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Biomedical subjects

J Rougerie

Publications and source records attributed to J Rougerie.

At least 19 recordsLinked to original sources
PubMed1985

[Supratentorial glioblastoma in adults. Therapeutic results].

This retrospective study concerns 55 adult patients with supratentorial glioblastoma. The tumours were treated by complete or partial surgical excision whenever possible (31 cases), radiotherapy (22 cases) in doses of 60 Gy over 6 to 7 weeks (40 Gy with telecobalt and 20 Gy with superimposed electrons) and multiple chemotherapy (10 cases) with VM26 and CCNU or BCNU. Although the number of patients in some categories was too small for statistical evaluation, the results obtained were in agreement with those found in the literature and indicative of what can be expected. In patients with inoperable tumours the mean survival was increased from 2 to 8 months by radiotherapy or chemotherapy given separately, and from 2 to 9 or 10 months only when these two methods were combined. The mean survival of patients with partial tumoral excision was 2.5 months extended to 10 months after post-operative radiotherapy; one patient in this group who received both radiotherapy and chemotherapy is still alive after more than 5 years. In patients with macroscopically satisfactory excision, the 12 months good quality survival obtained by surgery was apparently prolonged to 22 months with radiotherapy; 3 of these patients who had both radiotherapy and chemotherapy after surgery are alive and in good condition after 15, 16 and 28 months respectively.

Adult↗
PubMed1984

[Loss of consciousness during benign intracranial hypertension. Correlations between cerebrospinal fluid pressure and the electroencephalogram].

A patient with benign intracranial hypertension developed paroxysmal attacks of falling due to loss of consciousness. Prolonged simultaneous recordings of CSF pressure, through a lumbar needle, and of EEG showed that these episodes resulted from bouts of elevation of CSF pressure (120 mm Hg systolic pressure). The pathophysiology of the increased pressure waves, described as Lundberg 's A waves or plateau waves, is discussed. The analogy between EEG records and those observed in normal subjects during Valsalva's manoeuvre is a further argument in favor of cerebral anoxia during the increased pressure plateau, this being apparently the explanation for the clinical disorders.

Electroencephalography↗
PubMed1980

[Optic chiasm gliomas (author's transl)].

A follow up study of 40 cases of optic chiasm gliomas is presented. Histological examination was obtained in 26 cases. All were bipolar spongioblastomas. Four of these were optic nerve gliomas, 17 chiasmatic gliomas and 19 invasive optohypothalamic tumors. The main clinical features are reviewed with special attention to endocrine disorders, including precocious puberty and diencephalic emaciation. Neurofibromatosis was present in 30%. Diagnostic difficulties are outlined, especially in chiasmatic tumors without optic nerve involvement: event with C T scan, the differential diagnosis with ectopic pinealomas, craniopharyngiomas and primary hypothalamic tumors, may be difficult. The operative mortality was 12% (3/25). All but one, had radiotherapy either alone or post operative. All four of the patients with unilateral optic nerve gliomas have a normal C T scan more than 10 years after treatment. Of the 17 patients with chiasmatic gliomas, 14 are alive with normal C T scan in 2 cases, and with reduction in size of the tumor in 7. Eleven of 19 patients with invasive gliomas are alive with diminished size of the tumor in 7. Improvement in visual acuity, reduction in size of tumor mass, persistent increase in size of non irradiated tumor and lack of recurrence of optic nerve glioma even with histological proven chiasmatic involvement is taken as evidence of the effect of radiotherapy. The sub frontal approach is emphasized for optic nerve and optic chiasm tumors: it provides direct surgical verification with the opportunity for complete removal, large biopsy, decompression of the optic foramina or cyst removal. Regarding secondary endocrine disorders, radiotherapy is discussed in children. If necessary it must be managed under careful evaluation of endocrine status, principally growth function.

Adolescent↗
PubMed1979

What can be expected from the surgical treatment of craniopharyngiomas in children. Report of 92 cases.

