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Le Petit L, Jecko V, Coll G, Roblot P. Use and consequences of less-lethal weapons in France: A neurosurgical perspective. Neurochirurgie 2024; 70:101556. [PMID: 38593656 DOI: 10.1016/j.neuchi.2024.101556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Laetitia Le Petit
- Department of Neurosurgery A, University Hospital of Bordeaux, Bordeaux, France; Laboratory of Anatomy, University of Bordeaux, 33000 Bordeaux, France
| | - Vincent Jecko
- Department of Neurosurgery A, University Hospital of Bordeaux, Bordeaux, France; Laboratory of Anatomy, University of Bordeaux, 33000 Bordeaux, France
| | - Guillaume Coll
- Department of Neurosurgery, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Paul Roblot
- Department of Neurosurgery A, University Hospital of Bordeaux, Bordeaux, France; Laboratory of Anatomy, University of Bordeaux, 33000 Bordeaux, France.
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Berton Q, Arrighi M, Barthélémy I, Garcier JM, Loit MP, Cambier S, Coll G. Reossification of Bone Defects After Surgical Correction of Nonsyndromic Craniosynostosis: A Review and An Original Study. Neurosurgery 2024:00006123-990000000-01045. [PMID: 38323819 DOI: 10.1227/neu.0000000000002854] [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] [Received: 09/07/2023] [Accepted: 12/17/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Surgical correction of nonsyndromic craniosynostosis (NSC) aims to restore cranial shape. Reossification of bone defects is paramount for the best aesthetic prognosis. However, the literature on the quantitative evaluation of bone defects after NSC surgery is scarce. This study aimed to quantify and analyze the surface area of bone defects after NSC surgery and establish a threshold value for predicting persistent defects. METHODS We conducted a systematic review and a prospective study of 28 children undergoing surgical treatment for NSC. We analyzed 426 defects on the first computed tomography scan (1 year postoperative) and 132 defects on the second computed tomography scan (4.6 years postoperative). Statistical analysis was performed using Spearman's rank correlation coefficient, Mann-Whitney-Wilcoxon rank-sum test, and Youden's J statistic. RESULTS Our systematic review identified three studies reporting on bone defects' surface area and reossification rate. In our study, we found no statistically significant differences in the number or size of defects between sex or type of NSC. The threshold value for the surface area of bone defects above which there was a higher probability of persistent defects was 0.19 cm2 (Youden point), with an 89.47 % probability of persistence. Defects with a surface area below 0.19 cm2 had a considerably lower probability, only 15.07%, of persistence over time. CONCLUSION Our study provides valuable quantitative data for managing bone defects after NSC surgery. Defects with a surface area above 0.19 cm2 should be monitored with radiological imaging because of the risk of persistence. Our findings highlight the importance of developing robust and reproducible methods for the quantitative analysis of bone defects after NSC surgery.
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Affiliation(s)
- Quentin Berton
- Department of Neurosurgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- INSERM, CIC 1405, CRECHE Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marta Arrighi
- Department of Neurosurgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- INSERM, CIC 1405, CRECHE Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Isabelle Barthélémy
- Department of Maxillofacial Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Jean-Marc Garcier
- Service de Radiologie Infantiled'Imagerie Médicale, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Institut Pascal, UMR 6602 CNRS SIGMA UCA, Clermont-Ferrand, France
| | - Marie-Pierre Loit
- Department of Neurosurgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Sébastien Cambier
- DRCI, Biostatistics Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Guillaume Coll
- Department of Neurosurgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- INSERM, CIC 1405, CRECHE Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Orange C, Lanhers C, Coll G, Coste N, Dutheil F, Hauret I, Pereira B, Coudeyre E. Determinants of Return to Work After a Stroke: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:359-368. [PMID: 37797913 DOI: 10.1016/j.apmr.2023.08.027] [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: 08/22/2022] [Revised: 08/13/2023] [Accepted: 08/26/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To identify prognostic factors for return to work (RTW) after stroke. DATA SOURCES PubMed, MEDLINE, Cochrane, and Embase were systematically searched. STUDY SELECTION Studies had to include people of working age (<65 years old) at the time of stroke (ischemic, hemorrhagic, or subarachnoid hemorrhage). The evaluation of RTW and rate of RTW had to be mentioned. Study selection was done by 2 independent authors. In total, 1241 articles were screened, 39 met all inclusion criteria. DATA EXTRACTION Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or with a third author. Quality was assessed using the Scottish Intercollegiate Guidelines Network quality assessment tool. DATA SYNTHESIS Among the 39 studies, prognostic factors for RTW were hemorrhagic stroke (odds ratio 0.53 [95% confidence interval 0.45-0.60], n=18 studies), sex (men) (1.26 [1.14-1.40], n=31), aphasia (0.37 [0.20-0.69], n=7), occupation (white collar worker) (1.84 [1.64-2.06], n=17), independence in activities of daily living (3.99 [1.73-9.23], n=7), and stroke severity (NIHSS) (1.23 [1.08-1.39], n=6). CONCLUSIONS This meta-analysis highlighted positive and negative prognostic factors associated with RTW after stroke. Two categories were distinguished: modifiable and non-modifiable prognostic factors. This study provides information to help understand the issues, set appropriate objectives and implement appropriate strategies to guide people to RTW after stroke. Randomized controlled studies are needed to better evaluate work-place intervention programs as well as the effects of intravenous thrombolysis, and cognitive and neuropsychological rehabilitation on return-to-work rates after stroke.
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Affiliation(s)
- Charles Orange
- Physical Medicine and Rehabilitation, CMPR Maurice Gantchoula Pionsat, France; Physical Medicine and Rehabilitation, INRAE, UNH, Université Clermont-Auvergne, university hospital of Clermont-Ferrand, Clermont-Ferrand, France.
| | - Charlotte Lanhers
- Physical Medicine and Rehabilitation, CMPR Maurice Gantchoula Pionsat, France
| | - Guillaume Coll
- University hospital of Clermont-Ferrand, Neurosurgery B, Clermont-Ferrand, France
| | - Nicolas Coste
- Physical Medicine and Rehabilitation, Notre-Dame, Chamalières, France
| | - Frederic Dutheil
- Occupational and Environmental Medicine, CNRS, LaPSCo, Physiological and Psychosocial Stress, university hospital of Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Isabelle Hauret
- Physical Medicine and Rehabilitation, INRAE, UNH, Université Clermont-Auvergne, university hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Clinical research and innovation direction, biostatistics, university hospital of Clermont-Ferrand, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Emmanuel Coudeyre
- Physical Medicine and Rehabilitation, INRAE, UNH, Université Clermont-Auvergne, university hospital of Clermont-Ferrand, Clermont-Ferrand, France
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Chabert E, Hugonnet E, Kastler A, Sakka L, Rabbo FA, Zerroug A, Coudeyre E, Pereira B, Coll G. Vertebroplasty versus bracing in acute vertebral compression fractures: A prospective randomized trial. Ann Phys Rehabil Med 2023; 66:101746. [PMID: 37030247 DOI: 10.1016/j.rehab.2023.101746] [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: 12/14/2021] [Revised: 11/21/2022] [Accepted: 12/17/2022] [Indexed: 04/10/2023]
Abstract
BACKGROUND The treatment of stable vertebral compression fractures remains controversial. OBJECTIVE To compare the efficacy of vertebroplasty and bracing for acute vertebral compression fractures. METHODS We conducted a prospective, randomized, non-blinded, single-center study. Adult participants were randomized to undergo vertebroplasty or bracing. Both groups were stratified by age. The primary outcome was functional disability (Roland-Morris disability questionnaire [RMDQ]). Secondary outcomes were pain intensity (Visual Analogue Scale [VAS]), and change in vertebral body height and kyphosis angle. Outcomes were assessed on day 2, and 1, 3 and 6 months after treatment. RESULTS Ninety-nine people were included, 51 in the vertebroplasty group and 48 in the brace group. Treatment was performed within 2 weeks of the trauma. On day 2 post-treatment, pain was lower in the vertebroplasty group (mean [SD] 2.3 [1.5] versus 3.4 [2.1], p = 0.004) but the difference was no longer significant at 6 months. Functional disability was significantly lower in the vertebroplasty than brace group at all time-points (RMDQ score 7.5 [5.7] vs 11.4 [5.3], p<0.001 at 1 month). At 6 months, the increase in kyphosis angle was smaller in the vertebroplasty than the brace group (+1.5°versus +4°, p<0.001). CONCLUSION In people with acute vertebral compression fractures, the immediate effect of vertebroplasty was greater than that of bracing on pain and function, and for restoring sagittal balance. At 6 months, the superiority of vertebroplasty decreased, except for the maintenance of sagittal balance. DATABASE REGISTRATION ClinicalTrials.gov number, NCT01643395.
