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Savagner J, Ducassou A, Cabarrou B, Hangard G, Gambart M, Bertozzi AI, Baudou E, Boetto S, Larrieu D, Laprie A. Helical tomotherapy craniospinal irradiation in primary brain tumours: Toxicities and outcomes in a peadiatric and adult population. Clin Transl Radiat Oncol 2024; 46:100777. [PMID: 38628594 PMCID: PMC11019098 DOI: 10.1016/j.ctro.2024.100777] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Objective As craniospinal irradiation (CSI) is delivered more frequently by helical tomotherapy (HT) with few reports about late effects, we analysed all patients treated in our centre over an 11-year period. Methods and materials Our study included all patients that underwent CSI by HT, between September 2009 and January 2020, in the Department of Radiation Oncology of the Toulouse Cancer Institute. Acute radiotherapy toxicities were reported and medium- to long-term outcomes analysed. Results Among the 79 patients included, 70.9 % were younger than 18 years at diagnosis, the median age was 13 (range: 1-52) at the time of radiation therapy, 67.1 % of patients had medulloblastoma. Half of them (49.4 %) had a metastatic disease at diagnosis. The median dose of CSI was 36 Gy (range, 18-36). Seventy-seven patients received a radiation boost to the original location of the primary tumour (97.5 %), 32 patients also received a boost to their metastatic sites (40.5 %). Median follow-up was 55.5 months (95 %CI = [41.2; 71.8]). The 3-year event-free survival rate was 66.3 % (95 %CI = [54.2; 75.9]). Most patients presented with acute haematological toxicities during CSI (85.9 %), predominantly severe thrombocytopenia (39.7 %). Among the 64 patients assessed for medium- and long-term outcomes, 52 survived and 47 were alive and disease-free at the latest follow-up visit on record. There were 3.8 % secondary tumours: two meningiomas and one diffuse intrinsic pontine glioma. Adult and paediatric patients respectively presented with secondary cataract (4.3 % vs 22.0 %), persistent hearing disorders (26.1 % vs 29.3 %), pulmonary or cardiac late effects (4.3 % vs 2.4 %), hormonal pituitary gland deficiencies (30.0 % vs 56.8 %) and psycho-cognitive disorders (56.5 % vs 53.7 %). Conclusion CSI dispensed by HT, did not result in any additional acute or late toxicities when compared to 3D-CSI. There was no increase in the secondary tumour rate compared to that reported in the literature.
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Affiliation(s)
- Julie Savagner
- Department of Paediatric Neurology, Children’s Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France
| | - Anne Ducassou
- Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France
| | - Bastien Cabarrou
- Department of Biostatistics, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France
| | - Gregory Hangard
- Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France
| | - Marion Gambart
- Department of Paediatric Oncology, Children’s Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France
| | - Anne-Isabelle Bertozzi
- Department of Paediatric Oncology, Children’s Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France
| | - Eloise Baudou
- Department of Paediatric Neurology, Children’s Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France
| | - Sergio Boetto
- Department of Neurosurgery, Toulouse University Hospital, Pierre-Paul Riquet Hospital, Place du Docteur Baylac, Toulouse, France
| | - Delphine Larrieu
- Department of Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France
| | - Anne Laprie
- Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France
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Laprie A, Noel G, Chaltiel L, Truc G, Sunyach MP, Charissoux M, Magne N, Auberdiac P, Biau J, Ken S, Tensaouti F, Khalifa J, Sidibe I, Roux FE, Vieillevigne L, Catalaa I, Boetto S, Uro-Coste E, Supiot S, Bernier V, Filleron T, Mounier M, Poublanc M, Olivier P, Delord JP, Cohen-Jonathan-Moyal E. Randomized phase III trial of metabolic imaging-guided dose escalation of radio-chemotherapy in patients with newly diagnosed glioblastoma (SPECTRO GLIO trial). Neuro Oncol 2024; 26:153-163. [PMID: 37417948 PMCID: PMC10768994 DOI: 10.1093/neuonc/noad119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/30/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Glioblastoma (GBM) systematically recurs after a standard 60 Gy radio-chemotherapy regimen. Since magnetic resonance spectroscopic imaging (MRSI) has been shown to predict the site of relapse, we analyzed the effect of MRSI-guided dose escalation on overall survival (OS) of patients with newly diagnosed GBM. METHODS In this multicentric prospective phase III trial, patients who had undergone biopsy or surgery for a GBM were randomly assigned to a standard dose (SD) of 60 Gy or a high dose (HD) of 60 Gy with an additional simultaneous integrated boost totaling 72 Gy to MRSI metabolic abnormalities, the tumor bed and residual contrast enhancements. Temozolomide was administered concomitantly and maintained for 6 months thereafter. RESULTS One hundred and eighty patients were included in the study between March 2011 and March 2018. After a median follow-up of 43.9 months (95% CI [42.5; 45.5]), median OS was 22.6 months (95% CI [18.9; 25.4]) versus 22.2 months (95% CI [18.3; 27.8]) for HD, and median progression-free survival was 8.6 (95% CI [6.8; 10.8]) versus 7.8 months (95% CI [6.3; 8.6]), in SD versus HD, respectively. No increase in toxicity rate was observed in the study arm. The pseudoprogression rate was similar across the SD (14.4%) and HD (16.7%) groups. For O(6)-methylguanine-DNA methyltransferase (MGMT) methylated patients, the median OS was 38 months (95% CI [23.2; NR]) for HD patients versus 28.5 months (95% CI [21.1; 35.7]) for SD patients. CONCLUSION The additional MRSI-guided irradiation dose totaling 72 Gy was well tolerated but did not improve OS in newly diagnosed GBM. TRIAL REGISTRATION NCT01507506; registration date: December 20, 2011. https://clinicaltrials.gov/ct2/show/NCT01507506?cond=NCT01507506&rank=1.
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Affiliation(s)
- Anne Laprie
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Leonor Chaltiel
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Gilles Truc
- Centre Georges-François Leclerc, Dijon, France
| | | | | | - Nicolas Magne
- Institut de Cancérologie de la Loire, Saint-Priest en Jarez, France
| | | | - Julian Biau
- Centre Jean-Perrin, Clermont-Ferrand, France
| | - Soléakhéna Ken
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, RadOpt-CRCT-INSERM, Toulouse, France
| | - Fatima Tensaouti
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole & ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Jonathan Khalifa
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | | | - Franck-Emmanuel Roux
- Centre Hospitalier Universitaire de Toulouse, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Laure Vieillevigne
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | | | - Sergio Boetto
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Emmanuelle Uro-Coste
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, RadOpt-CRCT-INSERM, Toulouse, France
| | - Stéphane Supiot
- Institut de Cancerologie de l’Ouest, Nantes st Herblain, France
| | - Valérie Bernier
- Institut de Cancérologie de Lorraine Centre Alexis Vautrin, Nancy, France
| | - Thomas Filleron
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Muriel Mounier
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Muriel Poublanc
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Pascale Olivier
- Service de Pharmacologie Médicale et Clinique, Centre Régional de Pharmacovigilance, de Pharmacoépidémiologie et d’Information sur le Médicament CHU de Toulouse, Toulouse, France
| | - Jean-Pierre Delord
- Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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El Sayed Ahmad Y, Gallois Y, Sol JC, Boetto S, Attal J, Sabatier J, Debs R, Deguine O, Marx M. Evolution in the management of vestibular schwannoma: a single-center 15-year experience. Eur Arch Otorhinolaryngol 2023; 280:4885-4894. [PMID: 37195345 DOI: 10.1007/s00405-023-08009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/08/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS. METHODS Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021. RESULTS 1819 decisions were analyzed (average age 59.25, 54% females). Overall, 850 (47%) cases were allocated to a Wait and Scan (WS) approach, 416 (23%) received radiotherapy and 553 (30%) were treated surgically (MS). All stages considered WS increased from 39% before 2010 to 50% after 2010. Similarly, Stereotactic Radio Therapy (SRT) increased from 5 to 18%. MS decreased from 46 to 25%. It was more commonly proposed to younger patients and larger tumors, p < 0.001. For Koos stages 1, 2, and 3 there was a statistically significant increase in SRT, and a decrease in MS, p < 0.001. WS also increased for stages 1 and 2. However, such a trend was not observed for stage 3. MS remained the primary treatment modality for stage 4 tumors throughout the study period, p = 0.057. The significance of advanced age as a factor favoring SRT decreased over time. The opposite is true for serviceable hearing. There was also a decrease in the percentage of the justification "young age" in the MS category. CONCLUSION The is a continuing trend towards non-surgical treatment. Small- to medium-sized VS witnessed an increase in both WS and SRT. There is only an increase in SRT for moderately large VS. Physicians are less and less considering young age as a factor favoring MS over SRT. There is a tendency towards favoring SRT when hearing is serviceable.
