ABSTRACT
Section of the anterior two-thirds of the corpus callosum is a well-known treatment of some forms of epilepsy of long duration resistant to anti-epileptic drugs and dangerous for the patient (tonic and atonic seizures). The aim of this functional surgery is to obtain the most complete rostral and caudal section of the corpus callosum without risk of disconnection syndrome. Callosotomy is seldom performed in Europe. We present our experience of magnetic resonance imaging (MRI) in the pre- and postoperative assessment of 6 patients who underwent anterior callosotomy and were followed up for more than six months. Our results were encouraging with considerable improvement of the patients' social life.
Subject(s)
Corpus Callosum/surgery , Epilepsy, Frontal Lobe/surgery , Epilepsy, Generalized/surgery , Magnetic Resonance Imaging , Adolescent , Adult , Anticonvulsants/therapeutic use , Child , Cognition , Corpus Callosum/pathology , Electroencephalography , Epilepsy, Frontal Lobe/drug therapy , Epilepsy, Generalized/drug therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , RecurrenceABSTRACT
Transient ischaemic attack (TIA) represents a neurological deficit during less than 24 hours, without any abnormality on CT scan. This symptom may have 2 risks: it may give place to a severe stroke, and it is not always linked to an ischaemic mechanism. This work rests on a population-based registry existing in Dijon since 1985 with a specific and exhaustive registration. CT scan allows the mechanisms of stroke to be identified: cortical infarct, lacunar infarct, cerebral haemorrhage, and TIA. TIA represent 15% of stroke. Survival rate of 80% is better than other strokes. A TIA may appear before a cerebral infarct in 48% of the cases, a lacunar infarct in 18% of the cases, another TIA in 28% of the cases, and a haematoma in 8% of the cases. Therefore TIA is an important symptom appearing before severe stroke, that may let place to a preventative action.
Subject(s)
Cerebrovascular Disorders/physiopathology , Ischemic Attack, Transient/epidemiology , Aged , Aged, 80 and over , Cerebral Hemorrhage/physiopathology , Cerebral Infarction/physiopathology , Cerebrovascular Disorders/prevention & control , Female , Humans , Incidence , Male , Prevalence , Prognosis , Risk FactorsABSTRACT
The incidence of cerebral haemorrhage was studied from a population-based stroke registry. The incidence was 12.3 per 100,000 per year in women and 13.9 per 100,000 per year in men, with a peak in the eighth decade and a male preponderance. Haemorrhages were deep seated and mostly due to hypertension. Recognised clinical characteristics of haemorrhage are acute onset, convulsion, vomiting, and disturbed consciousness. This study showed that cerebral haemorrhage may present with pure motor deficit or transient deficit preceding the stroke. The mortality was 51% in the first month, and 61% by two years.
Subject(s)
Cerebral Hemorrhage/epidemiology , Cerebral Infarction/epidemiology , Ischemic Attack, Transient/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/mortality , Cerebral Infarction/diagnosis , Cerebral Infarction/mortality , Child , Cross-Sectional Studies , Female , France/epidemiology , Humans , Incidence , Ischemic Attack, Transient/diagnosis , Ischemic Attack, Transient/mortality , Male , Middle Aged , Population Surveillance , Prospective Studies , Registries , Survival Rate , Tomography, X-Ray ComputedABSTRACT
We describe a new case in which cocaine use was related to stroke and review the literature. Cocaine is increasingly used by drug addicts. The neurological complications are unpredictable. They include generalized or partial epileptic seizures, ischaemic or haemorrhagic cerebral vascular accident. In this case, stroke after intravenous drug injection is associated with rupture of an intra-cranial aneurysm. We put the accent on the difficulties to diagnose the cerebral stroke in cocaine abusers.
Subject(s)
Cocaine/adverse effects , Intracranial Aneurysm/complications , Substance-Related Disorders/complications , Adult , Cerebral Angiography , Female , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/surgery , Rupture, Spontaneous , Subarachnoid Hemorrhage/etiologyABSTRACT
The use of CT scans has entirely modified the prognosis of epidural hematomas of the posterior cranial fossa. The analysis of a personal series of 20 cases diagnosed and treated over a 10 year period, that is 6.5% of E.D.H. cases seen in this hospital, has enabled us: to propose an anatomical study regrouping the different topographic forms observed in the literature as well as in the present series. to check the deceptive radiological appearance of these hematomas. The main sign remains the existence of a cranial fracture at the level of the occipital bone. Repeated CT scans should attempt to localize this lesion. In 15% of our cases, the lesion was only detected on the second CT scan. to recommend a simple and rapid surgical procedure in the ventral decubitus position, which does not involve the foramen magnum approach. This is performed away from the occipital junction of the venous sinus. to underline the progressive decrease in the mortality rate (10%) and the good subsequent prognosis of these apparently serious forms which have left no sequelae.
Subject(s)
Cranial Fossa, Posterior , Hematoma, Epidural, Cranial/diagnostic imaging , Skull , Tomography, X-Ray Computed , Adolescent , Adult , Brain Injuries/complications , Brain Injuries/diagnostic imaging , Child , Female , Follow-Up Studies , Hematoma, Epidural, Cranial/etiology , Hematoma, Epidural, Cranial/surgery , Humans , Male , Middle Aged , Prognosis , Skull Fractures/complications , Skull Fractures/diagnostic imagingABSTRACT
Among 4,538 neuroradiology cases gathered at the NOHC of the XV-XX, an oculomotor paralysis is the 3rd (37.65%) clinical circumstances justifying a computerized tomography (directional plane by the neuro-ocular plane or PNO). The interpretation of the investigations requires to index them in 7 groups of items, therefore a computerized access follows (cross-sorting data). The injury of the VI overcomes (39.61%) followed by the one of the III (33.68%), and the IV (6.35%). In spite of limitations, the study puts forward and debates about etiological frequencies sometimes different from those in the literature.