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Alonso SM, Lersy F, Ardellier FD, Cebula H, Proust F, Onofrei A, Chammas A, Kremer S. Is non-contrast MRI sufficient to detect meningioma residue after surgery? J Neuroradiol 2024; 51:176-181. [PMID: 37598979 DOI: 10.1016/j.neurad.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Contrast-enhanced magnetic resonance imaging (MRI) is the imaging modality routinely used to follow up patients who have undergone surgical resection of brain meningiomas. There are growing concerns about the massive use of gadolinium-based contrast agents (GBCA). Our aim was to evaluate the performance of a new imaging protocol, performed without GBCA injection, in the detection of tumoral residue or local recurrence after surgery of parafalcine and convexity meningiomas. MATERIALS AND METHODS Only adult patients with a documented resected parafalcine or convexity meningioma were included. We performed a dedicated MRI protocol that included non-contrast and post-contrast sequences. The presence or absence of residue on the unenhanced sequences was independently recorded by three observers: first blindly, then in comparison with a baseline enhanced MRI examination. RESULTS A total of 51 patients were included. 37 of them featured a tumor residue on the reference enhanced sequence. Overall, an average of 32 of 37 (87%) residues were identified on the unenhanced sequences that were blindly reviewed; and more than 34 of 37 (93%) were identified with the help of the comparative baseline enhanced examination, with a high sensitivity. The missed cases were related to small residues. CONCLUSION Unenhanced MRI sequences are highly sensitive and specific in identifying a tumor residue or a local recurrence in the post operative follow up of brain meningiomas. Sensitivity is even higher with the help of a comparative baseline enhanced MRI examination, whatever the strength of magnetic field.
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Affiliation(s)
- S Motillon Alonso
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France.
| | - F Lersy
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France
| | - F D Ardellier
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France; Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France
| | - H Cebula
- Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France; Neurosurgery Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France
| | - F Proust
- Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France; Neurosurgery Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France
| | - A Onofrei
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France
| | - A Chammas
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France
| | - S Kremer
- Radiology 2 Department, Strasbourg University Hospital, Hautepierre Hospital, Strasbourg, France; Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France
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Lamy F, Lagha-Boukbiza O, Wirth T, Philipps C, Longato N, Gebus O, Montaut S, Mengin A, Voirin J, Proust F, Tuzin N, Anheim M, Tranchant C. Early hyperdopaminergic state following sub-thalamic nucleus deep brain stimulation in Parkinson disease. Rev Neurol (Paris) 2022; 178:896-906. [PMID: 36153257 DOI: 10.1016/j.neurol.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/26/2022] [Accepted: 07/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hyperdopaminergic state (HS), especially impulse control behaviors (ICBs), are not rare in Parkinson's disease (PD). Controversial data regarding HS prevalence one year following sub-thalamic nucleus deep brain stimulation (STN-DBS) are reported. OBJECTIVE Our objectives were to describe early postoperative HS (PoOHS) including ICBs, hypomania and psychotic symptoms during the first 3 months following STN-DBS (V1) and their prognosis at 1 year (V2). METHODS This descriptive study included 24 PD patients treated successively with bilateral STN-DBS between 2017 and 2019. The primary endpoint was prevalence of PoOHS at V1 according to the Ardouin Scale of Behaviour in Parkinson's Disease. RESULTS Prior to STN-DBS (V0), 25% patients had HS (only ICBs) whereas at V1 (during the 3 first months), 10 patients (41.7%) had one or several HS (P=0.22) (de novo in 29.2%): 7 (29.2%) ICBs, 4 (16.7%) hypomanic mood, 1 (4.7%) psychotic symptoms. At V2, all V0 and V1 HS had disappeared, while 1 patient (4.2%) presented de novo HS (P<0.01). No correlation was found between the occurrence of PoOHS at V1 and any V0 data. Higher levodopa equivalent dose of dopamine agonists at V1 was correlated with ICB at V1 (P=0.04). CONCLUSION We found that early PoOHS are frequent in PD after STN-DBS, mostly de novo, with ICBs and hypomania being the most frequent. Despite a good prognosis of PoOHS at one year, our work emphasizes the importance of both a cautious adjustment of dopamine agonist doses and a close non-motor monitoring pre- and post-STN-DBS in PD.
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Affiliation(s)
- F Lamy
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France; Département de neurologie fonctionnelle et d'épileptologie, hospices civils de Lyon, université de Lyon, Lyon, France
| | - O Lagha-Boukbiza
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - T Wirth
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - C Philipps
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - N Longato
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - O Gebus
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - S Montaut
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - A Mengin
- Clinique psychiatrique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, Strasbourg cedex, France
| | - J Voirin
- Service de neurochirurgie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - F Proust
- Service de neurochirurgie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - N Tuzin
- Département de santé publique, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - M Anheim
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France; Inserm-U964/CNRS-UMR7104, institut de génétique et de biologie moléculaire et cellulaire (IGBMC), université de Strasbourg, Illkirch, France; Fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, Strasbourg, France
| | - C Tranchant
- Service de neurologie, département de neurologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg cedex, France; Inserm-U964/CNRS-UMR7104, institut de génétique et de biologie moléculaire et cellulaire (IGBMC), université de Strasbourg, Illkirch, France; Fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, Strasbourg, France.
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Mallereau CH, Ribeiro M, Ardellier FD, Dannhoff G, Cebula H, Proust F, Chibbaro S, Todeschi J. Delayed cerebral ischemia after meningioma resection: Literature review and illustrative case. Neurochirurgie 2022; 68:e27-e33. [DOI: 10.1016/j.neuchi.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
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Cebula H, Garnon J, Todeschi J, Noel G, Lhermitte B, Mallereau CH, Chibbaro S, Burckel H, Schott R, de Mathelin M, Gangi A, Proust F. Interventional magnetic-resonance-guided cryotherapy combined with microsurgery for recurrent glioblastoma: An innovative treatment? Neurochirurgie 2021; 68:267-272. [PMID: 34906554 DOI: 10.1016/j.neuchi.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/27/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Glioblastoma invariably recurs after primary Stupp tumor therapy and portends a poor prognosis. Cryoablation is a well-established treatment strategy for extra-cranial tumors. The safety and efficacy of interventional MR-guided cryoablation (iMRgC) has not been explored in recurrent glioblastoma. METHODS A retrospective analysis of data collected over a period of 24 months was performed. The inclusion criteria were: (I) recurrent glioblastoma despite Stupp protocol; (II) MRI followed by histological confirmation of recurrent glioblastoma; (III) location allowing iMRgC followed by microsurgical resection; and (IV) patient's consent. The primary objective was to assess feasibility in terms of complications. The secondary objective was to analyze progression-free survival (PFS), post-iMRgC survival and overall survival (OS). RESULTS The study included 6 patients, with a mean age of 67±7.6 years [range, 54-70 years]. No major complications were observed. Median PFS was 7.5 months [IQR 3.75-9.75] and 6-month PFS was 50%. Median post-iMRgC survival was 9 months [IQR 7.5-15.25] and 6-month post-iMRgC survival was 80%. Median OS was 22.5 months [IQR 21.75-30]. CONCLUSION iMRgC for recurrent glioblastoma demonstrated a good safety profile, with no major complications. Our data suggest improved PFS and OS. TRIAL REGISTRATION NUMBER No. IRB00011687 retrospectively registred on July 7th 2021.
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Affiliation(s)
- H Cebula
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.
| | - J Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
| | - G Noel
- Department of Radiation Therapy, ICANS, Strasbourg, France
| | - B Lhermitte
- Department of Histology, University Hospital of Strasbourg, Strasbourg, France
| | - C-H Mallereau
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
| | - S Chibbaro
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
| | - H Burckel
- Department of Medical Oncology, ICANS, Strasbourg, France
| | - R Schott
- Department of Medical Oncology, ICANS, Strasbourg, France
| | | | - A Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - F Proust
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
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Laigle-Donadey F, Metellus P, Guyotat J, Menei P, Proust F, Dufour H, Chinot O, Honnorat J, Faillot T, Paquis P, Peruzzi P, Emery E, Guillamo JS, Carpentier A, Wager M, Lebbah S, Hajage D, Delattre JY, Cornu P. PL03.1.A Surgery for glioblastomas in the elderly: an ANOCEF trial (CSA). Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
The role of surgery for the treatment of malignant gliomas in patients 70 years of age or older is unsettled. We conducted a randomized trial that compared surgical resection of the tumor and biopsy only, both followed by standard therapy, in such patients.
MATERIAL AND METHODS
Patients aged 70 years and older, with a KPS of at least 50, presenting with a radiological suspicion of an operable glioblastoma (GBM) were randomly assigned between tumor resection and biopsy. Subsequently, they underwent standard radiotherapy during the first years of the trial (2008–2017), with the adjunction of concomitant and adjuvant temozolomide when this regimen became standard (2017–2019). The primary end point was survival; secondary endpoints were progression free survival (PFS), cognitive status (MMS), autonomy (KPS), quality of life (EORTC QLQ C30 and BN20), and perioperative morbidity/ mortality.
