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Graillon T, Romanet P, Camilla C, Gelin C, Appay R, Roche C, Lagarde A, Mougel G, Farah K, Le Bras M, Engelhardt J, Kalamarides M, Peyre M, Amelot A, Emery E, Magro E, Cebula H, Aboukais R, Bauters C, Jouanneau E, Berhouma M, Cuny T, Dufour H, Loiseau H, Figarella-Branger D, Bauchet L, Binquet C, Barlier A, Goudet P. A cohort study of CNS tumors in Multiple Endocrine Neoplasia Type 1. Clin Cancer Res 2024:743077. [PMID: 38630553 DOI: 10.1158/1078-0432.ccr-23-3308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Multiple Endocrine Neoplasia Type-1 (MEN1) is thought to increase the risk of meningioma and ependymoma. Hereby, we aimed to describe the frequency, the incidence and specific clinical and histological features of CNS tumors in the MEN1 population (except pituitary tumors). EXPERIMENTAL DESIGN The study population included patients harboring CNS tumors diagnosed with MEN1 syndrome after 1990 and followed-up in the French MEN1 national cohort. Standardized incidence rate (SIR) was calculated based on the French Gironde CNS tumors registry. Genomic analyses were performed on somatic DNA from 7 CNS tumors including meningiomas and ependymomas from MEN1 patients, then in 50 sporadic meningiomas and ependymomas. RESULTS Twenty-nine CNS tumors were found among the 1498 symptomatic patients (2%) (incidence=47.4/100'000 person-years; SIR=4.5), including 12 meningiomas (0.8%) (incidence=16.2/100'000; SIR=2.5), 8 ependymomas (0.5%) (incidence=10.8/100'000; SIR=17.6), 5 astrocytomas (0.3%) (incidence=6.7/100'000; SIR=5.8), and 4 schwannomas (0.3%) (incidence=5.4/100'000; SIR=12.7). Meningiomas in MEN1 patients were benign, mostly meningothelial, with 11 years earlier onset compared to the sporadic population and an F/M ratio of 1/1. Spinal and cranial ependymomas were mostly classified WHO grade 2. A biallelic MEN1 inactivation was observed in 4/5 ependymomas and 1/2 meningiomas from the MEN1 patients, whereas MEN1 deletion in one allele was present in respectively 3/41 and 0/9 sporadic meningiomas and ependymomas. CONCLUSIONS Incidence of each CNS tumor was higher in the MEN1 population than in the French general population. Meningiomas and ependymomas should be considered part of the MEN1 syndrome, but somatic molecular data are missing to conclude for astrocytomas and schwannomas.
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Affiliation(s)
- Thomas Graillon
- Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Clara Camilla
- Marseille Public University Hospital System, Marseille, France
| | | | | | | | - Arnaud Lagarde
- Marseille Public University Hospital System, Marseille, France
| | | | | | - Maëlle Le Bras
- Department of Endocrinology, Diabetology and Nutrition, l'institut du thorax, CHU Nantes, Nantes, France, Nantes, France
| | | | | | | | | | | | - Elsa Magro
- Centre Hospitalier Régional Universitaire de Brest, France
| | | | - Rabih Aboukais
- Centre Hospitalier Régional et Universitaire de Lille, France
| | | | | | - Moncef Berhouma
- Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Thomas Cuny
- 15. Department of Endocrinology, Conception Hospital, Aix-Marseille University, France, Marseille, France
| | | | | | | | - Luc Bauchet
- University Hospital of Montpellier, Montpellier, France
| | | | | | - Pierre Goudet
- Centre Hospitalier Universitaire Dijon Bourgogne, France
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Verbraeken B, Aboukais R, Voormolen M, Van der Zijden T, Boogaarts HD, Vanloon M, Menovsky T. Posterior Cerebral Artery-to-Superior Cerebellar Artery Side-to-Side Bypass via Extreme Lateral Supracerebellar Infratentorial Approach: Technical Note. World Neurosurg 2024; 186:108-115. [PMID: 38521223 DOI: 10.1016/j.wneu.2024.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Difficult-to-treat aneurysms of the distal posterior cerebral artery (PCA) can often be treated by parent artery occlusion. A cerebrovascular bypass can complement PCA occlusion to curb the risk of ischemic complications. An in situ bypass may be considered when the occipital artery or superficial temporal artery cannot serve as a bypass donor. This article describes the use of a side-to-side bypass of superior cerebellar artery as a donor to the PCA via an extreme lateral supracerebellar infratentorial approach (ELSCIT). This bypass approach can be a useful surgical strategy for PCA revascularization. METHODS A 40-year-old woman underwent a side-to-side PCA-superior cerebellar artery bypass via the ELSCIT approach for to treat a complex and previously coiled PCA aneurysm. The bypass was followed by endovascular aneurysm and parent artery occlusion. RESULTS Postoperatively, the patient experienced transient, partial trochlear nerve palsy of the left eye without ischemic lesions on magnetic resonance imaging. The clinical condition was stable, and angiography showed a patent bypass and complete aneurysm occlusion 12 months after surgery. CONCLUSIONS The ELSCIT approach offers access to the medial and distal PCA that is suitable for a side-to-side PCA-superior cerebellar artery bypass. This type of approach and bypass may be of value when revascularization of a P2-P3 portion of the PCA is needed, but a suitable occipital artery or superficial temporal artery is not available.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Department of Pathology, Jessa Hospital Hasselt, Hasselt, Belgium
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Hospital Nord, Lille, France
| | - Maurits Voormolen
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Thijs Van der Zijden
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Hieronymus D Boogaarts
- Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Maarten Vanloon
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Devalckeneer A, Bourgeois P, Caudron Y, Estrade L, Obled L, Leclerc X, Assaker R, Lejeune JP, Aboukais R. Surgical evolution in spinal dural arteriovenous fistula treatment-a 7 years monocentric experience. Neurosurg Rev 2023; 46:225. [PMID: 37670160 DOI: 10.1007/s10143-023-02131-z] [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: 03/21/2023] [Revised: 07/10/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023]
Abstract
Accounting for 70% of all spinal vascular malformations, spinal dural arteriovenous fistulas (SDAVF) are the most common type of malformation. Interruption of the fistulous arterialized vein point is the goal of surgical treatment. The aim of the study was to compare open surgery (laminectomy) versus minimal invasive surgery (MIS) in SDAVF treatment. Between March 2013 and March 2020, we retrospectively collected 21 consecutive adult patients with SDAVF. Since March 2017, MIS has been routinely used for surgical treatment. Pre- and post-operative clinical evaluations used Aminoff-Logue score (ALS). Complication rate was noted. Post-operative occlusion of the malformation was confirmed by digital subtraction angiography (DSA) in all patients. MIS was compared to open surgery in terms of efficacy and complications with statistical evaluation. Standard laminectomy was performed in 12 patients and MIS technique in 9 patients. No difference was noted on pre-operative parameters. ALS and MRI signs of myelopathy were improved in all cases except for 1 patient in each group. All SDAVFs were excluded based on post-operative DSA. Significant differences were noted between the 2 groups in terms of perioperative blood loss (p<0.001), post-operative pain visual analog scale values (p<0.001), and first time out of bed (p<0.001). Wrong level surgery occurred in one patient in each group; patients were re-operated using the same technique. No infection or cerebrospinal fluid (CSF) leak was noted. In our experience, MIS is a safe alternative to open laminectomy for SDAVF treatment. MIS contributes to patient comfort and minimizes blood loss without increasing complication rate.
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Affiliation(s)
- Antoine Devalckeneer
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France.
