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Biomedical subjects

H Mouchaty

Publications and source records attributed to H Mouchaty.

8 recordsLinked to original sources
PubMed2006

Assessment of three year experience of a strategy for patient selection and timing of operation in the management of acute thoracic and lumbar spine fractures: a prospective study.

BACKGROUND: The purpose of this article is to report experience gained over three years of the use of a protocol for patient selection and timing of operation for acute thoracic and lumbar fractures. METHOD: At admission, all patients underwent neurological and imaging exams. All patients with a spinal cord lesion scored as ASIA A at any level inferior to T10 and as ASIA B, C or D at any level, were categorized as emergency and operated on within eight hours from trauma. ASIA A cases in the T1-T10 tract and ASIA E cases at any level were treated in the ordinary operative work schedule. FINDINGS: Ninety-four patients with surgically treated lumbar or thoracic fractures took part in this study. On the imaging studies, 12 patients were classified as A, 50 as B and 32 as C following the AO classification. At the neurological exam, 39 patients were scored as ASIA A, nine as B, six as C, two as D and 38 as E. At follow-up, of the 39 patients scored as ASIA A, 13 (33%) improved at least one grade and of the 17 scored as ASIA B, C or D, 11 (64.7%) improved. None of the 38 patients scored as ASIA E deteriorated. CONCLUSIONS: The findings show that the strategy in the protocol was safe and followed by satisfactory rates of neurological outcome. Larger prospective studies, preferably randomized, are needed to establish definitively its place in the management of patients with spinal injury.

Adolescent↗
PubMed2006

Evaluation of donor site pain after anterior iliac crest harvesting for cervical fusion: a prospective study on 50 patients.

BACKGROUND: Autologous anterior iliac crest bone graft is still widely considered the gold standard for anterior cervical fusion after discectomy or corporectomy. Postoperative pain at the donor site is one of the main disadvantages to this technique. This prospective study aimed to evaluate pain at the donor site, after careful, standardised bone harvesting. METHODS: From March 2003 to March 2004, a prospective study was performed in a single neurosurgical department on 50 patients who underwent anterior iliac crest bone harvesting using a standard and careful surgical technique. During a one year follow-up, patient donor site pain was assessed with a Visual Analogous Scale (VAS) at 2, 7 and 60 days from surgery and finally, by a telephone interview, at one year. FINDINGS: The duration of time in hospital ranged from 4 to 9 days. On the 2(nd) day after surgery, pain, according to the VAS score, was recorded as being >7 by 4 patients (8%), 5-7/10 by 27 patients and >5/10 in 19 cases. On the 7(th) day after surgery, none of the patients reported any VAS > 7, 1 patient's VAS score was 6/10 and 49 patients had a VAS < 5. At 2 month follow-up, 45 patients were completely without pain (VAS 0) and the remaining 5 had a VAS < 5. At one year, 46 patients reported no pain (one patient was lost to follow-up); three continued to have pain <5 in VAS scale. CONCLUSIONS: After harvesting of bone from the iliac crest, using a standardised approach based on anatomised principles, most patients do not experience persisting pain at the donor site.

Adult↗
PubMed2006

Thoracic extradural paragangliomas: a case report and review of the literature.

STUDY DESIGN: Case report. OBJECTIVES: To report on a case of paraganglioma presenting in an uncommon extradural thoracic localization. SETTING: Department of Neurosurgery, Florence, Italy. CASE REPORT: A 43-year-old woman with a thoracic lesion extending into the extradural space along four levels, T(1)-T(4), presented with sudden spastic incomplete paraplegia and paresthesia at the lower limbs. RESULTS: The neoplasm was surgically resected 'en bloc' and histological findings corresponded to paraganglioma. One year after surgery, the patient was walking without assistance, a T(3)-T(4) hypoesthesia was still present and an magnetic resonance imaging (MRI) study showed no signs of focal recurrence. CONCLUSIONS: The imaging features of thoracic paragangliomas may be misleading and an advanced malignant lesion could be primarily suspected; thus, a histological study is always needed. Total resection is the gold standard therapy. Owing to the risk of recurrence or multicentric growth, follow-up must be prolonged and accurate.

Adult↗
PubMed2004

Misleading imaging features of intracranial dural plasmacytoma: report of two cases.

Dural plasmacytomas are very rare and often disregarded in the differential diagnosis of more common lesions of the convexity. We report two cases. Both patients exhibited headache as a main symptom. Computed tomography and magnetic resonance showed a homogeneously enhanced lesion without calcification and without bone involvement.

Diagnosis, Differential↗
PubMed2002

Radiation leukoencephalopathy associated with moderate hydrocephalus: intracranial pressure monitoring and results of ventriculoperitoneal shunting.

Delayed neurological sequelae of radiotherapy have several manifestations; leukoencephalopathy is one of the most common. Pathogenetic relationships between radiation leukoencephalopathy and other findings of diffuse radiation injury (brain atrophy and progressive ventriculomegaly) are not well defined. Moreover, no guidelines have been established for the treatment of hydrocephalus when associated with radiation leukoencephalopathy. Our study reports intracranial pressure (ICP) monitoring in two patients with radiation leukoencephalopathy with moderate hydrocephalus. High intraventricular mean pressure and high peaks were found, and marked improvement of clinical status after shunting was achieved. This study, although restricted to only two patients, shows that ventriculoperitoneal shunting insertion is useful in radiation-induced hydrocephalus, when ICP monitoring detects high mean pressure. A hypothesis is advanced concerning radiation-induced hydrocephalus with high ICP, emphasizing periventricular astrocytosis and its connections with cerebral compliance.

Adult↗