RESULTS
From 2008 to 2019, 107 patients from 9 centers were enrolled in the study, of whom 101 were evaluable for analysis because the diagnosis of GBM was histologically confirmed (50 patients in the “surgery” arm and 51 patients in the “biopsy” arm). There was no statistically significant difference of median survival between the “surgery” arm (9.37 mo) and the “biopsy” arms (8.96 mo, p=0.36). However, the surgery group had increased PFS (5.06 mo vs 4.02 mo; p=0.034; p=0.002 on multivariate analysis) and better QOL (e.g. physical and cognitive functioning, motor dysfunction, fatigue) and KPS score evolution as compared to the “biopsy” group. Surgery was not associated with increased mortality or morbidity.
CONCLUSION
This study suggests that optimal debulking surgery does not provide a significant survival benefit in elderly patients suffering from newly diagnosed malignant glioma, but resection improves QOL and autonomy with a significant though modest improvement of PFS.
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Affiliation(s)
| | - P Metellus
- Hôpital Privé Clairval, Marseille, France
| | | | - P Menei
- CHU d’Angers, Angers, France
| | - F Proust
- Hôpital Charles Nicolle, Rouen, France
| | - H Dufour
- Hôpital de la Timone, Marseille, France
| | - O Chinot
- Hôpital de la Timone, Marseille, France
| | | | | | | | | | | | | | | | - M Wager
- CHU de Poitiers, Poitiers, France
| | - S Lebbah
- Hôpital Pitié-Salpêtrière, Paris, France
| | - D Hajage
- Hôpital Pitié-Salpêtrière, Paris, France
| | | | - P Cornu
- Hôpital Pitié-Salpêtrière, Paris, France
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Georges N, Le Fevre C, Loit M, Keller A, Cebula H, Antoni D, Thiery A, Constans J, Proust F. PH-0605 Role of hippocampal location and radiation dose in glioblastoma patients with hippocampal atrophy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lopez C, Frechon P, Seizeur R, Emery E, Pelissou-Guyotat I, Proust F, Thines L, Gaberel T, Magro E. What is the role of neurosurgeons in the current management of intracranial aneurysm in France? An analysis of professional practices. Neurochirurgie 2021; 68:16-20. [PMID: 34246662 DOI: 10.1016/j.neuchi.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
STUDY DESIGN Retrospective observational survey-based study. INTRODUCTION In France, intracranial aneurysm (IA) patients are managed by neurosurgeons and by interventional neuroradiologists. The growth of endovascular treatment led us to reflect on the role of neurosurgeons in the management of patients with IA. The present study aimed to highlight the current organization of IA management in France. METHOD A 60-question survey was sent to the neurosurgeons in 34 hospitals managing IA patients. Thirty-three questions dealt with standards of care, follow-up procedures and the involvement of the specific specialist. RESULTS Twenty-seven centers (79.4%) responded to the survey. A Vascular Multidisciplinary Discussion Team was organized, including both surgeons and neuroradiologists, in 92% of responding centers. There were department protocols in 66% of centers, a local registry in 33% and clinical trials in IA in 60%. Patients with unruptured IA were first seen by a neurosurgeon or by an interventional neuroradiologist, with different practices. For ruptured IA, the neurosurgeons were contacted first in 93% of cases, and were systematically involved in initial intensive care unit management. The patients were hospitalized in the neurosurgery department in 89% of the centers. The neurosurgeons took care of initial follow-up in 85% of the centers, and of lifetime follow-up in 36%. In most centers, radiological monitoring of IA was based on MRI angiography for patients who were embolized or under surveillance, and on CT angiography after microsurgery. CONCLUSION Despite the growth of endovascular treatments, the present survey and the literature highlight a major role of neurosurgeons in treatment, follow-up and care coordination.
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Affiliation(s)
- C Lopez
- Department of Neurosurgery, CHRU de la Cavale Blanche, Boulevard Tanguy-Prigent, 29609 Brest cedex, France.
| | - P Frechon
- CHU Caen, Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14033 Caen, France
| | - R Seizeur
- Department of Neurosurgery, CHRU de la Cavale Blanche, Boulevard Tanguy-Prigent, 29609 Brest cedex, France; Université de Bretagne Occidentale, INSERM, UMR 1101, LaTIM, Laboratoire de Traitement de l'Information Médicale, 29200 Brest, France
| | - E Emery
- CHU Caen, Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14033 Caen, France; Normandie Université, UNICAEN, INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, 14000 Caen, France
| | - I Pelissou-Guyotat
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Department of Neurosurgery, 59, Boulevard Pinel, 69667 Bron, France
| | - F Proust
- Department of Neurosurgery, Hautepierre Hospital Strasbourg, University Hospital, 67098 Strasbourg, France
| | - L Thines
- Neurosurgery Department, Besançon University Hospital, 3, Boulevard Alexandre Fleming, 25030 Besançon cedex, France
| | - T Gaberel
- CHU Caen, Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14033 Caen, France; Normandie Université, UNICAEN, INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, 14000 Caen, France
| | - E Magro
- Department of Neurosurgery, CHRU de la Cavale Blanche, Boulevard Tanguy-Prigent, 29609 Brest cedex, France; Université de Bretagne Occidentale, INSERM, UMR 1101, LaTIM, Laboratoire de Traitement de l'Information Médicale, 29200 Brest, France
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Scibilia A, Gallinaro P, Todeschi J, Chibbaro S, Dannhoff G, Ollivier I, Bozzi MT, Ganau M, Proust F, Cebula H. Surgical management of persistent post-traumatic trans-tentorial brain hernia. Neurochirurgie 2021; 68:44-51. [PMID: 34224727 DOI: 10.1016/j.neuchi.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Temporal engagement may persist after etiologic surgical treatment of acute subdural hematoma (ASH) without clinical improvement despite normalized intracranial pressure (ICP). The aim of this study was to assess the feasibility of secondary direct temporal lobe disengagement (DTLD) after surgery for supratentorial ASH and to evaluate clinical outcome. MATERIALS AND METHODS This was a retrospective analysis of 4 patients undergoing secondary DTLD. Patient data were recorded at admission, pre- and postoperatively and at 6months' follow-up (FU): age, gender, Rotterdam score, Glasgow Coma Scale (GCS), neurological deficits, oculomotor nerve palsy (ONP), ICP, midline shift, complications and Extended Glasgow Outcome Scale (GOS-E). RESULTS At postoperative evaluation 48h after DTLD, we observed a significant improvement in GCS score (initial 6±3, preoperative 7±3, postoperative 14±1; P=0.02), midline shift (initial 16±3mm, preoperative 13±5mm, postoperative 9±2mm; P=0.049) and ONP (P=0.01). In all cases, early postoperative imaging documented visualization of a patent ipsilateral peri-mesencephalic cistern. At 6-month FU, GOS-E showed 75% good recovery and 25% disability. Complete ONP recovery was observed in 75% of patients (P=0.01). Neurological deficits were present at FU in 25% of patients. No surgery-related complications or mortality were recorded. CONCLUSIONS In traumatic brain injury, secondary DTLD may allow simple, effective and safe management of trans-tentorial uncal herniation, avoiding more challenging procedures. Clinical results are promising, as this technique seems to favorably influence neurological outcome in this selected subgroup of patients with persistent clinical and radiological signs of temporal engagement after etiological treatment with normal ICP values.
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Affiliation(s)
- A Scibilia
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - P Gallinaro
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - J Todeschi
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - S Chibbaro
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - G Dannhoff
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - I Ollivier
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - M T Bozzi
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - M Ganau
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - F Proust
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - H Cebula
- Division of Neurosurgery, University of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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Mallereau CH, Todeschi J, Lefevre E, Chibbaro S, Proust F, Cebula H. Is physical activity a trigger factor for subarachnoid hemorrhage? Neurochirurgie 2021; 68:315-319. [PMID: 34214496 DOI: 10.1016/j.neuchi.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/14/2021] [Accepted: 06/20/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Subarachnoid hemorrhage (SAH) is a serious pathology, associated with 43% mortality and significant disability. In the absence of relevant guidelines, some teams advocate that patients harboring an unruptured intracranial aneurysm (ICA) abstain from all sports activity, as a prophylactic precaution. The aim of the present study was to evaluate the impact of physical activity as a risk factor for SAH, through a review of the literature. METHOD A systematic literature review was performed for the period 2000 to 2020 in accordance with the PRISMA guidelines. Prospective and retrospective articles reporting more than 50 patients whose physical activity was associated with onset of SAH were included. The main end-point was prevalence of SAH occurring after physical activity. For comparison purposes, the prevalences of other circumstances were calculated to establish a range of frequency. RESULTS Physical activity appeared to be quite rarely associated with onset of SAH, with a prevalence of 3%, compared to 30% at rest, 7.3% in association with defecation and 4.5% in association with sexual activity. Age under 60 years, male gender (M/F ratio 1.38) and smoking (67.1%) were associated with onset of SAH during physical activity. CONCLUSION Physical activity appears to be a rare trigger factor for SAH. These results are in contrast to the idea that physical activity should, as a precaution, be avoided in patients with unruptured ICA. There is at present no scientific evidence of an association with aneurysmal SAH.
