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O Ille

Publications and source records attributed to O Ille.

6 recordsLinked to original sources
PubMed1997

MRI and MRA for diagnosis and follow-up of cerebral venous thrombosis (CVT).

OBJECTIVE: To assess the sensitivity of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in the diagnosis and the follow-up of cerebral venous thrombosis (CVT). To describe MRI and MRA features in CVT. MATERIAL AND METHODS: The clinical and neuroradiological studies of 20 patients with proven CVT were reviewed. All patients underwent computed tomography (CT), MRI (with MRA for 15 patients) and digital substraction angiography (DSA). Eleven patients had follow-up after treatment with MRI (nine with MRA). RESULTS: MRI and MRA together provided the diagnosis of CVT in all cases. The sensitivity of MRI alone was 90%. MRA showed abnormalities in all cases of CVT. Progressive sinus recanalization was demonstrated by follow-up with MRI and MRA at least 15 days after diagnosis and treatment. CONCLUSION: In most of cases, the combination of MRI and MRA is sufficient to allow diagnosis of CVT and obviates the need for invasive angiography. MR studies are also useful for the follow-up of CVT.

Adolescent↗
PubMed1997

Cerebral postischemic hyperperfusion assessed by Xenon-133 SPECT.

UNLABELLED: In this study, the functional and clinical evolution of the cerebral postischemic hyperperfusion (CPH) were evaluated. METHODS: Forty-four noncomatose patients suffering from unilateral cerebral ischemia located in the internal carotid territories were studied. Twenty-five consecutive patients having CPH with 133Xe-SPECT cerebral blood flow (CBF) measurement and 19 patients without cerebral hyperperfusion matched for age. CBF, vasoreactivity to acetazolamide and the evolution of the clinical state, scored by the National Institutes of Health scale for stroke, were compared. RESULTS: CPH coincided with CT-scan abnormalities in 57% of cases. The mean cerebral vasoreactivity to acetazolamide was comparable in the two groups, but there was local vasoplegia in the hyperperfused areas in 20% of CPH patients, including two cases (8%) with a steal syndrome. Comparison of the initial and late clinical scores showed no significant difference between patients with and without CPH. For patients without CPH, the interhemispheric CBF asymmetry was correlated with the initial and the late scores (p < 0.0001, r = 0.81). For the CPH group, the interhemispheric asymmetry, compensated or even inverted by the hyperperfusion, was not correlated with the initial score (ns, p = 0.051, r = 0.42) and was weakly correlated to the late score (p = 0.048, r = 0.43). CONCLUSION: The cerebral hemodynamics remain normal in 80% of cases of CPH patients. The presence of CPH does not interfere with the clinical evolution. The initial and late clinical scores were not different compared to those of patients without hyperperfusion. The clinical outcome of the CPH patients cannot be accurately predicted by the interhemispheric asymmetry.

Acetazolamide↗
PubMed1996

Fecal incontinence after pelvic radiotherapy: evidences for a lumbosacral plexopathy. Report of a case.

PURPOSE: Clinical manifestations of radiation-induced lumbosacral plexopathy remain a rare event. We report the case of a 62-year-old woman with neurogenic fecal incontinence that occurred after radiotherapy of cervical carcinoma. METHODS: Anorectal, bladder, and lower limb sensory-motor functions, as biologic and morphologic explorations, were performed on repeated occasions. RESULTS: Anorectal manometry, conduction times of pudendal nerves, sacral latencies, and pudendal nerve-evoked corticals disclosed lesions of the lumbosacral plexus that was confirmed by bladder manometry and electromyography of lower limbs. Biologic and morphologic explorations were within normal ranges. CONCLUSION: Because no other cause except radiation was demonstrated in this case, we suggest that plexopathy may be a late-occurring complication of radiotherapy.

Brachytherapy↗
PubMed1996

[Hypothermia and the nervous system. Review of the literature apropos of 4 cases].

Thermoregulation involves a long term adaptation system with hormonal processes and an immediate regulation system by extrapyramidal tracts, sympathetic part of autonomic nervous system and cortical integration of body temperature changes. Both system are under control of a hypothalamic center. Prolonged accidental exposure to intense cold and myxoedematous coma are the best known etiologies of hypothermia. However milder and often misdiagnosed hypothermia can occur at home in patients without endocrinologic disease. In these cases, hypothermia is due to dysfunction of immediate thermregulation under neuronal control, especially somatomotor and autonomic system. We report four cases of hypothermia of this kind. Two patients had an inhibition of peripherical mechanisms of protecting against cold (cutaneous vasoconstriction, shivering) and had dampened perception of cold: one was 73, had diabetes mellitus and took different drugs, the other one suffered from systemic lupus with myelopathy. The two other patients probably had a disorder of the thermoregulation hypothalamic center: one had Wernicke's encephalopathy and the other multiple sclerosis. From these cases and a review of the literature, we describe the different etiologies of hypothermia and their pathophysiology.

Adult↗
PubMed1995

Hypertensive encephalopathy after bilateral carotid endarterectomy.

BACKGROUND: Hypertension occurs frequently after carotid endarterectomy and may lead to cerebral vascular complications and myocardial infarction. Its pathophysiology has recently been related to surgically induced damage of carotid baroreceptors. CASE DESCRIPTION: A 45-year-old normotensive man with no history of epilepsy was admitted 3 weeks after bilateral carotid endarterectomy for severe repetitive paroxysmal headaches, vomiting, and agitation that were closely associated with attacks of marked hypertension. During one of these attacks, he had a grand mal seizure. Plasma catecholamine levels during hypertensive attacks were highly elevated despite the absence of pheochromocytoma, reflecting abnormalities in baroreceptor sensitivity that lead to unrestrained activation of the central sympathetic nervous system. Heart rate response to Valsalva maneuver showed suppression of the usual tachycardia, indicating baroreceptor reflex insensitivity. CONCLUSIONS: We report the first case of hypertensive encephalopathy associated with baroreflex failure syndrome after bilateral carotid endarterectomy. The role of blood pressure monitoring may be critical in revealing carotid baroreceptor insensitivity in such clinical settings.

Baroreflex↗