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Biomedical subjects

R Deruty

Publications and source records attributed to R Deruty.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Percutaneous injection of methyl-metacrylate in osteoporosis and severe vertebral osteolysis (Galibert's technic)].

The authors present their preliminary experiences using methyl-metacrylate by percutaneous injection for the treatment of osteoporosis and osteolysis of the vertebral body and for vertebral angiomas. The injection of cement strengthens the vertebral body and prevents its collapse. The mixture used consist of 4.80 g of powder with 5 cm3 of monomer liquid. The technique is performed with radiological control under neuroleptanalgesia and a local anesthesia before insertion of the needle. This technique gives good results for the treatment of vertebral pain caused by osteoporosis or osteolysis.

Adult↗
PubMed1988

Long-term outcome of the management of ruptured intracranial aneurysm. Review of 328 consecutive patients treated over a period of 12 years.

From 1972 to 1984, 328 patients were admitted into the neurosurgical department for the treatment of a ruptured intracranial aneurysm, being clinically in grades 1 to 4. These patients were submitted to a deferred surgery protocol: 5.5% of the patients died before surgery, and 94.5% were actually operated upon. The follow-up was at least over 1 yr, and up to 14 yr (average 3 yr 8 months). The long-term result was evaluated according to both the physical status of the patients and their activity resumption (professional, familial and social). This long-term result was compared to the immediate results, which had been evaluated either at the time of discharge or a few months later: 25.9% of the 328 patients were 'lost to view', and 74.1% were 'followed-up' (including preoperative and operative death). The immediate results were: death 17.7%, poor 7.3%, fair 9.1%, good 66.2%. The long-term results were evaluated as follows: poor 7%, fair (independent but with emotional or psychological difficulties) 14.8%, good (fully independent) 55.1%. The long-term activity resumption (ability to work) was: normal 46.5%, lesser level of work 7.8%, unable to work 20.5%. Out of the patients with a good and fair immediate result, only 66.5% resumed their previous occupation: 21.2% of these patients did not resume their previous occupation due to psychological or emotional disturbances.

Aged↗
PubMed1988

[Partial recovery of the oculomotor nerve after section and repair during the excision of a tumor].

The authors report the case of a patient having suffered a section of the oculomotor nerve during the excision of a tumor located in the tentorium incisura. The nerve was immediately sutured (end to end anastomosis). After 18 months, a partial recovery of the function of the nerve was seen clinically and on EMG. Ptosis had disappeared and adduction of the eye reappeared. An analysis of available data on the suture of oculomotor nerves is then given: reparation of the third nerve in animals and man give variable and partial results. Partial recovery and aberrant regeneration are explained by the fact that this nerve innervates many muscles and by the absence of ultrastructural systematisation. On the contrary, some still rare studies have indicated that the suture of the fourth and sixth cranial nerves give better results probably because these nerves have a simple ultrastructural organization, are purely motor and innervate only one ocular muscle.

Adult↗
PubMed1988

[Aneurysm of the internal carotid artery and cervical mega-dolicho-arteries in Marfan syndrome].

The authors describe the case of a Marfan syndrome who presented a giant intracranial internal carotid aneurysm associated with elongation and tortuosity of internal carotid and vertebral arteries on both sides. The skin microscopic examination showed fragmentation and distorsion of elastic fibers. There was no microscopic study of the vessels. Extra and intracranial vascular abnormalities are rarely reported in marfan syndrome: cardiovascular changes are seen mostly in aorta and pulmonary artery. In the literature are reported some giant aneurysms, dissections and dilatations of carotid, basilar and vertebral arteries. Usually the microscopic examination of the vessels show cystic medial necrosis. Other connective tissue diseases (pseudo-xanthoma elasticum, Ehlers-Danlos syndrome, progeria) are described with such clinical abnormalities. Reference is made to the possibility of unknown histological and chemical lesions weakening the vessels in patients without connective tissue disorders and presenting with arterial dissection or arterial aneurysm. So vessels would be more sensible to aging, arteriosclerosis or hypertension.

Aneurysm↗
PubMed1988

[Long-term results of the treatment of ruptured intracranial aneurysms. Study of a series of 328 patients hospitalized from 1972 to 1984].