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Affiliation(s)
- C-H Mallereau
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France.
| | - J Todeschi
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - E Lefevre
- Neurosurgery Department, Hôpital de La Pitié-Salpêtrière, AP-HP, Paris, France
| | - S Chibbaro
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - F Proust
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - H Cebula
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
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Mallereau CH, Ganau M, Todeschi J, Proust F, Chibbaro S. In response to Syrmos et al. letter: Proposal of a decisional algorithm for abdominal pseudocysts in patients with ventriculoperitoneal shunt. Neurochirurgie 2021; 68:358-360. [PMID: 34102224 DOI: 10.1016/j.neuchi.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- C-H Mallereau
- Neurosurgery Department, Strasbourg University Hospital, 1, Moliere avenue, Strasbourg, France.
| | - M Ganau
- Neurosurgery Department, Strasbourg University Hospital, 1, Moliere avenue, Strasbourg, France
| | - J Todeschi
- Neurosurgery Department, Strasbourg University Hospital, 1, Moliere avenue, Strasbourg, France
| | - F Proust
- Neurosurgery Department, Strasbourg University Hospital, 1, Moliere avenue, Strasbourg, France
| | - S Chibbaro
- Neurosurgery Department, Strasbourg University Hospital, 1, Moliere avenue, Strasbourg, France
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Dannhoff G, Cebula H, Chibbaro S, Ganau M, Todeschi J, Mallereau CH, Pottecher J, Proust F, Ollivier I. Investigating the real impact of COVID-19 pandemic on the daily neurosurgical practice? Neurochirurgie 2021; 67:99-103. [PMID: 33493541 PMCID: PMC7826024 DOI: 10.1016/j.neuchi.2021.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/27/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to relate the neurosurgical activity during a time of sanitary crisis such as experienced during the SARS-CoV-2 pandemic. METHODS A monocentric retrospective analysis was made based on a prospectively gathered cohort of all patients requiring neurosurgical care between March 15th and May 12th, 2020. Local impact of SARS-CoV-2 was analysed regarding number of patients admitted in ICU. RESULTS One hundred and sixty patients could benefit from neurosurgical care with a wide-ranging profile of clinical and surgical activities performed during the study that seemed similar to last year profile activity. Surgical indications were restricted to non-deferrable surgeries, leading to a drop in operative volume of 50%. Only 1.3% of patients required transfer to other units due to the impossibility of providing gold standard neurosurgical care in our centre. CONCLUSION Despite the challenges represented by the SARS-CoV-2 pandemic, it was proven possible to ensure the routine neurosurgical continuity and provide high standards of neurosurgical care without compromising patients' access to the required treatments.
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Affiliation(s)
- G Dannhoff
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France.
| | - H Cebula
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - S Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - M Ganau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - C-H Mallereau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - J Pottecher
- ICU, Strasbourg University Hospital, Strasbourg, France
| | - F Proust
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - I Ollivier
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
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Todeschi J, Stella I, Entz-Werle N, Coca HA, Joud A, Chastagner P, Proust F, Klein O. Cerebellar swelling after surgery for medulloblastoma with leptomeningeal dissemination in children. A case based-update. Neurochirurgie 2020; 67:145-151. [PMID: 33340509 DOI: 10.1016/j.neuchi.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 11/16/2022]
Abstract
OBJECT Despite the improvement in the overall management of medulloblastomas in recent years, certain phenomena and in particular postoperative cerebellar swelling remain an enigma. This rare complication, little described in the literature, is nonetheless life threatening for the patients. CASE REPORTS We report our experience about two children who developed severe cerebellar swelling with hydrocephalus and upward herniation soon after a gross total resection of a fourth ventricle medulloblastoma by a telo-velar approach. Despite rapid management of ventricular dilation and optimal medical intensive treatment of intracranial hypertension, both children died quickly after the surgery. Pathological examination analyses were in favour of anaplastic/large cell medulloblastoma. DISCUSSION Diffuse cerebellar swelling with upward herniation may occur postoperatively in young children with anaplastic/large cell medulloblastoma with leptomeningeal spread. In the literature, only 4 cases have been so far described with delayed onset of symptoms. Two children survived with an aggressive management (decompressive surgery and early radio-chemotherapy). CONCLUSION Cerebellar swelling is an unrecognised and sudden complication of posterior fossa surgery for metastatic anaplastic medulloblastoma with leptomeningeal dissemination in young children. An initial less invasive surgical approach could be considered in such cases, in order to prevent this complication with potentially tragic issue, and which cannot be managed with a CSF shunt alone.
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Affiliation(s)
- J Todeschi
- Department of pediatric neurosurgery, Nancy University Hospital, University of Lorraine, Nancy, France; Department of neurosurgery, Strasbourg university hospitals, University of Strasbourg, Strasbourg, France.
| | - I Stella
- Department of pediatric neurosurgery, Nancy University Hospital, University of Lorraine, Nancy, France
| | - N Entz-Werle
- Department of pediatric onco-hematology, Strasbourg university hospital, Strasbourg, France; UMR CNRS7021, Laboratory of bioimaging and pathologies, University of Strasbourg, Strasbourg, France
| | - H A Coca
- Department of neurosurgery, Strasbourg university hospitals, University of Strasbourg, Strasbourg, France
| | - A Joud
- Department of pediatric neurosurgery, Nancy University Hospital, University of Lorraine, Nancy, France
| | - P Chastagner
- Department of pediatric oncology, Nancy university hospital, University of Lorraine, Nancy, France
| | - F Proust
- Department of neurosurgery, Strasbourg university hospitals, University of Strasbourg, Strasbourg, France
| | - O Klein
- Department of pediatric neurosurgery, Nancy University Hospital, University of Lorraine, Nancy, France
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Chibbaro S, Gubian A, Zaed I, Hajhouji F, Pop R, Todeschi J, Bernard G, Di Emidio P, Mallereau CH, Proust F, Ganau M. Cervical myelopathy caused by ventrally located atlanto-axial synovial cysts: An open quest for the safest and most effective surgical management. Case series and systematic review of the literature. Neurochirurgie 2020; 66:447-454. [PMID: 33068595 DOI: 10.1016/j.neuchi.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/31/2020] [Accepted: 09/08/2020] [Indexed: 11/15/2022]
Abstract
OF BACKGROUND DATA Despite a good understanding of the natural history of spinal synovial cysts (SCs), a widespread agreement regarding their optimal management is still lacking. This is particularly true for SCs occurring at the C1-C2 level, which are rare, but oftentimes lead to a rapidly evolving cervical myelopathy. METHODS We report a series of 4 patients (M:F ratio=1:1; mean age 63.5 years) presenting with progressive cervical myelopathy secondary to ventrally located C1-C2 SCs. All patients underwent a postero-lateral facet-sparing intradural approach with total excision of the SCs. Functional status was assessed pre- and postoperatively with Nurick scale and the modified Japanese Orthopaedic association grading. Furthermore we conducted a systematic review, following PRISMA guidelines of pertinent literature to contextualize the options for surgical management of such lesions. RESULTS Complete excision of the SCs was confirmed radiologically and on histological analysis. All measures of functional status improved post-operatively, and no cyst recurrence or need for instrumented fusion were noted during follow up (range from 22 to 88 months). CONCLUSION Our experience suggests that the facet-sparing intradural approach provides excellent clinical outcomes without causing any C1-C2 instability. This is in keeping with the take home message emerging from our literature review, which confirms that treatment should aim at radical resection of SCs while minimizing the risk of postoperative instability.
