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Biomedical subjects

L Riffaud

Publications and source records attributed to L Riffaud.

16 recordsLinked to original sources
PubMed2001

Primary isolated lymphoma of the fourth ventricle: case report.

The authors present the case of a 33-year-old woman presenting with a 4-week history of vertigo and headaches. Physical examination revealed an isolated static cerebellar syndrome. Magnetic resonance imaging showed a homogeneously enhancing tumor located in the fourth ventricle. Complete surgical removal was performed and microscopic examination revealed a high-grade B-cell lymphoma. Postoperative investigations confirmed it to be primary. Only one case of primary isolated lymphoma of the fourth ventricle has been briefly reported in the medical literature. The authors suggest that primary lymphoma must be considered in the list of fourth ventricle tumors.

Adult↗
PubMed2001

Supratentorial ependymoma in children.

The clinical and pathological characteristics of supratentorial ependymomas (STE) in children are not well identified in the literature, because most series deal with ependymomas regardless of their location or the age of the patient. As a result, the pathological description of the disorder is still debated. We therefore reviewed our cases of children operated for STE and compared them with cases of infratentorial ependymomas (ITE) to provide a better characterization of STE and suggest guidelines for treatment. From 1985 to 1999, we operated 18 children for STE, almost half of which developed with no connection to the ventricular system. Intraoperative bleeding and infiltration of the basal ganglia prevented total removal in 4 cases and were the main causes of operative mortality and morbidity. The 5-year overall survival and recurrence-free survival rates were 54 and 37%, respectively, and were highly affected by the extent of resection, but not by histological grade. Because of the high recurrence rate, we recommend systematic postoperative irradiation limited to the tumor site for all high-grade tumors in older children, and reoperation after subtotal removal and for recurrences.

Adolescent↗
PubMed2001

Intracerebral hemorrhage complicating cervical "hourglass" schwannoma removal. Case report.

The authors report a case of infra- and supratentorial intracerebral hemorrhage complicating the postoperative course of a patient who had undergone surgical removal of a cervical schwannoma with an hourglass configuration. To their knowledge, this is the first case in which this neurosurgical procedure was followed by such a complication. Possible mechanisms are discussed; however, pathological events leading to this complication are unclear. The development of new neurological deficits not attributable to the surgical procedure should suggest this possibility.

Adult↗
PubMed2001

[Extraosseous Ewing's sarcoma of the spinal epidural space].

Ewing's sarcoma is found exceptionally as a primary epidural tumor of the spine. Four cases of extraosseous Ewing's sarcoma of the spinal epidural space are presented. Another 17 cases were found in the pertinent literature and are discussed. There were 15 males and 6 females with mean age of 16 years (range, 4 to 30). Symptoms included back pain and/or radicular pain, paresis of one or more limbs, sensory disturbances, and bladder and bowel dysfunction. The mean diagnostic delay was 4,7 months. Each patient underwent surgery but complete resection of the tumor was obtained in only half of the cases. Most patients received radiation therapy and chemotherapy. Twelve patients died, 1 to 54 months (mean, 18) after diagnosis. Even though the number of patients was too small in this series for statistical analysis, partially resected tumors do appear to be associated with a higher mortality.

Adolescent↗
PubMed2000

[Sulcal identification and neuronavigation in supratentorial cavernoma surgery].

We present the use of cortical sulci, segmented from magnetic resonance imaging, in image guided neurosurgery. Sulcal information was transferred to a surgical microscope with enhanced reality features. This assistance was used for the resection of supratentorial cavernomas (7 patients). Sulci were semi-automatically segmented from 3D MRI data sets. Sulci close to the cavernoma were selected and transferred to the neuronavigation system which allows the superimposition of graphics into the right ocular of the microscope. Selected sulci were displayed on the workstation and superimposed into the ocular of the microscope. Cortical sulci proved to be useful for the recognition of the anatomical environment. The superimposed sulci helped to optimize location and size of the skin incision as well as to guide the access to the cavernoma by using the course of a sulcus as indirect trajectory.

Adult↗
PubMed1999

Anatomic bases for the compression and neurolysis of the deep branch of the radial nerve in the radial tunnel.

The anatomy of the radial tunnel was studied on twenty-five elbow preparations. We noted five different elements that could affect the deep branch of the radial nerve in the radial tunnel and cause an entrapment syndrome: a capsule-tendon-aponeurotic complex on the anterior aspect of both the humeroradial joint and the radial head, the vascular arcade formed by the radial recurrent a, and its branches, the arcade formed by the medial edge of extensor carpi radialis brevis muscle, and the superior and inferior arcades of the superficial layer of the supinator muscle. These results are compared with recent anatomical and clinical data, and the relevance of a surgical approach between the extensor carpi radialis brevis and longus muscles is discussed.

