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Biomedical subjects

M Trémoulet

Publications and source records attributed to M Trémoulet.

12 recordsLinked to original sources
PubMed2006

[Decompressive craniectomy and intracranial hypertension].

Decompressive craniectomy was purposed for the treatment of refractory intracranial hypertension after head injury. This review discusses results obtained by this surgery in severe head trauma. Several studies have confirmed a reduction in intracranial pressure secondary to decompressive craniectomy. Mortality decreased and the proportion of good outcome of the survivors increased. These results have not been confirmed prospectively, and indications have to be clarified. The positive effects of decompressive craniectomy compared to barbiturate or hypocapnia in the "second tier therapy" in refractory intracranial hypertension could be interesting to evaluate.

Craniocerebral Trauma↗
PubMed2005

Detection of human cytomegalovirus genome and gene products in central nervous system tumours.

Human cytomegalovirus (HCMV) genome and related proteins have been reported in a great proportion of malignant gliomas. However, these results are unexpected since HCMV is not known as an oncogenic virus. By immunohistochemistry (with an anti-IE1 monoclonal antibody) and in situ hybridisation (with biotinylated DNA probes) on tissue microarrays and frozen sections, we investigated a French series of central nervous system (CNS) tumours, including 97 glioblastomas. In 10 cases of glioblastoma, rare astrocyte-like cells, admixed with tumour cells, stained positively for HCMV and in one case a doubtful staining of rare cells was noticed. This may indicate a reactivation of the virus under local immunosuppression but none of the cases of CNS tumours (n=132) contained HCMV genomes and/or proteins in a significant proportion of tumour cells. Our results strongly suggest that HCMV is unlikely to be implicated in the development of human malignant gliomas, at least in French cases.

Adult↗
PubMed1990

[Laitinen's stereo-adapter: application to the fractionated cerebral irradiation under stereotaxic conditions].

Radiosurgery is a technique which provides a single high dose of radiation very precisely to an intracranial lesion. The volume of tissue treated is small enough to avoid undue biological damage. This treatment requires very sophisticated apparatus and often considerable modifications in the treatment apparatus. The authors have closen to elaborate a system which makes it possible to deliver conventional fractionated irradiation, using a non-invasive stereotactic head frame called "Laitinen stereo-adapter". By fractionating the dose, most benign or low-grade malignant brain tumours can be treated, whatever their volume. The stereo-adapter and the target localization process are described. It can be used with C.T. scanning, angiography or M.R.I. The treatment apparatus is a linear accelerator delivering a 10 M.V. photon beam and treatment is made in the precise positioning of the target localization. The geometrical accuracy of the repeated mountings was studied in a preliminary study, showing a mean discrepancy of less than 1 mm in the three space planes. The geometrical accuracy of the radiation treatment was also studied on a phantom and the precision evaluated at less than 1 mm. The addition of extra collimators with a precollimation system decreased the lateral penumbra to 2-3 mm. Careful dosimetry was performed for each collimator. The use of non-coplanar arcs makes it possible to obtain a steep dose fall off outside the target volume. The dose planning calculations were compared to photodensitometry and thermoluminescent measurements, showing a good correlation. Each technical point will be discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗
PubMed1983

[Atraumatic measurement of cerebral blood flow in spontaneous meningeal hemorrhage].

Cerebral blood flow (CBF) was measured 74 times in 50 patients with spontaneous meningeal hemorrhage using a method involving the inhalation of Xenon-133. The procedure is non-invasive, reproductible, and provides reliable results. Correlation was found between the clinical state and the CBF, but very low mean values for CBF, and ischemic foci associated with these values, were detected in cases where this could not be predicted from the clinical findings. No correlation existed between vasospasm seen on angiography and the ischemic foci revealed by the isotopic method. The age of patients had an influence on CBF values but not on the clinical course. Mean CBF levels during the first two weeks of the disease were significantly higher in patients in whom the course was uncomplicated, whatever their clinical condition (excluding coma) at the time of CBF measurement. A figure of 60 ml/100 g/min for gray substance blood flow appeared to be a threshold value, below which there was a greater risk of complications. Inversely, the outcome was favorable in all cases with a cortical blood flow superior to 70 ml. These findings suggest that cerebral blood flow measurement provides prognostic information which could be of marked assistance when deciding on appropriate therapy in such cases.

Adult↗
PubMed1982

[Haemorrhages of the posterior fossa in full-term newborns (author's transl)].

Four cases of non-traumatic haemorrhage of the posterior fossa in full-term newborns are reported and compared with the 30 cases already published. Computerized tomography is the only method that permits both a diagnostic and a therapeutic approach. Surgery is indicated in the presence of brain stem compression but should be carefully discussed in cases of intracerebellar haemorrhage with secondary extension to the posterior fossa. Early hydrocephalus is common and requires shunting in about 25% of the cases

Cerebellar Diseases↗
PubMed1981

[Pituitary tumours. Their effect on gonad function; a study of 47 tumours that had been operated on (author's transl)].

The authors describe, as a result of studying a homogeneous series of 47 tumours that were operated on, the effect on the gonad function and on sterility. Although most of these tumours are accompanied by the classical amenorrhoea-galactorrhoea syndrome, it is pointed out that it may just present as simple poor progesterone effect without a major upset in menstruation. There are two difficult problems that are characteristic of these hyperprolactinaemia-producing tumors : that, that states that a micro-adenoma is responsible for the hyperprolactinaemia when there is no change in the shape of the sella of the pituitary fossa and when the level of prolactin and the dynamic tests are unable to give absolute proof that there is an organic reason for the condition; that of the decision as to what to do therapeutically, either medically or surgically, with a prolactin-producing micro-adenoma because nobody knows the "natural history" of these tumours. The present attitude of the authors is not to operate on these micro-adenomata except when the woman wants to have a baby and has been treated for at least one year with bromocriptine.

Amenorrhea↗
PubMed1980

[Transtentorial central impaction in traumatic cranio-cerebral pathology (author's transl)].

On the basis of a series of 255 severe head injuries, the authors present a clinical, radiological and anatomical study of central transtentorial impaction. Anatomical examination reveals the frequency of central impaction which affects from above downwards and in succession all of the axial structures in their median part. Clinically, these lesions fall into three categories in terms of signs: homogeneous and corresponding to the anatomical lesions. Scanner findings confirm the anatomoclinical data and provide important information in the assessment of prognosis.

Brain↗