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Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France; Department of Neurosurgery, Lariboisiere University Hospital, Paris, France
| | - A Gubian
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - I Zaed
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France.
| | - F Hajhouji
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - R Pop
- Interventional Neuroradiology Unit, Strasbourg University Hospital, Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - G Bernard
- Department of Neurosurgery, Lariboisiere University Hospital, Paris, France
| | - P Di Emidio
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - C-H Mallereau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - F Proust
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - M Ganau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
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Cebula H, Noel G, Garnon J, Todeschi J, Burckel H, de Mathelin M, Gangi A, Proust F. The Cryo-immunologic effect: A therapeutic advance in the treatment of glioblastomas? Neurochirurgie 2020; 66:455-460. [PMID: 33045247 DOI: 10.1016/j.neuchi.2020.06.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/15/2020] [Accepted: 06/28/2020] [Indexed: 11/17/2022]
Abstract
The immunotherapy of cerebral glioblastoma has become a hot topic. Immune checkpoint blockade antibodies have progressively acquired a role in the management of malignant tumors. A multimodal approach using surgery, radiotherapy, chemotherapy in combination with immunotherapy represent a potent weapon against glioblastomas. In parallel, clinical applications of cryotherapy-freezing tumors based on repetition of rapid freeze-slow thaw cycle-for various cancers such as skin, lung, breast, esophagus, hepatic, kidney, prostate and bone tumors were developed. The future immunomodulatory approaches might be combined with brain tumors cryoablation to increase the cryoimmune response. The objective of this study was to analyze from the literature the relationship between cerebral cryosurgery and immunomodulation using PRISMA method. The animals' studies demonstrate the dendritic cells maturation and activation with the enhancement of antigen-presenting function after cryotherapy suggesting the potential usefulness of the association of cryotherapy and immunomodulator in the management of gliomas.
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Affiliation(s)
- H Cebula
- Department of Neurosurgery, University Hospital of Strasbourg, 67100 Strasbourg, France.
| | - G Noel
- Department of Radiotherapy, ICANS, 67100 Strasbourg, France
| | - J Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, 67100 Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, University Hospital of Strasbourg, 67100 Strasbourg, France
| | - H Burckel
- Department of Radiotherapy, ICANS, 67100 Strasbourg, France
| | - M de Mathelin
- Icube-UMR 7357 Télécom Physique, 67100 Strasbourg, France
| | - A Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, 67100 Strasbourg, France
| | - F Proust
- Department of Neurosurgery, University Hospital of Strasbourg, 67100 Strasbourg, France
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Mallereau CH, Ollivier I, Valenti-Hirsch MP, Hirsch E, Proust F, Chaussemy D. Vagus nerve stimulation in epilepsy: Efficiency and safety of outpatient practice. Neurochirurgie 2020; 66:270-274. [DOI: 10.1016/j.neuchi.2020.04.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/25/2020] [Accepted: 04/13/2020] [Indexed: 11/27/2022]
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Todeschi J, Ferracci FX, Metayer T, Gouges B, Leroy HA, Hamdam N, Bougaci N, De Barros A, Timofeev A, Pretat PH, Bannwarth M, Roblot P, Peltier C, Lleu M, Pommier B, Chibbaro S, Proust F, Cebula H. Impact of discontinuation of antithrombotic therapy after surgery for chronic subdural hematoma. Neurochirurgie 2020; 66:195-202. [DOI: 10.1016/j.neuchi.2020.04.136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 04/05/2020] [Indexed: 02/08/2023]
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Santin MDN, Todeschi J, Pop R, Baloglu S, Ollivier I, Beaujeux R, Proust F, Cebula H. A combined single-stage procedure to treat brain AVM. Neurochirurgie 2020; 66:349-358. [PMID: 32574612 DOI: 10.1016/j.neuchi.2020.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/04/2020] [Accepted: 03/07/2020] [Indexed: 11/29/2022]
Abstract
Complete resection of brain arteriovenous malformation (AVM) is a surgical challenge, mainly due to risk of intraoperative rupture. The objective of this feasibility study was to analyze complete resection rate at 3 months and clinical outcome at 6 months after treatment of brain AVM by combined single-stage embolization and surgical resection. A retrospective observational study from July 2015 to February 2019 was conducted at the Department of Neurosurgery of Strasbourg University Hospital, France. Decision to treat was taken on the basis of history of AVM rupture, symptomatic AVM, or morphologic risk factors for rupture. Complete resection rate was assessed on postoperative cerebral subtraction angiography at 3 months and clinical outcome at 6 months was evaluated on the modified Rankin Scale (mRS). In the 16 patients treated for symptomatic brain AVM, the rate of complete resection was 75%, resection with residual shunt 18.7%, and incomplete resection with residual nidus 6.3%. Good clinical outcome (mRS=0 or 1) was achieved in 81.3% of patients at 6 months. The transfusion rate was 7.1%. There were procedural complications in 12.5% of patients but no intraoperative ruptures. This combined single-stage procedure allows extensive preoperative embolization of the AVM, facilitating surgical microdissection by identifying the dissection plane and perforating arteries and allowing the operator to work in close contact with the nidus without fear of intraoperative rupture.
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Affiliation(s)
- M D N Santin
- Service de neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - J Todeschi
- Service de neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - R Pop
- Service de neuroradiologie interventionnelle, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - S Baloglu
- Service de neuroradiologie diagnostique (radiologie 2), hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - I Ollivier
- Service de neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - R Beaujeux
- Service de neuroradiologie interventionnelle, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - F Proust
- Service de neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - H Cebula
- Service de neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
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18
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Ollivier I, Cebula H, Todeschi J, Santin M, Séverac F, Valenti-Hirsch M, Hirsch E, Proust F. Predictive factors of epilepsy in arteriovenous malformation. Neurochirurgie 2020; 66:144-149. [DOI: 10.1016/j.neuchi.2019.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/11/2019] [Accepted: 12/15/2019] [Indexed: 11/29/2022]
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Chibbaro S, Ganau M, Todeschi J, Proust F, Cebula H. How SARS-CoV-2 is forcing us to reconsider and reorganize our daily neurosurgical practice. Neurochirurgie 2020; 66:189-191. [PMID: 32405094 PMCID: PMC7219419 DOI: 10.1016/j.neuchi.2020.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/03/2020] [Indexed: 12/24/2022]
Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, 1, avenue Molière, 67098 Strasbourg, France.
| | - M Ganau
- Department of Neurosurgery, Strasbourg University Hospital, 1, avenue Molière, 67098 Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, 1, avenue Molière, 67098 Strasbourg, France
| | - F Proust
- Department of Neurosurgery, Strasbourg University Hospital, 1, avenue Molière, 67098 Strasbourg, France
| | - H Cebula
- Department of Neurosurgery, Strasbourg University Hospital, 1, avenue Molière, 67098 Strasbourg, France
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Proust F, Bracard S, Thines L, Pelissou-Guyotat I, Leclerc X, Penchet G, Bergé J, Morandi X, Gauvrit JY, Mourier K, Ricolfi F, Lonjon M, Sedat J, Bataille B, Drouineau J, Civit T, Magro E, Cebula H, Chassagne P, David P, Emery E, Gaberel T, Vignes JR, Aghakani N, Troude L, Gay E, Roche PH, Irthum B, Lejeune JP. Functional outcome 1 year after aneurysmal subarachnoid hemorrhage due to ruptured intracranial aneurysm in elderly patients. Neurochirurgie 2019; 66:1-8. [PMID: 31863744 DOI: 10.1016/j.neuchi.2019.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/13/2019] [Accepted: 11/03/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Population aging raises questions about extending treatment indications in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH). We therefore assessed functional status 1 year after treatment. METHODS This study involved 310 patients, aged over 70 years, with ruptured brain aneurysm, enrolled between 2008 and 2014 in a prospective multicentre trial (FASHE study: NCT00692744) but considered unsuitable for randomisation and therefore analysed in the observational arms of the study: endovascular occlusion (EV), microsurgical exclusion (MS) and conservative treatment. The aims were to assess independence, cognition, autonomy and quality of life (QOL) at 1 year post-treatment, using questionnaires (MMSE, ADLI, IADL, EORTC-QLQ-C30) filled in by independent nurses after discharge. RESULTS The 310 patients received the following treatments: 208 underwent EV (67.1%), 54 MS (17.4%) and 48 were conservatively managed (15.5%). At 1 year, independence rates for patients admitted with good clinical status (WFNS I-III) were, according to the aneurysm exclusion procedure (EV, MS or conservative), 58.9%, 50% and 12.1% respectively. MMSE score was pathological in 26 of the 112 EV patients (23.2%), 10 of the 25 MS patients (40%) and 4 of the 9 patients treated conservatively (44%), without any statistically significant difference [Pearson's Chi2 test, F ratio=4.29; P=0.11]. Regarding QoL, overall score was similar between the EV and MS cohorts, but significantly lower with conservative treatment. CONCLUSION Elderly patients in good clinical condition with aSAH should be treated regardless of associated comorbidities. Curative treatment (EV or MS) reduced mortality without increasing dependence, in comparison with conservative treatment.
