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Biomedical subjects

N Leboucq

Publications and source records attributed to N Leboucq.

At least 19 recordsLinked to original sources
PubMed2005

[Study of the morphologic variations of the scaphocephaly. Deduction for their systematisation].

PURPOSE: The scaphocephaly is the most frequent craniosynostosis secondary to a premature synostosis of the sagittal suture. Despite this univocal pathogeny there are a great heterogeneity in the skull deformation and their systematisation stay imprecise. The aim of this study was to analyse the different morphology of the scaphocephaly by 3D CT-scan to clarify the different shapes. MATERIAL AND METHODS: This retrospective study was done from the morphometric analysis of forty-two 3D CT-scan (10 girls and 32 boys). The scaphocephaly was classified in two groups according to the systematisation of Stricker and Montaut: the sphenocephaly (large forehead) and the leptocephaly (narrow forehead). The variation of the calvaria shape was analysed and different index were calculated. RESULTS: There were 30 sphenocephaly and 12 leptocephaly. Excepted for the forehead deformation there was a morphometric difference of the occipital pole that was backward rotated in the leptocephaly. In the two groups there were retro-coronal constriction (40.5%) or pre-lambdoid constriction (9.5%) independently of the sagittal synostosis degree. CONCLUSIONS: The morphometric analysis shows that the deformation of the skull secondary to the premature synostosis of the sagittal suture can be different. The adaptative defect of the metopic suture can be to explain this difference. This deformation can be harmonious, or with a retro-coronal constriction resulting in a bitemporal narrowing, or with a pre-lambdoid constriction resulting in an occipital chignon. These results conduce to qualify the surgical correction to adapt at the different shapes.

Child, Preschool↗
PubMed2003

Plagiocephaly: morphometry of skull base asymmetry.

The aim of this study was to perform a morphometric analysis of the skull base to understand the mechanism of asymmetry between malformational and deformational plagiocephaly. Since 1988, we have carried out 102 CT scans with three-dimensional reconstruction of the endocranial side of the skull base. There were 20 cases of malformational plagiocephaly, consisting of 18 unicoronal synostoses (UCS) and two unilambdoid synostoses (ULS), and 82 cases of plagiocephaly without synostosis, made up of 60 cases of frontal plagiocephaly (FP) and 22 of occipital plagiocephaly (OP). The skull base asymmetry was analyzed in three ways: (1) the hemibases and the cranial fossa angles were compared with each other; (2) the structural asymmetry of the chondrocranium was calculated; and (3) the architectural asymmetry was measured in relation to the medio-labyrinthine plane. The skull base asymmetry of malformational plagiocephaly was located in the anterior and middle cranial fossae for UCS and in the posterior and middle cranial fossae for ULS. The asymmetry was the result of a localized structural anomaly of the chondrocranium. The asymmetry of deformational plagiocephaly corresponded to a distortion in relation to the medio-labyrinthine plane while the chondrocranium remained symmetric. The skull base asymmetry of malformational plagiocephaly is secondary to a localized malformation of the chondrocranium, and that of the deformational plagiocephaly is secondary to an architectural deformation.

Analysis of Variance↗
PubMed2003

[Clinico-radiological study of the skull deformation in the plagiocephaly without synostosis].

UNLABELLED: The aim of this study was to analyze the mechanism of the skull deformation observed in frontal and occipital plagiocephaly without synostosis. POPULATION AND METHODS: From 1987 to 2001, 96 plagiocephalies without synostosis, 72 males and 24 females, were examined. There were 72 Frontal Plagiocephalies (FP) and 24 Occipital Plagiocephalies (OP). The clinical examination of the neck muscles was performed to find out a torticolis with or without retraction. All patients underwent a 3D CT scan of the skull to exclude a craniostenosis. Cephalic Index (CI) was also calculated. RESULTS: The FP had a torticollis in 89.3% of cases associated with a muscle retraction (54.8%), a tonus asymmetry (16.6%), or in association (28.6%). The skull had a parallelepiped shape and the greater axis was oblique. The CI was 0.85. The OP had a torticollis in 50% of case associated with a retraction (28.6%), a tonus asymmetry (57.1%), or the association (14.3%). The skull had a square shape with an occipital flat and the CI was 0.95. DISCUSSION: The FP and OP are two deformations whose mechanism is different. The FP corresponds to a three plans skull asymmetry secondary to muscle traction on the base of the skull, and the OP corresponds to a posterior localized asymmetry of the skull secondary to compression. CONCLUSION: The traction and/or compression deformation start in utero or in the newborn period and the supine position is an aggravating positional factor.

Anthropometry↗
PubMed2001

[Imaging of oto-mandibular dysplasias].