- INSERM, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.
| | - Philippe Bourgeois
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
| | - Yohan Caudron
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
| | - Laurent Estrade
- Department of Radiology, Lille University Hospital, Lille, France
| | - Louis Obled
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
| | - Xavier Leclerc
- Department of Radiology, Lille University Hospital, Lille, France
| | - Richard Assaker
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
- INSERM, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Rue E. Laine, 59037, Lille Cedex, France
- INSERM, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
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Aboukais R, Karnoub MA, Haettel P, Bretzner M, Bourgeois P, Lejeune JP. Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option. Clin Neurol Neurosurg 2023; 232:107868. [PMID: 37421931 DOI: 10.1016/j.clineuro.2023.107868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Giant anterior communicating artery (AcomA) aneurysm represent a significant surgical challenge. Our study aimed to discuss the therapeutic strategy in patients with a giant AcomA aneurysm treated by selective neck clipping through a pterional approach. METHODS Among all operated patients from an intracranial aneurysm between January 2015 and January 2022 (n = 726) in our institution, three patients with a giant AcomA aneurysm treated by neck clipping were included. Early (<7days) outcome was noted. Early postoperative CT scan was performed in all patients to detect any complications. Early DSA was also performed to confirm giant AcomA aneurysm exclusion. The mRS score was recorded 3 months after treatment. The mRS≤ 2 was considered as a good functional outcome. Control DSA was performed one year after treatment. RESULTS In the three patients, after a large frontopterional approach, a selective exclusion of their giant AcomA aneurysm was obtained after a partial pars orbitalis of the inferior frontal gyrus resection. Ischemic lesion was noted in 1 patient and chronic hydrocephalus in 2 patients with ruptured aneurysm. The mRS score after 3 months was good in 2 patients. Long term complete occlusion of the aneurysm were noted in the three patients. CONCLUSION Selective clipping of a giant AcomA aneurysm is a reliable therapeutic option after a careful evaluation of local vascular anatomy. An adequate surgical exposure is frequently obtained through an enlarged pterional approach with an anterior basifrontal lobe resection, especially in an emergency situation and/or in case of high position of anterior communicating artery.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, France; Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000 Lille, France.
| | | | - Pierre Haettel
- Department of Neurosurgery, Lille University Hospital, France
| | - Martin Bretzner
- Department of Neuroradiology, Lille University Hospital, France
| | | | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, France; Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
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Vinchon M, Toubol A, Karnoub MA, Aboukais R, Leclerc X, Reyns N. Unruptured cerebral arteriovenous malformation in children: Outcome in treated and untreated patients. Neurochirurgie 2023; 69:101440. [PMID: 37060846 DOI: 10.1016/j.neuchi.2023.101440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/17/2023] [Accepted: 03/21/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND The management of unruptured cerebral arteriovenous malformation (URCAVM) is highly controversial; however, data regarding URCAVM in children are scarce. MATERIAL AND METHODS We retrospectively reviewed consecutive children followed for URCAVM in our department between 2001 and 2021. RESULTS Out of 36 patients, 12 were initially managed by observation, and 24 underwent first-line treatment: 8 by microsurgery, 10 by radiosurgery, 2 by embolization, and 4 by combined treatment. Mean follow-up of the whole group was 63months. Complete cure of the malformation was obtained in 14 patients (58%) in the treatment group: 8/8 in the microsurgery group, 5/10 in the radiosurgery group, 1/4 in the combined treatment group, and none in the embolization group. Two of the initially non-treated patients presented cerebral hemorrhage, with significant neurological consequences. In the treatment group, 5 patients presented new neurological deficits, only 1 of which, however, was functionally significant. Headache improved in 11 cases, mostly in the treatment group. Overall, 6 patients in the treatment group became asymptomatic, versus none in the observation group. CONCLUSIONS The treatment of URCAVM is a reasonable option in many pediatric cases, considering the cumulative risk of cerebral hemorrhage during the child's lifetime, as well as the symptoms specific to URCAVM. Microsurgery, when feasible, offers the best functional results and control of the AVM; however, the risk-benefit ratio should be weighed on a case-by-case basis. More studies will be needed to inform treatment decisions in pediatric URCAVM.
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Affiliation(s)
| | - Amelie Toubol
- Neurosurgery Clinic, Lille University Hospital, Lille, France
| | | | - Rabih Aboukais
- Neurosurgery Clinic, Lille University Hospital, Lille, France
| | - Xavier Leclerc
- Interventional Neuroradiology, Lille University Hospital, Lille, France
| | - Nicolas Reyns
- Neurosurgery Clinic, Lille University Hospital, Lille, France
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Tuleasca C, Aboukais R, Vannod-Michel Q, Lejeune JP. Microsurgical resection under intraoperative MRI guidance and diffusion tractography for a cavernous malformation of the primary motor cortex. Acta Neurol Belg 2022:10.1007/s13760-022-02112-x. [PMID: 36192595 DOI: 10.1007/s13760-022-02112-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Constantin Tuleasca
- Neurosurgery and Neurooncology Service, Lille University Hospital, Lille, France. .,Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, 1011, Lausanne, Switzerland. .,Faculty of Biology and Medicine (FBM), University of Lausanne (Unil), Lausanne, Switzerland. .,Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
| | - Rabih Aboukais
- Neurosurgery and Neurooncology Service, Lille University Hospital, Lille, France
| | | | - Jean-Paul Lejeune
- Neurosurgery and Neurooncology Service, Lille University Hospital, Lille, France
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Haettel P, Devalckeneer A, Bretzner M, Bourgeois P, Lejeune JP, Reyns N, Aboukais R. Cerebral arterio-venous malformations hemodynamics changes in hereditary hemorrhagic telangiectasia – case report. Neurochirurgie 2022; 68:e101-e103. [DOI: 10.1016/j.neuchi.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 11/26/2022]
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Aboukais R, Devalckeneer A, Boussemart P, Bourgeois P, Menovsky T, Leclerc X, Vinchon M, Lejeune JP. Is malignant edema and hemorrhage after occlusion of high-flow arteriovenous malformation related to the size of feeding arteries and draining veins? Neurochirurgie 2022; 68:e1-e7. [DOI: 10.1016/j.neuchi.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022]
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Devalckeneer A, Aboukais R, Bourgeois P, De Witte O, Racape J, Caron S, Perbet R, Maurage CA, Lejeune JP. Preliminary report of patients with meningiomas exposed to Cyproterone Acetate, Nomegestrol Acetate and Chlormadinone Acetate - Monocentric ongoing study on progestin related meningiomas. Clin Neurol Neurosurg 2021; 210:106959. [PMID: 34592677 DOI: 10.1016/j.clineuro.2021.106959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The relationship between meningioma and progestins has not been elucidated. Meningioma regression after acetate cyproterone (CA) withdrawal has been reported. Our purpose was to evaluate the meningioma evolution after withdrawal of progestins in patients who underwent long-term exposure to CA, nomegestrol acetate (NA), chlormadinone acetate (ChlA). METHODS Our study retrospectively included 69 patients with intracranial meningioma and exposed to one of these 3 progestins between December 2006 and March 2019. In each patient, clinico-radiological (MRI) follow-up was performed every 6 months after diagnosis and treatment withdrawal recommendation. Statistical analyses were applied to compare tumor location and respect of prescription rules between the 3 groups. RESULTS The mean hormonal exposure was 16 years in CA group (n = 46), 16 years in NA group (n = 12) and 9.7 years in ChlA group (n = 11). A higher rate of "out of label" use was observed in the CA group (p = 0.003). Multiple meningiomas were demonstrated in more than 60% of cases in each group. Anterior skull base location was noted in 60.5% of cases in CA group, 25% of cases in NA group and 36.7% of cases in ChlA group (p = 0.05). Incomplete tumor regression was recorded in 11 cases of CA group and in 2 cases of ChlA group. CONCLUSION In CA group, our results suggest a strong relationship between this treatment and development of intracranial meningioma. In presence of voluminous asymptomatic meningioma, treatment can be delayed due to the potential regression after withdrawal. On the contrary in NA and ChlA groups, further studies are needed.
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Affiliation(s)
- Antoine Devalckeneer
- Department of Neurosurgery, Lille University Hospital, Hôpital Nord, Rue E. Laine, 59037 Lille cedex, France.