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Affiliation(s)
- Youssef El Sayed Ahmad
- Department of Otology, Otoneurology and Pediatric Otolaryngology, Pierre-Paul Riquet Hospital, Toulouse University hospital, Toulouse, France.
| | - Yohan Gallois
- Department of Otology, Otoneurology and Pediatric Otolaryngology, Pierre-Paul Riquet Hospital, Toulouse University hospital, Toulouse, France
| | | | - Sergio Boetto
- Neuro-Surgery Department, CHU de Toulouse, Purpan, 31000, Toulouse, France
| | - Justine Attal
- Radiotherapy Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Jean Sabatier
- Department of Neuroradiology, Purpan Hospital, Toulouse, France
| | - Rachel Debs
- Department of Neurology, Pierre-Paul Riquet/Purpan University Hospital, Toulouse, France
| | - Olivier Deguine
- Department of Otology, Otoneurology and Pediatric Otolaryngology, Pierre-Paul Riquet Hospital, Toulouse University hospital, Toulouse, France
| | - Mathieu Marx
- Department of Otology, Otoneurology and Pediatric Otolaryngology, Pierre-Paul Riquet Hospital, Toulouse University hospital, Toulouse, France
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Tauziède-Espariat A, Siegfried A, Uro-Coste E, Nicaise Y, Castel D, Sevely A, Gambart M, Boetto S, Hasty L, Métais A, Chrétien F, Benzakoun J, Puget S, Grill J, Dangouloff-Ros V, Boddaert N, Ebrahimi A, Varlet P. Disseminated diffuse midline gliomas, H3K27-altered mimicking diffuse leptomeningeal glioneuronal tumors: a diagnostical challenge! Acta Neuropathol Commun 2022; 10:119. [PMID: 35986414 PMCID: PMC9392342 DOI: 10.1186/s40478-022-01419-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
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Mazerand E, Benichi S, Taverne M, Paternoster G, Rolland A, Antherieu P, Todeschi J, Kamdem Noumoye L, Gilard V, Bretonnier M, Fournier LL, Jecko V, Gimbert E, Proust F, Boetto S, Roujeau T, James S, Khonsari RH, Riffaud L, Delion M, Zerah M, Scavarda D. Chiari malformation type I surgery in children: French multicenter 10-year cohort. J Neurosurg Pediatr 2022; 30:210-216. [PMID: 35916100 DOI: 10.3171/2022.4.peds21410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 04/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Chiari malformation type I (CM-I) is frequent in children and remains a surgical challenge. Several techniques have been described for posterior fossa decompression. No decision algorithm has been validated, and strategies are highly variable between institutions. The goal of this study was to define therapeutic guidelines that take into consideration patient specificities. METHODS The authors retrospectively collected data from patients who were < 18 years of age, were diagnosed with CM-I, and were treated surgically between 2008 and 2018 in 8 French pediatric neurosurgical centers. Data on clinical features, morphological parameters, and surgical techniques were collected. Clinical outcomes at 3 and 12 months after surgery were assessed by the Chicago Chiari Outcome Scale. The authors used a hierarchical clustering method to define clusters of patients by considering their anatomical similarities, and then compared outcomes between surgical strategies in each of these clusters. RESULTS Data from 255 patients were collected. The mean age at surgery was 9.6 ± 5.0 years, syringomyelia was reported in 60.2% of patients, the dura mater was opened in 65.0% of patients, and 17.3% of patients underwent a redo surgery for additional treatment. The mean Chicago Chiari Outcome Scale score was 14.4 ± 1.5 at 3 months (n = 211) and 14.6 ± 1.9 at 12 months (n = 157). The hierarchical clustering method identified three subgroups with potentially distinct mechanisms underlying tonsillar herniation: bony compression, basilar invagination, and foramen magnum obstruction. Each cluster matched with specific outcomes. CONCLUSIONS This French multicenter retrospective cohort study enabled the identification of three subgroups among pediatric patients who underwent surgery for CM-I, each of which was associated with specific outcomes. This morphological classification of patients might help in understanding the underlying mechanisms and providing personalized treatment.
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Affiliation(s)
| | - Sandro Benichi
- 2Department of Pediatric Neurosurgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris
| | - Maxime Taverne
- 3Craniofacial Growth and Form, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris
| | - Giovanna Paternoster
- 2Department of Pediatric Neurosurgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris.,12Department of Pediatric Neurosurgery, CHU Timone Enfant, Marseille, France
| | - Alice Rolland
- 4Department of Pediatric Neurosurgery, Montpellier University Hospital, Montpellier
| | - Pierre Antherieu
- 5Department of Neurosurgery, Toulouse University Hospital, Toulouse
| | - Julien Todeschi
- 6Department of Neurosurgery, Strasbourg University Hospital, Strasbourg
| | | | - Vianney Gilard
- 8Department of Neurosurgery, Rouen University Hospital, Rouen
| | | | - Luc Le Fournier
- 1Department of Neurosurgery, Angers University Hospital, Angers
| | - Vincent Jecko
- 7Department of Pediatric Neurosurgery, Bordeaux University Hospital, Bordeaux
| | - Edouard Gimbert
- 7Department of Pediatric Neurosurgery, Bordeaux University Hospital, Bordeaux
| | - François Proust
- 6Department of Neurosurgery, Strasbourg University Hospital, Strasbourg
| | - Sergio Boetto
- 5Department of Neurosurgery, Toulouse University Hospital, Toulouse
| | - Thomas Roujeau
- 4Department of Pediatric Neurosurgery, Montpellier University Hospital, Montpellier
| | - Syril James
- 2Department of Pediatric Neurosurgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris.,10Department of Neurosurgery, French Reference Center for Chiari and Rare Vertebral and Medullary Malformations (C-MAVEM), Montpellier University Hospital, Montpellier
| | - Roman H Khonsari
- 3Craniofacial Growth and Form, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris.,11Department of Pediatric Maxillofacial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris; and
| | - Laurent Riffaud
- 9Department of Neurosurgery, Rennes University Hospital, Rennes
| | - Matthieu Delion
- 1Department of Neurosurgery, Angers University Hospital, Angers
| | - Michel Zerah
- 2Department of Pediatric Neurosurgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris.,10Department of Neurosurgery, French Reference Center for Chiari and Rare Vertebral and Medullary Malformations (C-MAVEM), Montpellier University Hospital, Montpellier
| | - Didier Scavarda
- 12Department of Pediatric Neurosurgery, CHU Timone Enfant, Marseille, France
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Laprie A, Noel G, Chaltiel L, Truc G, Sunyach M, Charissoux M, Magné N, Auberdiac P, Ken S, Roux F, Vieillevigne L, Tensaouti F, Catalaa I, Boetto S, Uro-Coste E, Supiot S, Bernier V, Filleron T, Mounier M, Poublanc M, Delord J, Cohen-Jonathan-Moyal E. OC-0333 Dose-painting multicenter phase III trial in newly diagnosed glioblastoma: the SPECTRO-GLIO trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06866-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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desrousseaux J, Chaltiel L, Claude L, Padovani L, Ducassou A, Bolle S, Habrand J, Carrié C, Muracciole X, Escande A, Alapetite C, Supiot S, Bernier-Chastagner V, Huchet A, Lesueur J, Kerr C, Truc G, Servagi-Vernat S, Leblond P, Bertozzi A, Boetto S, Sevely A, Tensaouti F, Laprie A. PH-0326 Treatment for recurrent Ependymoma : A retrospective and multicentric French study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07299-6] [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: 11/16/2022]
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Swider P, Delanoë F, Jalbert F, Boetto S, Assemat P, Estivalèzes E, Lauwers F. Mechanical properties of fused sagittal sutures in scaphocephaly. Clin Biomech (Bristol, Avon) 2021; 86:105369. [PMID: 34000627 DOI: 10.1016/j.clinbiomech.2021.105369] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/25/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Craniosynostosis in newborns is caused by the premature closure of the cranial sutures leading to cranial vault deformity. It results in aesthetic imbalance and developmental disabilities and surgery is frequent during the first months of growth. Our study focused on scaphocephaly defined as the premature closure of the sagittal suture. We hypothesised that the effective mechanical properties of sutures were altered as compared to those of the parietal adjacent tissue considered as control. METHODS The population consisted of seven males and four females (mean age 4.9 months). Sixteen suture samples and thirty-four parietal tissue samples were harvested during corrective surgery and investigated by using three-point bending tests to obtain the structure-stiffness of specimens. An energy model was used to derive the effective Young's modulus. A histological study complemented the experimental protocol. FINDINGS Fused sutures were thicker than adjacent bone and the natural curvature of sutures did not influence the static mechanical response. The stiffness of stenotic sutures was significantly higher than that of the parietal bone. The effective Young's modulus of stenotic sutures was significantly lower than that of the parietal adjacent tissue. The parietal tissue showed a parallel bone architecture whereas the central stenotic tissue was disorganised with more vascularisation. INTERPRETATION The stenotic suture differed in structural and mechanical terms from the adjacent bone during calvarial growth in the first year of life. Our study emphasised the alteration of effective tissue properties in craniosynostosis.
