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Biomedical subjects

P Courtheoux

Publications and source records attributed to P Courtheoux.

At least 19 recordsLinked to original sources
PubMed1992

Regional cerebral oxygen consumption, blood flow, and blood volume in healthy human aging.

Using high-resolution positron emission tomography and the oxygen 15 continuous inhalation method, we examined the changes in cerebral metabolic rate of oxygen, blood flow, blood volume, and oxygen extraction fraction as a function of age in 25 optimally healthy, unmedicated volunteers who ranged in age from 20 to 68 years. Subjects were strictly selected for absence of cerebrovascular risk factors, dementia, or mental disorders; they had neither biological nor clinical abnormalities, and no focal anomaly on computed tomographic scan. Regions of interest were determined according to the anatomical structures defined on corresponding computed tomographic scan cuts obtained using a stereotaxic head-positioning method. This same method was also used for positron emission tomographic imaging. There was no significant effect of aging on PaCO2 values, hematocrit, arterial blood pressure, cholesterol and triglyceride levels, and blood glucose levels. In most cerebral cortex gyri, the cerebral metabolic rate of oxygen significantly decreased with age according to a linear pattern, with the same magnitude (about -6% per decade) in all four lobes and on both sides. This effect of age on cortical cerebral metabolic rate of oxygen persisted when the possible influence of cortical atrophy, gender, and head size were partialled out. In contrast, the white matter, deep gray nuclei, thalamus, and cerebellum were not significantly affected. The cerebral blood volume declined with a similar pattern to cerebral metabolic rate of oxygen, while changes in cerebral blood flow were less significant, presumably because of larger variance of data across subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Embolization in venous erectile insufficiency].

The authors report their experience with management of venous erectile insufficiency. The patients were classified according to radiologic criteria. 46 patients with venous insufficiency of the Santorini plexus were treated by detachable balloons and coils with 57% of satisfactory clinical results.

Adult↗
PubMed1989

[The history of Horton's disease or ... 10 centuries of a fascinating adventure].

In 1932, Horton, Magath and Brown reported two cases of a "new form of arteritis affecting the temporal vessels ... which probably represents a new clinical syndrome". In reality, several publications, devoted to the same pathology already preceded this article. The most ancient is that of an ophthalmologist from Baghdad, Ali Ibn Isa (940 to 1010). In his memories, translated and published in english in 1936, the author states that "he undertook excision and cauterisation of arteries to treat patients who were suffering from heat and inflammation of their temporal muscles and which sometimes ended in loss of vision ...". In 1890, J. Hutchinson, an English surgeon, reported a case "... of inflammed and swollen temporal arteries ...". This article was only brought to light in 1946. In 1930, M. Schmidt, published a probable case of temporal arteritis, subsequently reported in 1947. In 1934 and 1936, Horton published new cases of temporal arteritis and defined the clinical characteristics of the disease and its histology. In 1938, Jennings made a particular contribution in reporting the first case of blindness. From this time on, cases of temporal arteritis became increasingly common in the literature. The first French case was described by J. Paviot et al. in 1934, but remained largely unrecognized until 1942. In 1936, J. Chavany was the first to describe the pillow sign, but more particularly in 1948, he prescribed the first treatment with steroids, with spectacular results. It was only in 1950 that R.M. Shick et al. published the effects of steroid therapy in temporal arteritis.(ABSTRACT TRUNCATED AT 250 WORDS)

Bibliographies as Topic↗
PubMed1989

[Intermittent claudication of the jaw in temporal arteritis].

Stiffness of the jaw was noted in the first descriptions of temporal arteritis. It was only in 1944 that Horton used the term intermittent claudication and related this sign to effort ischemia due to thrombosis of facial arteries. The introduction of ultrasound techniques has enabled the permeability of facial arteries to be confirmed in spite of induration and absence of pulsatility clinically. Anatomical studies have defined the preponderant role of the internal maxillary artery in the vascular supply of the masseter muscles and have enabled the localization of an appropriate and reliable site for ultrasound study: the pterygo-maxillary fossa. The velocimetric data thus collected confirm that the internal maxillary artery is affected and define the etiopathogenesis of intermittent jaw claudication during temporal arteritis. This sign is observed on average in one patient in three suffering from temporal arteritis. While several cases of intermittent jaw claudication have been described in severe atheromatous stenosis of the common carotid or external carotid arteries, or in relation to other causes (rheumatological, neoplastic, psychological ...), the observation of this syndrome in a suspicious clinical and paraclinical context constitutes an excellent orientation sign in favor of temporal arteritis.

Giant Cell Arteritis↗
PubMed1988

Local fibrinolytic therapy in ischemic carotid pathology.

Sixteen patients underwent local fibrinolytic therapy for thrombosis or embolism of the main trunk or intracranial branches of the internal carotid artery. There were eight cases of complete thrombosis of the internal carotid artery, five proximal stenoses of the internal carotid artery with extensive thrombus, one thrombus of the carotid siphon and two middle cerebral artery emboli. Indications for treatment included transient ischemic attacks in 11 cases, cerebral ischemia after carotid arteriography in two cases, and after surgery for atheromatous lesions of the carotid bifurcation in three cases. The fibrinolytic therapy was initiated during carotid surgery in three cases, where extended thrombosis of the internal carotid artery was discovered, which was inaccessible to a Fogarty catheter. The other 13 cases were treated during arteriography procedures. Lysis of the clot was always obtained. One patient died of hematoma of the frontal lobe. All other patients survived and showed neurologic improvement. The neurologic outcome was dependent on the duration and the degree of initial ischemia. Fibrinolytic therapy appears to be beneficial therapy for certain cases of cerebral ischemia.