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Hôpital Nord, Rue E. Laine, 59037 Lille cedex, France; Lille University, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
| | - Philippe Bourgeois
- Department of Neurosurgery, Lille University Hospital, Hôpital Nord, Rue E. Laine, 59037 Lille cedex, France
| | - Olivier De Witte
- Department of Neurosurgery, Erasme University Hospital, ULB, Belgique, Belgium
| | - Judith Racape
- Ecole de Santé Publique, Faculté de Médecine, ULB, Belgium
| | - Sabine Caron
- Department of Radiology, Lille University Hospital, Hôpital Nord, France
| | - Romain Perbet
- Department of Pathology, Centre Biologie Pathologie, Lille University Hospital, Hôpital Nord, France
| | - Claude-Alain Maurage
- Department of Pathology, Centre Biologie Pathologie, Lille University Hospital, Hôpital Nord, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, Hôpital Nord, Rue E. Laine, 59037 Lille cedex, France; Lille University, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
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Verbraeken B, Lavrysen E, Aboukais R, Menovsky T. Polyvinyl Alcohol Sponges to Facilitate Cerebral Bypass Surgery: Technical Note. World Neurosurg 2021; 156:53-55. [PMID: 34508907 DOI: 10.1016/j.wneu.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The standard way of isolating bypass vessels from surrounding structures during cerebral bypass surgery has been to use a rubber dam or neurosurgical patty. Here, the use of polyvinyl alcohol (PVA) sponges is described as a possible upgrade from these traditional bypass dams. METHODS PVA sponges were used to isolate bypass arteries from surrounding tissues during microvascular anastomosis in 25 patients undergoing bypass surgery at our institution. RESULTS There were no adverse events related to the use of PVA for microvascular anastomosis. PVA sponges offered some specific advantages when compared with rubber and cottonoid dams. CONCLUSIONS Although preliminary, our experience using PVA sponges during microvascular anastomosis suggests some of their properties can facilitate cerebral bypass surgery.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Eno Lavrysen
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Karnoub MA, Aboukais R, Obled L, Bourgeois P, Vinchon M, Leclerc X, Lejeune JP. Spontaneous disappearance of brain arteriovenous malformation: A case series. Neurochirurgie 2021; 68:163-167. [PMID: 34428471 DOI: 10.1016/j.neuchi.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/11/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Brain arteriovenous malformation (BAVM) is defined as abnormal communication between cerebral of arteries and veins, without capillaries. Clinically, it may involve intracranial hemorrhage or seizures. Complete spontaneous resolution, known as BAVM disappearance, has been reported in rare cases. METHODS We retrospectively collated all cases of BAVM in Lille University Hospital, from 2005 to 2018, and identified all cases of spontaneous BAVM disappearance on angiography (nidus and early venous drainage). RESULTS There were 4 cases of spontaneous BAVM disappearance, in 3573 patients: i.e., prevalence of 0.1%. Sex ratio was 2:2; ages ranged from 14 to 46 years; nidus size was generally small (<20mm); 3 of the 4 patients had superficial venous drainage. Revelation of BAVM was by hemorrhage in 3 cases and by seizure in 1. There were no cases of recanalization at 1 year's follow-up. CONCLUSION Spontaneous BAVM disappearance is rare. Associated factors may include small nidus, superficial venous drainage and hemorrhage.
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Affiliation(s)
- M-A Karnoub
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France.
| | - R Aboukais
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
| | - L Obled
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
| | - P Bourgeois
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
| | - M Vinchon
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
| | - X Leclerc
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
| | - J-P Lejeune
- Université Lille, CHU Lille, Neurosurgery Department, rue Emile Laine, 59000 Lille, France
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Verbraeken B, Aboukais R, Voormolen M, Boogaarts HD, Leclerc X, Lejeune JP, Menovsky T. Extreme Lateral Supracerebellar Infratentorial Approach (ELSCIT) for Occipital Artery-to-Posterior Cerebral Artery Bypass: Results in 3 Cases. World Neurosurg 2021; 152:214-220. [PMID: 34023461 DOI: 10.1016/j.wneu.2021.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE/BACKGROUND The need for revascularization of the distal posterior cerebral artery (PCA) in the treatment of PCA aneurysms is a contentious issue. Approaches to the PCA, such as the subtemporal route, carry significant perioperative risk. This risk at times outweighs the risk of ischemia associated with endovascular PCA sacrifice. This paper describes the use of an extreme lateral supracerebellar infratentorial (ELSCIT) approach as an alternative technique for distal PCA revascularization. METHODS Between 2016 and 2019, 3 patients underwent a PCA bypass via the ELSCIT approach for the treatment of a PCA aneurysm. In all cases, an end-to-side anastomosis to the P2- or P3-segment of the PCA was made, with the occipital artery as a donor. Bypass procedures were followed by endovascular parent artery occlusion, without ischemic complications. RESULTS In all 3 cases, the ELSCIT approach offered a broad enough surgical corridor to perform an occipital artery-to-PCA bypass. One patient suffered a cerebrospinal fluid leak that was surgically treated. Patients' clinical conditions were stable on follow-up (mean follow-up of 34 months). All 3 aneurysms remained occluded, and no ischemia was detected on magnetic resonance imaging. CONCLUSIONS The ELSCIT approach offers an alternative route to the distal PCA for extracranial-to-intracranial bypass with seemingly low perioperative morbidity and good surgical access to the PCA.
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Affiliation(s)
- Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Hopital Nord, Lille, France
| | - Maurits Voormolen
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Hieronymus D Boogaarts
- Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Xavier Leclerc
- Department of Neuroradiology, Lille University Hospital, Hopital Nord, Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, Hopital Nord, Lille, France
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital (UZA), Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Tuleasca C, Aboukais R, Vannod-Michel Q, Leclerc X, Reyns N, Lejeune JP. Intraoperative MRI for the microsurgical resection of meningiomas close to eloquent areas or dural sinuses: patient series. Journal of Neurosurgery: Case Lessons 2021; 1:CASE20149. [PMID: 35855309 PMCID: PMC9241345 DOI: 10.3171/case20149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Meningiomas are the most commonly encountered nonglial primary intracranial tumors. The authors report on the usefulness of intraoperative magnetic resonance imaging (iMRI) during microsurgical resection of meningiomas located close to eloquent areas or dural sinuses and on the feasibility of further radiation therapy. OBSERVATIONS Six patients benefited from this approach. The mean follow-up period after surgery was 3.3 (median 3.2, range 2.1–4.6) years. Five patients had no postoperative neurological deficit, of whom two with preoperative motor deficit completely recovered. One patient with preoperative left inferior limb deficit partially recovered. The mean interval between surgery and radiation therapy was 15.8 (median 16.9, range 1.4–40.5) months. Additional radiation therapy was required in five cases after surgery. The mean preoperative tumor volume was 38.7 (median 27.5, range 8.6–75.6) mL. The mean postoperative tumor volume was 1.2 (median 0.8, range 0–4.3) mL. At the last follow-up, all tumors were controlled. LESSONS The use of iMRI was particularly helpful to (1) decide on additional tumor resection according to iMRI findings during the surgical procedure; (2) evaluate the residual tumor volume at the end of the surgery; and (3) judge the need for further radiation and, in particular, the feasibility of single-fraction radiosurgery.