Between 1972 to 1984, 328 patients were admitted in the department of neurosurgery, for the treatment of a ruptured intracranial aneurysm, and being clinically in grades I to IV. These patients were submitted to a deferred surgery protocol. 5.5% of the patients died before surgery, and 94.5% were actually operated on. The follow-up was at least over one year, and up to 14 years (mean 3 years and 8 months). The long term result was appreciated according to the physical status of the patients and the activity resumption (professional, familial and social as well). This long term result was compared to the immediate results, which had been appreciated either at the time of discharge or a few months later. 25.9% of the 328 patients were lost of view, and 74.1% were followed (including pre-operative and operative death). The immediate results were: death 17.7%, poor 7.3%, fair 9.1%, good 66.2%. The long term results were appreciated as follows: Poor 7.3%, Fair (independent but with emotional or psychological difficulties), 14.8%, Good (fully independent) 55.1%. The long term activity resumption (ability to work) was: normal 46.5%, lesser level of work 7.8%, unable to work 20.5%. Out of the patients with a good and fair immediate result, only 66.5% have resumed their previous occupation. 21.2% of these patients did not resume their previous occupation due to psycho.

Activities of Daily Living↗
PubMed1987

Spontaneous progressive thrombosis and surgical resection of a giant aneurysm of the posterior cerebral artery in an 18-year-old.

The rare case is reported of an 18-year-old boy with giant fusiform aneurysm of the P1 and P2 segments of the posterior cerebral artery. The symptoms were two episodes of sudden headache with transient third-nerve palsy. The aneurysm developed into almost complete thrombosis over five months. The posterior cerebral artery distal to the aneurysm was also thrombosed and reirrigated by collateral channels without visual field deficit. The aneurysm was treated by resection. The development of this giant aneurysm, the progressive thrombosis and the clinical characteristics are discussed.

Adolescent↗
PubMed1986

Intra-operative embolization of cerebral arteriovenous malformations by means of isobutylcyanoacrylate (experience in 20 cases).

20 cases of cerebral arteriovenous malformations (AVM's) are reported, treated by direct intraoperative embolization. A 50% mixture of butyl-2-cyanoacrylate (IBC) and ethyl mono-iodostearate (Duroliopaque) was used. The clinical history of the patients was a long history of seizures in 10 cases, a haemorrhage in 9 cases, and a motor deficit in 1 case. In the immediate post-operative course, 1 patient died, 3 patients had a serious post-operative haemorrhage, 6 patients presented with a transient post-operative deficit, and in 10 patients the post-operative course was uneventful. During the following years, a late haemorrhage occurred after incomplete AVM eradication in 3 patients, leading to AVM resection. The AVM eradication was eventually complete in 3 cases with embolization only, and in 7 cases with embolization and AVM resection. The overall management of AVM in all 20 patients was: embolization only in 13 cases, embolization and resection in 7 cases. The long term results are: operative death 1, late death 3, long lasting deficit 1; uneventful 15. The authors discuss the technique of embolization, the effect of IBC on the vessel walls, the evolution of their general management of AVM's after this experience. Eventually the intra-operative embolization may be helpful after incomplete intra vascular embolization, to facilitate the AVM eradication.

Bucrylate↗
PubMed1986

Outcome of ruptured intra-cranial aneurysm treated by a deferred operation. Review of 345 consecutive cases treated over a period of 12 years.

This paper reports experience with 345 patients admitted to a neurosurgical department after an aneurysm rupture. At the time of admission, patients were separated into two groups: the patients unsuitable for planned surgery and called 'unoperable'; the patients planned for surgery and called 'operable patients' (328 patients). The general management attitude consisted of deferred surgery according to the clinical status of the patients and the risk of vasospasm and ischaemia. Of these, 18 died before the day of surgery, and are called 'operable and non-operated' patients. The cause of death was vasospasm and ischaemia in 10 cases and recurrence of haemorrhage in 8 cases. 310 patients were actually operated upon. Their final outcome was: good 70%, fair 9.6%, poor 7.7%, death 12.5%. This paper discusses the risk of SAH recurrence and the risk of vasospasm and ischaemia during the waiting time before surgery, in the attitude of deferred surgery which was elected in most cases of this series and compares the outcome with other published series.

Humans↗
PubMed1986

[Stenosis of the posterior cerebral artery (P1) discovered at the time of a meningeal hemorrhage and simulating an arterial aneurysm].