The modern imaging opened a possibility of precise exploration of otomandibular dysplasias. The techniques of browsing by IRM and CT Scan and the software of image processing which is associated with these techniques (three-dimensional, superposition and removing of the anatomical structures) allow to carry out a true anatomical dissection of the whole of these malformative syndromes. The study of the skeletal anomalies gains by specifying the disorders of development of the various mandibular segments: temporomandibular joint, ramus and horizontal branch and also, all cranio-maxillar structures: orbital rim, cranial basis. Study of masticatory muscles shows an important damage correlated with skeletal troubles and performs a grading of morphological and functional gravity. This analytical study emphasizes some malformative axis: malar axis in cases of mandibulofacial dystosis, temporomandibular axis in hemifacial microsomia. Modern imaging can appreciate, by development of three-dimensional cephalometry, growth anomalies and quantification of post therapeutical results. At last usefulness of imaging appears in therapeutic modelisation and in the field of Computer-Aided Planning of surgical techniques of osteotomies and overall maxillaries distractions.

Ear↗
PubMed2001

[Acute myelitis of an unusual cause in a child: the lymphocytic choriomeningitis virus].

UNLABELLED: Acute transverse myelitis is a rare disorder in childhood. It usually occurs as a post-infectious disease, but a precise infectious agent is identified in only 20% of cases. OBSERVATION: The diagnosis of acute transverse myelitis was made in a 5.5-year-old girl who initially presented with left Claude-Bernard-Horner syndrome and meningitis. A few days later, motor and sensory tetraparesia with bladder dysfunction was observed. Magnetic resonance imaging showed a diffuse lesion in the medulla, with a hypersignal in the T2 and a hyposignal in the T1 sequences. Serum analysis showed the presence of a viral infection due to the lymphocytic choriomeningitis (LCM) virus. The outcome was marked by complete recovery of the sensorimotor deficit, but a persistence of the left Claude-Bernard-Horner syndrome. CONCLUSION: In rare cases, the LCM virus is responsible for myelitis. In the present case, the Claude-Bernard-Horner syndrome was secondary to the cervico-medullary lesion. Recent reports in the literature have been discussed, in particular as regards the use of immunomodulatory therapy, which clearly improves patient prognosis.

Acute Disease↗
PubMed2001

[Imaging of cloverleaf skull].

The cloverleaf skull is a rare and due to complex craniosynostosis. This malformation can be isolated or associated with extracranial skeletal anomalies. This anomaly has a poor prognosis both in terms of neurological outcome and esthetic appearance. Our report underscores the need to obtain a global study of the skull, the brain and the cerebral vessels with 3D reconstructions and MRI prior to early surgery.

Craniosynostoses↗
PubMed1999

[Mycoplasma pneumoniae meningoencephalitis].

BACKGROUND: Severe central nervous system diseases, such as encephalitis, have been reported in association with Mycoplasma pneumoniae infections. CASE REPORT: After an ENT infection, a 9-year-old boy with Down's syndrome developed encephalitis revealed by an acute alteration in consciousness. Head computed tomography showed, after 2 weeks, an infiltration in the basal ganglia region. The diagnosis of Mycoplasma pneumoniae encephalitis was made; recovery was complete in a few weeks. CONCLUSION: Mycoplasma pneumoniae infection should be considered in all cases of acute encephalopathy; yet the pathogenesis of the disorder is unknown and the treatment uncertain.

Acute Disease↗
PubMed1999

[Congenital skull depression. Report of 2 cases].

Congenital depression of the fetal skull is a rare lesion (1 to 2.5 per 10,000 births) resulting in an asymmetrical skull. This depression is caused by exaggerated or prolonged pressure applied to the fetal head in utero or during delivery. Two types of congenital skull depression have been described: deformity without fracture and depression with fracture, the more common form. Congenital skull depression is important because it may be associated with underlying brain injury, especially when the depression is associated with fracture. The simple permanent cosmetic deformity may also constitute a complication. CT scan can now rule out intracranial complications and in this case, a conservative management is reasonable treatment option. The observation period should not exceed six months. After this period, orthopedic or surgical management may be indicated because spontaneous elevation of depression is uncommon after six months. The authors report two cases of congenital skull depression with deformity without fracture. The pathogenesis and treatment are discussed.

Fetal Diseases↗
PubMed1997

Familial Dandy-Walker malformation and leukodystrophy.