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Affiliation(s)
- Constantin Tuleasca
- Neurosurgery and Neurooncology Service and
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; and
- Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | | | - Xavier Leclerc
- Neuroradiology Department, Lille University Hospital, Lille, France
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Aboukais R, Tétard MC, Devalckeneer A, Boussemart P, Bourgeois P, Bricout N, Verbraeken B, Menovsky T, Leclerc X, Lejeune JP. Ruptured blood blister like aneurysm: does the best therapeutic option really exist? Neurosurg Rev 2021; 44:2767-2775. [PMID: 33411092 DOI: 10.1007/s10143-020-01463-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Our study aimed to evaluate the outcome of patients with ruptured blood-blister like aneurysm (BBLA) in our institution by comparing microsurgical selective treatment to endovascular treatment using flow-diverter stent (FD). Our study included 18 consecutive patients treated for BBLA between 2004 and 2020. Until 2014, microsurgery was preferred in all patients with BBLA (n = 10). Significant postoperative morbi-mortality was recorded at this time and led us to change therapeutic strategy and to favor FD as first-line treatment in all patients (n = 8). Postprocedural complications and BBLA occlusion were recorded. High WFNS score (> 2) was noted in 6 patients of microsurgical group and in 2 of endovascular group. In microsurgical group, ischemic lesions were noted in 6 patients and led to death in 3 patients. Immediate BBLA occlusion was obtained in all patients. Favorable outcome after 3 months (mRS < 3) was recorded in 4 of the 7 survivors. In endovascular group, ischemic lesions were noted in 4 patients. One patient died from early postprocedural BBLA rebleeding. Scarpa hematoma was noted in 3 patients with surgical evacuation in 1. Persistent BBLA at 3 months was recorded in 4 patients without rebleeding, but further FD was required in 1 with growing BBLA. Favorable outcome was noted in 6 of the 7 survivors. Although, rate of morbi-mortality appear lower in patients treated with FD, neurological presentation was better and BBLA diagnosis remains questionable in this group. Moreover, persistent BBLA imaging with potential risk of rebleeding after FD deserves to be discussed.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France.
| | - Marie Charlotte Tétard
- Department of Neurosurgery, Saint-Etienne University Hospital, Saint-Priest-en-Jarez, France
| | - Antoine Devalckeneer
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
| | - Pierre Boussemart
- Neurosurgical Intensive Care Department, Lille University Hospital, Lille, France
| | - Philippe Bourgeois
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
| | - Nicolas Bricout
- Department of Neuroradiology, Lille University Hospital, Lille, France
| | - Barbara Verbraeken
- Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Tomas Menovsky
- Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Xavier Leclerc
- Department of Neuroradiology, Lille University Hospital, Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France
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Aboukais R, Loiez C, Leclerc X, Bourgeois P, Wallet F, Menovsky T, Lejeune JP. Absence of bacteria in intracranial aneurysms. J Neurosurg 2020; 132:1197-1201. [DOI: 10.3171/2018.12.jns183044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/03/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThis study aimed to detect the presence of bacteria in the walls of both unruptured and ruptured aneurysms in a French population.METHODSPatients treated between January 2018 and July 2018 were included in a prospective study when specimens from ruptured or unruptured aneurysm walls were obtained intraoperatively. Samples from superficial temporal artery, dura mater, and middle meningeal artery were obtained from each patient during the same surgical procedure to be used as a negative control. Direct bacterial analysis, aerobic and anaerobic bacterial culture, and bacterial DNA detection were performed on each sample.RESULTSThere were 21 women and 9 men with a mean age at treatment of 54 years (range 31–70 years). Eighteen patients were smokers. Hypertension was present in 18 patients and hyperlipidemia in 5 patients. Chronic alcoholism was found in 6 patients. Polycystic kidney disease was present in 1 patient. Fifteen patients had multiple intracranial aneurysms. Ten patients had a ruptured aneurysm and 20 had an unruptured aneurysm. The mean diameter of all aneurysms was 8.5 mm (range 2.5–50 mm). No presence of bacteria was detected with direct bacterial analysis and culture in any of the samples. No bacterial DNA was detected in any of the samples.CONCLUSIONSUnlike in Finnish patients, no bacterial presence was found in the wall of aneurysms in French patients. This absence of bacterial infection might explain the lower risk of aneurysm rupture in the French population compared to the Finnish population.
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Affiliation(s)
- Rabih Aboukais
- 1Department of Neurosurgery, Lille University Hospital, Hopital Nord
- 2University Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille
| | - Caroline Loiez
- 3Laboratory of Bacteriology, Lille University Hospital, Hopital Nord
| | - Xavier Leclerc
- 4Department of Neuroradiology, Lille University Hospital, Hopital Nord, France; and
| | | | - Frederic Wallet
- 3Laboratory of Bacteriology, Lille University Hospital, Hopital Nord
| | - Tomas Menovsky
- 5Department of Neurosurgery, Antwerp University Hospital, University of Antwerp, Belgium
| | - Jean-Paul Lejeune
- 1Department of Neurosurgery, Lille University Hospital, Hopital Nord
- 2University Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille
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Aboukais R, Verbraeken B, Leclerc X, Gautier C, Henon H, Vermandel M, Menovsky T, Lejeune JP. Superficial temporal artery-middle cerebral artery anastomosis patency correlates with cerebrovascular reserve in adult moyamoya syndrome patients. Neurochirurgie 2019; 65:146-151. [DOI: 10.1016/j.neuchi.2019.05.001] [Citation(s) in RCA: 6] [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: 02/01/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
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Bonne NX, Risoud M, Hoa M, Lemesre PE, Aboukais R, Le Rhun E, Dubrulle F, Baroncini M, Lejeune JP, Vincent C. Hearing Response Following Internal Auditory Canal Decompression in Neurofibromatosis Type 2. Neurosurgery 2019; 85:E560-E567. [DOI: 10.1093/neuros/nyz057] [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] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 02/27/2019] [Indexed: 12/28/2022] Open
Abstract
AbstractBACKGROUNDHearing response following an osteodural decompression of the internal auditory canal (IAC) is controversial.OBJECTIVETo evaluate the course of auditory brainstem responses (ABRs) and the early hearing response during the first year following IAC decompression for small to medium-sized vestibular schwannomas occurring in neurofibromatosis type 2 (NF2).METHODSRetrospective chart review of middle fossa craniotomy for IAC osteodural decompression in NF2-related vestibular schwannomas.RESULTSTwelve NF2 patients were operated on from 2011 to 2016 for IAC decompression. All had NF2 according to the Manchester criteria. All had a progressive change of their ABRs documented from the diagnosis of NF2 over a mean period of 6.25 [0.36;10.9] yr. Treatment was proposed to stop hearing progression based on the speech discrimination scores (SDSs; n = 4) or for hearing maintenance (n = 8). In patients with prior hearing progression, hearing responses were observed in 3 of the 4 patients during the first year. One patient kept on progressing. In the hearing maintenance group, the SDSs remained stable. SDSs improved from 85% [20-100] to 92.5% [60-100] on average (n = 12) and from 55% [20-80] to 77.5% [50-100] in the hearing progression group (n = 4). ABRs improved in 4 patients following decompression.CONCLUSIONIAC decompression allows early objective hearing responses in select patients. We suggest that the procedure should be offered to patients with hearing progression based on their SDSs and/or associated progressive increases in their wave III and V latencies on ABRs.
