Lack of association between transiently evoked otoacoustic emission amplitude and experimentation linked-factors (repeated acoustic stimulation, cerebrospinal fluid pressure, supine and sitting positions, alertness level).

Changes in transiently evoked otoacoustic emissions (TEOAEs) occur during sleep and during tasks requiring attention. This can be due to a central nervous system effect on the cochlea. But, an additional or dominant influence by non-controlled factors is possible. In this paper, the effect of click-stimulus repetition, lying and sitting positions, state of alertness (awake or asleep) and CSF pressure variation on TEOAE features were studied. None of these factors affected TEOAE amplitude. In 2 subjects, TEOAE amplitude increased considerably during the night while remaining stable in 7 subjects during daytime sleep. This may be due to circadian variations of TEOAE amplitude.

[Pansinusitis of the face caused by Streptococcus milleri with cerebral thrombophlebitis after naso-sphenoid surgery of the pituitary gland]. / Pansinusite de la face à streptocoque milleri avec thrombophlébite cérébrale après chirurgie hypophysaire naso-sphénoïdale.

The authors report a patient operated on trans-nasosphenoidally for a pituitary adenoma (Cushing's disease) in whom a severe infection occurred with cavernous thrombophlebitis responsible for neurological complications.

[Anuric postoperative acute renal insufficiency in neurosurgery. Importance of continuous arteriovenous hemodialysis. Report of a case]. / Insuffisance rénale aiguë anurique post-opératoire en neurochirurgie. Intérêt de l'hémodialyse artério-veineuse continue. A propos d'un cas.

Post-operative acute oliguric renal failure was treated over a period of 17 days by continuous arterio-venous haemodialysis in man operated on for intracranial tumor. The Authors dwell on the advantages of this dialysis system in neurosurgery.

[Postoperative complications of trans-sphenoidal surgery]. / Complications post-opératoires de la voie trans-sphenoïdale.

One hundred and thirty three patients of both sexes were operated on for pituitary tumors with transphenoidal microsurgery. Postoperative complications are discussed.

[Value of cerebral blood flow study with nimodipine test in intracranial aneurysm]. / Intérêt de l'étude des débits sanguins cérébraux avec test à la nimodipine dans les anévrismes intracraniens.

The study of cerebral blood flow (DSC) in 29 patients with intracranial aneurysm is interesting to diagnose cerebral ischemia without clinical and radiological effect. A test with nimodipine sensitize this exam, confirm the efficacy of this drug in located ischemias. But may reveal a decrease of cerebral blood flow after nimodipine: it is probably an interesting therapeutic test.

[Value of thrombolysis in situ without general fibrinogenolysis in pulmonary embolisms of more than 5 days duration]. / Intérêt d'une thrombolyse in situ sans fibrinogénolyse générale dans les embolies pulmonaires de plus de 5 jours.

Fibrinogenolysis induced by thrombolytics exposes the risk of haemorrhagic complications. The efficacy is proved for pulmonary emboli of recent origin. The aim of this study is to research into the effect of local administration of low dose urokinase in six patients aged 40 (+/- 16 years) and presenting with old emboli (10 +/- 4 days). The initial clinic picture was serious with shock (2 cases), hypoxaemia (6 cases), pulmonary arterial hypertension (mean 40 +/- 8 mmHg) and a Miller index of 58 (+/- 8%). Mechanical ventilation was necessary four times. Urokinase was administered in situ using a Swan Ganz catheter, with 1,000 units per Kg per hour for six hours followed in sequence with 30 microkatals per hour of plasminogen for two hours. This eight hourly rotating sequence was followed for at least 72 hours. Six patients were cured with an end of treatment (5 +/- 2 days) improvement in their hypoxaemia of 22%, a fall of 47% of the pulmonary arterial pressure and a rise of 71% in the Miller index. The fibrinogenesis fell by 11% and the thrombolytics could not blamed for any side-effect. The sequence urokinase-plasminogen in low dose administered locally may represent an alternative treatment for severe and long standing pulmonary emboli in patients with a risk of haemorrhage.