Cadaver↗
PubMed1999

[A case of giant craniopharyngioma in an adult].

We report an unusual case of giant adamantinomatous craniopharyngioma in an adult who presented with impaired vision. The intra- and suprasellar tumor extended into the subfrontal, subtemporal and retroclival regions. CT and MRI allowed diagnosis and optimal surgical planning.

Adult↗
PubMed1999

Spontaneous chronic spinal epidural hematoma of the lumbar spine.

We report an exceptional description of a spontaneous chronic spinal epidural hematoma presenting as lumbar radiculitis. The computed tomographic, magnetic resonance imaging, and intraoperative findings are presented. We discuss anatomical and pathophysiological considerations that could lead to such a condition. We estimate that spontaneous spinal epidural hematomas located in the ventral space are in fact premembranous or posterior longitudinal ligament hematomas.

Aged↗
PubMed1999

Rathke's cleft cysts: surgical-MRI correlation in 16 symptomatic cases.

Rathke's cleft cysts (RCCs) are non neoplastic epithelial lesions of the sellar region that have been rarely reported as a clinical entity. We retrospectively reviewed the magnetic resonance imaging (MRI), intraoperative, and pathological findings of a series of 16 cases of RCCs operated at our institution since 1992. Concurrently, we discussed the different hypotheses about their embryological origin. The patients included 12 females and 4 males, 11 to 73 years of age. Endocrine disturbance was the most common presentation, followed by headaches and visual impairment. The location of the cyst was intrasellar in 7 cases, intrasellar and suprasellar in 6 cases, and suprasellar in 3 cases. The size of the cyst ranged from 8 to 26 mm (mean 12 mm). MRI signal intensity was quite variable on T1-weighted images. The cyst appeared hyperintense in 6 cases, hypointense in 6 cases, isointence in 3 cases, and heterogeneous in one case. On T2-weighted images (available in 13 cases), the signal intensity was more constant and appeared hyperintense in 11 cases and hypointense in 2 cases. After Gd-DTPA, we did not observe enhancement either of the cyst contents or of the cyst wall, but only of the pituitary gland in all patient. Most often, the pituitary gland was displaced inferiorly by the cyst located above showing a typical image of "an egg in a cup". Fifteen patients were operated upon via the transsphenoidal approach and one upon a frontal craniotomy. Intraoperatively, the cyst contents were gelatinous or thick, and dark colored. In 2 cases, it was cerebrospinal fluid-like corresponding to the signal observed on MRI. The position of the pituitary gland confirmed by surgery in 15 cases coincided with enhancement seen and MR imaging. In 13 cases where biopsy of the cyst wall was performed, it confirmed focally ciliated columnar or cuboid epithelium. A coexistent adenoma was found in one case. In conclusion, we consider that RCCs have varied MRI characteristics so that no pathognomonic sign may be observed. Except in few cases, there were no correlation between MRI and intraoperative findings. Therefore, even with MRI studies, differential diagnoses with others cystic lesions of the sellar region remains extremely difficult. The most interesting findings on MRI studies of RCCs were to locate the pituitary gland to help the surgeon to preserve pituitary tissue during surgery.

Adolescent↗
PubMed1999

Intramedullary cavernous malformations.

Five cases of intramedullary cavernous malformations were retrospectively reviewed. There were 4 women and one man ranging in age from 30 to 67 years. Thoracic spinal cord was involved twice and cervical cord in three cases. Four of them underwent surgery: two improved, one remained stable and symptoms worsened in one. Clinical, radiological features and surgical management are discussed in the light of the follow-up and literature analysis. The role of T2* weighted sequence in MR diagnosis of intramedullary cavernomas is emphasised.

Adult↗
PubMedDate not supplied

[Subperiosteal hematoma of the orbit associated with a frontal extradural hematoma].

The authors report the rare occurrence of an orbital roof fracture associated with extradural and subperiosteal orbital hematoma in a 53-year-old man. This case highlights the clinical association of intracranial extradural hematoma and subperiostal orbital hematoma. It stresses the importance of accurate diagnosis of the etiology of ipsilateral exophtalmos in craniofacial trauma. In this case, surgical removal of the extradural hematoma was warranted, and the subperiosteal blood was removed via a frontal craniotomy. Surgical intervention resulted in a complete recovery without any functional sequelae.

Accidents, Traffic↗