We report the first familial cases with two different types of posterior fossa cystic malformation and a leukodystrophic-like aspect on cerebral magnetic resonance imaging (MRI). The girl and her brother had severe encephalopathy, marked hypotonia, absent deep tendon reflexes, macrocrania, gigantism, and dysmorphic face and extremities. The girl had generalized seizures. The boy had unilateral cataract and bilateral optic atrophy. The parents were first cousins, suggesting autosomal recessive transmission. MRI showed Dandy-Walker variant in the girl, with cerebellar vermis hypoplasia and expansion of the cisterna magna, which communicated with the fourth ventricle. Her brother had mega cisterna magna communicating with the fourth ventricle and a normal cerebellum. The 2 children had abnormally high signal in the supratentorial white matter. Visual and auditory evoked potentials revealed prolonged latencies. Motor and sensory conduction velocities were normal. Muscle and nerve biopsies were normal. Metabolic exploration demonstrated no abnormality.

Brain Diseases↗
PubMed1995

Ito hypomelanosis and moyamoya disease.

A transient ischemic attack with nearly complete progressive recovery occurred at age 20 months in a girl with Ito's hypomelanosis. Outcome included mental deficiency and behavioral difficulties requiring special education, but without recurrence of ischemic attack. The angiographic investigation performed at 9 years of age disclosed bilateral stenosis of the internal carotid artery characteristic of moyamoya disease. This association has not been reported previously.

Brain Damage, Chronic↗
PubMed1994

Aplasia cutis congenita of the scalp with large underlying skull defect: a case report.

Localised agenesis of the scalp is the most frequent pattern in aplasia cutis congenita (ACC), a congenital absence of the skin and occasionally of deeper layers. Several clinical groups are characterised by the location and pattern of skin defects, associated malformations and the mode of inheritance. Death occurs in 20% of cases, secondary to the associated anomalies, to infections or to haemorrhage from ulceration of the sagittal sinus when there is also a defect of the underlying skull. In this latter case, we close the defect by two rotational scalp flaps (Orticochea technique) at birth. A three-dimensional CT study is useful for showing the extent of the skull defect and the deformity of the craniofacial complex and the changes in the bone after treatment.

Bone Remodeling↗
PubMed1993

Lambdoid craniosynostosis. A 3D-computerized tomographic approach.

From a series of eleven children aged from 4 months to eight years presenting with a parieto-occipital flattening that was unilateral in nine and bilateral in two, we attempted to determine a 3D-CT semeiology able to demonstrate the presence of a lambdoid suture synostosis, as well as the participation of coronal and lambdoid sutures in the genesis of complex cranial malformations. Pure isolated forms of lambdoid synostosis are rare and justify a surgical treatment for cosmetic purposes if the deformation is severe and progressive.

Child↗
PubMed1993

Hallervorden-Spatz syndrome and MRI: the "tiger's eye". One case.

The MRI exploration of a woman suspected, on clinical grounds, of having Hallervorden-Spatz disease (or rather syndrome) revealed, on T2-weighted sequences, the "tiger's eye" or "target" image of the pallidum described by previous authors: i.e. a high-intensity signal in the centre of a distinct low-intensity signal; it also showed an abnormal low-intensity signal of the substantia nigra. These changes are related to the iron deposits and neuro-axonal lesions which characterize the disease. The MRI semeiology of Hallervorden-Spatz disease has been analyzed in the literature. The images we obtained in this patient with the echo-gradient technique using T1-weighted sequences were unusual, showing a low-intensity signal of the globi pallidi surrounded by central and peripheral low-intensity signal areas, whereas the images obtained with spin-echo T1-weighted sequences were normal.

Adult↗
PubMed1992

[3D imaging and pathology of the base of the skull in children].

Three dimensional computed tomography was performed in 150 children suffering from a bone lesion of the base of the skull and face. These lesions were either malformative, neoplastic, infectious or traumatic. 3D CT provided an essential anatomical approach to the lesions facilitating the choice of the most appropriate treatment. 3D CT is also indicated in the follow-up of these operated children, particularly of the growth of the operated bone segment and its relations with adjacent structures.

Age Factors↗
PubMed1991

Value of 3D imaging for the study of craniofacial malformations in children.

Three-dimensional (3D) imaging was performed on 150 children with craniofacial malformations divided into three groups: craniostenosis, craniofacial dysraphism and labio-maxillo-palatine clefts arbitrarily included in a corpus of constitutional and acquired abnormalities. The authors believe that this technique is of interest not only for the management of these children, but also to understand the pathogenesis of their malformations.

Adolescent↗
PubMed1991

[Localization of the mandibular canal: experimental comparison of four types of radiological examination].

This investigation, involves eight dry mandibles, and compares four of radiological examinations to allow the measurement of the depth of the mandibular canal in relation to the alveolar crest. It showed that their (ability to detect the mandibular canal) differed significantly: coronal tomography: 64% retro-alveolar X-ray: 83% orthopantomography: 85% coronal tomodensitometry: 100% The retro-alveolar X-ray appears to have the best cost/information ratio, while the coronal tomography must be left aside.

Humans↗