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Affiliation(s)
- F Proust
- Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67098, Strasbourg, France; Department of Neurosurgery, Charles-Nicolle Hospital, Rouen University Hospital, 76000, Rouen, France.
| | - S Bracard
- University Hospital, neuroradiology department, 54000 Nancy, France
| | - L Thines
- University Hospital, neurosurgery department, 25000 Besancon, France
| | | | - X Leclerc
- University Hospital, neuroradiology department, 59000 Lille, France
| | - G Penchet
- University Hospital, neurosurgery department, 33000 Bordeaux, France
| | - J Bergé
- University Hospital, neurosurgery department, 33000 Bordeaux, France
| | - X Morandi
- University Hospital, neurosurgery department, 35000 Rennes, France
| | - J-Y Gauvrit
- University Hospital, neurosurgery department, 35000 Rennes, France
| | - K Mourier
- University Hospital, neurosurgery department, 21000 Dijon, France
| | - F Ricolfi
- University Hospital, neurosurgery department, 21000 Dijon, France
| | - M Lonjon
- University Hospital, neurosurgery department, 06000 Nice, France
| | - J Sedat
- University Hospital, neurosurgery department, 06000 Nice, France
| | - B Bataille
- University Hospital, neurosurgery department, 86000 Poitiers, France
| | - J Drouineau
- University Hospital, neurosurgery department, 86000 Poitiers, France
| | - T Civit
- University Hospital, neurosurgery department, 54000 Nancy, France
| | - E Magro
- University Hospital, neurosurgery department, 29000 Brest, France
| | - H Cebula
- University Hospital, neurosurgery department, 67000 Strasbourg, France
| | - P Chassagne
- University Hospital, Geriatry department, 76000 Rouen, France
| | - P David
- Bicêtre University Hospital, neurosurgery department, 94270 Le Kremlin-Bicêtre, France
| | - E Emery
- University Hospital, neurosurgery department, 14000 Caen, France
| | - T Gaberel
- University Hospital, neurosurgery department, 14000 Caen, France
| | - J R Vignes
- University Hospital, neurosurgery department, 33000 Bordeaux, France
| | - N Aghakani
- Bicêtre University Hospital, neurosurgery department, 94270 Le Kremlin-Bicêtre, France
| | - L Troude
- University Hospital, neurosurgery department, 13000 Marseille, France
| | - E Gay
- University Hospital, neurosurgery department, 38000 Grenoble, France
| | - P H Roche
- University Hospital, neurosurgery department, 13000 Marseille, France
| | - B Irthum
- University Hospital, neurosurgery department, 63000 Clermont Ferrand, France
| | - J-P Lejeune
- Lille University Hospital, neurosurgery department, 59000 Lille, France
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- Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67098, Strasbourg, France; Department of Neurosurgery, Charles-Nicolle Hospital, Rouen University Hospital, 76000, Rouen, France
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Darsaut T, Roy D, Weill A, Bojanowski M, Chaalala C, Bilocq A, Findlay J, Rempel J, Chow M, O’Kelly C, Ashforth R, Kotowski M, Magro E, Lemus M, Fahed R, Arikan F, Arrese I, Sarabia R, Altschul D, Chagnon M, Guilbert F, Shankar J, Proust F, Nolet S, Gevry G, Raymond J. A randomized trial of endovascular versus surgical management of ruptured intracranial aneurysms: Interim results from ISAT2. Neurochirurgie 2019; 65:370-376. [DOI: 10.1016/j.neuchi.2019.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/09/2019] [Accepted: 05/30/2019] [Indexed: 01/08/2023]
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Bringer-Macquère S, Trouette R, Dupin C, Pouypoudat C, Adgie S, Bailly L, Benech J, Bernard B, Coulibaly S, Sarrade C, Proust F, Vendrely V. Radiothérapie stéréotaxique des oligométastases surrénaliennes : retour d’expérience du CHU de Bordeaux. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Todeschi J, Bund C, Cebula H, Chibbaro S, Lhermitte B, Pin Y, Lefebvre F, Namer IJ, Proust F. Diagnostic value of fusion of metabolic and structural images for stereotactic biopsy of brain tumors without enhancement after contrast medium injection. Neurochirurgie 2019; 65:357-364. [PMID: 31560911 DOI: 10.1016/j.neuchi.2019.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/04/2019] [Accepted: 08/03/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND The heterogeneous nature of glioma makes it difficult to select a target for stereotactic biopsy that will be representative of grade severity on non-contrast-enhanced lesion imaging. The objective of this study was to evaluate the benefit of fusion of metabolic images (PET 18F-DOPA) with magnetic resonance imaging (MRI) morphological images for cerebral biopsy under stereotactic conditions of glioma without contrast enhancement. PATIENTS AND METHODS This single-center prospective observational study conducted between January 2016 and April 2018 included 20 consecutive patients (mean age: 45±19.5 years; range, 9-80 years) who underwent cerebral biopsy for a tumor without MRI enhancement but with hypermetabolism on 18F-FDOPA PET (positron emission tomography). Standard 18F-FDOPA uptake value (SUVmax) was determined for diagnosis of high-grade glioma, with comparison to histomolecular results. RESULTS Histological diagnosis was made in all patients (100%). Samples from hypermetabolism areas revealed high-grade glial tumor in 16 patients (80%). For a SUVmax threshold of 1.75, sensitivity was 81.2%, specificity 50%, PPV 86.7% and VPN 40% for diagnosis of high-grade glioma. No significant association between SUVmax and histomolecular mutation was found. CONCLUSION 18F-FDOPA metabolic imaging is an aid in choosing the target to be biopsied under stereotactic conditions in tumors without MR enhancement. Nevertheless, despite good sensitivity, 18F-FDOPA PET is insufficient for definitive diagnosis of high-grade tumor.
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Affiliation(s)
- J Todeschi
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - C Bund
- Department of nuclear medicine, hôpital de Hautepierre, 67200 Strasbourg, France
| | - H Cebula
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - S Chibbaro
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - B Lhermitte
- Department of pathology, hôpital de Hautepierre, 67200 Strasbourg, France
| | - Y Pin
- Department of radiotherapy, Centre Paul Strauss, 67065 Strasbourg, France
| | - F Lefebvre
- Department of public health, hôpitaux universitaires, 67200 Strasbourg, France
| | - I J Namer
- Department of nuclear medicine, hôpital de Hautepierre, 67200 Strasbourg, France
| | - F Proust
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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Pin Y, Loo M, Waissi W, Paix A, Todeschi J, Antoni D, Proust F, Ahle G, Noël G. P13.13 Clinical factors involved in brain metastasis edema: results of a retrospective cohort and evaluation of the best edema descriptor. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Brain metastasis (BM) are frequently surrounded by brain edema with a variable extension. This pathological increase in the water mass from the interstitial or intracellular space is the source of neurological symptoms but some studies also showed a prognosis impact of this edema. Nevertheless, the current edema evaluation methods are poorly reproducible and were not extensively evaluated. From a series of patients with brain metastasis, we analyzed factors influencing perilesional edema extension in function of three edema descriptors which were qualitatively evaluated: the absolute cumulative intracranial edema volume (CIEV, in mL), the edema on tumor volume ratio (ER), and the Edema Theoretical Thickness (ETT, in mm), new factor designed to be more independent from geometrical considerations.
MATERIAL AND METHODS
Clinical, biological and imaging factors were retrospectively recorded from patients referred for upfront stereotactic radiotherapy of one to three BMs. CIEV, ER and ETT were calculated for each patient. Non-colinear factors were selected using the Farrar-Glauber test. Impact of these factors on edema was tested with an univariate then a multivariate linear regression for each edema descriptor. Each resulting regression model was qualitatively evaluated using the F-test, R square value and residuals calculation.
RESULTS
Between January 2012 to December 2017, 182 patients were included. Upon 20 potentially prognostic factors recorded, 10 were kept, including clinical, biological and imaging factors. In the multivariate analysis, the CIEV was influenced by the cumulative intracranial tumor volume (CITV) (coefficient of 1.95, p<.001). The CIEV F-statistic p-value and R square were <10–15 and 0.30, respectively. The ETT was significantly influenced by the CITV (0.31, p<.001) and the extracerebral disease control (-1.58, p=.049). The F-test p-value and R square were <10-10 and 0.25, respectively. No significant linear regression was found for the ER. Residuals were more clinically relevant for the ETT compared to the CIEV.
CONCLUSION
Being significantly influenced by the cumulative brain tumor volume and the extracerebral disease control, the ETT might be a factor to include in future BM works because its strong relationships with confounding factors and its ability to provide robust intra and inter subjects comparisons.