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Affiliation(s)
- P Swider
- IMFT UMR 5502, Toulouse University, Toulouse, France.
| | - F Delanoë
- Maxillo-facial Surgery Department, Toulouse University Hospital, Toulouse, France
| | - F Jalbert
- Maxillo-facial Surgery Department, Toulouse University Hospital, Toulouse, France
| | - S Boetto
- Neuro-surgery Department, Toulouse University Hospital, Toulouse, France
| | - P Assemat
- IMFT UMR 5502, Toulouse University, Toulouse, France
| | - E Estivalèzes
- IMFT UMR 5502, Toulouse University, Toulouse, France
| | - F Lauwers
- Maxillo-facial Surgery Department, Toulouse University Hospital, Toulouse, France
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9
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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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Tauziède-Espariat A, Pagès M, Roux A, Siegfried A, Uro-Coste E, Nicaise Y, Sevely A, Gambart M, Boetto S, Dupuy M, Richard P, Perbet R, Vinchon M, Caron S, Andreiuolo F, Gareton A, Lechapt E, Chrétien F, Puget S, Grill J, Boddaert N, Varlet P. Pediatric methylation class HGNET-MN1: unresolved issues with terminology and grading. Acta Neuropathol Commun 2019; 7:176. [PMID: 31707996 PMCID: PMC6842469 DOI: 10.1186/s40478-019-0834-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/25/2019] [Indexed: 12/13/2022] Open
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11
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Manfiotto M, Beccaria K, Rolland A, Paternoster G, Plas B, Boetto S, Vinchon M, Mottolese C, Beuriat PA, Szathmari A, Di Rocco F, Scavarda D, Seigneuret E, Wrobleski I, Klein O, Joud A, Gimbert E, Jecko V, Vignes JR, Roujeau T, Dupont A, Zerah M, Lonjon M. Decompressive Craniectomy in Children with Severe Traumatic Brain Injury: A Multicenter Retrospective Study and Literature Review. World Neurosurg 2019; 129:e56-e62. [PMID: 31054345 DOI: 10.1016/j.wneu.2019.04.215] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
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12
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Laprie A, Ken S, Filleron T, Lubrano V, Vieillevigne L, Tensaouti F, Catalaa I, Boetto S, Khalifa J, Attal J, Peyraga G, Gomez-Roca C, Uro-Coste E, Noel G, Truc G, Sunyach MP, Magné N, Charissoux M, Supiot S, Bernier V, Mounier M, Poublanc M, Fabre A, Delord JP, Cohen-Jonathan Moyal E. Dose-painting multicenter phase III trial in newly diagnosed glioblastoma: the SPECTRO-GLIO trial comparing arm A standard radiochemotherapy to arm B radiochemotherapy with simultaneous integrated boost guided by MR spectroscopic imaging. BMC Cancer 2019; 19:167. [PMID: 30791889 PMCID: PMC6385401 DOI: 10.1186/s12885-019-5317-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 05/19/2018] [Accepted: 01/24/2019] [Indexed: 02/05/2023] Open
Abstract
Background Glioblastoma, a high-grade glial infiltrating tumor, is the most frequent malignant brain tumor in adults and carries a dismal prognosis. External beam radiotherapy (EBRT) increases overall survival but this is still low due to local relapses, mostly occurring in the irradiation field. As the ratio of spectra of choline/N acetyl aspartate> 2 (CNR2) on MR spectroscopic imaging has been described as predictive for the site of local relapse, we hypothesized that dose escalation on these regions would increase local control and hence global survival. Methods/design In this multicenter prospective phase III trial for newly diagnosed glioblastoma, 220 patients having undergone biopsy or surgery are planned for randomization to two arms. Arm A is the Stupp protocol (EBRT 60 Gy on contrast enhancement + 2 cm margin with concomitant temozolomide (TMZ) and 6 months of TMZ maintenance); Arm B is the same treatment with an additional simultaneous integrated boost of intensity-modulated radiotherapy (IMRT) of 72Gy/2.4Gy delivered on the MR spectroscopic imaging metabolic volumes of CHO/NAA > 2 and contrast-enhancing lesions or resection cavity. Stratification is performed on surgical and MGMT status. Discussion This is a dose-painting trial, i.e. delivery of heterogeneous dose guided by metabolic imaging. The principal endpoint is overall survival. An online prospective quality control of volumes and dose is performed in the experimental arm. The study will yield a large amount of longitudinal multimodal MR imaging data including planning CT, radiotherapy dosimetry, MR spectroscopic, diffusion and perfusion imaging. Trial registration NCT01507506, registration date December 20, 2011.
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Affiliation(s)
- Anne Laprie
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. .,ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France.
| | - Soléakhéna Ken
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France.,Department of Engineering and Medical Physics, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-OncopoleCancer de Toulouse-Oncopole, Toulouse, France
| | - Thomas Filleron
- Biostatistics Unit, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Vincent Lubrano
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France.,Neurosurgery Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Laure Vieillevigne
- Department of Engineering and Medical Physics, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-OncopoleCancer de Toulouse-Oncopole, Toulouse, France
| | - Fatima Tensaouti
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Isabelle Catalaa
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France.,Neuroimaging Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sergio Boetto
- Neurosurgery Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jonathan Khalifa
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Justine Attal
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Guillaume Peyraga
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Carlos Gomez-Roca
- Medical Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Emmanuelle Uro-Coste
- Pathology department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Georges Noel
- Radiation Oncology Department, Centre Paul Strauss, Strasbourg, France
| | - Gilles Truc
- Radiation Oncology Department Centre Georges-François Leclerc, Dijon, France
| | | | - Nicolas Magné
- Radiation Oncology Department, Institut de Cancérologie de la Loire, Saint-Priest en Jarez, France
| | - Marie Charissoux
- Radiation Oncology Department - Centre Val d'aurelle, Montpellier, France
| | - Stéphane Supiot
- Radiation Oncology Department, Institut de Cancerologie de l'Ouest, Nantes st Herblain, France
| | - Valérie Bernier
- Radiation Oncology Department, Institut de cancérologie de Lorraine centre Alexis Vautrin, Nancy, France
| | - Muriel Mounier
- Clinical Research Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Muriel Poublanc
- Clinical Research Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Amandine Fabre
- Clinical Research Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Jean-Pierre Delord
- Medical Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Elizabeth Cohen-Jonathan Moyal
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.,INSERM UMR1037, Cancer Research Center of Toulouse, Oncopole, Toulouse, France
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13
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Uro-Coste E, Masliah-Planchon J, Siegfried A, Blanluet M, Lambo S, Kool M, Roujeau T, Boetto S, Palenzuela G, Bertozzi AI, Gambart M, Coupier I, Oliver-Petit I, Golmard L, Julia S, Savagner F, Mohand-Oumoussa B, Tauziede-Espariat A, Delisle MB, Figarella-Branger D, Bourdeaut F, Rigau V. ETMR-like infantile cerebellar embryonal tumors in the extended morphologic spectrum of DICER1-related tumors. Acta Neuropathol 2019; 137:175-177. [PMID: 30446821 DOI: 10.1007/s00401-018-1935-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/11/2018] [Accepted: 11/11/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Emmanuelle Uro-Coste
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France.
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse, France.
| | - Julien Masliah-Planchon
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Aurore Siegfried
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse, France
| | - Maud Blanluet
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France
| | - Sander Lambo
- Hopp Children's Cancer Center at the NCT (KiTZ), Heidelberg, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Marcel Kool
- Hopp Children's Cancer Center at the NCT (KiTZ), Heidelberg, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Thomas Roujeau
- Departments of Pathology, Neurosurgery, Oncopediatry, and Genetic, Montpellier University Medical Center, Montpellier, France
| | - Sergio Boetto
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Gilles Palenzuela
- Departments of Pathology, Neurosurgery, Oncopediatry, and Genetic, Montpellier University Medical Center, Montpellier, France
| | - Anne-Isabelle Bertozzi
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Marion Gambart
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Isabelle Coupier
- Departments of Pathology, Neurosurgery, Oncopediatry, and Genetic, Montpellier University Medical Center, Montpellier, France
| | - Isabelle Oliver-Petit
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Lisa Golmard
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France
| | - Sophie Julia
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Fréderique Savagner
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
- Inserm UMR1048, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France
| | | | | | - Marie-Bernadette Delisle
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital, Toulouse, France
| | - Dominique Figarella-Branger
- Department of Pathology, Marseille University Hospital, Marseille, France
- Department of Pathology and Neuropathology, la Timone Hospital and UMR CNRS 7058, Neurophysiopathology Institute (INP), Aix-Marseille University, Marseille, France
| | - Franck Bourdeaut
- Departments of Genetics and of Oncopediatry and Young Adults, Curie Institute, Paris, France
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Curie Institute, Paris, France
| | - Valérie Rigau
- Departments of Pathology, Neurosurgery, Oncopediatry, and Genetic, Montpellier University Medical Center, Montpellier, France
- Institute for Neuroscience of Montpellier (INM), INSERM U1051, Montpellier University Hospital, Montpellier, France
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Jacquet C, Boetto S, Sevely A, Sol JC, Chaix Y, Cheuret E. Monitoring Criteria of Intracranial Lesions in Children Post Mild or Moderate Head Trauma. Neuropediatrics 2018; 49:385-391. [PMID: 30223286 DOI: 10.1055/s-0038-1668138] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Head injury is the most common cause of child traumatology. However, there exist no treatment guidelines in children having intracranial lesions due to minor or moderate head trauma. There is little knowledge about monitoring, clinical exacerbation risk factors, or optimal duration of hospitalization. The aim of this retrospective study is to find predictive factors in the clinical course of non-severe head trauma in children, and thus to determine an optimal management strategy. Poor clinical progress was observed in only 4 out of 113 children. When there are no clinical signs and no eating disorders, an earlier discharge is entirely appropriate. Nevertheless, persistent clinical symptoms including headache, vomiting, and late onset seizure, especially in conjunction with hemodynamic disorders such as bradycardia, present a risk of emergency neurosurgery or neurological deterioration. Special attention should be paid to extradural hematoma (EDH) of more than 10 mm, which can have the most severe consequences. Clinical aggravation does not necessarily correlate with a change in follow-up imaging. Conversely, an apparent increase in the brain lesion on the scan is not consistently linked to a pejorative outcome.
