Biomedical subjects
Publications and source records attributed to J Pruvo.
Endovascular treatment of carotid arteries stenoses is an acceptable therapeutic option to surgery in some selected patients. In this case report a patient successfully underwent carotid stenting in the presence of a severe restenosis following a surgical endarterectomy.
This case report highlights the complementarity of noninvasive imaging modalities in the diagnosis of extracranial cerebral arteries lesions. The need for a strategy in the treatment of patients with combined lesions is discussed.
Spinal cord magnetic resonance imaging (MRI) is of particular interest in the management of multiple sclerosis (MS) especially in primary progressive forms. Most of the demyelinating lesions are located in the cervical or dorsal cord. Spinal cord area reduction has been recently correlated with the progression of disability (Losseff et al., 1996, Lycklama a Nijeholt et al., 1998). The aim of this study was to confirm this first result, to assess the reproducibility of this method and to correlate demyelinating lesions with spinal cord area reduction. Fifty two patients were included and compared with 15 controls (normal subjects). T2 Sagittal and axial plane images were performed to localized hypersignal lesions. Spinal cord area was obtained by a volume acquired inversion prepared fast spoiled gradient echo acquisition (MP-Rage) sequence. We compared the mean area value with clinical parameters (age, course of the disease, expanded disability status scale ¿EDSS) and with the number and location of demyelinating lesions. Demyelinating lesions were found in 82p.100 of MS patients and in none of controls. Mean spinal cord area was closely similar to Losseff et al. (1996) results and was reduced compared with controls (p<0.001). Spinal cord reduction was correlated with disability, studied by the EDSS. Furthermore, no correlation was found between demyelinating lesions and spinal cord area reduction. This study confirms the interest of spinal cord area mesurement in MS. Spinal cord atrophy is a reliable marker for axonal loss. This method should be of particular interest for the follow-up of axonal loss in thepeutic trials especially in primary progressive MS.
MR imaging now appears as the best tool for diagnosis and pre-therapeutic assessment of tumors arising in the third ventricle (V3), as MR images can be obtained in the axial, coronal, and sagittal planes. MRI makes certain the location of the tumor in the V3 and delineates the anatomical landmarks in order to plan the surgical approach. It also allows the evaluation of associated hydrocephalus. Colloid cysts, choroid plexus papillomas, cavernomas, subependymal giant cell astrocytomas and germ-cell tumors may exhibit specific radiological features.
We report two cases of viral myelitis, one associated with adenovirus and the other with Epstein-Barr virus. The clinical presentation and course were similar, with viral illness, paraplegia with a D4 sensory level, and fever. Spinal magnetic resonance imaging showed a T2 cervico-dorsal high intensity signal. Cerebrospinal fluid examination showed pleocytosis without oligoclonal bands. Both patients recovered after treatment with high-dose methylprednisolone. These two cases suggest a similar clinical and paraclinical pattern in viral transverse myelitis. Moreover, treatment with corticosteroids seems to be useful in viral myelitis.
Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.