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J C Peragut

Publications and source records attributed to J C Peragut.

66 records · Page 4Linked to original sources
PubMed1981

[The role of stereotaxic biopsy in the therapeutic approach to malignant gliomas (author's transl)].

Analysis of 770 biopsies of intra-cerebral neoplasms under stereotaxic conditions and performed in Bordeaux, Rennes and Marseilles. The study emphasized the relative benign nature of this examination (1% deaths, 1.4 % severe sequellae) bearing in mind the severity of the underlying disease. In a very large number of cases (from 7 to 38% according to Schools) the diagnosis made before biopsy was fundamentally altered by this examination. The quasi-certitude of the nature of the lesion, and the possible facilitation of surgery by the precision of the lesional topography, and finally the possibility of a therapeutic gesture of evacuation in certain cases, is felt to justify intra-cranial biopsy performed under stereotaxic conditions.

Biopsy↗
PubMed1978

[Chronic intracerebral electric stimulation for analgesia in man].

This report concerns the current status of the results of intraencephalic implantations carried out up to the present time in man with the aim of relieving certain forms of chronic pain. It places little emphasis upon the neuro-physiological basis of these implantations, which have been studied at length during previous reports. After presenting the overall results of operations carried out in the world up until September 1967, a critical study is undertaken: 1--In relation to the targets (Postero-Lateral Ventral Nucleus, posterior arm of the internal capsule, para-ventricular thalamic grey matter). 2--In relation to etiologies, both analytically (syndrome) by syndrome as well as in terms of synthesis (excess of pain perception-deafferentation). 3--In terms of various factors, such as: --technical requirements; --side ffects; --duration of "post effect" (residual analgesia after stimulation); --parallel action of drugs. Conclusions are drawn concerning future perspectives of this technique.

Brain↗
PubMed1975

Extradural hematomas in children. 104 cases.

The authors have studied the clinical features of 104 extradural hematomas in children. The frequency of this complication seems rather high and its severity undeniable. 17 cases were observed in newborns and 2 cases were localized in the posterior fossa. From a clinical point of view, 57% of the children had no disturbances in consciousness at the time of the injury, and 7% had no disturbances at anytime. A lucid interval was found in 68% of the cases, and this was less than 24 h in 60% of the cases. In 19% of the cases there was no skull fracture. Angiography allowed correct diagnosis and a better choice of the surgical technique. The hematoma was distinctly localized in 59 children, whereas it was widespread in 45, meaning that, excepting the coronal suture, the cranial sutures do not limit the spreading of an extradural hematoma. For treatment the authors prefer a bone flap with four or five holes (90 operations). The results are rather unsatisfactory. 18 patients died and in 21 (7.2%) the motor sequelae were the most important complications.

Accidents, Traffic↗
PubMedDate not supplied

[Cerebral abscess. Analysis of 41 cases over a 10-year period].

Although treatment with antibiotics and computerized tomography (CT) of the brain have considerably improved the prognosis of intracranial purulent collections, brain abscess remains a lethal disease in about one out of ten cases. We present a series of 41 brain abscesses diagnosed between 1976 and 1986 and treated surgically. The clinical signs were more often neurological than infectious. Among the exploratory methods, only CT has a real diagnostic value. Treatment is both medical and surgical. Simple aspiration seems to have the triple advantage of producing prompt and effective decompression of brain tissue, enabling the pathogen(s) to be isolated so that the appropriate antibiotic can be chosen, and being a repeatable and little traumatic procedure with less sequelae than surgical excision.

Adolescent↗
PubMedDate not supplied

[Radiosurgery of brain metastasis].

Radiosurgery has recently provided an alternative to conventional therapy for the treatment of brain metastases. This non-invasive technique delivers a single large fraction of ionizing radiation to a well-defined small intracranial target as brain metastases. After a computerized tomography (CT) with stereotactic frame in place for tumor localization, a dosimetric study was performed. The sharp dose gradient of radiation reduces the dose to the surrounding normal structures at a minimal level (> 10%). The prescribed dose at the periphery of the lesion varies from 8 to 27 Gy with a combined whole brain irradiation and from 20 to 35 Gy without any irradiation. Radiosurgery has been reported to be highly efficacious with a local control rate of 86% (not increased size without local recurrence). Brain metastases from melanoma and renal carcinoma are usually resistant to conventional irradiation and are highly sensitive with this technique. The morbidity is very low with a symptomatic edema rate of 5-10% at 2 years, resolved with corticosteroids. A radiation necrosis has been reported in less than 5% of cases. The patients with a good performance status, without any extracranial metastasis and with a solitary brain metastases have presented the best survival rate. New brain metastases have occurred in 20 to 30% of the cases during the follow-up. Eleven to 25% of patients died from their intracranial disease and the others from the extracranial evolution of the cancer. The median survival was still poor, ranging from 8 to 12 months. Radiosurgery is a good choice for surgically inaccessible and recurrent tumors. It represents an alternative to the neurosurgery with or without whole brain irradiation, taking into account different prognostic factors and morbidity rate. The local control and the survival rates without neurologic symptom should be considered the major endpoints of different ongoing randomized studies for evaluating the role of the radiosurgery.

Brain Neoplasms↗
PubMedDate not supplied

[Preoperative approach to the histologic diagnosis of cerebral tumors by combination of clinical and paraclinical examinations (EEG, computerized cerebral tomography, scintigraphy, and angiography)].

The authors present their last series of one hundred operated cerebral tumors (19 meningiomas, 16 benign gliomas, 38 malignant gliomas, 20 isolated metastasis, 8 diversified tumors) studied on the clinical, E.E.G., isotopic scanner, computorized tomographies and angiographic point of view. The comparison of these multiple exams, permits one to determinate the malignant of benign nature of a tumor in 86 p. 100 of the cases and the precise histological nature in 56 p. 100 of the cases. The biopsy effectuated in stereotaxic conditions permits to solve the problem in uncertain cases. The interest of computorized tomography is emphasized (discovery or confirmation of a suspected tumor, definition of its extension in depth), but this recent technic is incapable of constant confirmation of the histological diagnosis; it cannot replace other confirmed methods of diagnosis. The angiography remains necessary to guide the surgical gesture.

Brain Neoplasms↗