Adaptations of the Talairach technique to the evolution of medical imaging.

We present an integrated imaging system which enables CT and MRI data to blend with angiographic or ventriculographic films obtained by teleradiography and digitized. From all the data fed to the calculator, orthogonal, frontal, lateral, simple or double-obliquity trajectories can be determined easily and rapidly.

[Intracerebral morphine therapy in cancer patients]. / Morphinothérapie par voie intracérébrale chez le cancéreux.

An overview of recent studies concerning opioids and their pharmacokinetics is presented. In the light of these findings it is shown that intracerebral administration may be justified. The authors experience with 63 cases is detailed: all cancer patients in the final stage. Initial dosage by the intraventricular route was 500 to 700 microgram-day but in one case twice daily injections of 1.200 microgram were needed. The dosage needed doubled over the observation period of 2 to 3 months. The mean length of survival was 75 days. Among complications nausea and vomiting were observed in 15 to 35% of the cases, sweating and pruritus in 15%, urinary retention in 15 to 20%. In some cases euphoria, motor excitement and hallucinations occurred. Chronic constipation was present in all cases. Two cases of meningitis were successfully treated by antibiotics. Pain relief was judged excellent or good in 75% of the cases. In 20% other analgesics had to be added to the treatment. In 5% the method failed.

[Pain and its pathways. A study for therapeutic action]. / La douleur et ses voies. Etude pour une action thérapeutique.

Pain is as old as mankind. It has a threshold beyond which nobody can escape it. Pain is a biological and physiological phenomenon, an integrated part of our body and ego. Will all our efforts eventually make it disappear? Is its disappearance desirable? Pain is one of the major expressions of sensation. It is integrated by the central structures and expressed as a behavior of avoidance or attenuation of the effects produced by the cause of pain. The study of this behavior and of the transmission of the pain message corresponds to the study of how to fight against this message, which means that it should logically lead to the treatment of pain.

[Vicious callus and unrecognized dislocations of the cervicothoracic junction]. / Cals vicieux et luxations méconnues de la jonction cervico-thoracique.

Five patients were treated after a period varying between 6 weeks and 18 months following original injury. The five lesions were similar in that they could not be reduced by conventional orthopedic measures and that they were fixed during dynamic review examinations using a brilliance amplifier.

[Is osteosynthesis justified for spinal injuries in children?]. / L'ostéosynthèse est-elle légitime en pathologie rachidienne traumatique chez l'enfant?

The legitimacy of osteosynthesis for the treatment of spinal injuries in children is analyzed as a function of results in 10 cases, 7 affecting the cervical, 2 the thoracic and one the lumbar region, six of the children being under 10 years of age. Five of these children had serious neurologic disorders, including 4 with high tetraplegia. Technical difficulties of osteosynthesis were not made easier by the poorly adapted nature of the material for infantile statures. Indications for this surgery were not only those cases not improved by orthopedic therapy: instability of lesions, the child's condition and deterioration in the neurologic state can also require initial treatment by osteosynthesis. The principal complication is postoperative cervical kyphosis, but this can be prevented by early active reeducation, the stability of the fixation dispensing with the need for external contention.

[Contribution of arteriography to the investigation of peripheral nerve tumours (author's transl)]. / Apport de l'artériographie dans les tumeurs nerveuses tronculaires des membres.

Based on their personal experience of the use of arteriography in 11 patients, the authors describe the angiographic appearances of both benign and malignant peripheral nerve tumours. They emphasise the reasons for errors, and the criteria enabling the precise nature of the lesion to be determined pre-operatively in the majority of cases. Other contributions supplied by angiography are discussed.