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Affiliation(s)
- Emmanuel Chabert
- Service de Neuroradiologie, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Eulalie Hugonnet
- Service de Radiologie, Hôpital de Vichy, Boulevard Denière, 03200 Vichy, France
| | - Adrian Kastler
- Service de Neuroradiologie, Centre Hospitalier Universitaire de Grenoble-Alpes, Avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Laurent Sakka
- Service de Neurochirurgie, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Francis Abed Rabbo
- Service de Neurochirurgie, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Abderrahim Zerroug
- Service de Neuroradiologie, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Emmanuel Coudeyre
- Service de médecine physique et réadaptation, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Bruno Pereira
- Délégation à La Recherche Clinique et à L'Innovation, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France
| | - Guillaume Coll
- Service de Neurochirurgie, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France; INSERM, CIC 1405, unité CRECHE, Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63 000 Clermont-Ferrand, France.
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Arrighi M, Coll G. Letter: Mechanical Complications of Sophysa SM8 Shunt in Adult Hydrocephalus: A Monocentric Experience. Oper Neurosurg (Hagerstown) 2023; 25:e115. [PMID: 37195046 DOI: 10.1227/ons.0000000000000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/18/2023] Open
Affiliation(s)
- Marta Arrighi
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Guillaume Coll
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Unité Crèche, CIC 1450, INSERM, Clermont-Ferrand, France
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Sendy F, Arrighi M, Berton Q, Mourinet S, Screnci M, Gallot D, Coll G. Diagnosis of medulloblastoma in pregnant women: to continue with the pregnancy or not? A case report and literature review. Neurochirurgie 2023; 69:101443. [PMID: 37061180 DOI: 10.1016/j.neuchi.2023.101443] [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: 01/18/2023] [Revised: 03/12/2023] [Accepted: 03/29/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Medulloblastoma (MB) is an uncommon and challenging diagnosis in pregnant women, and especially in pregnancy after in-vitro fertilization (IVF). Clinical features are easily misinterpreted and mistaken for other more common gestation-related pathologies. We report the case of a 34-year-old patient with clinical symptoms of intracranial hypertension. MB was diagnosed and operated on during the pregnancy. OBJECTIVE To conduct a systematic literature review of other cases of MB operated on during pregnancy, and discuss the clinical and surgical management of MB in pregnancy. METHOD We conducted a systematic literature review according to PRISMA guidelines. RESULTS In addition to the present case, 9 cases of MB were reported as operated on during viable pregnancy. In one case, medical abortion was decided on before surgical debulking. Pregnancy term was between 8 and 30 weeks. The most common symptoms were headache, nausea and vomiting followed by dizziness. Tumor prognosis after treatment was favorable in 6 cases out of 10 and unfavorable in 4, with 3 cases of recurrence and 3 of death. CONCLUSION We report the first case of long-term survival after MB in a woman pregnant via IVF. In standard-risk MB, it is possible to carry the pregnancy to term. Vaginal delivery is not contraindicated a priori. Early diagnosis, close clinical and radiological surveillance and surgery are the key factors for better prognosis. Multidisciplinary collaboration is crucial to determine the best timing and treatment.
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Affiliation(s)
- Feras Sendy
- Service de Gynécologie et d'Obstétrique, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Marta Arrighi
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Quentin Berton
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Shadey Mourinet
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Melina Screnci
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Denis Gallot
- Service de Gynécologie et d'Obstétrique, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France
| | - Guillaume Coll
- Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France; INSERM, CIC 1405, unité CRECHE, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France.
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De Schlichting E, Pech-Gourg G, Jecko V, Lechanoine F, Gimbert E, Zaldivar-Jolissaint JF, Coll G. Posterior Cranial Vault Distraction for Treating Syndromic Brachyturricephaly: A 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2022; 24:e363. [PMID: 36701418 DOI: 10.1227/ons.0000000000000579] [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: 11/22/2021] [Accepted: 10/09/2022] [Indexed: 01/27/2023] Open
Affiliation(s)
| | - Grégoire Pech-Gourg
- Service de Neurochirurgie, Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Vincent Jecko
- Service de Neurochirurgie A, Centre Universitaire de BordeauSx, Bordeaux, France.,Université de Bordeaux, Laboratoire INCIA, CNRS, UMR5287, Bordeaux, France
| | | | - Edouard Gimbert
- Service de Neurochirurgie A, Centre Universitaire de BordeauSx, Bordeaux, France
| | | | - Guillaume Coll
- Service de Neurochirurgie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont Ferrand, France
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Coll G, Arrighi M, Berton Q, Coste A, de Schlichting E, Chazal J, Sakka L, Abed Rabbo F. Mechanical Complications of Sophysa SM8 Shunt in Adult Hydrocephalus: A Monocentric Experience. Oper Neurosurg (Hagerstown) 2022; 23:318-325. [PMID: 36001762 DOI: 10.1227/ons.0000000000000337] [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] [Received: 12/23/2021] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Sophysa SM8 is widely used by neurosurgeons in France. Published studies report shunt malfunction rates in adults between 18% and 29%. However, these studies included multiple valve types and thus entailed a serious confounding factor. OBJECTIVE To ascertain the incidence the Sophysa SM8 cerebrospinal fluid (CSF) shunt malfunctions in adults. METHODS We present a retrospective series of adult patients who underwent CSF shunt placement between 2000 and 2013 with Sophysa SM8. RESULTS In total, 599 patients (329 males and 270 females) were included. The mean age at surgery was 64.15 years (19-90) (SD 16.17; median 68.0). The causes of hydrocephalus were normal pressure hydrocephalus (49%), traumatic hemorrhages (26.5%), tumors (15.7%), cerebral aqueduct stenoses (3%), and arachnoid cysts (2%). The mean follow-up was 3.9 years (0-16) (SD 4.10; median 3 years). The rate of complications was 22.04% (132 of 599). Most frequent causes of complications were disconnection (25%), migration (12.9%), overdrainage (9.1%), and proximal obstruction (6.8%). In 17 cases (12.9%), no failure was diagnosed during revision. Seven infections (5.3%) were reported. The mean delay for the first revision was 1.70 years (0-13.93) (SD 2.67, median 0.35). The risk of shunt failure was 36% at 10 years. Seventeen percent of revisions occurred during the first year after shunt placement. CONCLUSION Disconnections are a very frequent complication of Sophysa SM8 valve. They are related to the 2-connector system of this valve. Based on these results, we recommend using 1-piece valves.