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Affiliation(s)
- Y Pin
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - M Loo
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - W Waissi
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - A Paix
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - J Todeschi
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - D Antoni
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - F Proust
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - G Ahle
- Centre de Lutee Contre le Cancer Paul Strauss, Strasbourg, France
| | - G Noël
- Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
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Proust F. Brain revascularization, a relevant procedure? Neurochirurgie 2019; 65:145. [PMID: 31399154 DOI: 10.1016/j.neuchi.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brahimi Y, Antoni D, Srour R, Wagner P, Proust F, Thiery A, Labani A, Noël G. [Skull base meningioma: Clinical and radiological efficacy based on a quantitative volumetric analysis]. Cancer Radiother 2019; 23:290-295. [PMID: 31128988 DOI: 10.1016/j.canrad.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 06/23/2018] [Accepted: 11/13/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE To date, no correlation has been found between clinical and radiological efficacy after irradiation of skull base meningiomas. However, the evaluation of the radiological response was most often made by questionable methods that may have underestimated the radiological effectiveness of radiotherapy. The objective of this work is to verify this hypothesis by quantitative volumetric analysis. MATERIAL AND METHODS Data from 35 patients treated with either helical tomotherapy (45.7%) or fractionated stereotactic radiotherapy (54.3%) were retrospectively analysed. These were mainly women (94%) aged 59 (43-81) with lesions mainly of the cavernous sinus (60%). There was a median of 2 (1-4) symptoms and the main symptoms were visual impairment (39%), cranial nerve deficits (23.4%) and headaches (17.2%). RESULTS Median tumour volume decreased significantly (P<0.05) from 9.6mL (0.3-36.6) to 6.8mL (0.1-26.5) after median follow-up of 44 months (24-77). Sixty-three percent of patients had an improvement of at least one symptom. In univariate analysis, clinical efficacy (P<0.05), radiotherapy technique (P<0.05), tumor topography (P<0.05) and initial tumor volume (P<0.05) were predictive factors for radiological response. In multivariate analysis, only the inverse correlation between radiological response and initial tumor volume remained significant (ρ: -0.47 95% CI -3.2 to 5.7; P<0.05). CONCLUSION The quantitative volumetric monitoring demonstrates a major radiological efficiency of radiotherapy. However, no clear correlation between clinical and radiological efficacy was found.
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Affiliation(s)
- Y Brahimi
- University radiation oncology department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - D Antoni
- University radiation oncology department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratory of radiobiology, EA 3430, Federation of translational medicine, Strasbourg (FMTS), Strasbourg university, 67000 Strasbourg, France
| | - R Srour
- Neurosurgery department, hôpital Pasteur, 39, avenue de la Liberté, 68000 Colmar, France
| | - P Wagner
- Department of radiology, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - F Proust
- Neurosurgery department, CHU de Strasbourg, 1, rue Molière, 67000 Strasbourg, France
| | - A Thiery
- Epidemiology and biostatistics department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - A Labani
- Department of radiology, CHU de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - G Noël
- University radiation oncology department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratory of radiobiology, EA 3430, Federation of translational medicine, Strasbourg (FMTS), Strasbourg university, 67000 Strasbourg, France.
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Herrscher H, Artzner T, Coca HA, Schneider F, Proust F, Guillot M. Cerebral lymphoma presenting as a rhombencephalitis: Case report and review of the literature. Rev Neurol (Paris) 2019; 175:412-414. [PMID: 31030899 DOI: 10.1016/j.neurol.2018.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- H Herrscher
- Service de réanimation médicale, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - T Artzner
- Service de réanimation médicale, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - H-A Coca
- Service de neurochirurgie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - F Schneider
- Service de réanimation médicale, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - F Proust
- Service de neurochirurgie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - M Guillot
- Service de réanimation médicale, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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Roche PH, Cuny E, Régis J, Proust F, Paquis P, Gay E, Destandeau J. Demography of neurosurgery in France in 2018. Current state and a call to educate more young neurosurgeons. Neurochirurgie 2019; 65:4-6. [DOI: 10.1016/j.neuchi.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/16/2018] [Indexed: 11/16/2022]
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Sumodhee S, Adgie S, Fougerouse PA, Antoine M, Faure J, Proust F, Lagarde P, Trouette R. Radiothérapie en conditions stéréotaxiques pulmonaire : études de facteurs prédictifs de dégradation de dose et optimisation dosimétrique par arcthérapie dynamique. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dormegny L, Chibbaro S, Ganau M, Santin M, Kremer L, Proust F. Biopsying a spinal cord lesion: A diagnostic dilemma. Case report and review of literature. Neurochirurgie 2018; 64:425-430. [PMID: 30243464 DOI: 10.1016/j.neuchi.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/24/2018] [Accepted: 07/23/2018] [Indexed: 12/29/2022]
Abstract
Spinal cord biopsy is a difficult procedure fraught with the risk of false-negative results or even misdiagnosis in up to 30% of cases. Differential diagnoses of spinal cord lesions include a wide range of inflammatory, infectious and neoplastic diseases. Given the importance of correctly managing these pathologies, it is crucial to avoid delays in making the correct diagnosis in order to improve the patient's outcome. We present here the case of a 21-year-old male with rapidly progressing sphincter and lower limb motor dysfunctions up to complete paraplegia with evidence of thoracic spinal cord lesion on magnetic resonance imaging. None of the blood and cerebrospinal fluid tests pointed to a diagnosis, while a first spinal cord biopsy revealed an inflammatory necrotic process. After several weeks of empirical treatments and clinical stability, the patient started having focal structural seizures that became generalized with local progression of the lesion and diffuse leptomeningeal spread on magnetic resonance imaging. A second spinal cord biopsy found a grade IV glioblastoma with H3 K27M histone mutation. Unfortunately the patient passed away before any treatment could be initiated. In this report, the authors analyze the difficulty of making the rapid, correct diagnosis of a highly malignant intrinsic spinal cord lesion, discussing also possible strategies to avoid diagnostic delays and to improve the outcome of these difficult patients.
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Affiliation(s)
- L Dormegny
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France.
| | - S Chibbaro
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - M Ganau
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - Mdn Santin
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - L Kremer
- Service de neurologie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - F Proust
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
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Gangi A, Proust F. Multimodal management of vertebral hemangioma. Neurochirurgie 2018; 64:279-280. [DOI: 10.1016/j.neuchi.2018.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/11/2018] [Accepted: 04/03/2018] [Indexed: 10/14/2022]
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Metayer T, Emery E, Gaberel T, Proust F, Gilard V. Hémorragies intraventriculaires secondaires à la rupture d’un angiome cérébral : description, suivis et impact de la fibrinolyse. Neurochirurgie 2018. [DOI: 10.1016/j.neuchi.2018.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brahimi Y, Antoni D, Srour R, Proust F, Cebula H, Labani A, Noël G. [Base of the skull meningioma: Efficacy, clinical tolerance and radiological evaluation after radiotherapy]. Cancer Radiother 2018; 22:264-286. [PMID: 29773473 DOI: 10.1016/j.canrad.2017.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 09/15/2017] [Accepted: 09/20/2017] [Indexed: 11/29/2022]
Abstract
Skull base meningioma leads to functional disturbances, which can significantly alter the quality of life. The optimal management of these lesions, whose goals are neurological preservation and tumour local control, is not yet clearly established. It is widely recognized that the goal of a radical excision should be abandoned despite the advances in the field of microsurgery of skull base lesions. Although less morbid, partial tumour excision would be associated with increased risk of local tumour recurrence. Although discussed both exclusive and adjuvant have proven to be highly successful in terms of clinical improvement and local control. Various radiation techniques have demonstrated their efficacy in the management of this pathology. However, high rates of clinical improvement are in contrast with low rates of radiological improvement. The notion of clinical and radiological dissociation appeared. However, in most of these studies, the analysis of the radiological response could be subject of legitimate criticism. This work proposes to review the local control, the efficacy and the clinical tolerance and the radiological response of the various radiation techniques for the meningioma of the base of the skull and to demonstrate the interest of quantitative volumetric analyses in the follow-up of meningioma after radiotherapy.
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Affiliation(s)
- Y Brahimi
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire de radiobiologie, UMR 7178 institut pluridisciplinaire Hubert-Curien (IPHC), université de Strasbourg, 67000 Strasbourg, France; CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - R Srour
- Service de neurochirurgie, hôpital Pasteur, 39, avenue de la Liberté, 68024 Colmar cedex, France
| | - F Proust
- Service de neurochirurgie, hôpital universitaire de Strasbourg, 1, rue Molière, 67000 Strasbourg, France
| | - H Cebula
- Service de neurochirurgie, hôpital universitaire de Strasbourg, 1, rue Molière, 67000 Strasbourg, France
| | - A Labani
- Service de radiologie, hôpital universitaire de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire de radiobiologie, UMR 7178 institut pluridisciplinaire Hubert-Curien (IPHC), université de Strasbourg, 67000 Strasbourg, France; CNRS, IPHC UMR 7178, 67000 Strasbourg, France.
