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Biomedical subjects

P Freger

Publications and source records attributed to P Freger.

33 records · Page 2Linked to original sources
PubMed1988

[Vasospasm and ischemia in a series of 60 aneurysms treated quickly surgically].

Sixty patients with ruptured cerebral aneurysms were operated during the first 3 days after the onset of bleeding. In all cases the following investigations were performed: before surgery and 10 days after surgery angiography and CTScan, two months later a control CTScan. The first CTScans have been classified according to the staging defined by Fisher. Vasospasms (VS) were assessed comparing the arteriographies before and after surgery and classified as narrow or moderate; ischemia were assessed on post surgical CTScans. VS were found in any of the Fisher grades but were more frequent in grade 4; they occurred in 50% of cases (30 cases). Narrow VS were found 17 times in any Fisher grade. Ischemia occurred in 7 cases (1 death); following narrow VS in 6 cases. The high incidence of VS demonstration is emphasized: it is probably due to the lag time between bleeding and angiography and to the fact that angiographic controls were systematically performed. On the other hand ischemia occurred in 7 patients: the respective role of normalized intracranial pressure, hypervolemia, drug use and surgical procedure are discussed as candidate factors of this low incidence.

Brain Ischemia↗
PubMed1988

[Optochiasmatic tuberculoma and MRI. 2 cases].

Two cases are reported of optochiasmatic tuberculoma, an exceptional complication difficult to diagnose in the absence of any tuberculous context. Although diagnosis of the optochiasmatic occupying process is simple by scan or NMR imaging, it is generally difficult to identify the chiasma in a process of this type. It is therefore impossible to recognize the two forms of these tuberculomas: intra- and peri-chiasmatic histologic types, and yet these have an incidence on therapy and prognosis. Surgical exploration is justified when the diagnosis remains in doubt or when the functional prognosis is implicated.

Adult↗
PubMed1987

[Is it necessary to operate on asymptomatic aneurysms? Apropos of 114 surgically treated asymptomatic aneurysms].

A six years retrospective analysis of asymptomatic aneurysms (A.A.) was done in 4 neurosurgical departments: 114 AA were clipped in 99 patients. In 44 patients (48 asymptomatic aneurysms) the surgical procedure was achieved in one step for both symptomatic and asymptomatic aneurysms. In 59 patients (66 asymptomatic aneurysms) the surgical procedure was delayed as it necessitated a second and elective craniotomy. As regard the treatment of asymptomatic aneurysms, there was no morbidity, and one death due to a massive pulmonary embolism. These surgical results are undoubtebly better than the risk of hemorrhage from unruptured aneurysm as emphasized in the literature.

Adult↗
PubMed1987

[Intracranial hematoma in ruptured aneurysms. Apropos of 57 cases].

In 200 consecutive cases of ruptured aneurysms volume of resulting hematomas exceeded 5 ml in 57 patients (28.5%) and 50 ml in 25 patients (12.5%). We have studied the radio anatomical and clinical datas of these 57 cases: In most of them (90%) the aneurysm situation appears to determine hematomas characteristic features. Fatal issues are related to hematoma volume when above 50 ml and to vasospasm in other cases. Results in the 48 operated cases lead to advise neurosurgeons against surgical procedure when volume is greater than 60 ml in grade V patients (unless operation could take place immediately after rupture onset), and when severe intra ventricular hemorrhage is present. Death in ruptured aneurysms is a consequence of hematomas volume in at least 10% cases. Hematomas or vasospasm are responsible for sequellae or fatal issues which still occurs in 15-20% of overall population of patients with ruptured aneurysms, despite improvement in management and timing. Cases finding and preventive surgery of non incidental aneurysms should be a matter of concern.

Adolescent↗
PubMed1986

[Intraspinal epidural hematoma in the hemophiliac].

The authors report a series of 11 epidural haematoma in hemophilia. Of these, one case is observed in the department of Neurosurgery at the CHRU. From this study, main points results: a mechanic etiology was found in four cases; the main clinical and radiological signs are those of epidural haematoma; the indication to operate is required and the hemophiliacs should receive a "substitutive" treatment as soon as possible.

Hematoma, Epidural, Cranial↗
PubMed1985

[Early surgery of ruptured aneurysms. A factor in preventing ischemia].

110 patients with ruptured aneurysms were operated on within 4 to 96 hours after subarachnoid hemorrhage. Clinical grades (Hunt) were: 1-2-3 in 93 cases and 4-5 in 17 cases. Among the patients grades 1-2-3, 81% had a good out come without any neurological abnormality, among the patients graded 4-5, only 27% had a fair out come. Cerebral ischemia has been noted (CTS can + neurological deficits) in 7 cases only among patients graded 1-2-3 (93 cases). The results, concerning ischemia, are better than the natural course of ruptured aneurysms and better than the course in series with delayed operation. Probably vasospasm is not alone to create ischemia.

Adult↗
PubMedDate not supplied

Pudendal neuralgia: CT-guided pudendal nerve block technique.

Chronic anoperineal pain without any apparent etiology may be caused by compression of the pudendal nerve. This presentation illustrates the course of the pudendal nerve and the technique of computed tomography-guided infiltration of the nerve.

Anal Canal↗