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Affiliation(s)
- Guillaume Coll
- Service de Neurochirurgie B, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Marta Arrighi
- Service de Neurochirurgie B, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Quentin Berton
- Service de Neurochirurgie B, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Aurélien Coste
- Service de Neurochirurgie, CHU Grenoble-Alpes, Grenoble, France
| | | | - Jean Chazal
- Service de Neurochirurgie B, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Laurent Sakka
- Département d'Anatomie et d'Organogenèse, NeuroDol UMR INSERM 1107 CNRS, UFR de Médecine et des Professions Paramédicales, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Francis Abed Rabbo
- Service de Neurochirurgie B, CHU Clermont-Ferrand, Clermont-Ferrand, France
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9
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Coll G, Abed Rabbo F, de Schlichting E, Coste A, Chazal J, Garcier JM, Peyre H, Sakka L. Mechanical complications of cerebrospinal fluid shunt. Differences between adult and pediatric populations: myths or reality? Childs Nerv Syst 2021; 37:2215-2221. [PMID: 33768313 DOI: 10.1007/s00381-021-05125-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Shunt malfunctions seem more frequent in children (44 to 81%) than in adults (18 to 29%). Because of discrepancies between studies, it is not possible to affirm this disparity. The objective was to verify whether the incidence of cerebrospinal fluid (CSF) shunt malfunctions is higher in children than adults. METHODS We present a retrospective series of child and adult patients who underwent CSF shunt placement between 2000 and 2013 with a Sophysa SM8® valve. RESULTS 599 adults and 98 children (sex ratio 1.28) underwent CSF shunt placement. Age at first surgery ranged between 1 day of life and 90 years (mean of 55.8 years, SD 25.8, median 64.8 years). The mean follow-up was 4 years (SD 4.264, 0-16; median 3 years). The cumulative complication rate was 25.5% (178/697). Mechanical complications were disconnection (25.1%), migration (11.8%), intracranial catheter obstruction (8.9%) and malposition (8.4%). The mean delay for the first revision was 1.90 years (0-13.9), (SD 2.73, median 0.5). The probability of shunt failure was 65% at 10 years in the child group and 36% at 10 years in the adult group. Moreover, in the child group, 33% of revisions occurred during the first year after shunt placement versus 17% in the adult group. Thus, the probability of shunt failure was higher in children than in adults (log-rank test, p < 0.001). CONCLUSIONS This is the first retrospective study, comparing children and adults undergoing CSF shunt using the same valve, able to confirm the higher rate of complications in children.
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Affiliation(s)
- Guillaume Coll
- Service de Neurochirurgie B, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, F-63000, Clermont-Ferrand, France
| | - Francis Abed Rabbo
- Service de Neurochirurgie B, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, F-63000, Clermont-Ferrand, France. .,Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, faculté de médecine, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France.
| | | | - Aurélien Coste
- Service de Neurochirurgie B, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, F-63000, Clermont-Ferrand, France
| | - Jean Chazal
- Service de Neurochirurgie B, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, F-63000, Clermont-Ferrand, France.,Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, faculté de médecine, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Jean-Marc Garcier
- Service de Radiologie Pédiatrique, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Hugo Peyre
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75005, Paris, France
| | - Laurent Sakka
- Service de Neurochirurgie B, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, 58 rue Montalembert, F-63000, Clermont-Ferrand, France.,Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, faculté de médecine, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
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10
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Coll G, de Schlichting E, Sakka L, Garcier JM, Peyre H, Lemaire JJ. Assessment of Maturational Changes in White Matter Anisotropy and Volume in Children: A DTI Study. AJNR Am J Neuroradiol 2020; 41:1726-1732. [PMID: 32816761 DOI: 10.3174/ajnr.a6709] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/07/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Anisotropy is a good indicator of white matter fascicle macrostructure and organization but the interpretation of its changes with age remains difficult. The increase of WM fascicle fractional anisotropy with time and its relationship with WM fascicle volume have never been examined during childhood. We studied the maturation of associative WM fascicles during childhood using MR imaging-based DTI. We explored whether the fractional anisotropy increase of the main WM fascicles persists beyond the period of brain growth and is related to WM fascicle volume increase. MATERIALS AND METHODS In a series of 25 healthy children, the fractional anisotropy and volume of 15 associative WM fascicles were calculated. Several regression linear mixed models were used to study maturation parameters (fractional anisotropy, volume, and total telencephalon volume) considered as dependent variables, while age and sex were independent variables (the variable identifying the different WM fascicles was considered as a repeated measure). RESULTS In children older than 8 years of age, WM fascicle fractional anisotropy increased with age (P value = .045) but not its volume (P value = .7) or the telencephalon volume (P value = .16). The time course of WM fascicle fractional anisotropy and volume suggested that each WM fascicle might follow a specific pattern of maturation. CONCLUSIONS The fractional anisotropy increase of several WM fascicles after 8 years of age may not result from an increase in WM fascicle volume. It might be the consequence of other developmental processes such as myelination.
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Affiliation(s)
- G Coll
- Service de Neurochirurgie (G.C.), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France .,Centre National de la Recherche Scientifique (G.C.), SIGMA Clermont, Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - E de Schlichting
- Service de Neurochirurgie (E.d.S.), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - L Sakka
- Service de Neurochirurgie (L.S.), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France.,Laboratoire d'anatomie et d'organogenèse, laboratoire de biophysique sensorielle (L.S.), NeuroDol, faculté de médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - J-M Garcier
- Service de Radiologie Pédiatrique (J.M.-G.), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France.,Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle (J.M.G.), NeuroDol, Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - H Peyre
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Robert Debré (H.P.), Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J-J Lemaire
- Service de Neurochirurgie (J.-J.L.), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France.,Centre National de la Recherche Scientifique (J.-J.L.), SIGMA Clermont, Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
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Di Rocco F, Scavarda D, Vinchon M, Szathmari A, Riffaud L, Bohra A, Blauwblomme T, Boetto S, Gimbert E, Ferrand S, Coca A, Chivoret N, Coll G, Delion M, Roujeau T, Mottolese C, Zerah M. Impact de la pandémie COVID-19 sur la neurochirurgie pédiatrique en France. Neurochirurgie 2020; 66:192-194. [PMID: 32504645 PMCID: PMC7833797 DOI: 10.1016/j.neuchi.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/24/2022]
Affiliation(s)
- F Di Rocco
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France.
| | - D Scavarda
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Vinchon
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Szathmari
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - L Riffaud
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Bohra
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - T Blauwblomme
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - S Boetto
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - E Gimbert
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - S Ferrand
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Coca
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - N Chivoret
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - G Coll
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Delion
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - T Roujeau
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - C Mottolese
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Zerah
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
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- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
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12
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Abed Rabbo F, Kouyoumdjian P, Coste N, Coll G, Sakka L, Dupeyron A. Pelvic parameters and sagittal alignment in people with chronic low back pain and active discopathy (Modic 1 changes): A case-control study. Ann Phys Rehabil Med 2020; 64:101400. [PMID: 32535168 DOI: 10.1016/j.rehab.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Francis Abed Rabbo
- Service de Neurochirurgie B. Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Clermont-Ferrand, France; Département d'Anatomie, UFR de Médecine et des Professions Paramédicales, Université Clermont-Auvergne, Clermont-Ferrand, France.
| | - Pascal Kouyoumdjian
- Service de chirurgie Orthopédique et de la Colonne Vertébrale, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France
| | - Nicolas Coste
- Service de Médecine physique et réadaptation. Centre Hospitalo-Universitaire (CHU) de Clermont-Ferrand, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Guillaume Coll
- Service de Neurochirurgie B. Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Clermont-Ferrand, France
| | - Laurent Sakka
- Service de Neurochirurgie B. Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Clermont-Ferrand, France; Département d'Anatomie, UFR de Médecine et des Professions Paramédicales, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Arnaud Dupeyron
- Service de Médecine Physique & de Réadaptation, CHU Nîmes, Université de Montpellier, Montpellier France
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13
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El Ouadih Y, Coll G, Haro Y, Chaix R. Resolution of isolated syringomyelia after removing thoracic disc herniation. Br J Neurosurg 2020; 34:196-199. [DOI: 10.1080/02688697.2018.1424321] [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] [Indexed: 10/18/2022]
Affiliation(s)
| | - Guillaume Coll
- Neurosurgery, Hopital Gabriel Montpied, Clermont-Ferrand, France
- Image-Guided Clinical Neurosciences and Connectomics (IGCNC), Axe thérapies guidées par l'image (TGI), CNRS, Sigma, Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Yakouba Haro
- Neurosurgery, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | - Remi Chaix
- Neurosurgery, Hopital Gabriel Montpied, Clermont-Ferrand, France
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14
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de Schlichting E, Coll G, Zaldivar-Jolissaint JF, Coste J, Marques AR, Mulliez A, Durif F, Lemaire JJ. Pulse generator battery life in deep brain stimulation: out with the old… in with the less durable? Acta Neurochir (Wien) 2019; 161:2043-2046. [PMID: 31444678 DOI: 10.1007/s00701-019-04043-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Battery life of the most commonly used implantable pulse generators in deep brain stimulation is limited. Device replacement is costly and may expose patients to additional risks. Driven by the observation that in our experience newer generation devices seemed to need earlier replacement than the older generation, we aimed to retrospectively analyze the battery life of two generations of non-rechargeable devices, manufactured by a single company (Medtronic, USA). METHODS Battery life of 281 devices in 165 patients was taken into account for data analysis. This represented 243 older generation devices (Kinetra and Soletra) and 38 newer generation devices (Activa). RESULTS The battery life of older generation stimulators was 2-fold longer than the newer generation. CONCLUSIONS Newer devices are more versatile than the older generation. Their battery life is however significantly shorter. Development of next-generation devices needs to address this issue in order to limit health risks and reduce financial costs.
