G Brassier

Université de Rennes 1, Roazhon, Brittany, France

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Publications (104)121.02 Total impact

  • P. Mercier · M. Delion · M. Braun · G. Brassier
    Morphologie 09/2014; 98(322):129. DOI:10.1016/j.morpho.2014.04.072
  • P. Mercier · M. Delion · X. Papon · M. Dalibault · G. Brassier
    Morphologie 10/2013; 97(s 318–319):85. DOI:10.1016/j.morpho.2013.09.062
  • Gilles Brassier · Jean-Yves Poirier
  • Gilles Brassier · Jean-Yves Poirier
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    ABSTRACT: Background: Haemangioblastomas are benign vascular tumours that may appear sporadically or in von Hippel-Lindau disease. Despite their higher incidence, sporadic haemangioblastomas have been less studied than syndromic ones. In this article, we evaluate the specific features, outcome and quality of life of patients with intracranial sporadic haemangioblastomas (ISHs) operated on in our institution. Methods: Between 1998 and 2010, 38 patients harbouring 38 ISHs were operated on in our department. Their clinical, biological, radiological and surgical features were retrospectively reviewed. All patients were contacted for a quality-of-life (QOL) survey assessed by the Short Form 36 questionnaire (SF36). The mean duration of follow-up was 40 months (13-108 months). Results: ISH represented 0.9 % of primary intracranial neoplasms treated in our centre during this period. Patients comprised 23 men and 15 women with a mean age of 47 years. None had polycythaemia. Cerebellar locations accounted for 79 % of ISHs, and brainstem ISH with involvement of the floor of the fourth ventricle represented 11 % of ISHs. At last follow-up, two patients harbouring solid medulla oblongata haemangioblastoma had died following severe bulbar syndrome and five patients had died of unrelated causes. One patient had multiple surgeries for three recurrences. Tumoral control was achieved in all cases at last follow-up. Results of the SF-36 questionnaire were as follows: median physical functioning score 100 (range 0-100), median physical problems score 100 (range 0-100), median bodily pain score 100 (range 45-100), median social functioning score 100 (range 25-100), median general mental health score 84 (range 40-92), median emotional problems score 100 (range 0-100), median vitality score 70 (range 35-80) and median general health perceptions score 70 (range 35-100). Mean QOL scores were similar to the general healthy population. Conclusion: Surgery of ISH provides good QOL and tumoral control except for those located in the medulla oblongata. We recommend considering a careful multimodal therapeutic approach, including radiosurgery for these specific locations.
    Acta Neurochirurgica 04/2013; 155(6). DOI:10.1007/s00701-013-1681-5 · 1.77 Impact Factor
  • P. Mercier · M. Delion · X. Papon · P.-L. Henaux · G. Brassier
    Morphologie 10/2012; 96(s 314–315):67. DOI:10.1016/j.morpho.2012.08.004
  • Annales d Endocrinologie 09/2012; 73(4):293-294. DOI:10.1016/j.ando.2012.07.197 · 0.87 Impact Factor
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    ABSTRACT: Craniopharyngiomas are often associated with an unfavorable prognosis, but data on their long-term consequences are sparse. The aim of the study was to identify markers of recurrence and factors associated with compromised social rehabilitation and altered quality of life in a large cohort of patients with either childhood-onset (CO) or adult-onset craniopharyngioma. Retrospective analysis was performed for 171 patients treated for craniopharyngioma in two academic centers in France between 1972 and 2009. For each subject, data were collected concerning clinical presentation, imaging features, visual sequelae, endocrine and metabolic impact, treatment modalities (surgery, radiotherapy), recurrence-free survival rate, and social insertion, as well as answers to the WHO-QOL BREF questionnaire. A total of 65 CO and 106 adult-onset patients were reviewed. If CO was diagnosed before the age of 10 yr, this was associated with a higher incidence of obesity, blindness, and panhypopituitarism, and only 40.7% of subjects had adequate work or school attendance compared to 72.4% of patients with later disease onset. Initial symptoms of intracranial hypertension (SIHT), pterional surgery, and multiple surgery were associated with obesity and poorer social insertion. No determinant of quality of life was identified. In the subgroup of patients treated in the 1990s and later, the progression rate was 59.4% in patients with residual tumor on magnetic resonance imaging compared with a 19.8% recurrence rate in the group with apparently complete resection. Recurrence/progression correlates significantly with male gender, early onset (before 10 yr), and SIHT, but only SIHT at presentation remained a significant predictor with multivariate analysis. Craniopharyngioma continues to be associated with severe outcomes. Higher morbidity rates are found in patients with early-onset disease (before 10 yr), initial SIHT, or in whom pterional surgery was required. Markers of recurrence are difficult to identify, with SIHT being the most powerful predictor.
