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Biomedical subjects

L Mérienne

Publications and source records attributed to L Mérienne.

At least 19 recordsLinked to original sources

[Terson's syndrome and intraocular complications in meningeal hemorrhages (26 cases)].

The Terson syndrome was described in the early 1900's as the association of an intra-vitreous humor bleeding and a subarachnoidal hemorrhage (SAH). The high jeopardy of blindness of such a syndrome emphasizes the importance of evaluating as soon as possible the presence of blood in the posterior chamber of patients presenting with a SAH. 250 patients admitted in the Neurosurgical Department of Ste Anne Hospital with a SAH were evaluated between January 1984 and February 1990. 26 had an intra-ocular hemorrhage (10.5%). In those cases the mortality rate was not increased (15.4%) but the morbidity rate was higher (42%). Concerning the intra-ocular bleeding, 4 patients underwent a vitrectomy (2 had a complementary photocoagulation). Only one patient had a visual sequela (partial decrease of visual acuity). These data emphasize the visual risk which has to be considered; a specific treatment (vitrectomy and/or photocoagulation) must be performed as quickly as possible so as to save the vision. In some particular instances, the ophthalmological treatment might even be necessary before the intracranial procedure itself.

Adolescent

[Management of cranial-injured patients in the era of the Emergency Medical Service and the scanner. Comparative epidemiologic study with a 12-year interval in the same department of neurosurgery, in the Paris region].

The authors present an analysis of the different data concerning the emergencies admitted in the Neurosurgical department of Sainte-Anne Hospital in Paris, during the one year-period extending from 1st June 1983 to 1st June 1984. These data have been compared to the corresponding findings established during 1972 in the same department. Traumatology appears to be a more and more limited activity among neurosurgical emergencies: 55% of admissions in 1972, 43% in 1983-84. The main characteristics of injured patients on admission have not changed: 65% are in a coma, 1.25 are operated in emergency, age distribution and types of lesion are identical. The sorting of the patients has improved: 25% of them were operated upon in 1972, 37% in 1983-84. Conveyance of injured patients has undoubtedly improved in quality during the last years; yet the duration of transport is still important, too important, even in Paris: 2 h 30 as an average-time. Another favorable factor has been the coming out of CT-Scan; it is of course of great help for diagnosis, but it must not let forget basic and fundamental therapeutic decisions.

Adolescent

[Value and limitations of the use of CO2 laser in neurosurgery. Reflexions from a French experience].

The authors have been using routinely since February 1983 a french 80W. CO2 Laser unit. They discuss the advantages and limits of this technic in the light of the first 26 intracranial and intraspinal operations carried on with it. The main and wellknown qualities of CO2 Laser are: the easiness of the hemostasis of the tumor and of the surgical cavity; and the absence of traction on the same tissue. The coupling of CO2 Laser with the operating microscope appeared very useful and made safer deep tumor excision, particularly that of the posterior fossa such as neurinomas and meningiomas. It was also quite efficient for intra-orbital tumors. The maniability of the hand piece was increased by the use of oblique mirror (45 degrees and 60 degrees) fixed at its extremity. The incision of skin, subcutaneous and muscular layers was not simplified by CO2 Laser; indeed this apparatus increased the operatory duration and was responsible of a healing time extension.

Adolescent

[Radioanatomy of cerebral arteriovenous malformations].

New imaging modalities permit detailed knowledge of the anatomy of cerebral arteriovenous malformations. Magnetic resonance imaging (MRI) provides morphological data, size and topography of the nidus, anatomic relationship, as well as dynamic information particularly with the use of MR angiography. Selective and hyperselective cerebral angiography provide information about the angioarchitecture and search for associated vascular abnormalities such as aneurysms. It is therefore possible to distinguish malformations associated with a high risk of hemorrhage and to define the indications for radiosurgery.

Cerebral Angiography