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Affiliation(s)
- Nicolas-Xavier Bonne
- CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
- Université de Lille, Inserm U1192, Protéomique Réponse Inflamatoire Spectrométrie de Masse, PRISM, Lille, France
| | - Michaël Risoud
- CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Michael Hoa
- Department of Otolaryngology, Georgetown University Hospital, NC, Washington, District of Columbia
| | - Pierre-Emmanuel Lemesre
- CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Rabih Aboukais
- CHU Lille, Department of General and Stereotaxic Neurosurgery, Lille, France
| | - Emilie Le Rhun
- Université de Lille, Inserm U1192, Protéomique Réponse Inflamatoire Spectrométrie de Masse, PRISM, Lille, France
- CHU Lille, Department of General and Stereotaxic Neurosurgery, Lille, France
| | | | - Marc Baroncini
- CHU Lille, Department of General and Stereotaxic Neurosurgery, Lille, France
| | - Jean-Paul Lejeune
- CHU Lille, Department of General and Stereotaxic Neurosurgery, Lille, France
| | - Christophe Vincent
- CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
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Verbraeken B, Aboukais R, Lejeune JP, Lukes A, Menovsky T. Letter: Superficial Temporal Artery: Distal Posterior Cerebral Artery Bypass Through the Subtemporal Approach: Technical Note and Pilot Surgical Cases. Oper Neurosurg (Hagerstown) 2018; 15:46-47. [PMID: 29982804 DOI: 10.1093/ons/opy168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - Anton Lukes
- Department of NeurosurgeryLindenhofspitalBern, Switzerland
| | - Tomas Menovsky
- Department of NeurosurgeryAntwerp University HospitalEdegem, Belgium.,University of AntwerpAntwerp, Belgium
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Zairi F, Aboukais R, LE Rhun E, Marinho P, Maurage CA, Lejeune JP. Close follow-up after discontinuation of cyproterone acetate: a possible option to defer surgery in patients with voluminous intracranial meningioma. J Neurosurg Sci 2017; 61:98-101. [PMID: 27857037 DOI: 10.23736/s0390-5616.16.03243-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Fahed Zairi
- Department of Neurosurgery, Lille University Hospital, Lille, France -
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Quidet M, Aboukais R, Reyns N, Estrade L, Vinchon M. Faut-il traiter les malformations artério-veineuses non rompues de l’enfant ? Neurochirurgie 2017. [DOI: 10.1016/j.neuchi.2016.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Aboukais R, Estrade L, Devos P, Blond S, Lejeune JP, Reyns N. Gamma Knife Radiosurgery of Brainstem Cavernous Malformations. Stereotact Funct Neurosurg 2016; 94:397-403. [PMID: 27992870 DOI: 10.1159/000452844] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 10/18/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Our study aimed to evaluate the efficiency and morbidity of Gamma Knife radiosurgery (GKS) in the treatment of hemorrhagic brainstem cavernous malformations (CMs). METHODS We included in this study all patients who underwent GKS for the treatment of a hemorrhagic brainstem CM(s) in our institution between January 2007 and December 2012. The GKS was privileged when the surgical procedure was evaluated as very risky. The mean dose of radiation was 14.8 Gy, and the mean target volume was 0.282 cm3. All patients participated in a scheduled clinical follow-up. The posttreatment MRI was performed after 6 months and after 1 year, and then all patients had an annual MRI follow-up. RESULTS There were 19 patients with a mean age of 36.7 years. The mean follow-up period was 51.2 months. The annual hemorrhage rate (AHR) was 27.31% before GKS, 2.46% during the first 2 years following the GKS, and 2.46% after the first 2 years following the GKS. The decrease in AHR after GKS was significant (p < 0.001). CONCLUSION GKS should be suggested when the surgical procedure harbors a high risk of neurological morbidity in patients with brainstem CM. Compared to prior literature results, a lower dose than applied in this study could be discussed.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, CHU Lille, Université de Lille, Lille, France
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Aboukais R, Zairi F, Estrade L, Quidet M, Leclerc X, Lejeune JP. A dissecting aneurysm of a basilar perforating artery. Neurochirurgie 2016; 62:263-265. [PMID: 27546881 DOI: 10.1016/j.neuchi.2016.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 02/26/2016] [Accepted: 03/11/2016] [Indexed: 10/21/2022]
Abstract
We report an additional case of a ruptured basilar trunk perforator aneurysm, for which an endovascular treatment was initially planned, but aborted due to the spontaneous regression of the aneurysm. Thus, a conservative management consisting on a close follow-up was decided that confirmed the favorable radiological outcome. Spontaneous regression of such aneurysm should be well-known by neurosurgeons and neuroradiologists in order to prevent the potential iatrogenic effects of the related treatment modalities.
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Affiliation(s)
- R Aboukais
- Department of Neurosurgery, Lille University Hospital, France.
| | - F Zairi
- Department of Neurosurgery, Lille University Hospital, France
| | - L Estrade
- Department of Neuroradiology, Lille University Hospital, France
| | - M Quidet
- Department of Neurosurgery, Lille University Hospital, France
| | - X Leclerc
- Department of Neuroradiology, Lille University Hospital, France
| | - J-P Lejeune
- Department of Neurosurgery, Lille University Hospital, France
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Picry A, Bonne NX, Ding J, Aboukais R, Lejeune JP, Baroncini M, Dubrulle F, Vincent C. Long-term growth rate of vestibular schwannoma in neurofibromatosis 2: A volumetric consideration. Laryngoscope 2016; 126:2358-62. [PMID: 27075822 DOI: 10.1002/lary.25976] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 02/12/2016] [Accepted: 02/22/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the long-term growth rate of vestibular schwannoma (VS) in neurofibromatosis type 2 (NF2) patients based on volumetric measurements. STUDY DESIGN Retrospective review. METHODS We retrospectively reviewed magnetic resonance imaging (MRI) scans acquired from patients with NF2 from 1999 to 2013. Patients with an annual radiologic follow-up over at least 3 consecutive years were included. Volumetric VS growth was prospectively measured using a three-dimensional imaging workstation and through manual contouring of the lesion. Time to tumor progression was assessed according to the Response Evaluation in Neurofibromatosis and Schwannomatosis Tumor Measurement Group. RESULTS Eighteen patients presenting with a total of 26 VSs were included. The mean age at diagnosis was 26.1 years (range, 7 to 49 years). One hundred five MRI scans were analyzed during a median radiological follow-up of 5.6 years (range, 3 to 12 years). The annual volume and diameter growth rates were respectively 218.3 mm(3) /yr (range, -10 to 1,250 mm(3) /yr) and 0.9 mm/yr (range, -0.5 to 4.5 mm/yr). Time to tumor progression was 3 years (median survival). There was a weak correlation between volumetric and linear measurements (P < .0001, linear regression, n = 26, r(2) = 0.58). Among the 26 VSs, 76.9% (20/26) showed progression (VS growth more than 20%), 19.2% were stable, and 3.9% (1/26) exhibited shrinkage (spontaneous regression of more than 20% of the initial volume). CONCLUSIONS This study helps to assess the long-term growth profile of VS in a population of NF2 patients with untreated VS. These data could help to better acknowledge VS natural growth history. LEVEL OF EVIDENCE 4 Laryngoscope, 126:2358-2362, 2016.
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Affiliation(s)
- Aurore Picry
- Department of Otology and Neurotology, Roger Salengro Hospital, Lille University Hospital, Lille, France. .,Department of Anatomy, "Henri Warembourg" Faculty of Medicine, University of Lille, Lille, France.