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Affiliation(s)
- Coralie Jacquet
- Neurologie Pédiatrique, Hôpital des Enfants CHU Purpan, Toulouse, France
| | - Sergio Boetto
- Unité de Neurochirurgie, Pôle Neurosciences, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - Annick Sevely
- Unité de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Pierre-Paul Riquet, CHU Purpan, Pôle Imagerie Médicale, Toulouse, France
| | - Jean-Christophe Sol
- Unité de Neurochirurgie, Pôle Neurosciences, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - Yves Chaix
- Neurologie Pédiatrique, Hôpital des Enfants CHU Purpan, Toulouse, France
| | - Emmanuel Cheuret
- Neurologie Pédiatrique, Hôpital des Enfants CHU Purpan, Toulouse, France
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15
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Ducassou A, Padovani L, Chaltiel L, Bolle S, Habrand JL, Claude L, Carrie C, Muracciole X, Coche-Dequeant B, Alapetite C, Supiot S, Demoor-Goldschmidt C, Bernier-Chastagner V, Huchet A, Leseur J, Le Prise E, Kerr C, Truc G, Nguyen TD, Bertozzi AI, Frappaz D, Boetto S, Sevely A, Tensaouti F, Laprie A. Pediatric Localized Intracranial Ependymomas: A Multicenter Analysis of the Société Française de lutte contre les Cancers de l'Enfant (SFCE) from 2000 to 2013. Int J Radiat Oncol Biol Phys 2018; 102:166-173. [DOI: 10.1016/j.ijrobp.2018.05.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 10/16/2022]
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16
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Siegfried A, Rousseau A, Maurage CA, Pericart S, Nicaise Y, Escudie F, Grand D, Delrieu A, Gomez-Brouchet A, Le Guellec S, Franchet C, Boetto S, Vinchon M, Sol JC, Roux FE, Rigau V, Bertozzi AI, Jones DTW, Figarella-Branger D, Uro-Coste E. EWSR1-PATZ1 gene fusion may define a new glioneuronal tumor entity. Brain Pathol 2018; 29:53-62. [PMID: 29679497 DOI: 10.1111/bpa.12619] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 04/09/2018] [Indexed: 12/31/2022] Open
Abstract
We investigated the challenging diagnostic case of a ventricular cystic glioneuronal tumor with papillary features, by RNA sequencing using the Illumina TruSight RNA Fusion panel. We did not retrieve the SLC44A1-PRKCA fusion gene specific for papillary glioneuronal tumor, but an EWSR1-PATZ1 fusion transcript. RT-PCR followed by Sanger sequencing confirmed the EWSR1-PATZ1 fusion. It matched with canonic EWSR1 fusion oncogene, juxtaposing the entire N-terminal transcriptional activation domain of EWSR1 gene and the C-terminal DNA binding domain of a transcription factor gene, PATZ1. PATZ1 protein belongs to the BTB-ZF (broad-complex, tramtrack and bric-à-brac -zinc finger) family. It directly regulates Pou5f1 and Nanog and is essential to maintaining stemness by inhibiting neural differentiation. EWSR1-PATZ1 fusion is a rare event in tumors: it was only reported in six round cell sarcomas and in three gliomas of three exclusively molecular studies. The first reported glioma was a BRAFV600E negative ganglioglioma, the second a BRAFV600E negative glioneuronal tumor, not otherwise specified and the third, very recently reported, a high grade glioma, not otherwise specified. In our study, forty BRAFV600E negative gangliogliomas were screened by FISH using EWSR1 break-apart probes. We performed methylation profiling for the index case and for seven out of the ten FISH positive cases. The index case clustered apart from other pediatric low grade glioneuronal entities, and specifically from the well-defined ganglioglioma methylation group. An additional pediatric intraventricular ganglioglioma clustered slightly more closely with ganglioglioma, but showed differences from the main ganglioglioma group and similarities with the index case. Both cases harbored copy number variations at the PATZ1 locus. EWSR1-PATZ1 gene fusion might define a new type of glioneuronal tumors, distinct from gangliogliomas.
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Affiliation(s)
- Aurore Siegfried
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France.,INSERM U1037, Team 11, Cancer Research Center of Toulouse (CRCT), Toulouse, France
| | - Audrey Rousseau
- Department of Pathology, Angers University Hospital, Angers, France.,INSERM U1232, Cancer and Immunology Research Center of Nantes-Angers (CRCINA), Team 17, Nantes University, Angers University, Angers, France
| | - Claude-Alain Maurage
- Department of Pathology, Lille University Hospital, Lille, France.,INSERM U837 UMR-S1172, Centre de Recherche Jean Pierre Aubert, Team 1, Lille, France
| | - Sarah Pericart
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Yvan Nicaise
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Fréderic Escudie
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - David Grand
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Alix Delrieu
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Anne Gomez-Brouchet
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France.,UMR5089 Institut de Pharmacologie et de Biologie Structurale (IPBS), Department of Cancer Biology, Toulouse, France
| | - Sophie Le Guellec
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France.,Department of Pathology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Camille Franchet
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France.,Department of Pathology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Sergio Boetto
- Department of Neurosurgery, Toulouse University Hospital, Toulouse, France
| | - Matthieu Vinchon
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Jean-Christophe Sol
- Department of Neurosurgery, Toulouse University Hospital, Toulouse, France.,UMR1214 Toulouse Neuro Imaging Center (TONIC), Team iDREAM, INSERM and Paul Sabatier University of Toulouse, Toulouse, France
| | - Franck-Emmanuel Roux
- Department of Neurosurgery, Toulouse University Hospital, Toulouse, France.,UMR1214 Toulouse Neuro Imaging Center (TONIC), Team iDREAM, INSERM and Paul Sabatier University of Toulouse, Toulouse, France
| | - Valérie Rigau
- Department of Pathology, Montpellier University Medical Center, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM U1051, Team 4, Montpellier University Hospital, Montpellier, France
| | | | - David T W Jones
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Group Pediatric Glioma Research, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dominique Figarella-Branger
- Department of Pathology, Marseille University Hospital, Marseille, France.,UMR CNRS 7058. Institut de Neurophysiopathologie (INP), Team GlioME, Aix-Marseille University, Marseille, France
| | - Emmanuelle Uro-Coste
- Department of Pathology, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France.,INSERM U1037, Team 11, Cancer Research Center of Toulouse (CRCT), Toulouse, France
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Haine E, Sevely A, Boetto S, Delisle MB, Cances C. Infantile Hemangioma of the Posterior Fossa in a Newborn: Early Management and Long-Term Follow-up. Neuropediatrics 2017; 48:378-381. [PMID: 28301882 DOI: 10.1055/s-0037-1599235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A 21-day-old male infant was admitted with signs of intracranial hypertension. Brain magnetic resonance imaging (MRI) revealed a voluminous mass in the posterior fossa with an intense peripheral enhancement on T1 images with gadolinium. The child was treated secondarily by surgical decompression of the posterior fossa and the lesion was biopsied. The pathological findings indicated infantile hemangioma. Treatment with oral prednisolone was initiated at 3 months, given the lack of tumor involution. Six months after corticotherapy was stopped, repeated MRIs indicated a significant reduction in tumor size and then complete disappearance. Psychometric evaluation was performed at the age of 15 years, showing heterogeneous cognitive disabilities, with verbal abilities superior to nonverbal abilities and delayed motor development. Neurological examination was normal with no focal deficit. To our knowledge, this is the first published case reporting the long-term evolution of a patient with neonatal intracerebral hemangioma. We conclude that psychometric evaluations should be part of the long-term follow-up of children who have had an intracranial capillary hemangioma.
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Affiliation(s)
- Elsa Haine
- Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU Purpan, Toulouse, France
| | - Annick Sevely
- Unité de Neuroradiologie Diagnostique et Thérapeutique, Pôle imagerie médicale, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - Sergio Boetto
- Unité de Neurochirurgie, Pôle Neurosciences, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - Marie-Bernadette Delisle
- Laboratoire Universitaire d'Anatomie Pathologique, Neuropathologie Humaine et Expérimentale, CHU Rangueil, Toulouse, France
| | - Claude Cances
- Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU Purpan, Toulouse, France
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Mrozek S, Lonjaret L, Jaffre A, Januel AC, Raposo N, Boetto S, Albucher JF, Fourcade O, Geeraerts T. Reversible Cerebral Vasoconstriction Syndrome with Intracranial Hypertension: Should Decompressive Craniectomy Be Considered? Case Rep Neurol 2017; 9:6-11. [PMID: 28203185 PMCID: PMC5301123 DOI: 10.1159/000455090] [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: 11/17/2016] [Accepted: 12/13/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. METHODS Case report. RESULTS We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine. Neurological outcome was good. CONCLUSION RCVS has a complex pathophysiology and can be very difficult to manage in cases of intracranial hypertension. Decompressive craniectomy should probably be considered.
