Surgical therapy for frontal epilepsies.

We have described our 25 years experience concerning 100 patients operated on for frontal epilepsy. Results show that 55% of patients are practically cured of their seizures and that 76% benefited from cortectomy (reduction of more than 75% of seizures). These results are the worst in the total series of St.

[Current significance of stereotactic exploration in the diagnosis and therapy of space-occupying cerebral processes].

To reach good functional results in patients with spaceoccupying processes--especially with those localized in the dominant hemisphere operative treatment should be planned individually, which is impossible if all diagnostic assessments are followed by the same surgical procedure. The choice of appropriate method of therapy in case of brain tumor depends on various factors, such as the histological nature, extent and volume, relationship to the brain structures and vessels, and spatial form of the growth. The synthesis of all neuroradiological information from stereotactic exploration, together with the histological findings from stereotactic serial biopsies yields a three-dimensional representation of the brain with the tumor.

[Acute transient Korsakoff's syndrome caused by hematoma of the floor of the 3rd ventricle].

A forty four year-old woman had had an amenorrhea-galactorrhea syndrome for 3 months when a Korsakoff's syndrome with headache suddenly appeared. Neuroradiological investigations revealed a hematoma involving the anterior part of the IIIrd ventricle. After a short period of neurogenic hypernatremia the lesion disappeared with the development of a spontaneous ventriculocisternostomy.

[Familial forms of intracranial cavernous hemangioma. Apropos of 5 cases in 2 families].

The authors report five cases of cavernous hemangioma belonging to two families. In the first family, an 8 year old child was operated on in 1970 for a left frontal location. His mother, aged 39, was operated on in december, 1981, with stereotaxic approach, for two locations: one was frontal location, the other one was in the pineal region.

[Reliability of a simplified method of localization of CT images. Correlation with stereotaxic results in 30 cases].

A simplified method of localization of cerebral lesions by reference to CT Scan images was compared systematically in 30 cases, with localization obtained under stereotaxic conditions. The comparison was made in reference to the pineal gland and certain ventricular landmarks. The uncertainty of the method in an angular plane is less than or equal to 2,5 degrees; it is less than or equal to 3 mm in a linear plane in more than 90% of the cases.

[Definition of limits and 3D configuration of cerebral gliomas. Histological data, therapeutic incidences (author's transl)].

In neurosurgical common practice, the only histological informations usually taken into account for the treatment of gliomas are the histological type and degree of malignancy. Nevertheless, from a therapeutic point of view the spatial development of the tumor should be considered as a point of paramount importance. This spatial development can be evaluated in vivo with the help of C.

[Current experience of stereotaxic irradiations in the treatment of hemispheric gliomas (author's transl)].

Authors present a short review of the techniques and results of the stereotactic focal irradiations (S.I.) used at present in France for the treatment of small "active" gliomas localized in high risk areas (functional and vital) of the brain.

Circadian patterns of growth hormone, prolactin and corticotrophin secretion in hypothalamic and extra-hypothalamic lesions localized by stereotactic neuro-radiology in humans.

The integrity of mediobasal hypothalamus for the maintenance of normal circadian rhythms has been clearly established in the animal. Using precise stereotactic neuroradiologic localisations of various brain tumors, the authors demonstrate that in human, cortical lesions induce no significant modifications of the circadian variation of GH, prolactin or ACTH. In contrast subcortical lesions displacing the 3rd ventricle result in an inhibiton of the nocturnal rise in GH and prolactin, whereas the circadian rhythm of ACTH remains normal.

Application of stereotactic concepts to the surgery of epilepsy.

For the authors, the essential feature of stereotaxis is the three-dimensional representation of the entire brain, including the central gray nuclei as well as the cerebral cortex. Stereotactic neurosurgery, which in this conception might be called "global", associates data from indirect localization (basic reference lines, proportional grid) to direct individual localization (performed by bidirectional, orthogonal teleradiography, with stereoscopy). The obtained high precision radiographic documents allow to establish the three coordinates (X, Y, Z).

[Role of the amygdala in the occurence of oro-alimentary signs of during epileptic seizures in man (author's transl)].

The authors study the role of amygdala dysfunction in cases of oro-alimentary signs occuring in seizures recorded during a series of stereo-electroencephalographic investigations (S.E.E.

Distribution of beta2-microglobulin in cerebrospinal fluid and in cystic fluid of brain tumors. A preliminary study.

The concentrations of immuno-reactive beta2-microglobulin (beta2m) were measured in the cerebrospinal fluid (CSF) and the cystic fluid (CF) of Central Nervous System (CNS) tumours (gliomas, n = 5; craniopharyngiomas, n = 5) and in the culture medium of established cell lines derived from CNS tumors. These data are compared with plasma and CSF values of beta2m in normal subjects (n = 15) and in a group of peripheral solid tumors (metastatic breast carcinomas, n = 9). In the control group the absence of correlation between plasma and CSF values, suggests an independant production of beta2m in the two compartments considered.

The seizures of frontal lobe epilepsy. A study of clinical manifestations.

We describe ictal clinical manifestations of frontal lobe epileptic seizures in 22 patients. After examination of all ictal clinical data, 14 catergories of signs and symptoms were established. The validity of the ictal clinical data used was confirmed on the basis of 99 frontal lobe seizures recorded by tele-electroencephalogram or tele-stereo-electroencephalogram.

Interstitial gamma irradiation by 198Au of the pituitary in diabetic retinopathy. Selective growth hormone blockade and ocular results.

Pituitary interstitial irradiation by stereotaxic implantation of a gamma pointemitter was performed in 110 patients with progressing diabetic retinopathy. Reduction of growth hormone secretion peaks was delayed, but was consistent and selective in all cases controlled by somatotropin stimulation test, while other pituitary secretions remianed unchanged in all but five cases. In 31 patients who had no associated photocoagulation, long-term postoperative assessment showed significant improvement of hemorrhages and intrarentinal new vessels with preservation of visual acuity.

[Indications and results of interstitial hypophyseal stereo-gammatherapy in the treatment of diabetic retinopathy].

New interest for pituitary neurosurgery in diabetic retinopathy is based on several data: long-term efficacy of various medical therapeutic agents is still unproved, ocular treatment by photocoagulation remains symptomatic, growth-hormone (HGH) has a permissive or supportive role in the development of diabetic retinopathy. Stereo-GIHF performs the pituitary interstitial irradiation by stereotaxic implantation of a gamma point emitter (198Au) and results in the selective blockade of HGH secretion peaks. Different from all other procedures achieving a more or less complete hypophysectomy, Stereo-GIHF introduces a new trend for the functional neurosurgical treatment of diabetic retinopathy.

Distribution of growth hormone and thyroid-stimulating hormone in cerebrospinal fluid and pathological compartments of the central nervous system.

Human growth hormone (HGH) radio-immunoassay (RIA) was adapted for an accurate measurement of immunoreactive HGH concentrations in the CSF in different cases of hypothalamic-somatotropin dysfunctions. In control subjects (n = 43) mean HGH levels were 0.35 +/- 0.

In vivo localization of brain sulci by arteriography: a stereotactic anatomoradiological study.

The authors studied the course of the cortical arteries using the Talairach stereotactic system (orthogonal 4.8 m teleradiography, with rigid fixation of the skull in the stereotactic frame) in both anatomical specimens and normal bilateral carotid angiographies of epileptic patients. Anatomoradiological correlations between arterial patterns and underlying brain surface were identified by detailed 3-dimensional analysis of brain-skull preparations, where gyri and injected arteries were dissected progressively with stereotactic X-ray and photographic pictures taken at each step.