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M Desgeorges

Publications and source records attributed to M Desgeorges.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Intracranial schwannomas of the cranial nerves. The acoustic nerve excluded].

The schwannomas of the cranial nerves (except the IId and VIIIth nerves) are known to be infrequent although progress in diagnosis of these tumors have been obtained by C.T. scan. We report twelve cases involving the facial nerve and five cases of the caudal nerves that were developed into the foramen jugulare, and two cases of trigeminal schwannomas. One may suspect these tumors in presence of any minimal, unilateral defect of otological, facial, and pharyngo-laryngeal functions. The surgical approach to the tumors depends on both its location and symptomatology.

Adult↗
PubMed1986

[Surgery of acoustic neuroma and other tumors of the internal auditory canal and cerebellopontile angle. Apropos of 602 cases].

During the last two decades, 602 tumors of the internal auditory canal and of the cerebello-pontine angle were operated on, using the trans-temporal approaches. Among these tumors, 548 were unilateral acoustic neuromas, that were removed by the trans-labyrinthine approach (57%), the retro-labyrinthine-retro-sigmoid approach (33%) and the middle fossa approach (M.F.) (6%). Five fatalities occurred (1%). The facial nerve was preserved in 94% with an immediate normal function in 58%. The auditory function was preserved in 23% (51 cases).

Adolescent↗
PubMed1986

[Anesthesia in surgery of acoustic neuroma by the trans-petrous approach].

A combined oto-neurosurgical team has operated upon 86 patients with acoustic tumors larger than 2 cm via translabyrinthine (T.L.) approach over a period of two years. Authors describe anesthetic technic and discuss the advantages of T.L. approach versus sub-occipital approach: supine position, unnecessary invasive monitoring, anesthetic safety, no venous air embolism, quick recovery, no vital pulmonary complications.

Adult↗
PubMed1986

[Surgery of acoustic neurinoma in the elderly].

Eleven patients, between 70 and 85 years old, with acoustic neurinoma, were operated by translabyrinthic approach. The size of the tumor was between 2 and 4 cm in five cases, 4 cm or more in six cases. Complete tumor removal was possible in six cases (55%), in five cases (45%) residual tumor was left behind. Complications included cerebrospinal fluid leakage (2 cases), meningitis (1 case), and hemorrhage (1 case, fatal four days later). Anesthetic management is described.

Aged↗
PubMed1984

[Surgery of large neurinomas of the acoustic nerve performed only by the translabyrinthine approach. Apropos of 50 cases].

A combined otoneurosurgical team has operated upon 68 patients with acoustic nerve neurinomas over a period of 13 months (Sept. 1982-Oct. 1983). Exploration and operation in this homogeneous series were carried out under the same conditions, and a CT scan was performed in each patient before and after surgery. The size of the neuroma was less than 2 cm in diameter in 18 cases, between 2 and 3 cm in 28 cases, between 3 and 4 cm in 10 and 4 cm or more in 12. This report relates to the 50 neurinomas over 2 cm in diameter, these requiring multidisciplinary co-operation during surgical removal. The translabyrinthine approach was used exclusively in 48 cases, and was combined with a retrosigmoid approach in the other 2 cases. Total tumoral excision was possible in 46 cases (92%) and partial removal in 4 patients (8%). Complications included one death (bilateral giant neurinomas), resolving purulent meningitis (2 cases), 3 patients with cerebrospinal fluid fistulae which healed after lumbar drainage, and 1 case of postoperative hematoma in the ponto-cerebellar angle requiring further surgery. The facial nerve was undamaged in 48 cases (96%). Postoperative facial palsy developed in 39 cases, and 15 have recovered subnormal motility. Follow up is insufficient in the other 17 patients. It is suggested that the translabyrinthine approach enables ablation of neurinomas of whatever size. This approach is reliable since it avoids injury to neighboring nerve structures. The facial nerve is detected immediately and can be protected throughout operation. The latter is, however, a long and difficult procedure, and otoneurosurgical collaboration is advisable.

Adult↗
PubMed1980

[Brain abscesses. Value of computed tomography. A review of seven cases (author's transl)].

Based on a series of seven cases of subtentorial abscess, the authors analyze the results of different methods of exploration. Though in certain clinical conditions (intracranial hypertension and meningeal infections) the etiology is of no consequence, in most cases of definite diagnosis can be made of a space-occupying lesion by the use of EEG, arteriography, and scintigraphy examinations, without establishing the precise nature of the affection. As expected, computed tomography appears to be the most reliable examination. Diagnosis was confirmed by this method in 6 of the 7 cases, and it also enabled the number, size, and location of the lesions to be determined. Typical appearances after injection of an iodized contrast medium revealed the development of an abscess following the intracerebral infection, and determined the time for surgical intervention. In spite of intensive care and antibiotic therapy, an abscess remains a "delayed-action bomb", with poor prognosis, requiring drainage or surgical excision as soon as conditions are appropriate. The mortality and morbidity of this rare, and therefore poorly recognized, affection should improve with systematic use of the scanner during meningeal infections.