| | - Nicolas-Xavier Bonne
- Department of Otology and Neurotology, Roger Salengro Hospital, Lille University Hospital, Lille, France
| | | | - Rabih Aboukais
- Department of Neurosurgery, Roger Salengro Hospital, Lille University Hospital, Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, Roger Salengro Hospital, Lille University Hospital, Lille, France
| | - Marc Baroncini
- Department of Neurosurgery, Roger Salengro Hospital, Lille University Hospital, Lille, France
| | - Frédérique Dubrulle
- Department of Radiology, Claude Huriez Hospital, Lille University Hospital, Lille, France
| | - Christophe Vincent
- Department of Otology and Neurotology, Roger Salengro Hospital, Lille University Hospital, Lille, France
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Edjlali-Goujon M, Hassen WB, Aboukais R, Nouet A, Bielle F, Clarençon F, Nataf F, Mokhtari K, Oppenheim C, Meder JF, Cornu P, Galanaud D, Chrétien F, Lejeune JP, Leclerc X, Maurage CA, Naggara O. Inflammation et paroi anévrysmale. J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bonne NX, Risoud M, Wilkinson EP, Aboukais R, Baroncini M, Lejeune JP, Vincent C. Infrared videoangiographic assessment of cochlear nerve vasculature during middle fossa surgery. Laryngoscope 2016; 126:2597-2600. [DOI: 10.1002/lary.25859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/01/2015] [Accepted: 12/10/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Nicolas-Xavier Bonne
- Department of Otology and Neurotology; University Hospital of Lille, and INSERM U1008 Controlled Drug Delivery Systems and Biomaterials, University of Lille; Lille France
| | - Michaël Risoud
- Department of Otology and Neurotology; University Hospital of Lille, and INSERM U1008 Controlled Drug Delivery Systems and Biomaterials, University of Lille; Lille France
| | | | - Rabih Aboukais
- Department of Neurosurgery; University Hospital of Lille; Lille France
| | - Marc Baroncini
- Department of Neurosurgery; University Hospital of Lille; Lille France
| | - Jean-Paul Lejeune
- Department of Neurosurgery; University Hospital of Lille; Lille France
| | - Christophe Vincent
- Department of Otology and Neurotology; University Hospital of Lille, and INSERM U1008 Controlled Drug Delivery Systems and Biomaterials, University of Lille; Lille France
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Aboukais R, Zairi F, Lejeune JP, Le Rhun E, Vermandel M, Blond S, Devos P, Reyns N. Response. J Neurosurg 2016; 124:584-585. [PMID: 27243045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Zairi F, Vieillard MH, Devos P, Aboukais R, Gras L, Assaker R. Corrigendum to “Management of neoplastic spinal tumors in a spine surgery care unit” [Clin. Neurol. Neurosurg. 128 (2015) 35–40]. Clin Neurol Neurosurg 2015. [DOI: 10.1016/j.clineuro.2015.07.010] [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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Edjlali M, Rodriguez-Régent C, Hodel J, Aboukais R, Trystram D, Pruvo JP, Meder JF, Oppenheim C, Lejeune JP, Leclerc X, Naggara O. Subarachnoid hemorrhage in ten questions. Diagn Interv Imaging 2015; 96:657-66. [PMID: 26141485 DOI: 10.1016/j.diii.2015.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/10/2015] [Indexed: 11/16/2022]
Abstract
Traumatic subarachnoid hemorrhage (SAH) has an annual incidence of 9 per 100 000 people. It is a rare but serious event, with an estimated mortality rate of 40% within the first 48hours. In 85% of cases, it is due to rupture of an intracranial aneurysm. In the early phase, during the first 24hours, cerebral CT, combined with intracranial CT angiography is recommended to make a positive diagnosis of SAH, to identify the cause and to investigate for an intracranial aneurysm. Cerebral MRI may be proposed if the patient's clinical condition allows it. FLAIR imaging is more sensitive than CT to demonstrate a subarachnoid hemorrhage and offers greater degrees of sensitivity for the diagnosis of restricted subarachnoid hemorrhage in cortical sulcus. A lumbar puncture should be performed if these investigations are normal while clinical suspicion is high.
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Affiliation(s)
- M Edjlali
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France; Department of Neuroradiology, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France.
| | - C Rodriguez-Régent
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France
| | - J Hodel
- Department of Neuroradiology, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France
| | - R Aboukais
- Department of Neurosurgery, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France
| | - D Trystram
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France
| | - J-P Pruvo
- Department of Neuroradiology, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France
| | - J-F Meder
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France
| | - C Oppenheim
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France
| | - J-P Lejeune
- Department of Neurosurgery, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France
| | - X Leclerc
- Department of Neuroradiology, Lille Nord de France University, Roger Salengro Hospital, Lille University Hospitals, avenue Émile-Laine, 59037 Lille cedex, France
| | - O Naggara
- Inserm UMR 894, Department of Neuroradiolgy, Faculty of Medicine Paris Descartes University, Pyschiatry and Neurosciences Centers, Sainte-Anne Hospital, Sorbonne Paris Cité, 1, rue Cabanis, 75014 Paris, France
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Aboukais R, Bonne NX, Baroncini M, Zairi F, Schapira S, Vincent C, Lejeune JP. Management of multiple tumors in neurofibromatosis type 2 patients. Neurochirurgie 2015; 64:364-369. [PMID: 26071178 DOI: 10.1016/j.neuchi.2014.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 07/05/2014] [Revised: 10/15/2014] [Accepted: 11/02/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neurofibromatosis type 2 is characterized by the presence of bilateral vestibular schwannomas. However, other nervous system tumors may also occur. Therefore, the management of NF2 patients is complex and requires a multidisciplinary discussion in a specialized center. MATERIALS AND METHODS All recent articles concerning tumors other than vestibular schwannoma in NF2 disease were reviewed, using PubMed databases. RESULTS Intracranial meningiomas occur in 50% of NF2 patients, and are often multiple. Surgery remains the main treatment and should be performed in cases of growing tumors. The role of antiangiogenic therapy is currently under evaluation and the role of radiosurgery still remains to be defined in NF2 disease. Spinal tumors occur in about half of NF2 patients. Surgery should be discussed when radiological tumor progression is demonstrated, even if spinal tumors are asymptomatic, in order to preserve neurological function and good quality of life. As regards lower cranial nerve schwannomas, radiosurgery appears to be a more appropriate treatment for growing tumor with a small volume in order to avoid post-operative complications, especially swallowing disorders. Facial nerve schwannomas may appear, on MRI, like vestibular schwannomas. The diagnosis should be suspected when the facial palsy is an early symptom during cerebello-pontine tumor progression. Trigeminal schwannomas are frequent in NF2 disease and fortunately they are often asymptomatic. Among major neurofibromatosis types, peripheral nerve sheath schwannomas are only present in patients with NF2 disease and schwannomatosis. Surgical resection is required when the cutaneous schwannomas is painful or when tumor progression is observed and causes symptoms. CONCLUSION Tumors other than vestibular schwannoma are also associated with a poor prognosis in NF2 patients. Surgery remains the main treatment in most cases. Each treatment decision in NF2 disease requires a complete evaluation of all cranial and spinal locations of the disease in order to establish surgical priorities and strategies.
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Affiliation(s)
- R Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France.
| | - N-X Bonne
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - M Baroncini
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - F Zairi
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - S Schapira
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - C Vincent
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - J-P Lejeune
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
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Abstract
OBJECT
World Health Organization Grade 2 meningiomas are aggressive tumors associated with a high recurrence rate leading to repeated surgical procedures, which can seriously worsen a patient's neurological status. Although radiosurgery is an increasingly popular technique, its role in the management of Grade 2 meningiomas has yet to be defined. In this study the authors aimed to evaluate radiosurgery in achieving control of proven tumor progression occurring after resection of Grade 2 meningioma.
METHODS
This retrospective study included consecutive patients who, between 2000 and 2012, had undergone radiosurgery for radiologically proven progression of a previously surgically treated Grade 2 meningioma.
RESULTS
Twenty-seven patients were eligible for analysis. There were 9 men and 18 women with a mean age of 59 years. The mean radiation dose was 15.2 Gy (range 12–21 Gy), and the mean target volume was 5.4 cm3 (range 0.194–14.2 cm3). Thirty-four radiosurgical procedures were performed in the 27 patients. The mean progression-free survival after radiosurgery was 32.4 months among those with progression in a target irradiated volume and 26.4 months among those with progression in any intracranial meninges. With a mean follow-up of 56.4 months (range 12–108 months), the 12-, 24-, and 36-month actuarial local control rates for all patients were 75%, 52%, and 40%, respectively, and the regional control rates were 75%, 48%, and 33%. A single case of transient hemiparesis completely resolved without sequelae.
CONCLUSIONS
Radiosurgery appears to be a safe and effective treatment for the local control of delayed progression after resection of a Grade 2 meningioma. Higher radiation doses similar to those applied for malignant tumors should be recommended when possible.
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Affiliation(s)
| | | | | | | | | | | | - Patrick Devos
- 3Statistics, Lille University Hospital, Lille, France
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Abstract
We report the case of a large dissecting aneurysm of the anterior cerebral artery revealed by cerebral infarction in 38-year-old man. The volume and aspect of the aneurysm initially led us to the diagnosis of saccular aneurysm. Given the complete thrombosis, the risk of bleeding was low and antithrombotic therapy was started. Surgery could be discussed later. However radiological monitoring by MRI (magnetic resonance imaging) showed a rapid decrease in volume of the aneurysm. The final angiography found an aspect of stenosis followed by a little arterial dilatation. The diagnosis of dissecting anterior cerebral aneurysm was a posteriori established.
