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Biomedical subjects

L Villette

Publications and source records attributed to L Villette.

At least 19 recordsLinked to original sources
PubMed1990

[Natural history and current surgical prognosis of intracranial arterial aneurysms].

The abrupt flow of blood in the meninges or in the brain after fissure or rupture of an arterial aneurysm still remains a medico-surgical emergency which includes the mobilisation of important technical and financial means which justifies itself by the reduction of the occurrence of a more severe accident and to give the patient its best chances. The cure of a cerebral aneurysm and its intracranial consequences must not be dissociated from its clinical context. Surgical indication must take into account the cause of the vascular lesion, the background on which it has evoked, its natural outcome which is characterised by rebleeding and vasospasm. Surgical cure of intracranial aneurysm is one of the great achievement of modern surgery. A better understanding of the malformation, the improvement of neuro-anesthesia and intensive care, and the use of pre-operatoire adjuvants have considerably improved the surgical results over the years. At the moment, alternative treatment start to emerge such as selective vascular catheterism with ejectable balloon which become more feasible and seductive.

Catheterization↗
PubMed1989

[Treatment of osteo-dural injuries of the anterior segment of the skull base through the trans-lesion approach. Apropos of 25 cases surgically treated by a dual neurosurgical and maxillofacial team].

The authors describe a technique of mobilisation of the frontal sinus using the fractures of anterior and posterior walls. The translesional approach is adapted to cranio-facial borders surgery of traumatisms. It's a skull base approach which minimizes the cerebral retraction and enables or perfect viewing of the top of the ethmoid. The advantages, drawbacks and indications are discussed about 25 cases.

Adolescent↗
PubMed1989

[Secondary and late development of hematoma of the brain stem].

The functional and social outcome in 15 patients with brainstem hematomas surviving on the 15th day is reported. At the end of the first year post stroke, the main neurological deficits were sensory, postural and paresis of the 6th and 7th cranial nerves. This resulted from the preferential location of the lesions in the lateral and posterior pons. On a functional point of view, 8 patients were independent in daily living. Seven of them were regularly engaged in more elaborated activities, at home and outside: 1 had recovered his previous professional activities. Those functions evolved more slowly during the 2nd year and later on. A significant correlation was found between the initial neurological status and the functional outcome at 1 year, and also between the volume of the hematoma on C.T. scan and this outcome. In this series, the age of the patients was not correlated to the other variables.

Activities of Daily Living↗
PubMed1987

[Percutaneous surgery of the lumbar disk].

Percutaneous discectomy is performed with an equipment which has proved reliable in urological surgery, namely dilators and optic fibers. Carried out under local anaesthesia, it empties the intervertebral disc by an extra-spinal route, thus reducing the risk of fibrosis which is almost constant when the interlaminar route is used. Its indications must be discussed with those of chemonucleolysis.

Adult↗
PubMed1987

[Surgical prognosis of unruptured intracranial arterial aneurysms. 50 cases].

The authors have reviewed a series of 53 patients with unruptured intracranial arterial aneurysm. Out of 50 patients operated upon, 2 died post-operatively, 5 remained with neural deficits that were present before surgery, and 43 were cured without subsequent cerebral or meningeal haemorrhage. None of the 3 unoperated patients developed cerebral vascular accidents. In 25 cases the aneurysm was asymptomatic and was discovered accidentally during angiography; it varied in size from 3 to 6 mm. In 28 cases, the aneurysm gave rise to various symptoms, including headache or facial pain (9 cases), ischaemic vascular accident (7 cases), ocular symptoms (8 cases), seizures (4 cases); its size ranged from 7 to 10 mm. The clinical and post-mortem series available in the literature show the usefulness of surgery in patients presenting with factors that increase the risk of rupture, i.e.: age comprised between 40 and 65 years, history of arterial hypertension, aneurysm located on the anterior segment of Willis' circle and about 10 cm in diameter, which is the critical size for rupture.

Adult↗
PubMed1987

Surgical prognosis of unruptured intracranial arterial aneurysms. Report of 50 cases.

The authors analyze a series of 53 patients who presented with unruptured intracranial aneurysms. Fifty were operated upon, 2 died during the post-operative period, 5 were left with their pre-operative neurological deficit, 43 were cured and have not subsequently presented with any cerebral or meningeal haemorrhages. None of the 3 patients who were not operated upon has since presented with a cerebro-vascular accident. Twenty-five aneurysms were asymptomatic, discovered fortuitously during angiographic examination, and their size was generally between 3 and 6 mm. Twenty-eight aneurysms presented with various neurological signs and symptoms (headaches, facial pain on 9 occasions, ischaemic vascular accidents on 7 occasions, ocular signs on 8 occasions and generalized epilepsy on 4 occasions), with a range in size from 7 to 10 mm. The clinical and autopsy series published in the literature show the usefulness of surgery when certain factors come together and increase the risk of rupture: middle-aged patients (between 40 and 65), arterial hypertension, aneurysm located on the anterior part of the circle of Willis and with a diameter close to the critical size (10 mm) for rupture.

Adolescent↗
PubMed1987

The midline supra-orbital approach, using a large single free bone flap. Technical note.

Surgical access to the anterior frontal region of the skull base is facilitated by the removal of a fronto-orbital bone flap. This technique was first described as a two-step procedure by Cophignon. We recently devised a simplified one-step approach in which a single bifrontal supra-orbital bone flap is removed. This report is a technical description and resume of our experiences.

Bone Wires↗
PubMed1987

Transcervical approach and screw fixation for upper cervical spine pathology.

The authors report on the use of transcervical approach and screw fixation for upper cervical spine pathology. They describe the direct osteosynthesis for odontoid fractures and atlantoaxial fixation using a screw fixation of the articular processes. The surgical technique is described and its advantages and disadvantages are discussed as are its indications.

Bone Screws↗
PubMed1987

Thoracic disk herniation and Scheuermann's disease.

The authors report 6 cases of thoracic disk herniations in patients with Scheuermann's disease. They underline the relationship between the neurological symptomatology and Scheuermann's disease by the herniation and evolution in their treatment by a new surgical approach.

Adult↗