[Complications observed in the surgery of aneurysms of the circle of Willis in a perspective of early operation]. / Les complications observées dans la chirurgie des anévrysmes du polygone de Willis dans une optique d'intervention précoce.

This report concern a series of 100 consecutive patients operated by direct attack for intracranial ruptured aneurysms (mortality: 14%, complete removal: 70%). 35% of this patients have been early operated before the 96e hour. In this series, only one case of spasm was observed. But we have observed other neurosurgical complications, analysed and compared to the postoperative course of the patients who had delayed operations.

[X-ray computed tomography in a series of aneurysms of the circle of Willis]. / L'apport de la tomodensitométrie dans une série d'anévrysmes du polygone de Willis.

During four years, 80 patients with intracranial aneurysms were examined by a CT scanner. The CT was helpful for: The rapid and easy diagnosis of subarachnoid hemorrhage. Direct visualization of intracranial aneurysms. Detecting intracerebral or intraventricular hematoma and distribution of subarachnoid clots. The limitations and pitfalls of CT were: No abnormality was seen on 16 scans (20%). The identification of the source of bleeding in multiple intracranial aneurysms.

[A series of 106 cases of ruptured aneurysms operated on during the 1st week]. / Une série de 106 cas d'anévrysmes rompus opéres pendant la première semaine.

The authors report 106 intracranial aneurysms operated on during the first 7 days post S.A.H. The résults according to grade and operative day are compared to the results of litterature, operative indications according to grades and spasms are given.

[Intracranial aneurysm and polycystic kidneys]. / Anévrysmes intracrâniens et maladie polykystique des reins.

Five cases of intracranial aneurysms with polycystic kidneys are reported: --15% of polycystic kidneys have an intracranial aneurysm, and about 4% - 5% of intracranial aneurysms are joined with polycystic kidneys; --the surgical treatment of intracranial aneurysm with this association doesn't present more risk than an intracranial aneurysm, and the surgical prognosis isn't bad; --the pathogeny isn't clear. This association is perhaps a congenital elastic system disease.

[Scanography in head injuries. Critical study of 500 cases]. / La scanographie en traumatologie crânienne. Etude critique de 500 cas.

In 22 months, about 2 000 patients were hospitalized for head injury and 410 of these had computerized tomography to determine the presence and extent of intracranial pathology. 165 patients had normal C.T. scan, and in 245 cases the scan showed an intracranial pathology: 132 brain contusions, 45 epidural hematomas, 36 subdural hygromas, 32 chronic subdural hematomas, 8 intracerebral hematomas, 2 pneumocephalus. The C.T. scan is a very useful technique for evaluation of the head injured patient in emergency. For epidural hematomas, mortality rate which was 16% before C.T. scan period decreased to 8% after C.T. scan period. The C.T. scan has a definite advantage over angiography in brain contusions. Instead of seeing only mass effect, one can tell on C.T. scans whether the abnormality is a small hematoma, an area of contused swollen brain, an hemorrhagic contusion, or a brain oedema. The surgical decisions are more precise with this information. In the management of head injury, we think that C.T. scan must be repeat because many patients developed new lesions and delayed hematomas: intracerebral, subdural, epidural.

[Anaesthesia for computerised axial tomography in children (author's transl)]. / Attitude anesthésique pour examens tomodensitométriques céphaliques chez l'enfant.

Computerised axial tomography requires total immobility, which must be obtained by a simple and safe technique of anaesthesia. Three anaesthesia techniques were used and analysed in 54 children aged less than 5 years: the technique of the feeding bottle, sedation with pentobarbital or diazepam and general anaesthesia with ketamine hydrochloride. The technique of the feeding bottle can be proposed in selected patients. Sedation can be also used but judiciously, not to deep. The systematic use of an depression immobilizing mattress with these two techniques gives better results. Intramuscular ketamine hydrochloride, when not contrindicate (intracranial hypertension or acute hydrocephaly), has been used always successfully.

[Plastic coating in the surgical treatment of intracranial aneurysms. Late results of twenty cases (author's transl)]. / L'enrobage par matière plastique : complément important de la chirurgie actuelle des anévrysmes des artères cérébrales suites éloignées d'une série opératoire de 20 cas.

The authors reported the late results of a serie of fifteen intracranial aneurysm treated by plastic coating. These fifteen patients belong to a group of twenty cases operated with this technic. Four patients were pre-operatively in stade V. One patient died massive pre-frontal infract probably to retractor. In the same period, seventy-two others patients were operated for intracranial aneurysm by usual clip. The fifteen patients with plastic coating have been from two years to seven years observed. One case of minor epilepsy, one case of meningitis good imprevoded were noted. In this serie, no relapsing meningeal hemorrhage, is noted.

[The neurosurgical treatment of the cerebral localisations of the alveolaris (multilocularis) echinococcosis (author's transl)]. / Exérèse chirurgicale des localisations cérébrales de l'échinococcose multiloculaire.

A case of adult woman surgically treated for hepatic alveolaris ecchinococcosis on 1975 is presented. On 1976, a hypertensive intracranial syndrome is treated by removal of a right temporal kystic localisation. On 1977, a new localisation is successfully raised. The authors, in a short review of the literature note that these cerebral localisations are not always terminal. The alveolaris ecchinococcosis is now autochthonous in France.