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G Rancurel

Publications and source records attributed to G Rancurel.

At least 109 records · Page 6Linked to original sources

[C.T. scan appearances of acute necrotizing herpes encephalitis (7 cases). Preliminary therapeutic results after isoprinosine (author's transl)].

Seven cases of confirmed or probable acute necrotizing herpes encephalitis (ANE) were studied using computer tomography during the various acute or chronic stages of the disease. They were bilateral, or in some rare patients, asymmetrical pseudofocal cases of ANE. Computer tomography appearances are described from the morphological and topographical point of view, before and after intravenous injection of a contrast medium. Analogous data reported in the published literature is used to describe the findings and to emphasize the problem of differential diagnosis. Computer tomography appears to be an essential examination for establishing the diagnosis and prognosis in herpes encephalitis, but it must be correlated with the results of an electro-encephalogram, and biological and immunological tests of the cerebrospinal fluid. It can also be of value for choosing the optimal site for urgent cerebral biopsy with immunofluorescence. Treatment must be given very early, whether Ara A antiviral DNA or Isoprinosine (Inosiplex) which stimulates cellular immunity, as soon after diagnosis has been established as possible. The authors chose the latter medication for 6 of the 7 cases reported, as well as in 12 other cases of acute primary viral encephalitis, and 3 cases of subacute sclerozing panencephalitis, and obtained very positive results.

Adolescent↗

[Cerebral tuberculosis. There clinicopathological cases (author's transl)].

The clinico-pathological report of three cases of cerebral tuberculosis, collected over a 10 year period in a single neurological department from non immigrant patients emphasizes the difficulties of diagnosis and therapy of this disease. Multiple tuberculomas have simulated either an alcoolic encephalopathy in one case or a primitive cerebral tumour in another one. In the third case, the course of an exceptional cerebral miliary tuberculosis was not modified by the treatment. Liver cirrhosis was present in every case.

Aged↗

Bismuth encephalopathy and cerebral computed tomography.

Five cases of severe encephalopathy due to chronic ingestion of bismuth have been studied by cerebral computed tomography (CT). In every case, areas of increased attenuation coefficient in the basal ganglia and the cortex of the cerebral hemispheres were demonstrated. These regions of increased attenuation were diffuse with irregular, patchy denser areas. The increased attenuation in the gray matter territories contrasted with decreased attenuation of the white matter, particularly evident in the centrum semiovale of each hemisphere and probably related to edema. Some ventricular dilatation was also present in three cases. In one patient, areas of increased attenuation were demonstrated in the cerebellum. Follow-up CT studies of one patient revealed regression of the pathological findings. This regression accompanied the clinical improvement, which, in every case, followed the termination of the bismuth intake.

Adult↗

[Familial Creutzfeldt-Jakob disease. A clinical and pathological study of three cases in a family with eight affected members in three generations (author's transl)].

We report here a family with three pathologically confirmed cases of Creutzfeldt-Jakob disease in three siblings and with transmission of one case to the squirrel monkey. This family, originating from the South-East of England, settled in France in 1870. Eight members of the family, distributed in three generations, were affected by the disease at the same age (about 50), with similar symptoms and length of evolution. Two cases were confirmed at post-mortem and one case by cerebral biopsy. The genealogic inquiry dealth with 46 members of 5 generations. All the affected members, six men and two women, belonged to the three older generations which were comprised of 15 individuals. All had lived in close relationship in a limited area of the north of Ardennas. The possible mechanisms of dominant inheritance or cross infection are discussed.

Animals↗

[Tomodensitometric aspects of 3 cases of acute bismuth encephalopathy (author's transl)].

A study of 3 cases of acute bismuth encephalopathy by C. T. scanner revealed indisputable evidence of abnormal hyperdensity in certain brain regions. These hyperdensities, or rather hyperattenuations, are very typical in case no. 1, where the central grey nuclei, especially the caudate nuclei and cerebral cortex, have an important hyperdence appearance. The images are heterogenous, sometimes granular, and are not modified by the injection of a contrast medium. There are also ventricular and cisternal dilatations which are even more remarkable when the age of the patients (less than 45 years) is considered. Cases Nos. 2 and 3 showed hyperdensity which was mainly in the cortical hemispheres. Blood bismuth levels vary according to the date of bismuth stoppage, lying between 850 and 1.350 microgram p. 1.000 ml. The pathogenesis of these tomodensitometric images are discussed as a function the of atomic number of bismuth metal and its unequal distribution in the cerebral parenchyma and the meninges.

Adult↗

Toxic encephalopathy due to ingestion of bismuth salts: clinical and EEG studies of 45 patients.

Forty-five patients taking bismuth subnitrate orally for therapeutic reasons were admitted to hospital with a myoclonic encephalopathy of acute onset. The clinical features were similar, mostly with mental confusion, disorder of walking and standing, dysarthria, and myoclonic jerks. In 31 cases the EEG showed a characteristic pattern, not previously recognised, which assisted differential diagnosis.

Adult↗

[Attempted treatment of a voluminous tympano-jugular and retropharyngeal glomus tumor by embolization].

The authors report a case of glomus tumor effectively treated by embolisation. The very large size of this tumor, the age and very poor general condition of the patient due to swallowing difficulties represented a contraindication to classical methods of treatment. Elective devascularisation was carried out by embolisation of the tumour itself using non-resorbable inert material by way of selective catheterisation of the vessels supplying it, almost all of which arose from the external carotid. Rapid and durable disappearance of part of the left cranial nerve involvement, in particular swallowing difficulties, reflected the effectiveness of the method. 18 months after this attempt at palliative treatment, the patient's condition remains satisfactory, with no detectable evidence of any recurrence or progression of the tumour.

