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Biomedical subjects

V Bousson

Publications and source records attributed to V Bousson.

16 recordsLinked to original sources

CACNA1A gene de novo mutation causing hemiplegic migraine, coma, and cerebellar atrophy.

Familial hemiplegic migraine is caused by CACNA1A missense mutations in 50% of families, including all families with cerebellar ataxia. A patient with healthy parents, who experienced prolonged attacks of migraine with hemiplegia, coma, and seizures, is reported. The patient also had mental retardation, permanent cerebellar ataxia with cerebellar atrophy, and right-sided brain atrophy. This patient carried a de novo Tyr 1385 Cys mutation in the CACNA1A gene and illustrates a novel phenotype associated with CACNA1A mutations.

Adult↗

CT of the middiaphyseal femur: cortical bone mineral density and relation to porosity.

PURPOSE: To determine whether computed tomography (CT) can be used to quantify age- and site-related changes in cortical bone mineral density (cBMD) at the middiaphyseal femur and whether cBMD differences are related to intracortical porosity. MATERIALS AND METHODS: Cortical bone specimens from 163 femurs were studied with CT and microradiography. Femurs were from 77 males and 86 females in a white anthropologic collection covering a broad age spectrum. In each sample, the cBMD was measured in the entire cortical width and in periosteal, midcortical, and endosteal subregions of interest. Age- and site-related changes in cBMD were tested for significance by using a two-way analysis of variance for both sexes. By using linear regression, cBMD was compared with porosity in the entire cortical width and in each subregion. RESULTS: There were significant age-related differences in cBMD (P <.001 in females, P =.008 in males). In addition, cBMD values were significantly different between the three cortical subregions (P <.001 for both sexes), decreasing from the periosteum to the midcortex to the endosteum. The cBMD values were closely related to porosity, and porosity contributed to 71.6% of the variance in cBMD in the overall population. CONCLUSION: CT is effective in the measurement of age- and site-related changes in cBMD. Decreases in cBMD are closely correlated with increased cortical porosity.

Adolescent↗

MR angiography for the long-term follow-up of dissecting aneurysms of the extracranial internal carotid artery.

OBJECTIVE: We used MR angiography to examine and follow up the changes of dissecting aneurysms of the extracranial internal carotid artery (ICA). MATERIALS AND METHODS: We retrospectively reviewed the records of 101 consecutive patients with dissecting aneurysms of the extracranial ICA. Twenty patients with 26 spontaneous dissecting aneurysms were followed up with MR angiography every 1-2 years (men, 16; women, four; age range, 28-67 years; mean age, 51 years). RESULTS: The mean duration of follow-up was 41 months (range, 10-93 months). At MR angiography follow-up, 20 aneurysms did not change, four decreased from their original size by 33-53% (mean, 43%), and two resolved. One patient had an asymptomatic recurrent dissecting aneurysm of the extracranial ICA. Clinically, no patient had a thromboembolic stroke or transient ischemic attack during the follow-up period. CONCLUSION: MR angiography revealed that dissecting aneurysms of the extracranial ICA remain stable, decrease in size, or resolve--but they do not increase in size.

Adult↗

[Facial palsy, enhancement of cranial nerves and Lyme disease].

Lyme disease involves multiple organ systems including in 10-15% of cases, the nervous system. Cranial neuropathies are observed in the second stage of the disease. The facial nerve is the most frequently affected nerve (20-30%). Facial nerve enhancement may be associated with cochleovestibular nerve abnormalities and can mimick an intracanalicular pseudomass. We present post-gadolinium enhancement of multiple cranial nerves associated to an intracanicular enhancement illustrated in a patient referred for a facial nerve palsy and presenting a Lyme disease. We discuss the differential diagnosis.

Adult↗

Intracranial dural fistula as a cause of diffuse MR enhancement of the cervical spinal cord.

Spinal MR findings are reported in a patient with progressive myelopathy and intracranial dural arteriovenous fistula draining into spinal veins. Associated with previously reported abnormalities on T1 weighted and T2 weighted images, postcontrast T1 weighted images disclosed diffuse intense enhancement of the cervical cord itself. This enhancement decreased after endovascular treatment.

Adult↗

[Brain imaging in AIDS].

Encephalic diseases remain an important problem in AIDS patients despite improvement in the rate of disease spread. We provide data on the current situation and describe the clinical, pathological and imaging features commonly observed in encephalic diseases in AIDS patients.

AIDS Dementia Complex↗

[Magnetic resonance angiography of the carotid artery: artifacts, anatomy, diseases].

Magnetic resonance angiography is now a technique commonly used in neurologic practice. We give a brief overview of the biophysical principles of this technique. Recent refinements and technical innovations are also noted. After some anatomic considerations about the carotid artery, we provide some data about the role of MRA in atherosclerotic and non atherosclerotic diseases (dissections, aneurysms, arteritis, post operative follow-up...) of the extra and intracranial carotid arteries. The purpose of this review is to concentrate on the role of magnetic resonance angiography in patients with various carotid artery diseases and to specify possibilities, limitations and risk of misinterpretation. Magnetic resonance angiography is a major, still evolving technique.