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15
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Coll G, El Ouadih Y, Abed Rabbo F, Jecko V, Sakka L, Di Rocco F. Hydrocephalus and Chiari malformation pathophysiology in FGFR2-related faciocraniosynostosis: A review. Neurochirurgie 2019; 65:264-268. [PMID: 31525395 DOI: 10.1016/j.neuchi.2019.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/22/2019] [Revised: 08/25/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients with syndromic faciocraniosynostosis due to the mutation of the fibroblast growth factor receptor (FGFR) 2 gene present premature fusion of the coronal sutures and of the cranial base synchondrosis. Cerebrospinal fluid (CSF) circulation disorders and cerebellar tonsil prolapse are frequent findings in faciocraniosynostosis. OBJECTIVE We reviewed the medical literature on the pathophysiological mechanisms of CSF disorders such as hydrocephalus and of cerebellar tonsil prolapse in FGFR2-related faciocraniosynostosis. DISCUSSION Different pathophysiological theories have been proposed, but none elucidated all the symptoms present in Apert, Crouzon and Pfeiffer syndromes. The first theory that addressed CSF circulation disruption was the constrictive theory (cephalocranial disproportion): cerebellum and brain stem are constricted by the small volume of the posterior fossa. The second theory proposed venous hyperpressure due to jugular foramens stenosis. The most recent theory proposed a pressure differential between CSF in the posterior fossa and in the vertebral canal, due to foramen magnum stenosis.
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Affiliation(s)
- G Coll
- Service de Neurochirurgie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, CNRS, SIGMA, Institut Pascal, Clermont-Ferrand, France.
| | - Y El Ouadih
- Service de Neurochirurgie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - F Abed Rabbo
- Service de Neurochirurgie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - V Jecko
- Service de Neurochirurgie, CHU Bordeaux, Bordeaux, France
| | - L Sakka
- Service de Neurochirurgie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, Faculté de Médecine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - F Di Rocco
- Service de Neurochirurgie Pédiatrique, Hôpital Femme Mère Enfant, Lyon, France; Université Claude Bernard, INSERM 1033, Lyon, France
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16
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Lemaire JJ, De Salles A, Coll G, El Ouadih Y, Chaix R, Coste J, Durif F, Makris N, Kikinis R. MRI Atlas of the Human Deep Brain. Front Neurol 2019; 10:851. [PMID: 31507507 PMCID: PMC6718608 DOI: 10.3389/fneur.2019.00851] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/23/2019] [Indexed: 12/15/2022] Open
Abstract
Mastering detailed anatomy of the human deep brain in clinical neurosciences is challenging. Although numerous pioneering works have gathered a large dataset of structural and topographic information, it is still difficult to transfer this knowledge into practice, even with advanced magnetic resonance imaging techniques. Thus, classical histological atlases continue to be used to identify structures for stereotactic targeting in functional neurosurgery. Physicians mainly use these atlases as a template co-registered with the patient's brain. However, it is possible to directly identify stereotactic targets on MRI scans, enabling personalized targeting. In order to help clinicians directly identify deep brain structures relevant to present and future medical applications, we built a volumetric MRI atlas of the deep brain (MDBA) on a large scale (infra millimetric). Twelve hypothalamic, 39 subthalamic, 36 telencephalic, and 32 thalamic structures were identified, contoured, and labeled. Nineteen coronal, 18 axial, and 15 sagittal MRI plates were created. Although primarily designed for direct labeling, the anatomic space was also subdivided in twelfths of AC-PC distance, leading to proportional scaling in the coronal, axial, and sagittal planes. This extensive work is now available to clinicians and neuroscientists, offering another representation of the human deep brain ([https://hal.archives-ouvertes.fr/] [hal-02116633]). The atlas may also be used by computer scientists who are interested in deciphering the topography of this complex region.
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Affiliation(s)
- Jean-Jacques Lemaire
- Service de Neurochirurgie, CHU Clermont-Ferrand, Université Clermont Auvergne, Centre National de la Recherche Scientifique, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Antonio De Salles
- Department of Neurosurgery, Radiation Oncology, HCOR Neuroscience, São Paulo, Brazil
| | - Guillaume Coll
- Service de Neurochirurgie, CHU Clermont-Ferrand, Université Clermont Auvergne, Centre National de la Recherche Scientifique, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Youssef El Ouadih
- Service de Neurochirurgie, CHU Clermont-Ferrand, Université Clermont Auvergne, Centre National de la Recherche Scientifique, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Rémi Chaix
- Service de Neurochirurgie, CHU Clermont-Ferrand, Université Clermont Auvergne, Centre National de la Recherche Scientifique, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Jérôme Coste
- Service de Neurochirurgie, CHU Clermont-Ferrand, Université Clermont Auvergne, Centre National de la Recherche Scientifique, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Franck Durif
- Service de Neurologie, Centre National de la Recherche Scientifique, CHU Clermont-Ferrand, Université Clermont Auvergne, Engineering School SIGMA Clermont, Clermont-Ferrand, France
| | - Nikos Makris
- Surgical Planning Laboratory, Center for Morphometric Analysis, A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA, United States
| | - Ron Kikinis
- Surgical Planning Laboratory, Center for Morphometric Analysis, A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA, United States.,Robert Greenes Distinguished Director of Biomedical Informatics, Brigham and Women's Hospital, Boston, MA, United States.,Computer Science Department, Fraunhofer MEVIS, University of Bremen, Bremen, Germany
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17
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El Ouadih Y, Coll G, Jean B, Coste A, Chaix R, Sakka L, Lemaire JJ. A rare complication of flow diverter: delayed migration causing aneurysm expansion and brainstem compression. Br J Neurosurg 2019:1-4. [PMID: 31130025 DOI: 10.1080/02688697.2019.1617406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Flow-diverting stents (FD) are admitted therapeutic devices for challenging aneurysms. Delayed migrations of FD remain exceptional, particularly with brainstem compression. We report a case of delayed migration of pipeline embolization device (PED) responsible of medulla oblongata compression due to expansion of posterior inferior cerebellar artery (PICA) aneurysm. This is the first report of brainstem compression due to delayed migration of FD. Among the seven previously reported cases of FD delayed migration, two led to death. Our case illustrates the importance of technical issues of stenting and the role of surgery facing the clinical emergency of vascular compression of lower brainstem. We wanted to warn neurosurgeons of this rare and delayed complication, which likely could become less exceptional with the increase of indications and utilizations of FD.