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Affiliation(s)
- Ségolène Mrozek
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Laurent Lonjaret
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Aude Jaffre
- Department of Vascular Neurology, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Anne-Christine Januel
- Department of Neuroradiology, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Nicolas Raposo
- Department of Vascular Neurology, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Sergio Boetto
- Department of Neurosurgery, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Jean-François Albucher
- Department of Vascular Neurology, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Olivier Fourcade
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
| | - Thomas Geeraerts
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier-Toulouse 3, Toulouse, France
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Chhun V, Sacko O, Boetto S, Roux FE. Third Ventriculocisternostomy for Shunt Failure. World Neurosurg 2015; 83:970-5. [DOI: 10.1016/j.wneu.2015.01.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 10/23/2022]
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Dupuy M, Boetto S, Jalbert F, Sol J. Surgery for Spheno-orbital Meningiomas: Should Orbital Walls Have to Be Reconstructed? Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bertozzi AI, Munzer C, Fouyssac F, Andre N, Boetto S, Leblond P, Bourdeaut F, Dufour C, Deshpande RK, Bhat KG, Mahalingam S, Muscat A, Cain J, Ferguson M, Popovski D, Algar E, Rossello FJ, Jayasekara S, Watkins DN, Hodge J, Ashley D, Hishii M, Saito M, Arai H, Han ZY, Richer W, Lucchesi C, Freneaux P, Nicolas A, Grison C, Pierron G, Delattre O, Bourdeaut F, Epari S, TS N, Gupta T, Chinnaswamy G, Sastri JG, Shetty P, Moiyadi A, Jalali R, Fay-McClymont T, Johnston D, Janzen L, Guger S, Scheinemann K, Fleming A, Fryer C, Hukin J, Mabbott D, Huang A, Bouffet E, Lafay-Cousin L, Kawamura A, Yamamoto K, Nagashima T, Bartelheim K, Benesch M, Buchner J, Gerss J, Hasselblatt M, Kortmann RD, Fleischack G, Quiroga E, Reinhard H, Schneppenheim R, Seeringer A, Siebert R, Timmermann B, Warmuth-Metz M, Schmid I, Fruhwald MC, Fruhwald MC, Bartelheim K, Seeringer A, Kerl K, Kortmann RD, Warmuth-Metz M, Hasselblatt M, Schneppenheim R, Siebert R, Klingebiel T, Al-Kofide A, Khafaga Y, Al-Hindi H, Dababo M, Ul-Haq A, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, Al-Shail E, Hasselblatt M, Jeibmann A, Eikmeier K, Linge A, Johann P, Koos B, Bartelheim K, Kool M, Pfister SM, Fruhwald MC, Paulus W, Hasselblatt M, Schuller U, Junckerstorff R, Rosenblum MK, Alassiri AH, Rossi S, Bartelheim K, Schmid I, Gottardo N, Toledano H, Viscardi E, Witkowski L, Nagel I, Oyen F, Foulkes WD, Paulus W, Siebert R, Schneppenheim R, Fruhwald MC, Schrey D, Malietzis G, Chi S, Dufour C, Lafay-Cousin L, Marshall L, Carceller F, Moreno L, Zacharoulis S, Bhardwaj R, Chakravadhanula M, Ozals V, Hampton C, Metpally R, Grillner P, Asmundsson J, Gustavsson B, Holm S, Johann PD, Korshunov A, Ryzhova M, Kerl K, Milde T, Witt O, Jones DTW, Hovestadt V, Gajjar A, Hasselblatt M, Fruhwald M, Pfister S, Kool M, Finetti M, Pons ADC, Selby M, Smith A, Crosier S, Wood J, Skalkoyannis B, Bailey S, Clifford S, Williamson D, Seeringer A, Bartelheim K, Kerl K, Hasselblatt M, Rutkowski S, Timmermann B, Kortmann RD, Schneppenheim R, Warmuth-Metz M, Gerss J, Siebert R, Graf N, Boos J, Nysom K, Fruhwald MC, Kerl K, Moreno N, Holsten T, Ahlfeld J, Mertins J, Hotfilder M, Kool M, Bartelheim K, Schleicher S, Handgretinger R, Fruhwald M, Meisterernst M, Kerl K, Schmidt C, Ahlfeld J, Moreno N, Dittmar S, Pfister S, Fruhwald M, Kool M, Meisterernst M, Schuller U, Chan GCF, Shing MMK, Yuen HL, Li RCH, Ling SL, Slavc I, Peyrl A, Chocholous M, Azizi A, Czech T, Dieckmann K, Haberler C, Leiss U, Gotti G, Biassoni V, Schiavello E, Spreafico F, Pecori E, Gandola L, Massimino M, Mertins J, Kornelius K, Moreno N, Holsten T, Fruhwald M, Kool M, Meisterernst M, Yano H, Nakayama N, Ohe N, Ozeki M, Kanda K, Kimura T, Hori T, Fukao T, Iwama T, Weil AG, Diaz A, Gernsback J, Bhatia S, Ragheb J, Niazi T, Khatib Z, Kerl K, Holsten T, Moreno N, Zoghbi A, Meisterernst AM, Birks D, Griesinger A, Amani V, Donson A, Posner R, Dunham C, Kleinschmidt-DeMasters BK, Handler M, Vibhakar R, Foreman N, Bhardwaj R, Ozals V, Hampton C, Zhou L, Catchpoole D, Chakravadhanula M, Kakkar A, Biswas A, Suri V, Sharma M, Kale S, Mahapatra A, Sarkar C, Torchia J, Picard D, Ho KC, Khuong-Quang DA, Louterneau L, Bourgey M, Chan T, Golbourn B, Cousin LL, Taylor MD, Dirks P, Rutka JT, Bouffet E, Hawkins C, Majewski J, Kim SK, Jabado N, Huang A, Chang JHC, Confer M, Chang A, Goldman S, Dunn M, Hartsell W. ATYPICAL TERATOID RHABDOID TUMOUR. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou065] [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: 11/14/2022] Open
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Jalbert F, Boetto S, Nadon F, Lauwers F, Schmidt E, Lopez R. One-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants. J Craniomaxillofac Surg 2014; 42:141-8. [DOI: 10.1016/j.jcms.2013.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/30/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022] Open
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Lonjaret L, Ros M, Boetto S, Fourcade O, Geeraerts T. Brainstem hemorrhage following decompressive craniectomy. J Clin Neurosci 2012; 19:1293-5. [PMID: 22721886 DOI: 10.1016/j.jocn.2012.01.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 01/06/2012] [Accepted: 01/10/2012] [Indexed: 11/17/2022]
Abstract
Decompressive craniectomy (DC) is used for the management of refractory raised intracranial pressure, but the impact of DC on surgical outcome is still controversial. We report a 21-year-old man admitted to our hospital after a road traffic accident. The brain CT scan revealed a left hemispheric acute subdural hematoma. After DC, he developed a brainstem hemorrhage. Recovery was, however, good.
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Affiliation(s)
- Laurent Lonjaret
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, Hôpital Purpan, Place du Dr Baylac, 31059 Toulouse Cedex 9, France.
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Hankinson T, Fields E, Handler M, Foreman N, Liu A, Muller HL, Gebhardt U, Warmuth-Metz M, Kortmann RD, Faldum A, Pietsch T, Sorensen N, Calaminus G, Muller HL, Gebhardt U, Maroske J, Hanisch E, Muller HL, Gebhardt U, Pohl F, Kortmann RD, Faldum A, Warmuth-Metz M, Pietsch T, Calaminus G, Sorensen N, Muller HL, Enriori PJ, Gebhardt U, Hinney A, Hebebrandt J, Reinehr T, Cowley M, Roth C, Rosenfeld A, Arrington D, Etzl M, Miller J, Gieseking A, Dvorchik I, Kaplan A, Jakacki R, Yeung J, Panigrahy A, Pollack I, Mallucci C, Pizer B, Didi M, Blair J, Upadrasta S, Doss A, Avula S, Pettorini B, Alapetite C, Puget S, Ruffier A, Habrand JL, Bolle S, Noel G, Nauraye C, De Marzy L, Boddaert N, Brisse H, Sainte-Rose C, Zerah M, Boetto S, Laffond C, Chevignard M, Grill J, Doz F, Jalali R, Gupta T, Goswami S, Shah N, Golambade N, Ikazoboh EC, Dattani M, Spoudeas H, Confer M, McNall-Knapp R, Krishnan S, Gross N, Keole S, Ormandy D, Alston R, Kamaly-Asl I, Gattamaneni R, Birch J, Estlin E, Kiehna E, Laws E, Oldfield E, Jane J. CRANIOPHARYNGIOMA. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Idir I, Cuvinciuc V, Uro-Coste E, Penna M, Boetto S, Cognard C, Bonneville F. MR perfusion of intracranial Rosai-Dorfman disease mimicking meningioma. J Neuroradiol 2010; 38:133-4. [PMID: 20727592 DOI: 10.1016/j.neurad.2010.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 06/13/2010] [Accepted: 06/15/2010] [Indexed: 11/17/2022]
Affiliation(s)
- I Idir
- Neuroradiology Department, University Hospital Toulouse, Toulouse, France
| | - V Cuvinciuc
- Neuroradiology Department, University Hospital Toulouse, Toulouse, France; Neuroradiology Department, University Hospital Grenoble, Grenoble, France
| | - E Uro-Coste
- Pathology Department, University Hospital Toulouse, Toulouse, France
| | - M Penna
- Intensive Care Department, University Hospital Bordeaux, Bordeaux, France
| | - S Boetto
- Neurosurgery Department, University Hospital Toulouse, Toulouse, France
| | - C Cognard
- Neuroradiology Department, University Hospital Toulouse, Toulouse, France
| | - F Bonneville
- Neuroradiology Department, University Hospital Toulouse, Toulouse, France.
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Abstract
OBJECT Although endoscopic third ventriculostomy (ETV) has been accepted as a procedure of choice for the treatment of obstructive hydrocephalus, the outcome of this treatment remains controversial with regard to age, cause, and long-term follow-up results. The goal of this study was to assess the risk of failure associated with these factors in a retrospective cohort study. METHODS Between 1999 and 2007, 368 ETVs were performed in 350 patients (165 patients < 18 years of age) with hydrocephalus at the University Hospital of Toulouse. Failure of ETV was defined as cases requiring any subsequent surgical procedure for CSF diversion or death related to hydrocephalus management. RESULTS Tumors (53%), primary aqueductal stenosis (18%), and intracranial hemorrhage (13%) were the most common causes of hydrocephalus. The median follow-up period was 47 months (range 6-106 months), and the overall success rate was 68.5% (252 of the 368 procedures). Patients < 6 months of age had a 5-fold increased risk of ETV failure than older patients (adjusted hazard ratio [HRa] 5.0; 95% CI 2.4-10.4; p < 0.001). Hemorrhage-related (HRa 4.0; 95% CI 1.9-8.5; p < 0.001) and idiopathic chronic hydrocephalus (HRa 6.3, 95% CI 2.5-15.0, p < 0.001) had a higher risk of failure than other causes. Most failures (97%) occurred within 2 months of the initial procedure. The overall morbidity rate was 10%, although most complications were minor. Finally, the introduction of ETV in the authors' department reduced the number of shunt insertions and hospital admissions for shunt failures by half and was a source of cost savings. CONCLUSIONS Endoscopic third ventriculostomy is a safe procedure and an effective treatment option for hydrocephalus. Factors indicating potential poor ETV outcome seem to be very young children and hemorrhage-related and chronic hydrocephalus in adults.
