[Scaphocephaly. Treatment and complications apropos of 115 cases]. / Scaphocéphalies. Traitement et complications à propos de 115 cas.

The authors report, concerning 115 cas of scaphocephaly, the clinical (spheno., lepto., bathmo., clino., the kinds without dolichocephaly) radiological characteristics (temporal curve without dolichocephaly), orbito-sphenoidal obliquity regressing after treatment). They discuss the accepted ideas of the merely morphological problems of this type of craniostenosis, about their clinical and X-ray findings of encephalic disorder. The therapeutic methods are stated, so are the complications met during the surgical treatment. They suggest the craniectomy, taking away the sagittal suture associated with the linear coagulation of the dura mater. To the median sagittal craniectomy, one can add retrocoronal, pre lambdoid or metopic craniectomies according to the type of scaphocephaly. This treatment is simple, efficient and not very dangerous during the first year.

[Electroencephalographic impact of propofol anesthesia]. / Retentissement électroencéphalographique de l'anesthésie au propofol.

Two groups of patients were studied. In group A, propofol was used alone, given by repeat injections of 2.5 mg X kg-1 in 30 s, in 5 patients undergoing percutaneous thermocoagulation of the Vth cranial nerve. In group B, a series of 12 patients undergoing lumbar disc hernia surgery, propofol was given as a bolus of 2.5 mg X kg-1 in 60 s followed by an infusion of 7 to 12 mg X kg-1 X h-1 together with vecuronium and fentanyl. The EEG recording was carried out during the whole length of anaesthesia and for 1 h after its end. The recordings were all stereotyped, within five successive phases: the awake physiological pattern (phase 0) was desynchronized a mean 52 s after the start of the propofol injection; it was followed by an increase in amplitude of the alpha rhythm (phase I); within a mean of 132 s were seen phases II to V. Phase V corresponded to surgical anaesthesia and could be kept up by a rate of infusion of 9 mg X kg-1 X h-1 propofol. An increase in this rate gave rise to burst suppressions which lasted as much as 15 s or more, and disappeared very quickly when the infusion rate was slowed. After stopping the anaesthesia, the EEG phases were quickly reversed, V to 0: in a mean of 11.1 min, the EEG pattern had returned to the awake state (extremes 4.3 to 19 min).(ABSTRACT TRUNCATED AT 250 WORDS)