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Affiliation(s)
- Youssef El Ouadih
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
| | - Guillaume Coll
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
| | - Betty Jean
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
| | - Aurélien Coste
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
| | - Rémi Chaix
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
| | - Laurent Sakka
- a Service de Neurochirurgie , CHU Gabriel Montpied , Clermont-Ferrand , France
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Lemaire J, Sontheimer A, Pereira B, Coste J, Rosenberg S, Sarret C, Coll G, Gabrillargues J, Jean B, Gillart T, Coste A, Roche B, Kelly A, Pontier B, Feschet F. Deep brain stimulation in five patients with severe disorders of consciousness. Ann Clin Transl Neurol 2018; 5:1372-1384. [PMID: 30480031 PMCID: PMC6243378 DOI: 10.1002/acn3.648] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/07/2018] [Accepted: 08/22/2018] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The efficacy of deep brain stimulation in disorders of consciousness remains inconclusive. We investigated bilateral 30-Hz low-frequency stimulation designed to overdrive neuronal activity by dual pallido-thalamic targeting, using the Coma Recovery Scale Revised (CRS-R) to assess conscious behavior. METHODS We conducted a prospective, single center, observational 11-month pilot study comprising four phases: baseline (2 months); surgery and titration (1 month); blind, random, crossover, 1.5-month ON and OFF periods; and unblinded, 5-month stimulation ON. Five adult patients were included: one unresponsive-wakefulness-syndrome male (traumatic brain injury); and four patients in a minimally conscious state, one male (traumatic brain injury) and three females (two hemorrhagic strokes and one traumatic brain injury). Primary outcome measures focused on CRS-R scores. Secondary outcome measures focused notably on baseline brain metabolism and variation in activity (stimulation ON - baseline) using normalized fluorodeoxyglucose positron emission tomography maps. Statistical analysis used random-effect models. RESULTS The two male patients (one minimally conscious and one unresponsive wakefulness syndrome) showed improved mean CRS-R scores (stimulation ON vs. baseline), in auditory, visual and oromotor/verbal subscores, and visual subscores respectively. The metabolism of the medial cortices (low at baseline in all five patients) increased specifically in the two responders. INTERPRETATION Our findings show there were robust but limited individual clinical benefits, mainly in visual and auditory processes. Overall modifications seem linked to the modulation of thalamo-cortico-basal and tegmental loops activating default mode network cortices. Specifically, in the two responders there was an increase in medial cortex activity related to internal awareness.
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Affiliation(s)
- Jean‐Jacques Lemaire
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Anna Sontheimer
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Bruno Pereira
- Unité de Biostatistiques (Délégation Recherche Clinique & Innovation)CHU Clermont‐FerrandClermont‐FerrandF‐63000France
| | - Jérôme Coste
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Sarah Rosenberg
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Catherine Sarret
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Guillaume Coll
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Jean Gabrillargues
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
- Service de RadiologieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
| | - Betty Jean
- Service de RadiologieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
| | - Thierry Gillart
- Département d'Anesthésie RéanimationCHU Clermont‐FerrandClermont‐FerrandF‐63000France
| | - Aurélien Coste
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
| | - Basile Roche
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Antony Kelly
- Service de Médecine NucléaireCentre Jean PerrinClermont‐FerrandF‐63000France
| | - Bénédicte Pontier
- Service de NeurochirurgieCHU Clermont‐FerrandClermont‐FerrandF‐63000France
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
| | - Fabien Feschet
- Université Clermont AuvergneCNRS, SIGMA Clermont, Institut PascalClermont‐FerrandF‐63000France
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Sakka L, Delétage N, Chalus M, Aissouni Y, Sylvain-Vidal V, Gobron S, Coll G. Assessment of citalopram and escitalopram on neuroblastoma cell lines. Cell toxicity and gene modulation. Oncotarget 2018; 8:42789-42807. [PMID: 28467792 PMCID: PMC5522106 DOI: 10.18632/oncotarget.17050] [Citation(s) in RCA: 12] [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: 10/07/2016] [Accepted: 03/15/2017] [Indexed: 12/13/2022] Open
Abstract
Selective serotonin reuptake inhibitors (SSRI) are common antidepressants which cytotoxicity has been assessed in cancers notably colorectal carcinomas and glioma cell lines. We assessed and compared the cytotoxicity of 2 SSRI, citalopram and escitalopram, on neuroblastoma cell lines. The study was performed on 2 non-MYCN amplified cell lines (rat B104 and human SH-SY5Y) and 2 human MYCN amplified cell lines (IMR32 and Kelly). Citalopram and escitalopram showed concentration-dependent cytotoxicity on all cell lines. Citalopram was more cytotoxic than escitalopram. IMR32 was the most sensitive cell line. The absence of toxicity on human primary Schwann cells demonstrated the safety of both molecules for myelin. The mechanisms of cytotoxicity were explored using gene-expression profiles and quantitative real-time PCR (qPCR). Citalopram modulated 1 502 genes and escitalopram 1 164 genes with a fold change ≥ 2. 1 021 genes were modulated by both citalopram and escitalopram; 481 genes were regulated only by citalopram while 143 genes were regulated only by escitalopram. Citalopram modulated 69 pathways (KEGG) and escitalopram 42. Ten pathways were differently modulated by citalopram and escitalopram. Citalopram drastically decreased the expression of MYBL2, BIRC5 and BARD1 poor prognosis factors of neuroblastoma with fold-changes of -107 (p<2.26 10−7), -24.1 (p<5.6 10−9) and -17.7 (p<1.2 10−7). CCNE1, AURKA, IGF2, MYCN and ERBB2 were more moderately down-regulated by both molecules. Glioma markers E2F1, DAPK1 and CCND1 were down-regulated. Citalopram displayed more powerful action with broader and distinct spectrum of action than escitalopram.
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Affiliation(s)
- Laurent Sakka
- Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, Faculté de Médecine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France.,Service de Neurochirurgie, Pole RMND, CHU de Clermont-Ferrand, Hôpital Gabriel-Montpied, 63003 Clermont-Ferrand Cedex, France
| | - Nathalie Delétage
- Neuronax SAS, Biopôle Clermont-Limagne, F-63360 Saint-Beauzire, France
| | - Maryse Chalus
- Laboratoire d'Anatomie et d'Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, Faculté de Médecine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Youssef Aissouni
- Laboratoire de Pharmacologie Fondamentale et Clinique de la Douleur, NeuroDol, Faculté de Médecine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | | | - Stéphane Gobron
- Neuronax SAS, Biopôle Clermont-Limagne, F-63360 Saint-Beauzire, France
| | - Guillaume Coll
- Service de Neurochirurgie, Pole RMND, CHU de Clermont-Ferrand, Hôpital Gabriel-Montpied, 63003 Clermont-Ferrand Cedex, France
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Coll G, Lemaire JJ, Di Rocco F, Barthélémy I, Garcier JM, De Schlichting E, Sakka L. Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development. Neurosurgery 2017; 79:722-735. [PMID: 27341342 DOI: 10.1227/neu.0000000000001309] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND To date, no study has compared the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification. OBJECTIVE To illustrate these features in healthy children. METHODS The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan. RESULTS The mean FMA of 6.49 cm in girls was significantly inferior to the FMA of 7.67 cm in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously. CONCLUSION The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P ≤ .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01). ABBREVIATIONS AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years old.
