Prognosis in diffuse injury. A cooperative study.
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Biomedical subjects
Publications and source records attributed to J Espagno.
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The authors present two observations of dorsal medullary compression by intraspinal benign osseous proliferations developing in subjects who present with anterior vertebral hyperostosis. In the second observation operative intervention confirmed the site and nature of the lesion. The authors have researched the same radiological findings in other cases of vertebral hyperostosis. They describe the lesions which are of considerable practical importance as they are able to injure the spinal cord and the nerve roots, resulting in a hyperostotic dorsal myelopathy. All unexplained paraplegias should be investigated for such lesions by meticulous tomographic studies.
Over the past few years considerable amount of clinical syndromes describing brain stem levels of lesion were reported. This work was undertaken to establish, if possible, a simplification of criterions of axial lesions in head injuries. 125 patients with severe head injuries were strictly selected. Statistical analysis of careful examination of clinical pattern was performed and correlated, when possible, with anatomical lesions. Only four homogeneous groups were isolated:--group I represents the cortico-sub-cortical level,--group II représents the diencéphalie level,--group III represents the upper brain stem level with two subdivisions dependent upon the mechanism of herniation : central or uncus,--group IV represents the lower brain stem level.
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The authors report twenty cases of lumbar arachnitis, from the clinical, biological, and neuroradiological points of view; a discussion is developed in connexion with various etiological factors centred, on the one hand, on the responsibility of the contrast media used in neuro-radiology and, on the other hand, on that of the act of surgery, a factor that was encountered in half of the cases reported. The possibilities of therapy are also discussed.
Metrizamide, a new water-soluble contrast medium with low toxicity, was used for cranial computed tomography (computerized cisternography) in 26 patients. When injected by lumbar puncture, the pericerebral cisterns (posterior fossa and sella turcica especially), can be visualized with much greater precision than with classical computed tomography. It also allows the normal and pathological circulation of the CSF to be studied. The authors report on 6 cases of tumours of the posterior fossa, 10 cases of pituitary tumours, 2 cases of "empty" sella, 2 cases of CSF rhinorrhoea, 2 cases of normal pressure hydrocephalus, and 2 cases of syringomyelia, studied by this method. The examination was normal in 3 cases. The authors stress the rapidity, reliability, and good tolerance of this new method.
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