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Affiliation(s)
- Rabih Aboukais
- Lille University Hospital, Department of Neurosurgery, Lille, France
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Aboukais R, Zairi F, Marinho P, Lejeune JP. Management of cardiac migration of a distal shunt catheter: The radiological pitfalls. Neurochirurgie 2015; 61:43-5. [DOI: 10.1016/j.neuchi.2014.10.109] [Citation(s) in RCA: 8] [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: 07/11/2014] [Revised: 09/21/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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Zairi F, Fahed Z, Vieillard MH, Marie-Helene V, Devos P, Patrick D, Aboukais R, Aboukais R, Gras L, Louis G, Assaker R, Richard A. Management of neoplastic spinal tumors in a spine surgery care unit. Clin Neurol Neurosurg 2014; 128:35-40. [PMID: 25462092 DOI: 10.1016/j.clineuro.2014.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 10/20/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND CONTEXT Spinal cord compression and fracture are possible complications of spine metastasis and multiple myeloma. Prompt diagnosis and treatment of threatening lesions are likely to reduce the frequency of these dreaded complications. PURPOSE To evaluate the proportion of neoplastic spine lesions operated on emergency. STUDY DESIGN Retrospective study. PATIENT SAMPLE All patients who underwent palliative surgery for the treatment of a neoplastic spine lesion in our institution between 2005 and 2012. OUTCOME MEASURES Percentage of patients who underwent surgery as an emergency for acute fracture or rapid neurological decline. METHODS We retrospectively reviewed the data of all patients who underwent palliative surgery for the treatment of a neoplastic spine lesion from solid cancer or multiple myeloma, in our institution between January 2005 and December 2012. The study was supported by grant from our institution. RESULTS A total of 317 patients were included in the study. There were 166 men and 151 women and the mean age was 57.97 years (range 26-88; SD 12.45). The cancer was known for 224 patients, while the lesion revealed the disease for the other 93 patients. The percentage of patients with known cancer operated as an emergency in our institution decreased significantly between 2005 and 2012 (p = 0.0006). CONCLUSION Due to the variability of clinical and radiological presentations, best care requires a truly multidisciplinary approach, to offer each patient a prompt and individualized treatment option, which is likely to reduce the incidence of emergency surgeries.
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Affiliation(s)
- Fahed Zairi
- Department of Neurosurgery, Lille University Hospital, Lille, France.
| | | | - Marie-Helene Vieillard
- Department of Rheumatology, Lille University Hospital, Lille, France; Department of Oncology, Centre Oscar Lambret, Lille, France
| | | | - Patrick Devos
- Department of Biostatistics, Lille University Hospital, Lille, France
| | | | - Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | | | - Louis Gras
- Department of Radiation Oncology, Centre Oscar Lambret, Lille, France
| | | | - Richard Assaker
- Department of Neurosurgery, Lille University Hospital, Lille, France
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Zairi F, Ouammou Y, Le Rhun E, Aboukais R, Blond S, Vermandel M, Deken V, Devos P, Reyns N. Relevance of gamma knife radiosurgery alone for the treatment of non-small cell lung cancer brain metastases. Clin Neurol Neurosurg 2014; 125:87-93. [DOI: 10.1016/j.clineuro.2014.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 07/21/2014] [Indexed: 11/26/2022]
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Hodel J, Aboukais R, Dutouquet B, Kalsoum E, Benadjaoud MA, Chechin D, Zins M, Rahmouni A, Luciani A, Pruvo JP, Lejeune JP, Leclerc X. Double inversion recovery MR sequence for the detection of subacute subarachnoid hemorrhage. AJNR Am J Neuroradiol 2014; 36:251-8. [PMID: 25213883 DOI: 10.3174/ajnr.a4102] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE The diagnosis of subacute subarachnoid hemorrhage is important because rebleeding may occur with subsequent life-threatening hemorrhage. Our aim was to determine the sensitivity of the 3D double inversion recovery sequence compared with CT, 2D and 3D FLAIR, 2D T2*, and 3D SWI sequences for the detection of subacute SAH. MATERIALS AND METHODS This prospective study included 25 patients with a CT-proved acute SAH. Brain imaging was repeated between days 14 and 16 (mean, 14.75 days) after clinical onset and included MR imaging (2D and 3D FLAIR, 2D T2*, SWI, and 3D double inversion recovery) after CT (median delay, 3 hours; range, 2-5 hours). A control group of 20 healthy volunteers was used for comparison. MR images and CT scans were analyzed independently in a randomized order by 3 blinded readers. For each subject, the presence or absence of hemorrhage was assessed in 4 subarachnoid areas (basal cisterns, Sylvian fissures, interhemispheric fissure, and convexity) and in brain ventricles. The diagnosis of subacute SAH was defined by the presence of at least 1 subarachnoid area with hemorrhage. RESULTS For the diagnosis of subacute SAH, the double inversion recovery sequence had a higher sensitivity compared with CT (P < .001), 2D FLAIR (P = .005), T2* (P = .02), SWI, and 3D FLAIR (P = .03) sequences. Hemorrhage was present for all patients in the interhemispheric fissure on double inversion recovery images, while no signal abnormality was noted in healthy volunteers. Interobserver agreement was excellent with double inversion recovery. CONCLUSIONS Our study showed that the double inversion recovery sequence has a higher sensitivity for the detection of subacute SAH than CT, 2D or 3D FLAIR, 2D T2*, and SWI.
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Affiliation(s)
- J Hodel
- From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.) Department of Radiology (J.H., M.Z.), Hôpital Saint Joseph, Paris, France
| | - R Aboukais
- Neurosurgery (R.A., J.-P.L.), Hôpital Roger Salengro, Lille, France
| | - B Dutouquet
- From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.)
| | - E Kalsoum
- From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.)
| | - M A Benadjaoud
- Institut National De La Santé et De La Recherche Médicale (M.A.B.), Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - D Chechin
- Philips Medical Systems (D.C.), Suresnes, France
| | - M Zins
- Department of Radiology (J.H., M.Z.), Hôpital Saint Joseph, Paris, France
| | - A Rahmouni
- Department of Radiology (A.R., A.L.), Centre Hospitalier Universitaire, Henri Mondor, Créteil, France
| | - A Luciani
- Department of Radiology (A.R., A.L.), Centre Hospitalier Universitaire, Henri Mondor, Créteil, France
| | - J-P Pruvo
- From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.)
| | - J-P Lejeune
- Neurosurgery (R.A., J.-P.L.), Hôpital Roger Salengro, Lille, France
| | - X Leclerc
- From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.)
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Zairi F, Le Rhun E, Ouammou Y, Aboukais R, Vermandel M, Blond S, Devos P, Reyns N. P08.15 * RELEVANCE OF GAMMA KNIFE RADIOSURGERY ALONE FOR THE TREATMENT OF NON-SMALL CELL LUNG CANCER BRAIN METASTASES. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.203] [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: 11/13/2022] Open
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Zairi F, Aboukais R, Marinho P, Allaoui M, Assaker R. Minimally invasive percutaneous stabilization plus balloon kyphoplasty for the treatment of type A thoraco lumbar spine fractures: minimum 4 year's follow-up. J Neurosurg Sci 2014; 58:169-175. [PMID: 25033976] [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: 06/03/2023]
Abstract
AIM There is no consensus regarding the ideal treatment of type A thoraco-lumbar fractures. Many surgical techniques have been described but none has demonstrated its superiority over others. Recently, minimally invasive techniques have been widely used as they reduce the immediate morbidity related to the procedure. Percutaneous pedicle screw stabilization plus balloon kyphoplasty is a valuable technique, but there are only few data regarding clinical and radiological results in the long term. The purpose of this study was to report the long-term clinical and radiological outcome of patients undergoing minimally invasive management of thoracolumbar fracture in our institution. METHODS This was a retrospective review of prospectively collected data. Between January 2006 and June 2008, 22 patients underwent short-segment percutaneous stabilization and balloon kyphoplasty for treatment of a type A fracture of the thoraco-lumbar spine. The study included 12 males and 10 females and the mean age was 50.5 years (25-75 years). The affected levels were T10 (N.=1), T11 (N.=1), T12 (N.=3), L1 (N.=9), L2 (N.=4), L3 (N.=3) and L4 (N.=1). RESULTS The mean follow-up period was 60.9 months (50-75 months). The mean operative time was 77 min (range 55-135 min) and the bleeding was very low (<100 mL). VAS was significantly improved from 6.1 to 1.1 at last follow-up. Vertebral kyphosis decreased by 19° to 7.7° (ap<0.001) and local kyphosis was also significantly improved from 12.3° to 4.4° at last follow-up. We reported one screw misplacement that required early repositioning and 4 cement leakage, none of which was symptomatic. No patient worsened his neurological condition postoperatively. CONCLUSION This treatment strategy is safe and effective. Clinical and radiological results seem to be stable over the time.