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Affiliation(s)
- Guillaume Coll
- *Service de Neurochirurgie, Hôpital Gabriel Montpied, Clermont-Ferrand, France;‡Laboratoire d'anatomie, Université Clermont Auvergne, Université d'Auvergne, Clermont-Ferrand, France;§Université Clermont Auvergne, Université d'Auvergne, EA 7282, Image Guided Clinical Neurosciences and Connectomics, Clermont-Ferrand, France;¶Unité de Chirurgie Craniofaciale, Service de Neurochirurgie Pédiatrique, Centre de Référence National des Dysostoses Crâniofaciales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France;‖Service de Chirurgie Maxillo-Faciale, Hôpital Estaing, Clermont-Ferrand, France;#Service de Radiologie Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France
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Lemaire JJ, Pereira B, Derost P, Vassal F, Ulla M, Morand D, Coll G, Gabrillargues J, Marques A, Debilly B, Coste J, Durif F. Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts. Surg Neurol Int 2016; 7:S837-S847. [PMID: 27990316 PMCID: PMC5134117 DOI: 10.4103/2152-7806.194066] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/27/2016] [Indexed: 01/24/2023] Open
Abstract
Background: Deep brain stimulation (DBS) in Parkinson's disease uses bi-hemispheric high-frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual-level clinical impact of locations of right-left contact pair-up accounting for each subthalamic nucleus (STN) anatomy. Methods: Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010. Location of contacts was defined relatively to the main axis of STN used to map longitudinal and transversal positions, and STN membership (out meaning out-of-STN). Contact pairings were described via three methods: (i) Unified contact location (UCL) collapsing DBS into an all-in-one contact; (ii) balance of contact pair-up (BCPU), defined as symmetric or asymmetric regardless of laterality; (iii) hemisphere-wise most frequent contact pair-up (MFCP) regardless of BCPU. Clinical data were: mean levodopa equivalent dose, Unified Parkinson's Disease Rating Scale (UPDRS) motor score III without medication, UPDRS II and III speech sub-scores, UPDRS II freezing sub-score, 1 year versus preoperative values, with and without levodopa. Ad-hoc two-sided tests were used for statistical analysis. Results: Worsening speech, was more frequent for UCL_out patients and when the left MFCP contact was rear and/or superolateral, however, it less frequent for BCPU-asymmetric patients. Worsening freezing was more frequent when the right MFCP contact was rear and superolateral. Conclusions: These results point to strategies for minimizing dysarthria and freezing as adverse effects of DBS.
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Affiliation(s)
- Jean-Jacques Lemaire
- Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France; Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France
| | - Bruno Pereira
- Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France; Biostatistics, Clinical Research Direction, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Derost
- Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - François Vassal
- Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France
| | - Miguel Ulla
- Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Dominique Morand
- Biostatistics, Clinical Research Direction, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Guillaume Coll
- Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France; Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France
| | - Jean Gabrillargues
- Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France; Service of Radiology, Neuroradiology Unit, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Ana Marques
- Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Bérangère Debilly
- Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jérôme Coste
- Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France; Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France
| | - Franck Durif
- Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
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Zerroug A, Gabrillargues J, Coll G, Vassal F, Jean B, Chabert E, Claise B, Khalil T, Sakka L, Feschet F, Durif F, Boyer L, Coste J, Lemaire JJ. Personalized mapping of the deep brain with a white matter attenuated inversion recovery (WAIR) sequence at 1.5-tesla: Experience based on a series of 156 patients. Neurochirurgie 2016; 62:183-9. [PMID: 27236731 DOI: 10.1016/j.neuchi.2016.01.009] [Citation(s) in RCA: 6] [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: 10/19/2015] [Revised: 12/29/2015] [Accepted: 01/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Deep brain mapping has been proposed for direct targeting in stereotactic functional surgery, aiming to personalize electrode implantation according to individual MRI anatomy without atlas or statistical template. We report our clinical experience of direct targeting in a series of 156 patients operated on using a dedicated Inversion Recovery Turbo Spin Echo sequence at 1.5-tesla, called White Matter Attenuated Inversion Recovery (WAIR). METHODS After manual contouring of all pertinent structures and 3D planning of trajectories, 312 DBS electrodes were implanted. Detailed anatomy of close neighbouring structures, whether gray nuclei or white matter regions, was identified during each planning procedure. We gathered the experience of these 312 deep brain mappings and elaborated consistent procedures of anatomical MRI mapping for pallidal, subthalamic and ventral thalamic regions. We studied the number of times the central track anatomically optimized was selected for implantation of definitive electrodes. RESULTS WAIR sequence provided high-quality images of most common functional targets, successfully used for pure direct stereotactic targeting: the central track corresponding to the optimized primary anatomical trajectory was chosen for implantation of definitive electrodes in 90.38%. CONCLUSION WAIR sequence is anatomically reliable, enabling precise deep brain mapping and direct stereotactic targeting under routine clinical conditions.
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Affiliation(s)
- A Zerroug
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - J Gabrillargues
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - G Coll
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Vassal
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - B Jean
- Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - E Chabert
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Claise
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - T Khalil
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - L Sakka
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Feschet
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - F Durif
- Service of neurology, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - L Boyer
- Service of radiology, CHU de Clermont-Ferrand, 63003 Clemront-Ferrand, France
| | - J Coste
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-J Lemaire
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
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Abstract
Abstract
BACKGROUND
The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis.
OBJECTIVE
This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications. It examines their involvement in spinal cord development, functioning, and repair.
METHODS
This work is a review of the literature using PubMed as a search engine on Medline.
RESULTS
The stages followed by the meninges along the phylogenesis could not be easily compared with their development in vertebrates for methodological aspects and convergence processes throughout evolution. The distinction between arachnoid and pia mater appeared controversial. Several points of descriptive anatomy remain debatable: the functional organization of the arterial network, and the venous and lymphatic drainages, considered differently by classical anatomic and neuroradiological approaches. Spinal meninges are involved in neurodevelopment and neurorepair producing neural stem cells and morphogens, in cerebrospinal fluid dynamics and neuraxis functioning by the synthesis of active molecules, and the elimination of waste products of central nervous system metabolism.
CONCLUSION
The spinal meninges should be considered as dynamic functional formations evolving over a lifetime, with ultrastructural features and functional interactions with the neuraxis remaining not fully understood.
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Affiliation(s)
- Laurent Sakka
- Laboratoire d'Anatomie, Université Clermont Auvergne, Université d'Auvergne, Clermont-Ferrand, France
- Service de Neurochirurgie, Pole RMND, CHU Gabriel Montpied, Clermont-Ferrand, France
- Neurosensory Biophysics, INSERM Unit 1107, University of Auvergne, France
| | - Jean Gabrillargues
- Service de Neuroradiologie, Pole RMND, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Guillaume Coll
- Laboratoire d'Anatomie, Université Clermont Auvergne, Université d'Auvergne, Clermont-Ferrand, France
- Service de Neurochirurgie, Pole RMND, CHU Gabriel Montpied, Clermont-Ferrand, France
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Coll G, Arnaud E, Collet C, Brunelle F, Sainte-Rose C, Di Rocco F. Skull base morphology in fibroblast growth factor receptor type 2-related faciocraniosynostosis: a descriptive analysis. Neurosurgery 2015; 76:571-83; discussion 583. [PMID: 25886248 DOI: 10.1227/neu.0000000000000676] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Children with faciocraniosynostosis present skull base abnormalities and may develop hydrocephalus or cerebellar tonsils ectopia (CTE). Several pathophysiological hypotheses were formulated in the past decades to explain these associations. However, no study has described in a genetically homogeneous population with confirmed fibroblast growth factor receptor type 2 (FGFR2) mutation eventual correlations between skull base abnormalities and hydrocephalus or CTE. OBJECTIVE To illustrate these features in children <2 years of age with a genetically confirmed FGFR2-related faciocraniosynostosis. METHODS We measured the foramen magnum area (FMA) and its sagittal and transversal components: the right, left, and mean area of the jugular foramen; the posterior fossa volume; and the cerebellar volume on preoperative millimetric computed tomography scan slices in 31 children with an FGFR2 mutation (14 with Crouzon syndrome, 11 with Apert syndrome, and 6 with Pfeiffer syndrome). They were compared with 17 children without synostosis. All children were <24 months of age. We correlated all these measures with the presence of hydrocephalus or CTE. RESULTS We observed a significantly small FMA in children with Crouzon (P = .03) and in children with Pfeiffer (P = .05) resulting from a reduced sagittal diameter (P = .02 for Crouzon and P = .002 for Pfeiffer). Hydrocephalus was associated with small FMA (P = .02). The jugular foramen area, posterior fossa volume, and cerebellar volume were not associated with hydrocephalus or CTE. Hydrocephalus and CTE were statistically associated (P = .002). CONCLUSION Hydrocephalus in FGFR2-related Crouzon and Pfeiffer syndromes is statistically associated with a small FMA. Hydrocephalus is statistically associated with CTE.