Acute Disease↗
PubMed1988

[Cervical chemodectoma disclosed by coma. Pathogenic hypotheses].

The authors reported a case of cervical paraganglioma. Patient had a coma suggesting secretary activity of the lesion or cerebral venous thrombosis. Angiography showed an hypervascular lesion characterized by venous reflux into the contro-lateral sinus. After neurological stabilization by tumor embolization, the tumor was surgically removed.

Coma↗
PubMed1987

Percutaneous endoluminal angioplasty of post endarterectomy carotid stenoses.

Percutaneous transluminal angioplasty of the carotid artery was performed in four patients with recurrent stenosis following endarterectomy. Balloon catheter dilatation was successful in 3 of the 4 lesions. Post dilatation angiography demonstrated an increase in luminal diameter: there were no neurological complications with the procedure. PTA appears to be an effective method of treating recurrent stenosis following carotid endarterectomy.

Aged↗
PubMed1987

Treatment of bilateral spontaneous dural carotid-cavernous fistulas by coils and sclerotherapy. Case report.

A case of bilateral spontaneous carotid-cavernous fistulas producing increased intraocular pressure is reported. The fistulas lay between the meningeal branches of the internal carotid artery (ICA) and the cavernous sinus, but the ICA itself was not involved. Successful treatment was accomplished by the introduction of steel coils and a sclerotic liquid into the cavernous sinus via the distal superior ophthalmic vein.

Arteriovenous Fistula↗
PubMed1987

[Hemodynamic study of obstructive lesions of the internal carotid artery: value of coupled measurement of regional cerebral blood flow and volume].

A study of 130 patients having presented either a transient ischemic attack or a completed stroke, or admitted for an asymptomatic carotid stenosis, allowed the following investigations: CT-scan, doppler, angiography, measurement of the regional cerebral blood flow (rCBF) by the study of 133Xe clearance (Novocerebrograph (R)), and measurement of the regional cerebral blood volume (rCBV) made by gamma emission tomography after autotransfusion of 99m Tc-labeled erythrocytes with an Elscint Apex 415 ECT (R) camera. Our aim was to look in which case a rCBF and/or a rCBV interhemispheric asymmetry was observed, by comparing the previous hemodynamic parameters with clinical, CT-scan and angiographic data. Although a rCBF and/or a rCBV asymmetry appeared more often among patients presenting with infarction than among those of the asymptomatic category, this does not seem specific for any clinical grade. The same statement applies to the comparison between hemodynamic parameters and CT data. The arterial lesions were classified in 4 groups: no stenosis (12 cases), uni or bilateral moderate carotid stenosis (40 cases), unilateral severe carotid stenosis or occlusion (65 cases), bilateral carotid severe stenosis or occlusion (13 cases). We observed a rCBF asymmetry among some patients in the 4 groups, although this was more frequent among the two latter groups. Nevertheless no case of a rCBV asymmetry was observed in the 2 first groups. Such an asymmetry was present in 31 percent of the patients belonging to the two latter groups. In patients of the third group the asymmetry was always due to a relative increase of rCBV beyond the carotid lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1987

[Acute hydrocephalus drained in emergency. Consequence of cerebellar infarction in Haemophilus meningitis].

A 2 year-old child admitted for Haemophilus meningitis was immediately treated by adequate antibiotic treatment. Three days later multiple hypertonic strokes and periodic respiration occurred; a resuscitation was necessary. CAT scan showed an acute hydrocephalus with non visible 4th ventricle and low-density areas in both cerebellar hemispheres allowing the diagnosis of cerebellar infarction. External drainage of CSF was rapidly performed and maintained for 11 days with success. The child was secondarily discharged with temporary cortical blindness and persistent moderate static cerebellar signs. The etiology of the cerebellar infarction was likely to be an arterial thrombosis in the vertebro-basilar area, probably secondary to cerebral arteritis related to Haemophilus.

Acute Disease↗
PubMed1987

[Study and treatment using an endovascular approach of erectile insufficiency of venous origin].

Forty-six patients with defective erection of venous origin were treated by embolization of deep dorsal vein at the Santorini plexus level. Embolization was by insertion of disposable balloons after surgical approach to deep dorsal vein of penis. Follow up showed that 57% of patients had recovered satisfactory, normal sexual activity and 15% a fairly satisfactory sexual activity.

Adult↗
PubMed1987

[Chemoembolization of hepatic metastases. Preliminary study].

Twenty-one patients with hepatic metastases were treated by chemoembolization over a 2-year period, the technique consisting of selective injection of a mixture of Spongel powder and Adriamycin plus 5-FU into the hepatic artery. Indications and results are discussed as a function of clinical, biologic and radiologic criteria.

Adult↗