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Affiliation(s)
- Oumar Sacko
- Service de Neurochirurgie, Centres Hospitalo-Universitaires de Toulouse, Toulouse, France
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Uro-Coste E, Ssi-Yan-Kai G, Guilbeau-Frugier C, Boetto S, Bertozzi AI, Sevely A, Lolmede K, Delisle MB. Desmoplastic infantile astrocytoma with benign histological phenotype and multiple intracranial localizations at presentation. J Neurooncol 2009; 98:143-9. [DOI: 10.1007/s11060-009-0075-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 11/16/2009] [Indexed: 10/20/2022]
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Edouard T, Stafford D, Oliver I, Jesuran M, Bertozzi A, Cances C, Boetto S, Guilbeau-Frugier C, Delisle B, Tauber M. Isolated Lymphocytic Infiltration of Pituitary Stalk Preceding the Diagnosis of Germinoma in 2 Prepubertal Children Treated with Growth Hormone. Horm Res 2009; 72:57-62. [DOI: 10.1159/000224342] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 09/01/2008] [Indexed: 11/19/2022]
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Frederic L, Jalbert F, Bessard J, Boutault F, Roux E, Schmidt E, Boetto S. P.146 PEEK implants for cranioplasty of complex cranial defects. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71934-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Labauge P, Bouly S, Parker F, Gallas S, Emery E, Loiseau H, Lejeune JP, Lonjon M, Proust F, Boetto S, Coulbois S, Auque J, Boulliat J. Outcome in 53 patients with spinal cord cavernomas. ACTA ACUST UNITED AC 2008; 70:176-81; discussion 181. [DOI: 10.1016/j.surneu.2007.06.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 06/13/2007] [Indexed: 10/22/2022]
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Parker F, Lejeune JP, Bouly S, Lonjon M, Emery E, Proust F, Auque J, Loiseau H, Gallas S, Boetto S, Labauge P. [Natural history of intramedullary cavernomas. Results of the French Multicentric Study]. Neurochirurgie 2007; 53:208-16. [PMID: 17507049 DOI: 10.1016/j.neuchi.2007.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 02/28/2007] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The prevalence of cerebral cavernomas is about 0.5% in the general population. In contrast, spinal cord cavernomas are considered as rare. The objective of this study was to determine the natural history of spinal cord cavernomas in a multicentric study. METHODS Clinical and neuroradiological findings were retrospectively collected. Diagnosis was based on pathological criteria or magnetic resonance (MR) findings. RESULTS Fifty-three patients were included (26 males, 27 females). Mean age at onset of symptoms was 40.2 years (range: 11-80). Initial symptoms were progressive (32) and acute myelopathy (20). One patient was asymptomatic. Clinical symptoms were related to spinal cord compression (24) and hematomyelia (19). Cavernoma location was dorsal (41) and cervical (12.). MR findings consisted of hyperintense signal on T1 and T2 sequences (19 cases), mixed hyperintense and hypointense signal (33 cases), and hypointense signal on T1 and T2 sequences in 1 case. Mean size was 16.3 mm (range: 3-54). Forty patients underwent surgical resection. Improvement was observed in 20 patients and worsening of neurological symptoms in 11. Length of follow up was 7.1 years. At the end of the study, 26 patients were autonomous, 18 handicapped and 1 bedridden. CONCLUSION This study provided precise data on the clinical and MR patterns of these lesions. The natural history is associated with a higher risk of hemorrhage recurrence, but is favorable in many operated patients. Microsurgery is the treatment of choice for most of these lesions.
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Affiliation(s)
- F Parker
- Service de neurochirurgie, CHU de Bicêtre, université Paris-XI, 78 rue du Général-Leclerc, 94275 Le-Kremlin-Bicêtre cedex, France.
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Labauge P, Bouly S, Parker F, Lejeune J, Lonjon M, Emery E, Proust F, Auque J, Loiseau H, Gallas S, Boetto S. Histoire naturelle des cavernomes intramédullaires. Étude rétrospective de 53 cas. Résultats de l’étude française multicentrique. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fjørtoft MI, Sevely A, Boetto S, Kessler S, Sarramon MF, Rolland M. Prenatal diagnosis of craniosynostosis: value of MR imaging. Neuroradiology 2007; 49:515-21. [PMID: 17310357 DOI: 10.1007/s00234-007-0212-6] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 01/02/2007] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The aim of our study was to assess the utility and reliability of magnetic resonance imaging (MRI) in antenatal diagnosis of craniosynostosis. METHODS We retrospectively reviewed the MRI examinations of the head of 15 fetuses requested over a period of 11 years on the basis of sonographic suspicion of craniosynostosis. The postnatal diagnosis was available for 14 neonates. RESULTS No termination of pregnancy was performed. There were four neonates with sporadic multisuture craniosynostoses, three of which were syndromic, including one Crouzon and one Pfeiffer syndrome. Eight neonates were normal, two showed cranial vault deformities without synostosis, and one was lost to follow-up. MRI showed a high predictive value for craniosynostosis, as there were no false-negative or false-positive diagnoses. However, the severity of the abnormalities were underestimated in two neonates. CONCLUSION We suggest that prenatal MRI has diagnostic value when synostosis is suspected on ultrasonography. Moreover, MRI is accurate in the detection of associated brain abnormalities, which is an important prognostic issue in this diagnosis. Prenatal diagnosis of craniosynostosis is difficult and could benefit from three-dimensional ultrasonography and three-dimensional CT.
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Affiliation(s)
- M Irsutti Fjørtoft
- Service de Neuroradiologie Diagnostique et Thérapeutique, Centre Hospitalier Universitaire Purpan, Place du Dr Baylac, F-31059, Toulouse Cedex 9, France.
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Sabatier J, Uro-Coste E, Benouaich A, Boetto S, Gigaud M, Tremoulet M, Delisle MB, Galateau-Sallé F, Brousset P. Immunodetection of SV40 large T antigen in human central nervous system tumours. J Clin Pathol 2005; 58:429-31. [PMID: 15790713 PMCID: PMC1770612 DOI: 10.1136/jcp.2004.020131] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIMS DNA sequences from Simian virus 40 (SV40) have been previously isolated from various human tumours of the central nervous system (CNS). This study aimed to investigate a series of tumours of the CNS for the expression of the SV40 large T antigen (Tag), which is an oncogenic protein of the virus. METHODS A French series of 82 CNS tumours was investigated for Tag expression using a monoclonal antibody and immunohistochemistry. A Tag positive hepatocellular carcinoma cell line from transgenic mice and a kidney biopsy from a patient infected by SV40 were used as positive controls. RESULTS None of the tumours (20 ependymomas, 20 glioblastomas, 12 oligodendrogliomas, three plexus choroid adenomas, two plexus choroid carcinomas, 15 meningiomas, and 10 medulloblastomas) contained SV40 Tag positive cells. CONCLUSIONS The lack of SV40 Tag in 82 CNS tumours of various types is at variance with previous studies from different countries, and suggests that the virus may not be an important factor in CNS tumorigenesis, at least in French cases.
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Affiliation(s)
- J Sabatier
- Department of Neurosurgery, Purpan Hospital, Place Baylac, 31059 Toulouse Cedex, France
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Bergametti F, Denier C, Labauge P, Arnoult M, Boetto S, Clanet M, Coubes P, Echenne B, Ibrahim R, Irthum B, Jacquet G, Lonjon M, Moreau JJ, Neau JP, Parker F, Tremoulet M, Tournier-Lasserve E. Mutations within the programmed cell death 10 gene cause cerebral cavernous malformations. Am J Hum Genet 2005; 76:42-51. [PMID: 15543491 PMCID: PMC1196432 DOI: 10.1086/426952] [Citation(s) in RCA: 319] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Accepted: 10/11/2004] [Indexed: 11/03/2022] Open
Abstract
Cerebral cavernous malformations (CCMs) are hamartomatous vascular malformations characterized by abnormally enlarged capillary cavities without intervening brain parenchyma. They cause seizures and cerebral hemorrhages, which can result in focal neurological deficits. Three CCM loci have been mapped, and loss-of-function mutations were identified in the KRIT1 (CCM1) and MGC4607 (CCM2) genes. We report herein the identification of PDCD10 (programmed cell death 10) as the CCM3 gene. The CCM3 locus has been previously mapped to 3q26-27 within a 22-cM interval that is bracketed by D3S1763 and D3S1262. We hypothesized that genomic deletions might occur at the CCM3 locus, as reported previously to occur at the CCM2 locus. Through high-density microsatellite genotyping of 20 families, we identified, in one family, null alleles that resulted from a deletion within a 4-Mb interval flanked by markers D3S3668 and D3S1614. This de novo deletion encompassed D3S1763, which strongly suggests that the CCM3 gene lies within a 970-kb region bracketed by D3S1763 and D3S1614. Six additional distinct deleterious mutations within PDCD10, one of the five known genes mapped within this interval, were identified in seven families. Three of these mutations were nonsense mutations, and two led to an aberrant splicing of exon 9, with a frameshift and a longer open reading frame within exon 10. The last of the six mutations led to an aberrant splicing of exon 5, without frameshift. Three of these mutations occurred de novo. All of them cosegregated with the disease in the families and were not observed in 200 control chromosomes. PDCD10, also called "TFAR15," had been initially identified through a screening for genes differentially expressed during the induction of apoptosis in the TF-1 premyeloid cell line. It is highly conserved in both vertebrates and invertebrates. Its implication in cerebral cavernous malformations strongly suggests that it is a new player in vascular morphogenesis and/or remodeling.