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Affiliation(s)
- Guillaume Coll
- *Unité de Chirurgie Craniofaciale, Service de Neurochirurgie Pédiatrique, Centre de Référence National des Dysostoses Crâniofaciales, Hôpital Necker-Enfants Malades, APHP, Paris, France; ‡Service de Neurochirurgie, Hôpital Gabriel Montpied, Clermont-Ferrand, France; §Laboratoire d'anatomie, UFR Médecine, Universite[Combining Acute Accent] d'Auvergne, Clermont-Ferrand, France; ¶Image-Guided Clinical Neuroscience and Connectomics, EA 7282, UFR Médecine, Université Clermont 1, Universite d'Auvergne, Clermont-Ferrand, France; ‖Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, APHP, Paris, France; #Département de Radiologie, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Coll G, Combes JD, Isfan F, Rochette E, Chazal J, Lemaire JJ, de Schlichting E, Kanold J. Incidence and survival of childhood central nervous system tumors: A report of the regional registry of childhood cancers in Auvergne-Limousin. Neurochirurgie 2015; 61:237-43. [PMID: 26123613 DOI: 10.1016/j.neuchi.2015.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Central nervous system tumors (CNST) are the most lethal of solid tumors in childhood cancer. PATIENTS AND METHODS We report incidence and survival data for all CNST (International Classification of Diseases for Oncology third edition, category III or Xa) recorded in children under 15 years of age by the Auvergne-Limousin cancer registry for the period 1986-2009. RESULTS Annual incidence of all CNST was 3.27 per 100,000 and the male to female ratio was 0.95. Over 45.0% of CNST were glial. Astrocytomas (36.2%) showed the highest incidence for each age group except between 1 and 4 years where embryonal tumors were more common. For all CNST, no significant variation in incidence over time was observed for the evaluated period of 23 years (annual percent change: -0.4%, 95% CI, [-2.8-2.1]). Globally, 5 years overall survival was 67% [59-73] and had increased by more than 16% between 1986-1999 and 2000-2009, mainly due to better survival for astrocytomas, other gliomas, ependymomas and choroid plexus tumors (P=0.01). CONCLUSION We report that the incidence of CNST in Auvergne-Limousin is similar to that in the literature and did not increase between 1986 and 2009. In addition, 5 years overall survival increased after 1999, especially for surgically treatable tumors.
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Affiliation(s)
- G Coll
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, BP 69, 58, rue Montalembert, 63001 Clermont-Ferrand, France; Université Clermont Auvergne, université d'Auvergne, BP 10448, 63000 Clermont-Ferrand, France.
| | - J-D Combes
- International Agency for Research on Cancer, 69372 Lyon, France
| | - F Isfan
- Centre régional de cancérologie et thérapie cellulaire pédiatrique, hôpital Estaing, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France; Unité CRECHE Inserm-CIC 1405, 63003 Clermont-Ferrand, France
| | - E Rochette
- Centre régional de cancérologie et thérapie cellulaire pédiatrique, hôpital Estaing, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France; Unité CRECHE Inserm-CIC 1405, 63003 Clermont-Ferrand, France
| | - J Chazal
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, BP 69, 58, rue Montalembert, 63001 Clermont-Ferrand, France; Université Clermont Auvergne, université d'Auvergne, BP 10448, 63000 Clermont-Ferrand, France
| | - J-J Lemaire
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, BP 69, 58, rue Montalembert, 63001 Clermont-Ferrand, France; Université Clermont Auvergne, université d'Auvergne, BP 10448, 63000 Clermont-Ferrand, France
| | - E de Schlichting
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, BP 69, 58, rue Montalembert, 63001 Clermont-Ferrand, France
| | - J Kanold
- Centre régional de cancérologie et thérapie cellulaire pédiatrique, hôpital Estaing, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France; Unité CRECHE Inserm-CIC 1405, 63003 Clermont-Ferrand, France; Université Clermont Auvergne, université d'Auvergne, BP 10448, 63000 Clermont-Ferrand, France
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Lemaire JJ, Delom C, Coste A, Khalil T, Jourdy JC, Pontier B, Gabrillargues J, Sinardet D, Chabanne A, Achim V, Sakka L, Coste J, Chazal J, Salagnac A, Coll G, Irthum B. [Medico-economic analysis of a neurosurgery department at a university hospital]. Neurochirurgie 2015; 61:2-15. [PMID: 25665774 DOI: 10.1016/j.neuchi.2014.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/10/2014] [Revised: 10/29/2014] [Accepted: 11/11/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. MATERIAL AND METHODS Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. RESULTS The average annual, analytic income statement was +1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. CONCLUSION Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value.
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Affiliation(s)
- J-J Lemaire
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France.
| | - C Delom
- Direction des finances, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - A Coste
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - T Khalil
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-C Jourdy
- Département d'information médicale, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Pontier
- Coordination soins de suite et réadaptation, agence régional de santé - Auvergne, 63057 Clermont-Ferrand, France
| | - J Gabrillargues
- Unité de neuroradiologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - D Sinardet
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - A Chabanne
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - V Achim
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - L Sakka
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J Coste
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J Chazal
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - A Salagnac
- Délégation à la recherche clinique & à l'innovation, direction générale adjointe, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - G Coll
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
| | - B Irthum
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 51, rue Montalembert, 63003 Clermont-Ferrand, France
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Chaix R, Coste A, Botella C, Loit M, De Schlichting E, Coll G, Irthum B, Lemaire J. Étude de paramètres de tractographie d’imagerie par tenseur de diffusion des nerfs trijumeaux chez des sujets sains. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.058] [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: 11/17/2022]
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Lemaire JJ, Pereira B, Derost P, Coste J, Ulla M, Morand D, Gabrillargues J, Coll G, Durif F. Étude rétrospective de la localisation des contacts effectifs sous-thalamiques chez 53 parkinsoniens sévères : analyse des couples de contacts par une approche unifiée (droit-gauche) et indépendante (droit et gauche). Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.024] [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: 11/26/2022]
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Lemaire JJ, Nezzar H, Sakka L, Boirie Y, Fontaine D, Coste A, Coll G, Sontheimer A, Sarret C, Gabrillargues J, De Salles A. Maps of the adult human hypothalamus. Surg Neurol Int 2013; 4:S156-63. [PMID: 23682342 PMCID: PMC3654779 DOI: 10.4103/2152-7806.110667] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [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: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 01/14/2023] Open
Abstract
The human hypothalamus is a small deeply located region placed at the crossroad of neurovegetative, neuroendocrine, limbic, and optic systems. Although deep brain stimulation techniques have proven that it could be feasible to modulate these systems, targeting the hypothalamus and in particular specific nuclei and white bundles, is still challenging. Our goal was to make a synthesis of relevant topographical data of the human hypothalamus, under the form of magnetic resonance imaging maps useful for mastering its elaborated structure as well as its neighborhood. As from 1.5 Tesla, Inversion-Recovery sequence allows locating the hypothalamus and most of its components. Spotting hypothalamic compartments is possible according to specific landmarks: the anterior commissure, the mammillary bodies, the preoptic recess, the infundibular recess, the crest between the preoptic and the infundibular recesses, the optical tract, the fornix, and the mammillo-thalamic bundle. The identification of hypothalamus and most of its components could be useful to allow the quantification of local pathological processes and to target specific circuitry to alleviate severe symptoms, using physical or biological agents.
