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Biomedical subjects

L Verdure

Publications and source records attributed to L Verdure.

13 recordsLinked to original sources
PubMed2005

[Unruptured intracranial aneurysm: possible therapeutic strategies?].

Intracranial unruptured aneurysm (ICUA) has become a common condition for patient consultation. The mortality rate after fissuration is estimated to be between 52% and 85.7%. The final therapeutic decision results from a balance between the risk of rupture and risks related to the aneurysmal exclusion. Analysis of the risk of rupture risk enables a classification of risk factors. Depending on the circumstances of diagnosis, we considered the ICUA at high risk of rupture for incidental ICUA larger than 7 mm and in the event of associated aneurysms. Classifying by morphologic features, high-risk ICUA were located in the vertebrobasilar system (RR: 4.4; 95%CI: 2.7-6.8), those with a size between 7 and 12 mm (RR: 3.3; 95%CO: 1.3-8.2), larger than 12 mm (RR: 17; 95%CI: 8-36.1), those that were multilobular or a larger size and those ones with a index P/L superior to 3.4 (risk x20). Familial ICUA would expose to a major rupture risk (2 to 7 times sporadic ICUA). Some systemic factors were related to ICUA rupture: arterial hypertension (RR: 1.46; 95%CI: 1.01-2.11) and smoking addiction (RR: 3.04; 95%CI: 1.21-7.66). After microsurgical exclusion, the morbidity and mortality rates were 10% and 2% respectively. Some microsurgical morbidity factors were identified: age (32%>65 years), size (14%>15 mm), vertebrobasilar location and temporary occlusion. The rupture incidence after microsurgical exclusion was estimated 0.26%/year. After endovascular exclusion, the morbidity and mortality rates were 8% and 1% respectively. The complete exclusion rate varied between 47% and 67%. The rupture risk was estimated at 0.9%/year. Treatment recommendations were classified into 3 categories.

Humans↗
PubMed2003

[Bilateral chronic subdural hematoma: spontaneous intracranial hypotension?].

We report a case of bilateral chronic subdural hematoma (SDH) in a 48-year-old man, who presented with postural headaches, tinnitus and progressive confusion without intoxication, head trauma or abnormal hemostasis. Magnetic resonance imaging revealed cerebellar tonsillar herniation in the foramen magnum and a deformation of the brainstem. Outcome was normal after surgery. We discuss about the rare causes of SDH in young adults.

Confusion↗
PubMed1997

[Intracranial meningioma in the elderly. Postoperative mortality, morbidity and quality of life in a series of 39 patients over 70 years of age].

UNLABELLED: The aim of this study was to assess the current morbidity and mortality in patients over 70 operated for intracranial meningioma. PATIENTS AND METHOD: We report a series of 39 consecutive patients (mean age: 73 y) operated for an intracranial meningioma over a period of 5 years (1990-1994). According to the Karnofski scale (KS), preoperative neurological status was inferior or equal to 70 in 21 patients (53.8%) and superior or equal to 80 in 18 (46.2%). All patients were followed up in order to precisely assess their post-operative condition and a computed tomographic scan (CT scan) was performed during the second semester of 1995 (mean follow-up 29 months). RESULTS: Operative mortality and permanent morbidity were respectively 7.6% and 10.3%. In 77% of this series, the KS score checked at the last follow up was 80 to 100 (good outcome). Poor outcome was defined by death or a postoperative (KS < or = 70, the principal cause being an hemorrhagic infarction. Three factors were predictors of poor outcome: poor preoperative neurological condition (KS < or = 70) (p = 0.07), location of the tumor on the base (p = 0.007), and the duration of surgery > 3 hours (p = 0.06). The logistical regression analysis showed that these three factors were independent. Tumor recurrence occurred in 5 (12.8%) of 39 patients. CONCLUSION: Preoperative KS is a prognosis factor, but a poor preoperative condition is not in itself a sufficient condition contraindicating surgery. The rates of operative mortality of 7.6%, and permanent operative morbidity of 10.3% can be given to patients and their families.

Aged↗
PubMed1985

Acute migraine attack therapy: comparison of naproxen sodium and an ergotamine tartrate compound.

The efficacy of safety of naproxen sodium and ergotamine tartrate were compared for the treatment of acute migraine attack in a randomized, parallel trial with 114 participating patients. At the start of symptoms, patients took either three tablets of naproxen sodium (275 mg each) or one of an ergotamine combination (containing 2 mg ergotamine tartrate, 91.5 mg caffeine, and 50 mg cyclizine chlorhydrate). Patients were followed for three months or until six attacks were monitored, whichever came first. Both medications substantially shortened the duration of migraine attacks and reduced the severity of symptoms. When the test medications were taken within 2 h of onset of attack, naproxen sodium was statistically significantly more effective than the ergotamine combination in reducing the severity of headache pain, nausea, and lightheadedness. The ergotamine combination was associated with significantly more vomiting, need for rescue medication, and side effects than was naproxen sodium. Four patients required discontinuation of the ergotamine combination and one of naproxen sodium. Both patients and investigators rated tolerance for naproxen sodium as superior to tolerance for the ergotamine combination. Naproxen sodium seems to be an effective and safe treatment for migraine attacks.

Acute Disease↗