Deafness↗

["Astasia-abasia," unilateral left-sided apraxia, and touch disorders in an astrocytoma of the corpus callosum. A clinico-pathological report].

The authors report the case of a 55 year old woman suffering from an astrocytoma of the corpus callosum, probably originating in the middle part of the commissure and subsequently involving the whole structure, beyond which it extended very little. They describe the symptoms and signs, consisting initially of a progressive isolated astasia-abasia, in the absence of any psychological disturbance, and subsequently consisting of an apraxic disorganisation involving particularly gestural activity of the left upper limb. They discuss the significance of the psychological disturbances and problems of stasis and walking classically described in relation to tumoural pathology of the corpus callosum, generally attributed to an associated pre-frontal involvement. They review the principal features the "callosal disconnection syndrome" of which their patient constituted an example.

Apraxias↗

[Nondeficiency chronic polyneuropathies in celiac disease in adults (2 cases with inflammatory neuromuscular vascularitis)].

The neurological and muscular complications seen in coeliac disease in adults are usually attributed to deficiency secondary to malabsorption. Amongst them, however, there exists a very rare cateogory, described by Cooke et al. (1966) taking the form of a chronic myeloneuropathy which cannot be explained in terms of the malabsorption syndrome. Our two cases of gluten intolerance enteropathy, confirmed by biopsy before and after diet, fell into this group of polyneuropathies. The patients, both women, suffered from an essentially sensory ataxic polyneuropathy with accessory motor component with pyramidal and posterior column signs. CSF findings showed a meningeal inflammatory reaction in one of the two cases. These neurological signs, appearing paradoxically during a digestive disease cured by diet, evolve chronically but become stabilised with corticosteroid therapy. Any vitamin deficiency may be excluded in the aetiology of these problems. Neuropathological study of neuromuscular biopsies in very fine serial sections confirmed the mild peripheral nervous involvement but revealed identical inflammatory lesions in the nerve and muscle which were remarkable by virtue of their very highly segmentally selective micro-vasculitis appearance. In these two cases, general, clinical and biological arguments, as well as the type of histological lesion, make it possible to exclude monoclonal gammapathies, malignant haemopathies, amyloidosis and the major collagen diseases. This micro-vasculitis, having transient forms with P.A.N. is no less distinctive, and may be integrated into the provisional group of "allergic angeitis", related to physiopathology of circulating immune complexes and very fashionable in theories as to the mechanism of gluten-sensitive enteropathies. The exact nature of the link between the latter and these types of polyneuropathy remains unknown.

Adult↗

[Akinetic mutism and bicingular softening. 3 anatomo-clinical cases].

The authors describe three pathological cases of akinetic mutism with, as a common basic lesion, bilateral infarction of the cingulate gyrus secondary to aneurysm of the anterior communicating artery (case n degrees 1), to a huge olfactory meningioma (case n degrees 2), both operated on, and to atheromatous occlusion of the anterior cerebral arterial system (case n degrees 3). These three cases enable a variety of "anterior and waking" akinetic mutism to be described which is unusual enough to be compared with other mesencephalic and diencephalic aspects of this syndrome. It is in fact an akinetic mutism characterized by: a certain dissociation in its non-response to various stimuli, a particularly marked appearance of wakefulness when day-time alertness is considered, conservation of the waking-sleeping rhythm, perception and reaction unpredictable and paradoxical in both degree and quality, complete absence of any spontaneous verbal communication in contrast to relative break-down of solicited communication which is infrequent, uncertain and unresponsive to the usual methods of stimulation, without any possibility of a code. In addition, there is a remarkable mimic and segmental general akinesia, resistant to the usual nociceptive stimuli, but sensitive to slight excitation of the manual and oral zones. Besides this special akinetic mutism, there are variously systematised signs, mostly asymmetrical, indicating lesion of the cortico-sub-cortical frontal structures bordering on the gyrus cinguli. This unusual behaviour pattern corresponds in these three cases to extensive anterior bilateral ischemic lesions of the cingulate gyrus regularly associated with bilateral infarctions confined to the medial aspect of F1 in the superficial territory of the two anterior cerebral arteries, to possible neurosurgical changes (ablation of the right frontal pole) and to compressive or ischaemic lesions of the gyrus rectus. These exclusively cortico-sub-cortical associated lesions are in contrast with the remarkably intact caudate nuclei, the pallidal, thalamic, hypothalamic and septal formations and the anterior pillars of the fornix. These findings compared with the results of experimental research carried out by M. Kennard, help, if help is needed, to resolve the apparent contradictions between the effects of therapeutic cingulectomies or cingulotomies and the scanty pathological data already available in cerebral vascular pathology.

Adult↗

[Arthropathies due to bismuth poisoning].

Encephalopathies caused by intoxication with bismuth are liable to be complicated by arthropathies of the shoulder, on one or both sides, of an osteolytic, and probably osteonecrotic, type involving to a greater or lesser extent the humeral head and/or by destruction of articular cartilage with ateration and flattening of the heumeral head. The relation between these arthropathies and bismuth intoxication appears certain but is not yet understood. The strict electivity of the condition for the shoulder is not understood either. Certain analogies indicate similarity with metabolic arthropathies.

Bismuth↗