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Affiliation(s)
- F. Bergametti
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - C. Denier
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - P. Labauge
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - M. Arnoult
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - S. Boetto
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - M. Clanet
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - P. Coubes
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - B. Echenne
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - R. Ibrahim
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - B. Irthum
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - G. Jacquet
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - M. Lonjon
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - J. J. Moreau
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - J. P. Neau
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - F. Parker
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - M. Tremoulet
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
| | - E. Tournier-Lasserve
- INSERM E365, Faculté de Médecine Lariboisière, and Laboratoire de Cytogénétique et Génétique Moléculaire, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris; Service de Neurologie, Nîmes, France; Services des Neurochirurgie and Neurologie, Toulouse; Services des Neurochirurgie and Neuropédiatrie, Montpellier, France; Service de Neurochirurgie, Nantes, France; Service de Neurochirurgie, Limoges, France; Service de Neurochirurgie, Besançon, France; Service de Neurochirurgie, Nice; Service de Neurochirurgie, Poitiers, France; and Service de Neurochirurgie, Kremlin-Bicêtre, France
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Sabatier J, Boetto S, Gigaud M, Roux F, Schmidt E, Tremoulet M. Fractures de l’odontoïde avec signes neurologiques : étude rétrospective depuis 1996. Neurochirurgie 2004. [DOI: 10.1016/s0028-3770(04)98392-0] [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: 11/24/2022]
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Roux FE, Boetto S, Sacko O, Chollet F, Trémoulet M. Writing, calculating, and finger recognition in the region of the angular gyrus: a cortical stimulation study of Gerstmann syndrome. J Neurosurg 2003; 99:716-27. [PMID: 14567608 DOI: 10.3171/jns.2003.99.4.0716] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. In an attempt to gain a better understanding of the cerebral functions represented in the angular gyrus and to spare them during surgery, the authors studied patients with brain tumors located close to the angular gyrus and mapped cortical sites by using electrostimulation.
Methods. Before undergoing tumor removal, six right-handed patients (five with left and one with right hemisphere tumors) were studied using cortical mapping with the aid of calculating, writing, finger-recognition, and color-naming tasks in addition to standard reading and object-naming tasks (for a total of 36 brain mapping studies). Strict conditions of functional site validation were applied to include only those cortical sites that produced repetitive interferences in the function tested. Preoperatively, four of the patients exhibited discrete symptoms related to Gerstmann syndrome while performing very specific tasks, whereas the other two patients presented with no symptoms of the syndrome. No patient had significant language or apraxic deficits.
Distinct or shared cortical sites producing interferences in calculating, finger recognition, and writing were repeatedly found in the angular gyrus. Object- or color-naming sites and reading-interference sites were also found in or close to the angular gyrus; although frequently demonstrated, these latter results were variable and unpredictable in the group of patients studied. Finger agnosia and acalculia sites were also found elsewhere, such as in the supramarginal gyrus or close to the intraparietal sulcus. Mechanisms involved in acalculia, agraphia, or finger agnosia (either complete interferences or hesitations) during stimulation were various, from an aphasia-like form (for instance, the patient did not understand the numbers or words given for calculating or writing tasks) to an apparently pure interference in the function tested (patients understood the numbers, but were unable to perform a simple addition).
Conclusions. Symptoms of Gerstmann syndrome can be found during direct brain mapping in the angular gyrus region. In this series of patients, sites producing interferences in writing, calculating, and finger recognition were demonstrated in the angular gyrus, which may or may not have been associated with object-naming, color-naming, or reading sites.
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Affiliation(s)
- Franck-Emmanuel Roux
- Institut National de la Santé et de la Recherche Médicale, Unité 455, Hôpital Purpan, Toulouse, France.
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Abstract
BACKGROUND We prospectively evaluated the role of endoscopic third ventriculocisternostomy in the management of acute obstructive hydrocephalus created by cerebellar hematomas. METHOD Following a therapeutic diagram based on clinical and radiological signs, endoscopic third ventriculocisternostomy was used to treat hydrocephalus associated with cerebellar hematomas in 8 patients (male: 5, female: 3, mean age: 67 years-old). Causes of cerebellar hemorrhage were spontaneous in 6 cases, traumatic in 1 case, and acute bleeding of a posterior fossa tumor (lung metastasis) in the remaining case. Deeply comatose patients (Glasgow Coma Score between 3 and 5) and patients with signs of brainstem compression were initially excluded from this study. FINDINGS Overall clinical improvement after third ventriculocisternostomy was achieved in all patients and was associated with the decrease of the ventricle size on follow-up CT scans. One patient who initially had a clot evacuation associated with an external ventricular drainage and persistant hydrocephalus had a successful third ventriculocisternostomy in the post operative course. No complication related to the procedure was noted. INTERPRETATION In selected patients, third ventriculocisternostomy can be used to treat hydrocephalus associated with posterior fossa hematomas.
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Affiliation(s)
- F-E Roux
- Department of Adult and Pediatric Neurosurgery, Hôpital Purpan, Toulouse, France
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39
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Roux FE, Boetto S, Jan M. [French neurosurgery in the Bosnia-Herzegovina conflict]. Neurochirurgie 2001; 47:111-8. [PMID: 11404680] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Seven French neurosurgical missions, from June 1994 to December 1996, were sent successively to Bosnia-Herzegovina with the help of a non-governmental organisation Médecins du Monde. The aim of this article is to present the working conditions, make an overall evaluation of the missions and then to draw lessons and discuss the limits. The initial aim of these neurosurgical missions was: i) to provide human and logistic support to the Bosniac teams in the field; ii) to exchange knowledge and help in the training of local young neurosurgeons; iii) to be present as witnesses. The towns of Tuzla and Zenica in Eastern and Central Bosnia respectively were chosen as the missions bases. One hundred five neurosurgical operations were carried out in precarious conditions, particularly concerning anesthesia. The largest number of the operations (52%) concerned standard neurosurgical pathologies, without any direct link to the war but which had been put off or made difficult due to the war. Cranioplasties and peripheric nerve injuries were the main lesions directly related to the war situation which the French missions had to deal with. Actually, war neurosurgical pathologies were very often dealt with in emergency by Bosniac teams in the field hospitals near the front. Previously existing neurosurgical environment, in particular with access to a scanner is an absolute necessity to carry out a good quality neurosurgical mission. Precarious anesthesia and operating conditions require the surgical team to adapt to local conditions, but are not a contra-indication to such missions. Although help in the field can prove useful on occasions, training the resident teams is important. This can be done locally, but additional training in a neurosurgically developed country is fundamental. Missions such as these require relatively major funding (about 150 000 French francs for each of our missions) and suitable infrastructures. Prior to undertaking this type of mission, a neurosurgeon must evaluate local human and equipment needs.
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Affiliation(s)
- F E Roux
- Service de Neurochirurgie, Hôpital Purpan, 31059 Toulouse Cedex
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40
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Murgio A, Patrick PD, Andrade FA, Boetto S, Leung KM, Muñoz Sanchez MA. International study of emergency department care for pediatric traumatic brain injury and the role of CT scanning. Childs Nerv Syst 2001; 17:257-62. [PMID: 11398946 DOI: 10.1007/s003810000403] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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] [Indexed: 11/30/2022]
Abstract
OBJECTS Our objective was to investigate the use of CT and its relationship to head injury severity and age. METHOD The multi-center group International Study of Head Injury Project (ISHIP) serves as the administrative body for research design, data collection and analysis. This is a nonrandomized prospective study of longitudinal outcomes following examination and care in emergency department in five different countries. The subjects of our study were 4,690 children from birth to 15 years of age, all of whom were systematically evaluated. Each child was medically evaluated and categorized as to injury severity, mechanism of injury and findings on X-ray and CT scan. Follow-up interview and assessment was completed for comparison with the presenting clinical state. RESULTS CT scans were performed for 674 (14.3%) of the children: 438 scans were normal and 236 were abnormal (P<0.001). Of the children with abnormal CT scans, 23.3% had mild head injuries, 42.7% had moderate injuries, and 33.8% had severe injuries, as determined by the GCS. By age, 10.5% of the positive CTs were in children aged 0-2 years, 56.3% in 3- to 9-year-olds, and 33% in 10- to 15-year-olds; only in 2% of cases were both CT and X-ray positive. CONCLUSIONS The majority of children did not need significant medical intervention. Physicians ordered X-ray investigations more frequently than CT scanning. The use of X-ray to decide whether or not CT is necessary is not warranted. The implications of positive CTs in mild or moderate injuries were most noteworthy, as were age-related interactions with positive CT findings.
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41
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Abstract
With the object of evaluating different epidemiological factors in the acute phase of head injury (HI) in the pediatric age group in five countries (Argentina, Brazil, France, Hong-Kong and Spain), we carried out a prospective and descriptive study, in which we analyzed the clinical and radiological risk factors versus management and outcome 7-30 days after trauma. We included all children seen in the emergency department and hospitalized who were aged between 0 and 15 years and had sustained HI. Data were compiled from the clinical records and analyzed for neurological evaluation with the Glasgow Coma Scale (GCS) and the Glasgow Paediatric Coma Score (GPCS), and also by means of dynamics, symptoms, skull X-rays, CT scans. The total of 2478 patients enrolled in the study was made up of 60.9% boys and 39.1 % girls. Age distribution was as follows: 55.2% aged 0-4 years; 28.3% aged 5-9 years, and 16.4% aged 10-15 years. Most (75.3%, or 1768) of these patients completed follow-up. The total sample included 1058 children (42.7%) who required hospitalization. Skull fractures were identified in 11.8% (298) of the cases, and 6.4% (158) of CT scans were pathologic. Minor HI accounted for 56.4% of these children, moderate HI for 38.9%, and severe HI for the remaining 4.7%. The lethality rate was 1.6%. Our preliminary data reveal that it is very important for new guidelines on the treatment of minor HI to be prepared, because patients with minor HI had undergone the most skull X-rays and also most frequently been admitted to hospital for unnecessarily long periods of time, though the incidence of brain damage (1.6%) was lowest in this group of the study population. We intend to carry out a full analysis of the various risk factors at the end of the study.