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Todeschi J, Gubian A, Wirth T, Coca HA, Proust F, Cebula H. Multimodal management of severe herpes simplex virus encephalitis: A case report and literature review. Neurochirurgie 2018; 64:183-189. [PMID: 29730051 DOI: 10.1016/j.neuchi.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/28/2017] [Accepted: 10/29/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Herpes simplex encephalitis (HSE) is the most frequent sporadic encephalitis in the world. In severe cases of HSE, the pathology usually progresses with an increase in intracranial pressure secondary to cerebral edema and/or hemorrhagic necrosis. Currently no high-power studies exist regarding the management of severe HSE and most of the papers reported in the literature are case reports. Decompressive craniectomy, effective in some cases of pharmaco-resistant intracranial hypertension (ICH) resulting from other causes, may be suggested in severe HSE, with several good results reported in the literature. CASE DESCRIPTION The case of a 26-year-old man with severe HSE and a subsequent ICH is reported. In dealing with an ICH rebellious to conservative treatment, it was decided to perform a right decompressive hemicraniectomy, associated with a right temporal polectomy. The postoperative evolution was satisfactory, with normal neuropsychological tests and a Glasgow Outcome Scale of 1. CONCLUSION Although herpes simplex encephalitis is sometimes devastatingly complicated by intracranial hypertension, its management lacks consensus and reliable data in the literature remains scarce. Surgical as well as conservative treatment, used together in a multimodal approach, may hold the key to a greater control of intracranial pressure, thus resulting in a better outcome. In this multimodal management, the window of opportunity where surgery may be considered is small, and must be discussed further and more precisely in future articles.
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Affiliation(s)
- J Todeschi
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - A Gubian
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - T Wirth
- Department of neurology, hôpital de Hautepierre, 67200 Strasbourg, France
| | - H-A Coca
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - F Proust
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - H Cebula
- Department of neurosurgery, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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Fath L, Cebula H, Santin MN, Coca A, Debry C, Proust F. The Grisel's syndrome: A non-traumatic subluxation of the atlantoaxial joint. Neurochirurgie 2018; 64:327-330. [PMID: 29731316 DOI: 10.1016/j.neuchi.2018.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Grisel's syndrome consists in rotational subluxation of C1-C2 following ENT infection or surgery. There is no consensus on management. We present 2 cases requiring surgical treatment in our center. CASE REPORTS Two 10-year-old patients presented torticollis with cervical pain resistant to medical treatment, with onset a few months after tonsillectomy. In both cases, radiological assessment, comprising CT scan and MRI, showed Fielding-Hawkins type-3 C1-C2 rotational subluxation, without ligament lesion. After failure of conservative treatment, posterior reaming, realignment, C1-C2 arthrodesis using lateral masses and pars interarticularis screws and bone graft achieved good fusion and immediate spinal stability in all planes of the atlantoaxial complex. DISCUSSION Grisel's syndrome consists in non-traumatic subluxation of the atlantoaxial joint with intact atlantoaxial ligaments. Initial pharyngeal inflammation spreads to the prevertebral fascia via direct connections between the periodontoidal venous plexus and pharyngovertebral veins, inducing fasciitis that leads to abnormal relaxation of the atlantoaxial ligaments and reactional muscle contraction with ankylosis. This phenomenon, appearing gradually and insidiously over a period of a few weeks, creates a frozen joint with ankylosis. Medical treatment with NSAIDs, muscle relaxants, and immobilization is usually sufficient; cervical traction may be needed. Surgical treatment by C1-C2 arthrodesis is indicated in case of failure of medical management or onset of neurologic signs. CONCLUSION Close collaboration between pediatricians, ENT surgeons and neurosurgeons is essential for early diagnosis and management, which is the main prognostic factor for successful medical treatment, avoiding surgery.
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Affiliation(s)
- L Fath
- CHU de Strasbourg, hôpital de Hautepierre, service d'ORL et chirurgie cervico-faciale, 67200 Strasbourg, France.
| | - H Cebula
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - M N Santin
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - A Coca
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - C Debry
- CHU de Strasbourg, hôpital de Hautepierre, service d'ORL et chirurgie cervico-faciale, 67200 Strasbourg, France
| | - F Proust
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
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Brahimi Y, Antoni D, Srour R, Proust F, Cebula H, Labani A, Noël G. Méningiomes de la base du crâne : efficacité et tolérance clinique, efficacité radiologique et cinétique tumorale après radiothérapie. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hervé D, Kossorotoff M, Bresson D, Blauwblomme T, Carneiro M, Touze E, Proust F, Desguerre I, Alamowitch S, Bleton JP, Borsali A, Brissaud E, Brunelle F, Calviere L, Chevignard M, Geffroy-Greco G, Faesch S, Habert MO, De Larocque H, Meyer P, Reyes S, Thines L, Tournier-Lasserve E, Chabriat H. French clinical practice guidelines for Moyamoya angiopathy. Rev Neurol (Paris) 2018. [PMID: 29519672 DOI: 10.1016/j.neurol.2017.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Pituitary apoplexy is an acute hemorragic or ischemic infarction in pituitary adenomas. The incidence in our series was 6.5%. Clinical diagnosis can often be difficult as the patient is frequently unaware of an existing adenoma (seven out of 11 patients). Therefore, the classic features of the syndrome must be known. They include sudden headaches, impairment of consciousness, endocrinological disturbances and sudden visual deterioration or oculomotor palsies. In this retrospective study from 1987 to 1994 of 14 patients presenting pituitary apoplexy there were 11 cases with visual abnormalities. Oculomotor palsies were more common (82%) than chiasmatic impairment (54.5%) and often revealed pituitary adenoma. CT-Scan and MRI examinations led to diagnosis, and emergency treatment (surgical removal by rhinoseptal approach or less often medical treatment) generally led to a regression of visual disturbances.
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Affiliation(s)
- S Milazzo
- Department of Ophthalmology, Centre Saint Victor, Amiens, France
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Chibbaro S, Cebula H, Ganau M, Gubian A, Todeschi J, Lhermitte B, Proust F, Noel G. Multidisciplinary management of an intra-sellar cavernous hemangioma: Case report and review of the literature. J Clin Neurosci 2018; 52:135-138. [PMID: 29622503 DOI: 10.1016/j.jocn.2018.03.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/12/2018] [Indexed: 10/17/2022]
Abstract
Extra-axial cavernous hemangiomas (ECH) are rare vascular lesions with a tendency to grow within the medial structures of the middle cranial fossa. This pathological entity lacks specific symptoms, and falls into the category of differential diagnosis of space occupying lesions in the cavernous sinus (CS) with or without sellar involvement, including those of tumoral, vascular and inflammatory nature. Of note, ECH can also be indolent, and is at times discovered incidentally during autopsy investigations. On radiological studies, ECH with sellar extension are frequently mistaken at first for pituitary adenomas. Total removal of intrasellar-CS ECH is technically demanding and burdened by remarkable morbidity and mortality rates, mostly related to the complex neuroanatomy of the CS-sellar region (i.e., peri and postoperative bleeding, and transitory or permanent nerve palsies, hormonal deficits). Consequently, only a few cases of successful total removal have been reported so far in the literature. Surgical debulking with cranial nerve decompression followed by stereotactic radiosurgery is currently considered the best alternative to total removal when the latter carries excessive perioperative risks. We present a rare case of a mainly located intrasellar ECH extending to the left CS discussing its clinical features and focusing on the most relevant aspects of the surgical management along with a review of the pertinent literature.
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Affiliation(s)
- S Chibbaro
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - H Cebula
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - M Ganau
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - A Gubian
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France.
| | - J Todeschi
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - B Lhermitte
- Histopathology Department, Strasbourg University Hospital, Strasbourg, France
| | - F Proust
- Neurosurgery Department, Strasbourg University Hospital, Strasbourg, France
| | - G Noel
- Radiotherapy Department, Paul Strauss Centre, Strasbourg, France
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Santin MDN, Cebula H, Ollivier I, Todeschi J, Baloglu S, Proust F. Diagnosis and suggested treatment against an isolated unilateral rupture of the alar ligament - Concerning one case. Neurochirurgie 2017; 63:478-482. [PMID: 29122308 DOI: 10.1016/j.neuchi.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/10/2017] [Accepted: 07/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND An isolated rupture of the alar ligament is a rare occurrence with only a few cases reported in the literature. CASE REPORT The objective was to report the case of a young man with a unilateral rupture of the alar ligament that we closely monitored, clinically and radiologically, in order to describe the evolution of the alar ligament lesions. CONCLUSION Radiological diagnosis using cervical MRI and duration of the conservative treatment remain debated and we proposed a close radiological follow-up in order to best understand the nature of these ligament lesions and their evolution following specific treatment.
