permissing always satisfactory life. The best results on vital and functional prognosis were obtained for patients with no prior important ICH. So we must indicate the radical removal of all known AVA or cirsoïd aneurysms. The opinion that these last malformations generally do not bleed, may produced mistakes with their weighty consequences.

Adolescent↗
PubMedDate not supplied

[Late posttraumatic syringomyelic syndromes. Pathogenetic theories apropos of 3 cases].

Three patients with a post-traumatic spinal cord cavity are described: clinical signs are identical to those of syringomyelia, but pain is more frequent. Diagnosis is made easier by magnetic resonance imaging (MRI) and a syringoperitoneal shunt is proposed for treatment. Nevertheless, if results are good, they seem worse than in idiopathic syringomyelia. The main pathogenic theories are discussed: the rupture and coalescence of microcysts developed at a distance of 1 or 2 mm from the transected spinal cord, subsequently leads to syrinx formation; haemorrhagic or ischemic post-traumatic areas could also lead to syrinx formation. Hydrodynamic factors could be expected and make the pathogenesis not far from syringomyelic one.

Adult↗