A case is reported, in which a patient 54 years old, was admitted after a SAH. The CT Scan (D1) demonstrated blood in the peri-peduncular cisterns. A first angiogram through femoral route was performed at D1. There was no vascular malformation on both carotid territories. An arterial ectasia was demonstrated on the basilar artery, arising at the origin of the left superior cerebellar artery. The left posterior cerebral artery was supplied only by the left carotid artery through a dilated posterior communicating artery. A second left vertebral angiogram was performed at D8, to make sure whether this ectasia was an aneurysm or a non aneurysmal dysplasia, but failed to provide certainty. The patient was operated upon at D17, with the diagnosis of possible aneurysm at the origin of the left superior cerebellar artery. Through a pterional route the posterior communicating artery was approached, no blood was found in the area of the upper basilar artery; there was an abnormal posterior circle of Willis, the superior cerebellar artery arising with a common trunk from the upper basilar artery; distal to this common trunk, the P1 segment was normal on the first three fourths of its course; the last fourth of the P1 segment was highly narrowed, the outer diameter of the narrowed P1 segment was approximately one third of the normal P1 segment, and was located at the junction with the complex posterior communicating artery-P2 segment. This narrowed part of the P1 segment showed evidence of an atheromatous plaque on its wall. No aneurysm was found in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗
PubMed1985

[Peroperative embolization of cerebral arteriovenous malformations with butylcyanoacrylate (18 cases)].

18 cases of cerebral Arterio-Venous malformations (AVM) are reported, treated by direct intra-operative embolisation. A 50% mixture of Butyl-2-Cyanoacrylate and Mono-Iodo-Stearate of Ethyl was used. The clinical history of the patients was a long history of seizures in 8 cases a sub-arachnoid or intra-cerebral hemorrhage in 9 cases, and a transient motor deficit in 1 case. The AVM site was supra-tentorial in 16 cases, and infra-tentorial in 2 cases. The AVM size was large with numerous feeders in 13 cases, and limited with a few feeders in 5 cases. Technically, after catheterisation of a cortical feeder, an intra-operative angiogram was performed (except for the first 6 cases) then the polymerizing mixture was pushed inside the feeder (from 1 cc to 3 cc routinely, depending of the AVM size; exceptionally 7 cc and 11 cc were used). In the immediate postoperative course, 1 patient died (case with the 11 cc embolization), 3 patients had a serious postoperative hemorrhage, 4 patients presented with a transient postoperative deficit, and in 10 patients the postoperative course was uneventful. The long term results are: 1 postoperative death, 1 death after recurrence of intra-cerebral hemorrhage (3 years postoperatively), 1 hemiplegia, 15 patients without long lasting complication. The embolization was performed as unique treatment in 14 cases, and was followed with the AVM removal in 4 cases (immediately in 1 case, delayed in 1 case, late after recurrence of intra-cerebral hemorrhage in 2 cases, respectively after 3 years and 2 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗
PubMed1985

[Giant traumatic aneurysms of the internal carotid developing in the sphenoid sinus. Apropos of 2 cases].

Two cases of traumatic aneurysms of the internal carotid artery developed into the sphenoidal sinus are reported by the authors. It is a very rare pathology (about fifteen cases are reported in the literature). Recurrent epistaxis are the most frequent symptom associated or not with a sphenoidal sinus syndrome. Our first observation corresponds to this description but the second suggests a tumour of the sphenoidal base. The diagnosis is performed by carotid angiography. The treatment consists of the exclusion of the aneurysm by ligating the cervical internal carotid artery or by trapping the aneurysmal segment. This treatment has produced a good result in nine cases of the literature and in our two cases. The direct approach of the aneurysm is very difficult, but the endovascular techniques can be performed in the future.

Brain Injuries↗
PubMed1984

[Outcome of ruptured intracranial aneurysms treated in accordance with the principle of deferred surgery. 308 consecutive cases over an 11 year period].

The diagnosis of the aneurysm rupture either was assessed at the time of admission, or was assessed after the admission into the surgical department. Most patients were admitted after the first 24 hours following the S.A.H. From the beginning the patients were separated in two groups: 1) The patients unsuitable for planned surgery (grade V--Botterrel, or general contra-indication, such as neoplasm), 2) The patients planned for surgery and called much less than operable patients much greater than (grade I to IV--Botterell, without extra neurological contra-indication). The general management attitude consisted of the delayed surgery according to the neurological status of the patients, and the risk of vaso spasm and ischemia. Thus, in most cases, the surgery was delayed after the 9th day, following S.A.H., and even after the 12th day for anterior communicating aneurysms. The following results were observed: 1) Unoperable patients: (15) The 12 patients in grade V at the time of admission died (with or without emergency surgery). The 3 patients with a general contra-indication have been lost of view. 2) 293 patients were considered for delayed surgery: 16 died before the day of surgery (5,5%). Out of these much less than operable and no operated patients much greater than, 10 died from cerebral ischemia (3,4% of operable patients) and 6 died from hemorrhage recurrence (2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