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Biomedical subjects

J Brunon

Publications and source records attributed to J Brunon.

At least 55 records · Page 3Linked to original sources
PubMed1990

The penetration of ceftriaxone into human brain tissue.

The cerebral penetration of ceftriaxone in patients who underwent surgery for cerebral tumours was investigated. Seventeen patients received 2 g of ceftriaxone given intravenously 2 to 13 h before blood and brain samples were taken. Antibiotic levels were determined by an agar-well diffusion method. Cerebral ceftriaxone concentrations ranged from 0.3 to 12 micrograms/g, with a mean value of 1.63 micrograms/g. These values were less than 2% of corresponding serum concentrations, but enough to inhibit 75% of bacterial strains recently isolated from brain abscesses in our unit.

Adult↗
PubMed1990

[Spontaneous rhinorrhea disclosing intranasal meningoencephalocele and ependymoma of the 4th ventricle].

The authors report a case of a spontaneous rhinorrhea due to an intranasal meningoencephalocele associated with a benign, perhaps congenital, ependymoma of the floor of the fourth ventricle. The tumour was initially unknown, because clinical symptoms suggested a congenital aqueductal stenosis (macrocrania, no neurological signs, association with a congenital defect of the cranial base). This observation, which belongs to "hypertensive spontaneous rhinorrhea" suggests that the C.S.F. fistula is possible only when hydrocephalus coexists with a congenital abnormality of the cranial base. Therapeutic problems are discussed: the direct approach of the fistula alone is most often insufficient, the treatment of the hydrocephalus alone is possible, but may induce a tension pneumocephalus, the best attitude is the treatment in the same stage, of the fistula and the hydrocephalus. But, in case of chronic non communicant hydrocephalus, aqueductal tubing or ventriculocisternostomy can be insufficient and permanent internal C.F.S. derivation may be performed.

Adolescent↗
PubMed1990

[Diffusion of ceftriaxone into the human brain].

Study of the penetration of ceftriaxone into the brain of patients who underwent surgery for cerebral tumors. Seventeen patients received 2 g of ceftriaxone intravenously 2 h to 13 h before blood and brain samples were taken. Ceftriaxone levels in serum and in non tumoral cerebral tissue were determined by the agar well diffusion technique. Hemoglobin concentration was measured in cerebral samples in order to subtract ceftriaxone due to blood contamination. True ceftriaxone levels in cerebral tissue ranged from 0.3 to 12 mcg/g, mean 1.63 mcg/g. The ceftriaxone level ratio in brain and serum was low, mean about 2%, but cerebral ceftriaxone concentrations would be sufficient to inhibit more than 75% of bacteria isolated in recent cerebral abscesses. These results allow to do further therapeutic studies of ceftriaxone in cerebral abscesses due to identified and susceptible bacteria or in random treatment in association with antibiotics directed on anaerobic organisms and resistant hospital strains.

Adult↗
PubMed1987

[Cerebral aspergillosis. Apropos of 4 cases].

Four patients with aspergillosis of the central nervous system collected in less than two years are reported. Three patients had hematologic malignancies (acute myelogenous leukemia, Hodgkin's disease) and were treated with corticosteroids and chemotherapy. One patient received antimicrobial agents fort a post operative meningitis (after acoustic neuroma surgery). Analysis of these cases and review of literature available us to point out the increased frequency of invasive and cerebral aspergillosis particularly in immunocompromised hosts treated by cytotoxic drugs or broad spectrum antibiotic therapy. Diagnosis is very difficult because: --there are non specific radiologic features for aspergillus granuloma, abscess, aneurysm or meningitis, --blood and cerebrospinal fluid cultures are invariably negative, --serologic tests have limited value in immunosuppressed patients (poor capacity to elaborate antibodies). Diagnosis can be made only by surgical biopsy who isolate fungal elements. However diagnosis in greatest cases is only made at autopsy. Treatment consist by antifungal drugs administered intravenously and surgery when it is possible. Prognosis of cerebral aspergillosis is very poor and mortality rate very high about 70%.

Adult↗
PubMed1986

[Peroperative spinal cord ultrasonography in neurosurgery].

Intraoperative spinal sonography is a new method of investigation. We are reporting 14 observations. The results of these explorations permit to describe the normal spinal sonography and a spinal ultrasonic semeiology. We underline the advantage of this technic in the neurospinal surgery particularly to locate the tumors and to facilitate the removal.

Adolescent↗
PubMed1986

[Peroperative spinal cord echography].

Real time intraoperative ultrasonography is used since 1982 in spinal surgery. It gives numerous information, so that the neurosurgeon may adapt his technique to the obtained views. The authors describe this technique and give their experience based on 25 preliminary cases and on the literature. The normal echoanatomy of the spinal cord and the spinal canal is described as well as the echostructure of the different components observed in all cases. They give afterwards the different aspects of intramedullary tumours, extramedullary lesions (intra or extradurally), spinal traumas and syringomyelia.

Humans↗
PubMed1986

[Dural arteriovenous fistulas of the posterior cerebral fossa and thrombosis of the lateral sinus. Discussion of their relations and treatment apropos of 2 cases].