Adult↗

[Artifacts in magnetic resonance angiography].

Magnetic resonance angiography (MRA) has become a major tool in the management of vascular diseases. However, many artifacts that may lead to misinterpretations are encountered with this imaging modality. The purpose of this paper was to enumerate, explain and illustrate each kind of artifact encountered with "time of flight" or "phase contrast" imaging methods. For each artifact, we tried to provide one or several techniques to minimize its consequences.

Artifacts↗

Preoperative portal vein embolization for extension of hepatectomy indications.

To render hepatectomy feasible in patients with an initially deficient volume of the future remnant liver (FRL), we redistributed portal blood flow rich in hepatotrophic substances toward the FRL. Redistribution was achieved with preoperative portal vein embolization (POPE) feeding the future resected liver. POPE was performed in 31 patients, under fluoroscopic guidance, via a percutaneous access. POPE was well tolerated and surgery was practicable in 24 patients without severe postoperative liver failure. Seven operations were cancelled, but only one due to insufficient hypertrophy of the FRL. FRL volume values were 90 to 560 mL (mean 260 mL) before POPE and 160-783 mL (mean 443 mL) after POPE, which represents a median increase of 79% +/- 50%. Hypertrophy of the FRL was 90% +/- 52% after 30 days with cyanoacrylate, 53% +/- 6% after 43 days with Gelfoam, and 44% +/- 30% after 35 days with coils. Slight shrinkage was obtained in the volume of the embolized liver, for which resection was planned. Overall survival was 2-62 months (mean 26 months), disease-free survival was 0-60 months (mean 19 months), and 7 patients are disease-free and alive 14 to 60 months (mean 43 months) after surgery. Although exclusively applicable in a limited subset of patients, POPE widens the possibilities of curative hepatectomies, because it induces sound hypertrophy of unembolized liver segments. Cyanoacrylate seems to ensure better and faster hypertrophy.

Adolescent↗

[Post-radiation necrosis of the cricoid cartilage: an uncommon case].

Radiation therapy is considered as the treatment of choice for early stage laryngeal cancer. However, a few patients, after several years, develop severe life threatening complications, like edema or chondronecrosis. The clinical examination or endoscopy follow up may be difficult. CT and MR imaging can show the exact diagnosis depicting exquisitely the anatomy of the larynx. But at the beginning, the abnormalities are radiographically subtle and their diagnosis may be difficult because of artefacts due to patient dyspnea and mucous secretions. The main suggestive imaging features for suspecting a chondronecrosis seem to be the lost of normal signal hyperintensity on T1 MR imaging or a focal lack of cortical bone on CT scans, just adjacent to a focal swelling of the pharyngo-larynx mucosa. The barium pharyngography remains the best imaging diagnosis procedure for depicting associated abnormal communication between the digestive tract and the adjacent spaces or the cartilages of the larynx. Therefore, when the diagnosis is delayed, only salvage total laryngectomy can stop the infectious process. We report one case of a cricoid cartilage chondronecrosis eleven years after radiation therapy for laryngeal cancer.

Cricoid Cartilage↗

[Anatomy of the circle of Willis with 3D time of flight magnetic resonance angiography and analysis of partitions].

The purpose of this study was to analyse with 3D TOF MR angiography the anatomical variants of the circle of Willis (CW) in 109 consecutive patients. In all cases, the quality of exams was sufficient to analyse the anatomy of CW. Nevertheless, MRA over estimated hypoplastic segments because incomplete CW were more frequently demonstrated with MRA than in anatomic literature. This lack of MRA sensitivity was related to artifacts as MIP artifacts and blood flow artifacts. MRA sensitivity was improved by analysis of partitions with MIP reconstructions.

Aged↗

Intractable hiccups: the role of cerebral MR in cases without systemic cause.

PURPOSE: To look for central nervous system abnormalities as possible causes of intractable hiccups. METHODS: Of a series of 50 patients with chronic (ie, lasting more than 48 hours) hiccups, a prospective study identified a subgroup of 9 patients with no clinical or gastroesophageal abnormalities (according to endoscopy, pH monitoring and manometry). We performed in all 9 patients brain and upper cervical cord MR examination with precontrast and postcontrast T1- and T2-weighted sequences. A study of the last cranial nerves was done with thin T2-weighted imaging (constructive interference in a steady state sequence). The cervical cord and parapharyngeal space were systematically explored using coronal T2- and sagittal T1-weighted imaging. RESULTS: Five of these 9 patients had definite MR abnormalities located in the temporal lobe (3 cases), cerebellopontine angle (1 case), or areas of high signal intensity compatible with demyelination (1 case). The relationship between hiccups and infratentorial abnormalities in 2 cases was doubtful (vascular loop and prominent posterior condylar canal). MR findings in 2 cases were considered normal. CONCLUSIONS: Brain MR is a useful investigation in patients with chronic hiccups when gastroesophageal lesions are either excluded or too mild to account for an intractable hiccup.

Adult↗