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Abstract
Meningiomas are rare tumours in children and lumbar lesions are exceptional. We report a clear-cell meningioma (CCM) of the cauda equina in a 10-year-old girl. The tumour was diagnosed by MRI, showing an enhancing intradural mass extending from L1 to L4. Pathology and immunohistochemical study demonstrated a CCM. The patient had a recurrence 6 months after the operation requiring further surgery. CCM are rare lesions, characterised by abundant cytoplasmic glycogen particles. Complete surgical removal is necessary because, despite their benign histological appearance, CCM are potentially aggressive and may recur, spread locally and even metastasize.
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Affiliation(s)
- A Dubois
- Service de Neuroradiologie, Hôpital Purpan, Toulouse, France
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Abstract
BACKGROUND Meningiomas represent 1.5% to 4.3% of cerebral and medullar primary tumors in children. CASE REPORT A 9-year-old girl had a history of thoracolumbar scoliosis. An intracanalar and extramedullar tumor was confined to the lumbar region. Resection identified a clear cell meningioma. A symptomatic and tumoral recurrence occurred 5 months later in the same region. After a second resection, the patient received radiotherapy. At 8 months follow-up, no recurrence was documented. CONCLUSIONS A stiff and painful scoliosis can be predictive of expansive intracanalar tumor. The recurrent or multifocal evolution of clear cell meningioma show the "aggressive behavior" of this histological type. A preventive radiotherapy could be proposed, depending on the age of the patient and the localization of the tumor.
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Affiliation(s)
- C Cancès
- Unité de neurologie pédiatrique, CHU Purpan, Toulouse, France
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Abstract
MRI in two children with moya-moya demonstrated low signal on T2-weighted images in the acute and subacute phases of ischaemia. Gradient-echo sequences, more sensitive to magnetic susceptibility, demonstrated these abnormalities better. Signal loss, due to temporary accumulation of iron, decreases progressively and disappears in the chronic stage of the disease. Diffusion-weighted MRI allows early detection of ischaemic lesions and can be used to monitor progressive spreading of the lesions. Magnetisation transfer maps provide sharp contrast, useful for demonstrating cortical atrophy.
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Affiliation(s)
- V Chabbert
- Service de Neuroradiologie, Hopital Purpan, Toulouse, France
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45
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Chaix Y, Grouteau E, Sevely A, Boetto S, Delisle MB, Carrière JP. [Pseudotumor forms of neurosarcoidosis in children. Diagnostic difficulties and therapeutic management]. Rev Neurol (Paris) 1997; 153:771-4. [PMID: 9686267] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In systemic sarcoidosis, neurologic manifestations are possible and occurred in 5 p. 100 of cases. The diagnosis is easier when sarcoiddosis is known, but in half case neurologic symptoms are inaugural. In these cases, involvement of other sites (liver, lung, eyes or skin) by the disease is needed to confirm sarcoidosis. Main manifestations in neurosarcoidosis are cranial nerve palsy, diabetes insipidus or chronic aseptic meningitis, but sometimes sarcoidosis can present as an intracranial mass. The diagnosis of neurosarcoidosis may be difficult and could be confused with infection (such tuberculosis or mycosis), with inflammatory diseases (such multiple sclerosis) or with neoplasm, particularly in case of oedema. Brain biopsy may be necessary in isolated neurosarcoidosis if no peripheral histology evidence of noncaseating granulomas has been obtained. Treatment with steroids alone is the best choice for initial therapy but must be prolonged. It is difficult to predict accurately the response to steroids and relapse may be possible after a long time. Other immunosuppressive therapeutics or radiotherapy have been used in patient with refractory neurosarcoidosis. Sequential magnetic resonance imaging is the useful mean for the follow-up of neurosarcoidosis.
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Affiliation(s)
- Y Chaix
- Service de Médecine Infantile A, Hôpital de Purpan, Toulouse
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46
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Abstract
BACKGROUND Association of venous angioma to cavernous malformation is rare. If bleeding occurs, it must be assigned to the cavernous malformation. CASE REPORT A 4 year-old boy suffered from an acute ataxia. Investigation showed a venous angioma and a cavernoma malformation in the posterior fossa. The patient was admitted again at the age of 8 years for a new episode of acute ataxia due to cerebellar hematoma. A conservative treatment was settled because of the risk of venous infarction. CONCLUSION Venous angiomas are rarely symptomatic and are considered as normal venous variants. Indeed, the cavernomas are true malformations with a high bleeding potential. When both lesions are associated and bleeding occurs, only the cavernous malformation has to be removed if surgically accessible.
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Affiliation(s)
- Y Chaix
- Service de médecine infantile A, CHU de Purpan, Toulouse, France
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47
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Delisle MB, Dastugue N, Uro E, Montmayeur F, Boetto S, Graber D, Hassoun J. Mixed desmoplastic primitive neuroepithelial tumor of infancy: a light microscopic, immunocytochemical, ultrastructural and genetic study. Acta Neuropathol 1995; 89:99-104. [PMID: 7709738 DOI: 10.1007/bf00294266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We describe a case of a desmoplastic brain tumor which was initially resected from the right fronto-temporal region in a 2 year-old boy. This nodular, calcified tumor was vascularized by the internal carotid artery and the middle meningeal artery branches. Grossly, it contained several mucoid cysts. Light microscopy showed cords or nests of small cuboidal cells surrounded by a loose connective tissue and desmoplastic areas containing fibers and spindle cells. The cuboidal cells expressed epithelial, neuronal and neuroendocrine markers. Some foci of spindle cells showed glial differentiation. The tumor recurred 16 months later and displayed some characteristics of the small cell neuroepithelial component, mitoses being conspicuous. Electron microscopy revealed undifferentiated clear cells, some containing neurosecretory granules. Karyotyping demonstrated the following formula: < 15 > 46, t(8;11) (q13; q11). The chromosome 11 breakpoint was different from that described in Ewing's sarcoma. This isolated translocation has not been previously reported to our knowledge. These unusual features lead us to report this case and to discuss its pathogenesis.
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Affiliation(s)
- M B Delisle
- Department of Pathology, C. H. U. Rangueil, Toulouse, France
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Holley P, Bonafé A, Cha F, Arrué P, Maillard A, Sabatier J, Boetto S, Delisle MB, Tremoulet M, Manelfe C. [Complications of the intravascular treatment of intracranial aneurysms using metal microcoils. Embolization using coils in intracranial aneurysms]. J Neuroradiol 1994; 21:205-12. [PMID: 9190373] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Embolization of intracranial aneurysms with coils. The authors present the results and complications of microcoils embolization of intracranial aneurysms in 28 patients. Fibers platinum microcoils were used (Target Therapeutic) 28 patients (males: 6, females: 22; mean age: 51 years) were treated, 27 suffered from sub-arachnoid hemorrhage (SAH) and one presented with a pseudotumoral syndrome (giant aneurysm). All patients were evaluated on the day of treatment, according to the World Federation of Neuro-Surgeon classification (W.F.N.S.) of SAH and after 4 months of follow-up. At a mean follow-up period of 4 months, according to Glasgow Outcome Scale (G.O.S.) there were 13 cases of good results, 5 cases of "moderate disability", 2 cases of "severe disability", 2 cases of "vegetative state" and 6 deaths. Complications were observed in 11/28 cases. Coils migration and malposition in the parent artery were linked to the procedure (mechanical detachable coil) and resulted in severe deficit (one case), transient disability (one case) or went unnoticed (4 cases). Primary or secondary complete occlusion was achieved in 8/28 patients (32%). A majority of cases (11 cases) ended with stable residual aneurysmal sac lumen while rebleeding occurred in 3 patients and was responsible for 2 deaths. In the third case a favourable outcome was obtained after balloon occlusion of the parent artery.
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Affiliation(s)
- P Holley
- Service de Neuroradiologie, CHU Purpan, Toulouse
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Richaud J, Boetto S, Lazorthes Y. Posterolateral approach and anterior spinal canal recalibration in severe spinal injury affecting T-12, L-1: a study of seven cases. Neurosurgery 1986; 19:218-27. [PMID: 3748349 DOI: 10.1227/00006123-198608000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The authors present seven cases of spinal trauma at the T-12--L-1 level with severe spinal canal stenosis secondary to compressive, anterior discocorporeal lesions. Associated neurological disorders were of varying severity. Six cases were investigated by computed tomography, which enabled the degree of thoracolumbar spinal canal stenosis to be determined. In all cases, the surgical procedure involved rectification of spinal deformity, with an initial unilateral posterolateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of ejected disc fragments. The stabilization was in all cases achieved by complimentary bilateral plates using Roy-Camille material, associated with posterolateral arthrodesis by grafting with reconstruction of the articulopedicular structure. The functional spinal result was excellent in all cases, and recalibration was verified by tomography. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis. The application of this posterolateral approach for severe lesions of the thoracolumbar junction seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods, which present widely recognized difficulties at the thoracoabdominal junction.
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