Adult↗
PubMed1979

[Arthrodesis of the cervical vertebrae by the anterior approach for the treatment of cervicobrachial neuralgias of discal origin (author's transl)].

Cervicobrachial neuralgia of discal origin can be improved by a simple operation: excision of the pathological disc followed by an intercorporeal arthrodesis by the anterior approach, using an implanted graft without the use of any osteosynthetic material. The authors performed 20 such operations, using this method as described by Cloward, with very encouraging results. The selection of patients suitable for surgery, however, depends on strict criteria: isolated definite discal pathology, usually post-traumatic, suspected clinically and confirmed by a standard radiograph and gas myelography; finally, conclusive proof of immobilisation. The simple nature of the operation, the rapidity with which it can be performed, the short period of hospitalization and professional care required, and the absence of sequelae, are several factors which suggest that this surgical procedure should become the standard therapy for cervicobrachial neuralgias, as it is for the surgical cure of lumbar disc hernias. The introduction of more precise and comfortable radiographic methods, such as the scanner and metrizamide myelography, will ensure that this functional type of surgery becomes more economical and responds to the individual needs of the patients.

Adult↗
PubMed1976

[Traumatic intracranial penetration of the mandibular condyle].

The authors report a case of severe multiple trauma in which, as a result of the large number of complex injuries together with necessary therapeutic measures, the intra-cranial penetration of the mandibular condyle was unnoticed during the first months following the accident. They emphasize the discordance between the anatomical lesions and their clinical manifestations. Thus a complete radiological examination is necessary at a secondary stage in order to detect such lesions which, by contrast to that which might be supposed, are not obvious clinically. As far as treatment is concerned, rather than resorting to orthopaedic menoeuvres with imprecise traction and which, in any case, fail to resolve the entire problem. the authors recommend a combined maxillo-facial neurosurgical operation.

Adult↗
PubMed1976

[Subdural hematoma and anticoagulant therapy].

The authors report a series of 22 cases of subdural hematomas in patients submitted to anticoagulant therapy. A review of the literature finds 150 cases. Subdural hematomas occurs in about one third of the patients presenting hemorrhage of central nervous system related to anticoagulant therapy. Among subdural hematomas of any cause, the possible role of a previous anticoagulant therapy is stressed in 4,8 to 14% of cases. In most cases, long term anticoagulants were indicated for arterial or heart (ischemic) lesions (16/22 cases). In 6 cases, anticoagulants were indicated for prevention or treatment of pulmonary embolies. In 18 cases, anticoagulant drug is from the group of dicoumarol or phenylindanedione. In 3 cases, the only anticoagulant given to patient was heparin. Pathogenic study suggests that hypocoagulability might not always be the only factor of bleeding: high blood pressure, other drugs and head trauma (10 cases) are often associated. Clinical features, in our series, are similar to those encountered in cases of subdural hematoma of any cause. According to the existence of a cranial injury and to the chronology of anticoagulant therapy, the authors divide their 22 patients into 3 groups. The use of protamin sulfate or human plasma fraction PPSB provides in few minutes a normal coagulability. Neurosurgical treatment in all our cases evacuated in 11 patients a chronic subdural hematoma, in 2 cases an acute, and in 9 cases a subacute hematoma. Results were fair in 19 patients with no sequelae. 3 patients died during the immediate post-operative period. The authors conclude by stressing several preventive measures.

Anticoagulants↗
PubMedDate not supplied

Multimodal anatomic, functional, and metabolic brain imaging for tumor resection.

OBJECTIVE: Improvement of neurosurgical techniques with a more detailed description of brain tumors and their functional environment. METHODS: We performed: (1) anatomical magnetic resonance imaging (MRI) for reference, (2) functional sequences dedicated to the adjacent cortical structures (sensorimotor, visual, language paradigms), and (3) thallium 201 cerebral tomoscintigraphy to visualize active tumor invasion. Data were transferred to a workstation for automatic registration. RESULTS: All data were combined into one synthetic image showing the foci of high proliferative activity, which have to be completely resected, and the peritumoral functional structures, which have to be spared in order to minimize postoperative sequelae. This trimodal image is entered into a surgical neuronavigation computer for preoperative planning in order to outline tumoral target and functional risk areas. All this information is displayed in the operative microscope (Zeiss MKM) optically linked to MR images. This multimodality technique diminishes operative time by reducing electrocorticography and improves the operative short-term outcome. CONCLUSION: Multimodal imaging is useful for optimization of neurosurgical tumor resection.

Adult↗