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Affiliation(s)
- F Zairi
- Lille University Hospital, Lille, France -
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Aboukais R, zairi F, Lejeune J, Vermandel M, Blond S, Le Rhun E, Reyns N. P06.07 * GRADE 2 MENINGIOMA AND RADIOSURGERY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.173] [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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Aboukais R, Zairi F, Reyns N, Le Rhun E, Touzet G, Blond S, Lejeune JP. Surgery followed by radiosurgery: A deliberate valuable strategy in the treatment of intracranial meningioma. Clin Neurol Neurosurg 2014; 124:123-6. [DOI: 10.1016/j.clineuro.2014.06.035] [Citation(s) in RCA: 9] [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: 03/19/2014] [Revised: 06/23/2014] [Accepted: 06/29/2014] [Indexed: 10/25/2022]
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Aboukais R, Zairi F, Bonne NX, Baroncini M, Schapira S, Vincent C, Lejeune JP. Causes of mortality in neurofibromatosis type 2. Br J Neurosurg 2014; 29:37-40. [DOI: 10.3109/02688697.2014.952266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aboukais R, Reyns N, Zairi F, Touzet G, Blond S, Lejeune JP. Chirurgie et radiochirurgie : traitement combiné des méningiomes intracrâniens de localisation critique. Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.042] [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: 10/25/2022]
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Aboukais R, Baroncini M, Zairi F, Reyns N, Lejeune JP. Early postoperative radiotherapy improves progression free survival in patients with grade 2 meningioma. Acta Neurochir (Wien) 2013; 155:1385-90; discussion 1390. [PMID: 23728501 DOI: 10.1007/s00701-013-1775-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [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: 03/18/2013] [Accepted: 05/13/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Grade 2 meningiomas are a real problem in therapeutic management because of their tendency to reoccur. The most effective treatment is surgery. The role of adjuvant radiotherapy in this disease is still disputed due to its uncertain effect on progression-free survival. OBJECTIVE To show that early adjuvant radiotherapy is an effective treatment in patients with grade 2 meningiomas. MATERIALS AND METHODS A retrospective study was performed on all patients operated on for grade 2 meningioma in our center between 1994 and 2011. For every patient, we recorded the age at diagnosis, sex, background of neurofibromatosis type 2 (NF2) or meningiomatosis, location of meningioma, quality of tumor resection and whether the patient received early postoperative radiotherapy. These prognosis factors were studied using statistical tests. RESULTS We included 167 patients (94 women, 73 men, sex ratio = 1.28); the mean age at diagnosis was 53.8 years. Twenty-seven patients received early adjuvant radiotherapy after surgery. Patients who received early postoperative radiotherapy had a significantly longer progression-free survival (8.2 years) than patients without radiotherapy (5.7 years, p = 0.04). In multivariate analysis, quality of tumor resection and early postoperative radiotherapy decrease the risk of recurrence of meningioma (p < 0.05). CONCLUSION Adjuvant radiotherapy is an important therapeutic tool in the treatment of patients with grade 2 meningioma. It delays tumor progression and reduces the need for further surgery. Adjuvant radiotherapy must be considered as a treatment option in oncological multidisciplinary meetings, regardless of the quality of surgical resection.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037 Lille cedex, France.
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Aboukais R, Zairi F, Baroncini M, Bonne NX, Schapira S, Vincent C, Lejeune JP. Intracranial meningiomas and neurofibromatosis type 2. Acta Neurochir (Wien) 2013; 155:997-1001; discussion 1001. [PMID: 23558725 DOI: 10.1007/s00701-013-1692-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 01/07/2013] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE In spite of the few clinical studies regarding the occurrence of intracranial meningiomas, their prognosis in neurofibromatosis type 2 (NF2) has not been accurately assessed and their management remains controversial. This study aims to compare NF2 patients with intracranial meningiomas to those without, and consequently to identify prognostic factors in attempt to improve the management of these tumors. METHODS This retrospective study includes a total of 80 NF2 patients followed at Lille Hospital Center between 1987 and 2011. The diagnosis of NF2 was confirmed either because the patient met the Manchester criteria or by the presence of genetic mutation. Clinical, radiological and genetic data were retrospectively recorded and analyzed. Patients underwent annual cranial and spinal MRI. Both location and size of each tumor were reported. RESULTS The mean follow-up period was 8.8 years (range 1-24 years; SD: ±0.8) and the mean age at diagnosis was 27.2 years (range 6-73 years; SD: ±1.7). Among all patients, 34 harbored intracranial meningiomas. Patients with intracranial meningiomas had a higher number of intracranial schwannomas, spinal tumors and cutaneous tumors (p < 0.05). They underwent more surgical procedures (p < 0.012). Twenty five intracranial meningiomas were surgically removed in 17 patients. The decision to perform surgery was taken in 10 cases for symptomatic tumors and in 15 cases for growing asymptomatic tumors determined by radiology. The histological analysis found a high rate of fibroblastic, transitional or grade 2 meningiomas preferentially located at the cerebri falx. CONCLUSION Intracranial meningiomas are common in NF2. They are associated with poor prognosis factors. Clinical and radiological monitoring could lead to early treatment of these tumors both when clinical symptoms are present and in case of proven radiological evolution, and thus trying to maintain a favorable functional prognosis for as long as possible.
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Affiliation(s)
- Rabih Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037, Lille cedex, France.
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Aboukais R, Baroncini M, Zairi F, Reyns N, Lejeune JP. La radiothérapie post-chirurgicale précoce augmente la survie sans progression tumorale des patients présentant un méningiome de grade 2. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zaïri F, Aboukais R, Thines L, Allaoui M, Assaker R. Relevance of expandable titanium cage for the treatment of cervical spondylotic myelopathy. Eur Spine J 2012; 21:1545-50. [PMID: 22639300 DOI: 10.1007/s00586-012-2380-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 05/06/2012] [Accepted: 05/13/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND In patients with cervical spondylotic myelopathy, ventral disease and loss of physiological cervical lordosis are indications for anterior approach. As bone graft and titanium cage present many drawbacks, expandable titanium cage has been recently introduced for this indication. The authors present the clinical and radiological outcomes in patients undergoing the placement of an expandable cage in the treatment of spondylotic myelopathy with straight or kyphotic cervical spine alignment. METHODS This was a retrospective review of prospectively collected data. A total of 26 patients underwent cervical corpectomy and reconstruction using an expandable titanium cage and anterior plate between 2005 and 2008. Pain and functional disability were measured using VAS and mJOA preoperatively and at 3 months, 6 months, 1 year and 2 years. Kyphosis was measured using lateral radiographs at the same points of follow-up. Fusion was evaluated on flexion-extension radiographs at 2 years. RESULTS The mean VAS improved from 4.2 to 1.7 and the mean mJOA increased from 12.85 to 16.04 at 2 years postoperatively (p < 0.05). The mean kyphosis angle decreased from 17° to 2° at the last follow-up (p < 0.05). The fusion rate was 100% at 2 years. Three complications were reported including a transient dysphagia, an epidural hematoma and an early hardware migration. CONCLUSION Expandable titanium cage is an effective device, which achieves good clinical and radiological outcomes at a minimum 2-year follow-up.
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Affiliation(s)
- Fahed Zaïri
- Department of Neurosurgery, Lille University Hospital, Lille, France.
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