Early mobilization following anterior fixation with bone graft and metal plate in traumatic cervical fracture dislocations.

Eighteen cases of traumatic fracture dislocation were managed surgically using a technique which involved an anterior cervical approach followed by discectomy, bone graft, and insertion of a metal plate. The patients were mobilized early to prevent the usual complications of bedsores, deep vein thrombosis, pulmonary embolism, chest infection, and contractures. After more than two years of follow-up, no patient has had problems with local infection, screw loosening, neurological deterioration, dysphagia, or persistence of laryngeal nerve paresis. The benefits of this technique, already endorsed by some authors, include reduced morbidity and hospitalization as well as decreased demand on the staff, particularly as required by quadriplegic patients.

[Cerebral aspergilloma. Review of the literature apropos of a case]. / L'aspergillome cérébral. Revue de la littérature à propos d'un cas.

The incidence of mycotic infection of C.N.S. seems to have increased in the last few years and the diagnosis is being made more and more frequently. The authors are reporting a case of a 27 year old man, admitted with severe intracranial hypertension, very poor visual acuity and right motor weakness. The C.T. Scan showed a massive space occupying lesion in the left hemisphere. Only the biopsy, then the surgical removal of the lesion revealed the true histological nature. It turned out to be aspergilloma. The patient expired 13 hours later. Up to date, 25 cases of Aspergillus granulomas have been reported. This disease is included in the entity of neuromycosis. Its specificity compared to the other types of cerebral mycotic localization as for example abscess, meningitis, mycotic aneurysm, lies in the fact that it presents as granulomatous mass in the hemisphere, mimicking a brain tumor without any specific neuroradiological findings. In the light of so far published literature, the authors draw the attention to the fact of the difficulty of diagnosis of this dreadful benign disease due to the lack of specific clinical and radiological findings. They are stressing the necessity of early and vigorous diagnosis mainly in patients with a risk factor to try to reduce the high mortality that has been universally reported in almost all cases.

[Comparative study of 3 implanted micrografts placed in the abdominal aorta of the rat]. / Etude comparative de trois microgreffes implantées en position aortique abdominale chez le rat.

A comparative study was conducted on three micrografts of 2 mm diameter: a frozen umbilical artery, a bovine heterograft and an inert P.T.F.E. material graft. These were implanted in the infrarenal aorta of 158 Wistar rats. Each graft was examined on eight occasions: after 4, 24 and 48 hours, one and two weeks, and 1, 2 and 6 months. Excluding 46 animals that died within 24 hours, the overall permeability rate for all grafts was 87.7% (88.9% for umbilical arteries, 82.8% for bovine heterografts and 85.4% for P.T.F.E.). All grafts were examined by optical and electron microscopy. The inert material showed excellent parietal stability. In contrast, alteration and resorption of the primary matrix were moderate in extent for bovine heterografts, and major for frozen umbilical arteries which appear to be a very unstable grafts.

[Intradural spinal metastasis by visceral cancers. Apropos of 4 cases]. / Les métastases rachidiennes intradurales des cancers viscéraux. A propos de 4 cas.

The authors present four new cases of intradural spinal metastasis from visceral neoplasms. The different pathogenic mechanisms (arterial and venous routes, spreading by the way of the perineural lymphatics and the subarachnoid space) are discussed in consideration of the metastatic localization (intramedullary or extramedullary).

Spinal cord compression by extradural fat after prolonged corticosteroid therapy.

This young man was operated on twice for thoracic spinal cord compression. He had been on corticosteroid therapy for the last 2 years subsequent to a renal transplant. The only anomaly discovered during the operation was a large quantity of extradural fat that did not present the characteristics of lipoma. The remarkable postoperative clinical improvement suggested that the fat deposit was responsible for the spinal cord compression.

[Limits of preventive extra-intracranial anastomoses. A propos of a meningioma of the clinoid process with stenosis of the internal carotid artery]. / Limites de l'anastomose extra-intracranienne préventive. A propos d'un méningiome clinoïdien sténosant la carotide interne.

In the case reported here a voluminous meningioma attached to the anterior clinoid process had invaded the cavernous sinus, involving and constricting the internal carotid artery and its terminal branches. To prevent occlusion of the carotid-sylvian system during surgery, an extra-intracranial anastomosis was carried out and its permeability was controlled and confirmed. However, excision of the meningioma, which entailed resection of the carotid segment, resulted in hemiplegia. The authors emphasize the importance of haemodynamic and anatomical factors in such cases.

Tentorial arteriovenous malformation presenting as an intracerebral hematoma. Case report.

A case of tentorial arteriovenous aneurysm is reported in a 54-year-old man. This malformation, fed by branches of the external carotid artery, was drained exclusively by a parieto-occipital cortical vein. The rupture of this vein was responsible for the presenting intracerebral hematoma.

Extra-intracranial anastomosis using a venous graft.

The authors describe a patient with ischaemic neurological incidents due to bilateral hypoplasia of the carotids. Because the use of the superficial temporal artery or the occipital artery was impossible, the extra-intracranial anastomosis was performed by a direct venous graft between the external carotid artery and the posterior temporal artery. The authors describe and illustrate the operation, emphasizing the particular difficulties due to differences in diameter of the arteries and the graft. Because postoperative control angiography demonstrated perfect permeability of the anastomosis, this technique is suggested for when a normal branch of sufficient diameter of the external carotid artery cannot be used.

Chiari Type I malformation with hydromyelia: findings at computerized metrizamide ventriculomyelography.

Computerized Metrizamide ventriculomyelography consists of CT exploration of the head and neck performed one hour after introduction of Metrizamide into the lateral ventricle via a frontal burr hole. This procedure permits visualisation of all soft-tissue anomalies present in Chiari malformation with hydromyelia as seen in two cases.