92 cases of craniopharyngiomas have been operated, 63 with a follow-up extending from 30 months to 20 years. The possibilities of the surgical treatment are mainly discussed on the basis of the anatomical location of the tumors. Simple intrasellar craniopharyngiomas can be operated by a transphenoidal approach with, sometimes, spectacular improvement (case of spontaneous normal pregnancy). The tumors most frequently seen are those with predominantly prechiasmatic expansion. A subfrontal approach is always required, aiming at radical excision. Microscopy can offer interesting possibilities for selective surgery. However, if the vital prognosis is excellent and recurrences rare, functional results remain very poor. In retrochiasmatic tumors involving the posterior hypothalamus, the principle of radical excision must be seriously discussed and sometimes challenged. The various combined approaches are described with their own limits and risks. Other therapeutic techniques are suggested. In many cases, selective neurosurgical dissection may raise some hope for better improvement of functional results.

Adolescent↗
PubMed1979

Surgical treatment of chronic subdural hematomas in infants.

Subdural hematomas in infants are associated with a high risk of recurrence. In an effort to combat this risk, a surgical procedure consisting of excision of the subdural membranes, a reduction of the craniocerebral disproportion and a restoration of the normal angle of junction of the cerebral bridging veins and the superior sagittal sinus is proposed.

Age Factors↗
PubMed1979

The so-called ectopic pinealomas. A cooperative study of 15 cases.

We present the results of a cooperative study of 15 cases of suprasellar dysgerminomas (ectopic pinealomas) and a review of cases of the literature with histological confirmation. In all the cases, histological similarities to the germinomas which appear extracerebrally, particularly testicular seminomas, were observed. We were unable to find in the sellar region tumors of true pineal histology and tend therefore to confirm the germinal origin of these neoplasms. From a clinical point of view, we define a syndrome that these tumors produce, consisting of diabetes insipidus as the first sign, visual impairment and endocrine disturbances, with few or no radiological signs in plain studies.

Adolescent↗
PubMed1978

Investigations of nontumoral hydrocephalus in children.

An analysis was made of 175 cases of pediatric nontumoral hydrocephalus. CT scan by itself permits a precise diagnosis in only one-third of the cases. However, when the clinical context suggests that hydrocephalus is secondary to certain conditions such as infection, bleeding, or trauma, CT scan may suffice, unless more advanced investigation permits more efficient treatment. When hydrocephalus is associated with brain malformations, however, more complete investigation is needed for a better understanding of the condition. Conventional contrast studies are quite safe, especially ventriculography which is easy to perform in this type of patient, who is usually investigated during the first 12 months of life.

Age Factors↗
PubMed1977

[Tumour-induced precocious puberty. Discussion of the indications for neurosurgery (author's transl)].

The tumour aetiology of precocious puberty is sometimes clinically evident when accompanied by visual disturbances or by raised intracranial pressure. It may be suspected in the presence of accelerated puberty but should also be feared in cases of apparently idiopathic precocious puberty. In the 13 cases studied, the tumour was studied in the posterior hypothalamus. Ten children underwent surgery (with additional radiotherapy in two cases). Two children died, the follow-up varying at present between 2 and 12 years. Amongst the various tumours, the hamartoma has a special nature by virtue of slow or absence of increase in tumour size. When the clinical and radiological signs suggest this type of tumour, abstention from surgery with close observation of the size of the tumour and medical slowing of puberty is advised.

Astrocytoma↗
PubMed1977

[Disk curettage in inveterate lumbago. Recent results in 45 cases].

Forty-five cases of intractable discogenic low back pain without sciatica were treated by curettage of the disc without grafting. One disc was curetted in 23 cases, two disc in 22 cases. The results are very good in 23 cases, good in 19 cases, and poor in 3 cases. The post-operative follow-up is between 1 and 2 years in 19 cases, 2 and 5 years in 13 cases, and more than 5 years in 13 cases. The length of follow-up and the number of discs curetted bear no relation to the quality of the result. In 8 cases a typical disc protrusion was found. In all other cases the appearance was different from that seen in the surgery of sciatica. Degeneration of the disc was a constant finding and presented various manifestations: simple protrusion, thickening of the posterior vertebral ligament, abnormal compressibility, and even an apparently normal disc, in which degeneration was only demonstrable after incision of the disc. Surgical exploration confirmed in early every case the data from discography. Radiodynamic examination after the operation showed a diminution in the mobility of the curetted disc, but perfect anatomical fusion is not necessary in order to obtain good results. The authors stress the necessity for great care in the selection of patients and in the operative technique.

Adult↗