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Affiliation(s)
- M-D-N Santin
- Service de Neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France.
| | - H Cebula
- Service de Neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
| | - I Ollivier
- Service de Neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
| | - J Todeschi
- Service de Neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
| | - S Baloglu
- Service de Neuroradiologie (Radiologie 2), hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
| | - F Proust
- Service de Neurochirurgie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France
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Adgie S, Sumodhee S, Fougerouse PA, Benech J, Bailly L, Proust F, Coulibaly S, Sarrade C, Vendrely V, Trouette R. Radiothérapie en conditions stéréotaxiques des cancers bronchopulmonaires - Détermination de facteurs prédictifs d’amélioration de plans d’arcthérapie volumétrique modulée (VMAT). Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gilard V, Terrier L, Langlois O, Derrey S, Curey S, Proust F. Untreated unruptured aneurysm: Natural history at long-term. Neurochirurgie 2017; 63:282-285. [DOI: 10.1016/j.neuchi.2016.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/15/2016] [Accepted: 10/23/2016] [Indexed: 11/25/2022]
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Cebula H, Ollivier I, Todeschi J, Proust F. Letter of response: Evidence for the existence of a communication between the eye and the brain? Acta Neurochir (Wien) 2017; 159:1415. [PMID: 28523424 DOI: 10.1007/s00701-017-3220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
Affiliation(s)
- H Cebula
- Department of Neurosurgery, University Hospital of Strasbourg, Avenue Moliere, 67000, Strasbourg, France.
| | - I Ollivier
- Department of Neurosurgery, University Hospital of Strasbourg, Avenue Moliere, 67000, Strasbourg, France
| | - J Todeschi
- Department of Neurosurgery, University Hospital of Strasbourg, Avenue Moliere, 67000, Strasbourg, France
| | - F Proust
- Department of Neurosurgery, University Hospital of Strasbourg, Avenue Moliere, 67000, Strasbourg, France
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Venkatasamy A, Le Foll D, Karol A, Lhermitte B, Charpiot A, Debry C, Proust F, Meyer N, Veillon F. Differentiation of vestibular schwannomas from meningiomas of the internal auditory canal using perilymphatic signal evaluation on T2-weighted gradient-echo fast imaging employing steady state acquisition at 3T. Eur Radiol Exp 2017; 1:8. [PMID: 29708179 PMCID: PMC5909335 DOI: 10.1186/s41747-017-0012-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/02/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Our aim was to confirm the usefulness of the perilymphatic signal changes on T2-weighted (T2W) gradient-echo sequence to differentiate vestibular schwannomas from internal auditory canal (IAC) meningiomas, through a compartmental analysis of inner ear fluids signal intensity. METHODS A total of 203 patients with all criteria for typical vestibular schwannoma on T1-weighted contrast-enhanced sequences were retrospectively enrolled (190 schwannomas and 13 meningiomas). All patients underwent a T2W gradient-echo steady state free precession (SSFP) acquisition at 3T. Two radiologists analysed the signal intensity of the perilymph (cistern and cochlea) and endolymph (saccule and utricle) using a region of interest-based method for obtaining ratios between the analysed structures and the cerebrospinal fluid (CSF). RESULTS Obstructive vestibular schwannomas showed a markedly decreased perilymphatic signal in both cistern and cochlea; the cistern/CSF ratio (Ci/CSF) was 0.62. The decrease was more moderate in IAC meningiomas (Ci/CSF = 0.81). For Ci/CSF > 0.70, the tumour was more likely a meningioma, with a 92% sensitivity and 83% specificity. No endolymphatic signal changes were observed. CONCLUSION The pronounced decrease in perilymphatic signal on a T2W SSFP sequence in obstructive vestibular schwannoma provides a new tool to differentiate schwannomas from IAC meningiomas, which may be useful to overcome the insufficiencies of morphological analysis.
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Affiliation(s)
- A. Venkatasamy
- Imagerie 1, Radiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - D. Le Foll
- Imagerie 1, Radiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A. Karol
- Imagerie 1, Radiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - B. Lhermitte
- Service d’Anatomie Pathologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A. Charpiot
- Service d’ORL, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - C. Debry
- Service d’ORL, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F. Proust
- Service de Neurochirurgie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N. Meyer
- Département de Statistiques, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F. Veillon
- Imagerie 1, Radiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Keller A, Doré M, Antoni D, Menoux I, Thillays F, Clavier JB, Delpon G, Jarnet D, Bourrier C, Lefebvre F, Chibbaro S, Darié I, Proust F, Noël G. [Risk of radionecrosis after hypofractionated stereotactic radiotherapy targeting the postoperative resection cavity of brain metastases]. Cancer Radiother 2017; 21:377-388. [PMID: 28551018 DOI: 10.1016/j.canrad.2017.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 01/02/2017] [Accepted: 01/31/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the factors that potentially lead to brain radionecrosis after hypofractionated stereotactic radiotherapy targeting the postoperative resection cavity of brain metastases. METHODS AND MATERIALS A retrospective analysis conducted in two French centres, was performed in patients treated with trifractionated stereotactic radiotherapy (3×7.7Gy prescribed to the 70% isodose line) for resected brain metastases. Patients with previous whole-brain irradiation were excluded of the analysis. Radionecrosis was diagnosed according to a combination of criteria including clinical, serial imaging or, in some cases, histology. Univariate and multivariate analyses were performed to determine the predictive factors of radionecrosis including clinical and dosimetric variables such as volume of brain receiving a specific dose (V8Gy-V22Gy). RESULTS One hundred eighty-one patients, with a total of 189 cavities were treated between March 2008 and February 2015. Thirty-five patients (18.5%) developed radionecrosis after a median follow-up of 15 months (range: 3-38 months) after hypofractionated stereotactic radiotherapy. One third of patients with radionecrosis were symptomatic. Multivariate analysis showed that infra-tentorial location was predictive of radionecrosis (hazard ratio [HR]: 2.97; 95% confidence interval [95% CI]: 1.47-6.01; P=0.0025). None V8Gy-V22Gy was associated with appearance of radionecrosis, even if V14Gy trended toward significance (P=0.059). CONCLUSION Analysis of patients and treatment variables revealed that infratentorial location of brain metastases was predictive for radionecrosis after hypofractionated stereotactic radiotherapy for postoperative resection cavities.
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Affiliation(s)
- A Keller
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - M Doré
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - I Menoux
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - F Thillays
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France
| | - J B Clavier
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - G Delpon
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France
| | - D Jarnet
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - C Bourrier
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - F Lefebvre
- Laboratoire de biostatistiques, faculté de médecine, 4, rue Kirschleger, 67085 Strasbourg cedex, France
| | - S Chibbaro
- Département de neurochirurgie, hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France
| | - I Darié
- Service de neurochirurgie, centre hospitalier régional d'Orléans, 1, rue Porte-Madeleine, 45000 Orléans, France
| | - F Proust
- Département de neurochirurgie, hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France.
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Ferracci FX, Gilard V, Cebula H, Magne N, Lejeune JP, Langlois O, Proust F. Growth of giant intracranial aneurysms: An aneurysmal wall disorder? Neurochirurgie 2017; 63:6-12. [DOI: 10.1016/j.neuchi.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 12/13/2016] [Accepted: 01/01/2017] [Indexed: 10/20/2022]
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Hajhouji F, Chibbaro S, Proust F. Mélanome malin primitif de la pinéale : à propos d’un cas et revue de la littérature. Neurochirurgie 2017. [DOI: 10.1016/j.neuchi.2016.11.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cebula H, Kremer S, Chibbaro S, Proust F, Bierry G. Subarachnoidal migration of intraocular silicone oil. Acta Neurochir (Wien) 2017; 159:347-348. [PMID: 27873047 DOI: 10.1007/s00701-016-3011-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- H Cebula
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France.
| | - S Kremer
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - S Chibbaro
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
| | - F Proust
- Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg, France
| | - G Bierry
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
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Aljohani HT, Chaussemy D, Proust F, Chibbaro S. Intracranial solitary fibrous tumor/hemangiopericytoma: Report of two cases and literature review. Int J Health Sci (Qassim) 2017; 11:69-70. [PMID: 28936155 PMCID: PMC5604277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Intracranial solitary fibrous tumors (ISFTs) are rare mesenchymal neoplasms originating in the meninges and constitute a heterogeneous group of rare spindle cell tumors that include benign and malignant neoplasms of which hemangiopericytoma is nowadays considered a cellular phenotypic variant. ISFT usually shows benign or indolent clinical behavior. We describe two cases of ISFT managed in our institution along with a review of pertinent literature.
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Affiliation(s)
- Hani Talal Aljohani
- Hôpital Civil de Colmar,Address for correspondence: Hani Talal Aljohani, Department of Surgery, College of Medicine Qassim University, Saudi Arabia Service de Neurochirurgie Hôpital Civil de Colmar, France. 366 Route De La Wantzenau, 67000 Strasbourg, France. Phone: +33951094573/33613554789. E-mail:
| | | | - F. Proust
- Les Hôpitaux Universitaire de Strasbourg
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