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Biomedical subjects

J M Ekherian

Publications and source records attributed to J M Ekherian.

7 recordsLinked to original sources

Polymicrobial meningitis revealing an anterior sacral meningocele in a 23-year-old woman.

Polymicrobial meningitis has become increasingly rare during recent decades. Historically, it has mainly been reported as being associated with disorders of the ENT-sphere. The treatment of these infections being optimized, polymicrobial meningitis nowadays is essentially a complication of gastrointestinal or gynaecological disorders and trauma. We present a case of polymicrobial meningitis following puncture of a unrecognized pre-sacral meningocele in a patient with Currarino syndrome and review of the relevant literature.

Adult↗

[Neurologic toxicity of methotrexate in a patient with cerebral arteritis. Report of a case].

We report the case of an 18 year-old woman treated for femoral osteogenic sarcoma who presented generalized seizures requiring sedation, tracheal intubation and artificial ventilation. CT brain scan showed diffuse hypodensities. Doppler studies showed an increased cerebral arterial resistance. Regional cerebral blood flow was decreased. A right carotid angiogram showed abnormalities consistent with diffuse cerebral arteritis. The patient slowly recovered and 6 weeks later, magnetic resonance imaging showed disseminated areas of hyposignal on T1 and hypersignal on T2 weighted images. We reviewed the different published cases of acute high dose methotrexate neurotoxicity and the different underlying mechanisms.

Adolescent↗

Streptococcus B meningitis in post-partum.

We report a case of post-partum meningitis due to group B-streptococcus developing 24 h after vaginal delivery. Diagnosis was established by latex agglutination of streptococcus B-antigenes and confirmed by cerebrospinal fluid-culture later on. Clinical and haematological signs of meningitis disappeared after treatment with ampicillin. In a review of the literature we found eight other cases of streptococcal post-partum meningitis. In all of these cases, delivery was vaginal and no antibioprophylaxis was given.

Adult↗

[Thrombosis of the basilar trunk in a young woman previously treated by radiotherapy for malignant lymphoma].

We report the case of a 23-year-old-woman, who had received mediastinal radiotherapy for non-Hodgkin lymphoma. Five years later, she presented a basal artery thrombosis. Arteriography showed an ectopic origin of the left vertebral artery on the aortic arch located within the irradiation field. This artery was irregular and narrowed up to 15 cm from its origin. All other cerebral arteries were normal. We reviewed the literature of other observations describing radiation-induced cervical arteritis.

Adult↗

[Motor block induced by spinal injection of pethidine. Quantification and comparison with lidocaine].

Intrathecal pethidine (or meperidine) at a dose of 1 mg.kg-1 has proved to be effective and useful for surgical procedures by producing a spinal nerve block due to its local anaesthetic properties. Motor blockade was assessed by dynamometric measurement of the dorsal flexion of foot in ten ASA I patients after subarachnoid pethidine, and in seven ASA I patients after subarachnoid 5% lidocaine at the same dosage. Measurements were made every 5 min during the first 30 min, then every 15 min until complete motor block recovery was obtained. Values were expressed as a percentage of the initial muscle strength registered before lumbar puncture. The two drugs gave a dramatic and similar decrease in muscle strength (92 vs 95%; NS). However, the delay of maximal effect was significantly longer with pethidine than with lidocaine (33.5 +/- 14 min vs 19 +/- 5.6 min; p less than 0.05). The duration of the motor blockade was similar for both drugs (116 vs 106 min) and the 25%-75% time intervals were identical (32 +/- 14 min vs 33 +/- 12.6 min). Two severe respiratory depressions were observed with pethidine, which were rapidly reversible by intravenous naloxone. Numerous other minor side-effects occurred more frequently with meperidine than with lidocaine. It was concluded that dynamometry gave an accurate description of motor blockade induced by spinal anaesthesia.

Adult↗