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Biomedical subjects

J Lepoire

Publications and source records attributed to J Lepoire.

At least 19 recordsLinked to original sources
PubMed1990

Role of angioplasty in the treatment of symptomatic vascular spasm occurring in the post-operative course of intracranial ruptured aneurysms.

Angioplasty of vascular spasm (VS), related to subarachnoid hemorrhage (SAH) has been recently introduced to the medical field. The authors report 5 cases treated by this mean in the postoperative period. These patients were all symptomatic from their VS inspite of early surgery and of the preventive treatment by Nimodipine. In all cases, obtained increase in the caliber of the spastic vessels was followed by a rapid clinical improvement coupled with a significant decline of the flow rates as confirmed by transcranial Doppler (TCD). No recurrence of VS has been observed. This technique appears quite effective provided that it is performed as early as the clinical symptoms come out in correlation with important acceleration of flow rates on TCD.

Adult↗
PubMed1990

Mucoceles of the sphenoidal sinus. Report of six cases and review of the literature.

Six personal cases of mucocele of the sphenoidal sinus are reported, and 124 cases from the literature are reviewed. Sphenoidal sinus mucocele is a benign and rare lesion which has long been unrecognized. Clinical features include fronto-orbital pain, oculomotor palsies, loss of visual acuity, exophthalmos and anosmia. Our series is of particular interest since four of our six patients presented with endocrine disorders. Recent advances in neuroradiological methods should rapidly lead to the correct diagnosis. Treatment consists of aspiration and drainage of the mucocele via a trans-sphenoidal approach. The results are good, and ophthalmoplegia usually subsides. In our experience, endocrine disorders do not always respond to treatment. The prognosis of sphenoidal sinus mucocele depends on the preoperative duration of the loss of visual acuity.

Adult↗
PubMed1990

[Extradural intracavernous epidermoid cyst. Apropos of 2 cases].

The authors report two cases of intracranial, extradural, intracavernous epidermoid cyst. In one case the cyst was ruptured into the subarachnoid space and in the substance of the temporal lobe. The two cysts had to be subtotally resected because of dense adherences with the internal carotid artery. In both cases the post-operative periods were uneventful.

Adult↗
PubMed1989

[Value of transcranial Doppler in the monitoring of aneurysmal subarachnoid hemorrhage treated with calcium inhibitors].

Fifty four patients (33 male and 21 female, mean age 47) with spontaneous aneurysmal subarachnoid hemorrhages have been tested by repeated TCD: 25 of them were systematically administered intravenous Nimodipine when admitted at hospital, the 29 others constituted a reference group. There was no statistically significant difference between the two groups of patients for age, sex, initial clinical status, importance of bleeding at CT scan, localization of aneurysm or existence of an angiospasm, whether clinically symptomatic or not. In 72% of the cases, TCD allowed to prove the existence of an angiospasm when higher flow velocity was registered in cranial basal arteries. There was no significant difference between the two groups. The final clinical status of the patients seemed to be more favourable in the treated group. Yet it did not appear to be directly linked to the existence of a spasm or not. This argued in favour of a non-univocal mechanism of action of Nimodipine.

Brain↗
PubMed1989

[Intracerebral cavernous angioma].

Thirty four cases (18 operated, 16 non-operated), of cavernous angioma are reported. The presenting symptoms and signs were epilepsy in 22 cases, neurologic deficit in 9 and cerebromeningeal hemorrhage without vigilance disorders in 3. In the operated group 15 angiomas were supratentorial, 3 were subtentorial. In the non-operated group symptoms and signs were epilepsy in 11 cases and a neurologic deficit related to a brain stem lesion in 4/5 cases. Follow-up of 2 to 39 years after the first fit episode and of 1 to 7 years after initial diagnosis suggested that the risk of hemorrhage is low. Indications for neurosurgery are discussed as a function of the site of the angiomas and of the operative hemorrhagic risk.

Adolescent↗
PubMed1988

[Immediate and severe epistaxis caused by traumatic rupture of the carotid siphon. Apropos of a case treated by intravascular approach].

The authors report a recent case of massive and immediate epistaxis resulting from a rupture of the internal intracavernous carotid artery caused by closed head injury. The point out the unusualness and the extreme severity of such lesions. The pathogenesis of these epistaxis can be explained by an immediate arterial rupture proceeding from a sphenoidal fracture. The emergency bilateral carotid angiography states precisely the diagnosis and the level of the rupture, allowing in the same time the intravascular treatment by detachable balloon.

Carotid Artery Injuries↗
PubMed1987

[Surgery of the remaining carotid artery].

Seven patients with unilateral arterial carotid occlusion and contralateral arterial carotid stenosis in the neck are reported. Authors perform an extra-cranial to intra-cranial anastomosis on the occluded side prior to realize endarterectomy on the stenosed side. This policy obviates the need of an internal vascular shunt during temporary occlusion of I.C.A.

Aged↗
PubMed1987

[Aneurysm of the ampulla of Galen. Nosologic reflections and endovascular therapy].

Nosologic concepts distinguish three types of aneurysm of Galen's ampulla: true aneurysms, related aneurysms, false aneurysms, whatever the type the majority of these malformations can be treated by the endovascular approach, frequently the most effective alternative therapy. Experience acquired during treatment of intracerebral arteriovenous angioma allows perfect control of direct, high output arteriovenous fistula by injection of pure isobutyl cyanoacrylate. Occlusion of shunts should be combined with prevention of consequences, that is to say extensive venous thrombosis. Two cases are reported that demonstrate the value of post-embolization heparin therapy.

Adult↗
PubMed1985

[Trans-cleido-manubrial approach to the upper thoracic spine (T1-T2)].

Authors describe their own experience of Sundaresan anterior approach and exposure of the upper thoracic vertebrae (T1-T2) including resection of the internal third of the clavicle and manubrium sterni. They point out technical details of that surgical approach and its indications.

Humans↗