Two cases of a posterior fossa dural arteriovenous malformation associated with a lateral sinus thrombosis are reported. In the first case, a right tentorial meningioma develops at the end of the superior sagittal sinus and on the transverse sinus which are occluded. A cranial bruit, heard by the patient four months after the surgical removal of the tumour, brings up a dural fistula supplied by the occipital, middle meningeal and pharyngeal arteries and drained away by cervical and cortical veins. Many attempts of extirpation and radiological embolization stop the bruit. In the second case, an increased intracranial pressure mixes up with an aphasia. A continuous emission doppler examination and a CT scan make likely a dural fistula. The malformation, which is associated to a left sigmoid sinus thrombosis, is fed by the occipital and middle meningeal arteries and drained by cortical veins to the cavernous sinus. The occipital artery ligation and a by-pass between the lateral sinus and the internal jugular vein cure the patient with a very good patency of the venous graft that holds up two years after. A few cases of the literature show the succession of the two vascular lesions and prove the primitive occurrence, either of the sinus occlusion, or of the dural fistula. A venous thrombosis might cause a fistula by the opening of physiological shunts of the dura-mater which consequently deviates the blood into the cortical veins, brings down the increased intracranial pressure and stops the thrombosis to spread.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Giant traumatic aneurysms of the internal carotid developing in the sphenoid sinus. Apropos of 2 cases].

Two cases of traumatic aneurysms of the internal carotid artery developed into the sphenoidal sinus are reported by the authors. It is a very rare pathology (about fifteen cases are reported in the literature). Recurrent epistaxis are the most frequent symptom associated or not with a sphenoidal sinus syndrome. Our first observation corresponds to this description but the second suggests a tumour of the sphenoidal base. The diagnosis is performed by carotid angiography. The treatment consists of the exclusion of the aneurysm by ligating the cervical internal carotid artery or by trapping the aneurysmal segment. This treatment has produced a good result in nine cases of the literature and in our two cases. The direct approach of the aneurysm is very difficult, but the endovascular techniques can be performed in the future.

Brain Injuries↗
PubMed1984

[Lumbar discal hernia after 65 years of age].

The authors make a retrospective study of a series of 200 patients who had been surgically treated, within a period of 26 months, for a lumbar discal pathology. Twenty of these (20%) were over 65 years old. A similar study was carried out in a rheumatological unit over a period of three years, and has included 266 patients, 21 of whom (7,8%) were older than 65. The comparison of both these series permits us to make some considerations concerning the frequency of this pathology after the age of 65, its clinical presentation and its treatment, which, as for the younger adult, must be surgical when the correct treatment fails and when a complication appears.

Aged↗
PubMed1983

[Intramedullary bronchogenic cyst. Apropos of 1 case. Discussion of the endo-ectodermal adhesion syndrome].

The authors report the case of a 40-year-old man who has presented for many years an intermittent progressive spastic paraplegia. Plain films of the spine show very important dysraphic abnormalities of the inferior dorsal column and the myelography shows a complete block suggesting an intramedullary space-occupying lesion at four levels above the vertebral abnormalities. The operation permits a total removal of an intramedullary "bronchogenic cyst". In the post-operative course, the neurologic deficit improves, six months later a spastic paraparesia remains. The review of the literature shows that this is an exceptional observation. Intramedullary bronchogenic cysts must be regarded as similar to intramedullary enterogenic cysts. They are not teratomas but dysembryoplasiae due to failure of the ento-ectoblastic separation between the second and the third weeks of life. These cysts form a part of the "ento-ectodermal adhesion syndrome" of Prob et al. The preoperative diagnosis is possible on the association of intermittent progressive syndrome of medullary compression and dysraphic spondylotic changes. The total surgical removal of the cyst, by micro-surgical techniques, is able to preserve the neurologic evolution with an excellent result if the operation is performed before definitive neurologic deficits occur.

Adult↗
PubMed1980

["Benign" intracranial hypertension due to bilateral thrombosis of the lateral sinuses treated with venous bypass (author's transl)].

The authors report on a case of "benign" intracranial hypertension due to bilateral thrombosis of the lateral sinuses and internal jugular veins of infectious origin (otitis). A venous by-pass was established between one of the lateral sinuses and an external jugular vein. As early as the first post-operative week, the intracranial pressure was reduced and the visual disorders regressed. Such venous by-passes, now made possible by micromicrosurgical techniques, can be suggested for treating occlusions of the intracranial sinuses due to thrombophlebitis, traumatisms or tumours.

Adolescent↗
PubMed1980

Bilateral thrombosis of the transverse sinuses: microsurgical revascularization with venous bypass.

The present paper reports a case of intracranial hypertension secondary to thrombophlebitis of the two transverse sinuses and internal jugular veins in which microsurgical revascularization was attempted. This was carried out by means of a bypass graft inserted between the right transverse sinus and the superficial jugular vein. As early as the first post-operative week, intracranial pressure improved and visual disorders regressed. This type of venous revascularization using microsurgical techniques should contribute to more successful and lasting results in cases of sinus occlusions of thrombophlebitic, traumatic or tumorous origins.

Adolescent↗
PubMed1980

[Actinomycotic brain abscess. (about four observations) (author's transl)].

The authors report four observations of actinomycotic brain abcess. One patient with multiple hemispheric abcesses and with stomatologic and pulmonary lesions, one with seemingly primary cerebellar abcess, one with associated hemispheric abcess associated with pneumopathy. About these four cases, they discuss the role of actinomycosis in infectious diseases of the central nervous system, and the elements necessary for the diagnosis. The neurological syndrom is not specific, but the discovery of visceral lesions is an excellent argument. From the histological point of view, the discovery of "granules" containing the bacteria conforms the diagnosis by special colorations. From the bacteriological point of view, the isolation of the germ is easy but its specific identification necessitates special techniques. The diagnosis of actinomycosis is indispensible to begin a correct treatment. For the authors, this treatment must associate surgical excision of the most extensive lesions and adapted antibiotherapy for more than four months.

Actinomycosis↗