[Radiosurgery for brain arteriovenous malformations].

Radiosurgery as treatment for arteriovenous malformations has shown a good efficacy in reducing intracranial bleeding due to rupture. The choice of therapeutic modalities is based on evolutive risk and arteriovenous malformations volume, patient profile and risks stratification following therapeutic techniques (microsurgery, radiosurgery, embolization). Nidus size, arteriovenous malformations anatomical localization, prior embolization or bleeding, distributed dose are predictive factors for radiosurgery's good results and tolerance.

[Treatment of trigeminal neuralgia with radiosurgery].

Idiopathic trigeminal neuralgia is defined as brief paroxysms of pain limited to the facial distribution of the trigeminal nerve. Drug therapy is considered to be the first-line of treatment for trigeminal neuralgia. Unfortunately, medical treatment does not always provide satisfactory pain relief for 25% of the patients.

[Stereotactic and diagnostic imaging in radiosurgery].

Constant progress in medical imaging and particularly magnetic resonance imaging has profound impact in planning for stereotactic radiosurgery and radiotherapy. The purpose of this paper is to discuss the integration of medical imaging modalities in the planning process. Principles of generic algorithms to calculate stereotactic coordinates are treated for tomographic imaging and digital substraction angiography, and their accuracies are analyzed in a review of the literature.

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients.

Study Design: Case series of a consecutive sample. Retrospective audit.

Objective: To analyze the long-term safety and efficacy of intrathecal baclofen (ITB), and technical incidents.

[Recurrent syncope and Chiari malformation].

Downward herniation of the cerebellar tonsils through the foramen magnum (Chiari I malformation) is usually revealed by head and neck pain, often associated with brain-stem or spinal cord disturbances. Syncopes are rarely reported and may be difficult to link to their cause when they occur alone. We report two cases with brief and repetitive syncopes revealing a Chiari I malformation.

[Multi-level traumatic lesions of the thoracic and lumbar spine. Value of the Cotrel-Dubousset instrumentation].

Trauma of the spine involving several thoracic and lumbar vertebrae is rare (4 case in 250 spine operated in our unit from 1985 to 1990) and require difficult therapeutic decisions. The patients has one or more unstable fractures which could require 4 screw-plates that would be mechanically unsatisfactory, or an unstable fracture combined with other stable lesions requiring a mixed orthopaedic and surgical treatment that would lead to long term decubitus with a corset. The Cotrel-Dubousset system makes it possible to approach each lesion separately with segmentary instrumentation.

[Effects of Diprivan on cerebral blood flow, intracranial pressure and cerebral metabolism in head injured patients].

The effects of propofol on cerebral blood flow, intracranial pressure (ICP) and cerebral oxygen consumption (CMRO2) were assessed in ten severely head-injured patients undergoing surgery for limb fractures. The patients, aged between 15 and 40 years, were in deep coma, scored 6-7 on the Glasgow coma score. They were mechanically ventilated and sedated with 1 mg.

Effects of propofol on cerebral hemodynamics and metabolism in patients with brain trauma.

The authors determined the effect of propofol on cerebral blood flow, intracranial pressure, and cerebral arteriovenous oxygen content difference in severely brain-injured patients during orthopedic treatment of fractures of the extremities. The Glasgow Coma Scale score was 6 or 7 at the time of the study. Data were collected in the operating room before and during (5 and 15 min) administration of propofol (2 mg/kg iv bolus immediately followed by a 150 micrograms.

Evaluation of human hemispheric blood flow based on non invasive carotid blood flow measurements using the range-gated Doppler technique.

Common carotid blood flow (CCBF) was measured in 11 anesthetised patients without extracranial arterial disease (nine acute subarachnoid haemorrhages and two cases of head injury). The range-gated Doppler flowmeter with an adjustable range-gated time system and a double transducer probe was used to determine diameter, blood velocity, and blood flow of the common carotid artery. Values were, respectively, 5.