Biomedical subjects
Publications and source records attributed to M Jiddane.
The authors report four cases of hemangiopericytoma. The preoperative diagnosis is strongly suggested by the use of selective angiography and post-iodine CT scan which provide images often rather similar to highly vascularized meningiomas.
Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: congenital heart disease; neonatal distress; infections, focal or general inducing vasculitis, but many cases are considered idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid siphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the hemorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological type of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of beads appearance).
CT Scan examination in 145 cases of neuromuscular diseases yielded the following results: Diagnosis between myogenic and neurogenic process is inconstant and cannot be considered as absolute. In myogenic diseases the X ray density of muscle is early decreased with a preservation of muscle outline. In neurogenic diseases muscle volume is early decreased. Coexistence of atrophic and hypertrophic muscles indicates primarily muscle disease. Some patterns of involvement appear to be frequent. In Duchenne's dystrophy a contrast exists between atrophic "empty" or hypertrophic muscles during the ambulatory period and "ghostly" muscles during the terminal period. In facio-scapulo-humeral muscular dystrophy, tibialis anterior and hamstring muscles have often a decreased density and psoas muscles are normal or hypertrophic. In myotonic dystrophy a hypodense perifemoral crescent is frequently observed. Diagnosis between limb-girdle myopathy ("empty" muscles with preserved limits, hypertrophic muscles, hypodense gastrocnemius medialis muscles) and chronic spinal amyotrophy (irregular and atrophic muscles without selective involvement and hypertrophic muscles) is tentatively proposed but is not considered to be clear-cut. Muscle involvement has an asymmetric distribution in amyotrophic lateral sclerosis and is rather symmetric in peripheral neuropathies.
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Eleven cases are reported of lateral lumbar herniated disc, an anatomical form presenting fairly atypical features and of relatively recent discovery. The patients presented with a highly painful single root lesion usually affecting L4 and L5 roots. Saccoradiculography was negative in almost all cases whereas computed tomography imaging allowed easy diagnosis of a lateral herniated disc, and demonstrated its foraminal or extraforaminal site. An appropriate surgical approach was thus possible, extremely lateral forms requiring an extraisthmian approach.
In four human left cerebral hemispheres the cortical speech areas were identified, having been marked by differential color code before transverse sectioning. The results from the anatomic dissection specimens were compared with thin CT sections in normal individuals, the CT plane being aligned to the orbitomeatal plane as an external reference, and thus closely parallel to the bicommissural plane, as an internal reference. The same cortical structures were identified in the CT sections. A strategic approach to CT examination of the cortical speech areas is formulated, based on the external-internal system of reference.
The lumbosacral nerve roots and their relation to the lateral recess in the lumbar region were studied by computed tomography both in anatomic specimens from six cadavers and in vivo in 100 patients with or without disk herniation. The anatomic and tomodensitometric correlations are discussed. The normal morphology and contents of the lumbar spinal canal can be used as a guide to radiologic diagnostic exploration, which in turn can indicate the etiology and extent of lumbar sciatica and the course of treatment.
Seventy-five patients with a variety of muscular dystrophies were studied using computed tomography (CT). At least 11 slices were taken in each patient, from the forearm to the lower leg. Sufficient information was obtained to provide some CT characteristics of several dystrophies, including Duchenne muscular dystrophy, facioscapulohumeral syndrome, limb-girdle muscle myopathies, and myopathic dystrophies. CT promises to be of increasing value in these areas in the future.
The progress made by noninvasive exploration for the assessment of vascular malformations now allows the therapeutic strategies to be better established. While observation and conservative methods are most often chosen, some arteriovenous malformations lead to contemplating a palliative or curative treatment. In these cases, embolization currently plays a great role, associated or not to surgery. This embolization obviously can be contemplated only after a collegial decision to treat these malformations has been made, knowing that they may be silent or acquire an uncontrollable evolution potential. The authors present 3 cases of peripheral arteriovenous malformations, treated by an endovascular way, and remind the principles and indications of these embolizations.