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Affiliation(s)
- Jean-Jacques Lemaire
- Univ Clermont 1, UFR Médecine, EA 7282, Image-Guided Clinical Neuroscience and Connectomics, Clermont-Ferrand, F-63001, France ; Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, F-63003, France
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Sakka L, Coll G, Chazal J. Anatomy and physiology of cerebrospinal fluid. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:309-16. [PMID: 22100360 DOI: 10.1016/j.anorl.2011.03.002] [Citation(s) in RCA: 382] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 03/28/2011] [Indexed: 12/21/2022]
Abstract
The cerebrospinal fluid (CSF) is contained in the brain ventricles and the cranial and spinal subarachnoid spaces. The mean CSF volume is 150 ml, with 25 ml in the ventricles and 125 ml in subarachnoid spaces. CSF is predominantly, but not exclusively, secreted by the choroid plexuses. Brain interstitial fluid, ependyma and capillaries may also play a poorly defined role in CSF secretion. CSF circulation from sites of secretion to sites of absorption largely depends on the arterial pulse wave. Additional factors such as respiratory waves, the subject's posture, jugular venous pressure and physical effort also modulate CSF flow dynamics and pressure. Cranial and spinal arachnoid villi have been considered for a long time to be the predominant sites of CSF absorption into the venous outflow system. Experimental data suggest that cranial and spinal nerve sheaths, the cribriform plate and the adventitia of cerebral arteries constitute substantial pathways of CSF drainage into the lymphatic outflow system. CSF is renewed about four times every 24 hours. Reduction of the CSF turnover rate during ageing leads to accumulation of catabolites in the brain and CSF that are also observed in certain neurodegenerative diseases. The CSF space is a dynamic pressure system. CSF pressure determines intracranial pressure with physiological values ranging between 3 and 4 mmHg before the age of one year, and between 10 and 15 mmHg in adults. Apart from its function of hydromechanical protection of the central nervous system, CSF also plays a prominent role in brain development and regulation of brain interstitial fluid homeostasis, which influences neuronal functioning.
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Affiliation(s)
- L Sakka
- Laboratoire d'anatomie, faculté de médecine, université d'Auvergne, 28, place Henri-Dunant, 63001 Clermont-Ferrand cedex 1, France.
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Foguet Q, Coll G, Rodriguez A. Response to "Are Retinal Examinations Useful in Assessing Cardiovascular Risk?". Am J Hypertens 2008. [DOI: 10.1038/ajh.2008.200] [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: 11/09/2022] Open
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Blumenkranz MS, Ohana E, Shaikh S, Chang S, Coll G, Morse LS, De Bustros S. Adjuvant methods in macular hole surgery: intraoperative plasma-thrombin mixture and postoperative fluid-gas exchange. Ophthalmic Surg Lasers 2001; 32:198-207. [PMID: 11371086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND AND OBJECTIVE The optimal method for surgical management of idiopathic macular holes remains unknown. Adjuvant methods including intraoperative cytokines and postoperative fluid-gas exchange with and without laser have been described. We report on the safety and final results of routine intraoperative autologous plasma-thrombin mixture and postoperative fluid-gas exchange when necessary as an adjunct to the surgical therapy of this disease. PATIENTS AND METHODS A consecutive series of 114 patients (mean age 66.9 years) with primary idiopathic full thickness Stage II, III, and IV macular holes were primarily treated by vitrectomy, fluid/perfluorocarbon gas exchange, and application of autologous plasma-thrombin mixture to the macular hole. Visible epiretinal membranes were peeled but the normal appearing internal limiting membrane was not routinely stripped. Outcome measures included final Snellen visual acuity, rate of macular hole closure, complications, and number of supplemental procedures performed. RESULTS Closed at one month, were 110 of 121 (91%) macular holes, including two that underwent repeat fluid/gas exchange and laser within the first two weeks after surgery. At the time of final follow-up (mean: 10.9 months), 110 of 121 (91%) macular holes were closed. This included 8 of 9 eyes that had reopening of the macular hole between one and 21 months successfully treated by repeat fluid-gas exchange and 2 eyes that underwent a second successful pars plana vitrectomy, membrane peeling, and repeat fluid-gas exchange. Overall, 98 of 121 eyes overall (81%) were successfully treated by a single surgery; 94 of 121 (78%) achieved two lines or greater of visual improvement; 83 of 121 (69%) achieved 20/70 or better vision; and 47 eyes (39%) achieved 20/40 or better vision. Complications in this series included infectious endophthalmitis (1 eye), intraoperative retinal break (2 eyes), late retinal detachment (5 eyes), transient mild intraocular pressure elevation (46 eyes), inflammatory response (six eyes), epiretinal membrane (6 eyes), intraretinal hemorrhages (1 eye), and cataract (33 of 99 phakic eyes underwent cataract extraction during the follow-up). CONCLUSION A combination of intravitreal perfluorocarbon gas and autologous plasma-thrombin mixture (tissue glue) was well tolerated in most patients and did not result in any specific long-term complications. The use of supplemental fluid-gas exchange when necessary improved the final success rate. Further well-controlled and randomized studies will be required to determine the efficacy of this as an adjunct or alternative to other methods of treatment for macular holes.
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Affiliation(s)
- M S Blumenkranz
- Department of Ophthalmology, Stanford University Medical Center, California 94305, USA.
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Martorell L, Virgos C, Valero J, Coll G, Figuera L, Joven J, Pocoví M, Labad A, Vilella E. Schizophrenic women with the APOE epsilon 4 allele have a worse prognosis than those without it. Mol Psychiatry 2001; 6:307-10. [PMID: 11326299 DOI: 10.1038/sj.mp.4000855] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2000] [Revised: 11/13/2000] [Accepted: 11/15/2000] [Indexed: 11/09/2022]
Abstract
The epsilon 4 allele of APOE is generally accepted to be a risk factor in Alzheimer's disease and it has been related to other neuropsychiatric disorders, including schizophrenia. The results of several case-control studies have been inconclusive. To shed more light on this issue we carried out an association study that compared the APOE common variant in a group of 365 schizophrenia patients and 584 controls. We found no differences in the genotype distributions and allele frequencies of patients and controls. In the group of patients, we also analysed the possible influence of the epsilon 4 allele in the clinical variables. The most important findings are that the age at onset (AAO) of epsilon 4+ schizophrenic women, those that have one or two epsilon 4 alleles, is 4 years earlier than that of epsilon 4- women and their risk of suffering a negative syndrome subtype is four times greater. This was not found in schizophrenic men. Our results show that the APOE variant is not a risk factor for developing schizophrenia but that it may modulate its phenotypic expression in a sex-dependent manner.
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Affiliation(s)
- L Martorell
- Departament de Formació i Investigació, Hospital Psiquiàtric Universitari Institut Pere Mata, Ctra de I'Institut Pere Mata s/n, 43206 Reus, Spain
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Abstract
In this paper we review the current status of intravascular ultrasound. Data from qualitative and quantitative studies is presented. Our experimental findings and those of other investigators are reviewed. Intravascular ultrasound has been shown to delineate normal and abnormal arterial morphology as well as to identify and differentiate fibrous, lipid-rich, calcified plaques and complicated plaques. Quantitative studies show strong correlations between ultrasound and histology for lumen area, wall thickness, and plaque area. In vivo studies from our experimental work and clinical laboratory as well as the work of other researchers is presented. This data supports the potential of ultrasound imaging for guidance of intravascular intervention. The potential advantages and limitations of this new technology are discussed. This methodology shows promise for the assessment of the extent and severity of atherosclerosis, monitoring its progression and regression and guiding intravascular plaque ablation technologies.
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Affiliation(s)
- R J Siegel
- Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048
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Corcino JJ, Coll G, Klipstein FA. Pteroylglutamic acid malabsorption in tropical sprue. Blood 1975; 45:577-80. [PMID: 803848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Pteroylglutamic acid (PGA) absorption was assessed in ten untreated tropical sprue (TS) and eight control subjects utilizing a marker perfusion technique. Physiologic concentrations of the vitamin (25 ng/ml) dissolved in iso-osmotic solutions containing either mannitol of glucose at a concentration of 55.6 mM were perfused on each subject on two consecutive days. A statistically significant difference in PGA absorption between TS and control subjects was obtained only when glucose was present in the perfusate. Thus, unequivocal malabsorption of PGA is demonstrable in all subjects with TS when more refined techniques than the ones applied heretofore are utilized.
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