    The Journal of Clinical Endocrinology and Metabolism 02/2012; 97(4):1258-67. DOI:10.1210/jc.2011-2817 · 6.21 Impact Factor
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    ABSTRACT: Type IIB odontoid fractures (OF) in elderly patients are life-threatening conditions. Optimal treatment of these fractures is still controversial. The aim of this study was to assess the clinical and radiological outcome of surgically treated type IIB OF by anterior screw fixation in octogenarians. Eleven octogenarians with type IIB OF were operated using anterior screw fixation. Follow-up assessment included operative mortality and morbidity rates, long-term functional outcome and fracture union and stability. There was neither operative mortality nor morbidity. Five patients had excellent clinical outcome, two good outcome, one fair and three poor. Two patients died of unrelated causes 2 months after surgery. Radiographs showed stable bone union in four patients and stable fibrous union in five patients. Given the results in this short series, we suggest that anterior screw fixation of Type IIB OF may be offered as primary treatment in octogenarians.
    European Spine Journal 02/2012; 21(2):335-9. DOI:10.1007/s00586-011-2044-7 · 2.07 Impact Factor
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    ABSTRACT: Cauda equina tumours (CET) are rare and usually benign. Treatment of schwannomas and benign ependymomas, which are the most frequent histopathological types of CET, is now well established. However, management of other presumed histopathological types of CET is still a matter of debate. The aim of this study was to assess the incidence and the surgical treatment of rare CET. A retrospective study was carried out on 176 adult patients surgically treated for CET in our two departments from 1994 to 2010. We reviewed pre- and postoperative symptoms, magnetic resonance imaging aspects, surgical findings, outcome including operative neurological morbidity, local recurrence rate and operative mortality, and incidence of rare CET. Seventeen percent (30 patients) of CETs operated on were neither schwannomas nor benign ependymomas. Half of these cases were benign tumours, with paragangliomas being the most common. Two patients were in poorer clinical condition after surgery, one patient experienced a local recurrence, and one died following surgery, from the progress of his disease (Von Hippel-Lindau disease). The other half were malignant tumours, with metastases being the most common. One third of the patients were worsened by surgery, and the mortality rate was 1/3 at 8 months (1-27 months). Roughly one in six CET were neither schwannomas nor benign ependymomas. This study demonstrated the efficiency of surgery for rare benign CET with a low local recurrence rate. Surgical treatment of rare malignant CET led to a high rate of increased postoperative neurological deficit in patients with a reduced life expectancy.
    Acta Neurochirurgica 09/2011; 153(9):1787-96. DOI:10.1007/s00701-011-1094-2 · 1.77 Impact Factor
  • Neurochirurgie 09/2011; 57(s 4–6):272. DOI:10.1016/j.neuchi.2011.09.071 · 0.41 Impact Factor
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    ABSTRACT: This article describes a two-year surveillance of neurosurgical site infections and an outbreak of infections in deep brain stimulation (DBS) cases. From April to December 2008, six patients had a DBS surgical site infection (SSI). Audits of hygiene practices, infection control of the healthcare environment, and preoperative antimicrobial prophylaxis characteristics were carried out. The results of surgical audits showed that skin preparation and antimicrobial prophylaxis were not being performed adequately. In 2008, the general SSI rate was 1.8% (27 SSIs/1471 patients). Length of preoperative stay was significantly longer among infected patients (2.7 ± 2.9 months) compared with uninfected patients (2.2 ± 4.6 months) (P=0.01). Based on these results, skin preparation and antimicrobial prophylaxis were reviewed with the neurosurgery team. In 2009, the general SSI rate was reduced to 1.1% (16 SSI in 1410 patients), a reduction from 2008 (P=0.12). Although the overall incidence of SSI in 2008 (1.8%) was within the range of published data, this surveillance of SSIs permitted identification of site operative infected patients surgically treated for DBS. A set of actions was then taken to reduce SSI risk. This work demonstrates how an active surveillance programme can successfully change clinical care practice.
    The Journal of hospital infection 04/2011; 77(4):352-5. DOI:10.1016/j.jhin.2010.10.011 · 2.54 Impact Factor
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    S Diabira · P-L Henaux · L Riffaud · A Hamlat · G Brassier · X Morandi
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    ABSTRACT: Brown-Sequard syndrome (BSS) is a rare form of severe myelopathy characterised by a clinical picture reflecting hemisection of the spinal cord. This syndrome is mostly due to a penetrating injury to the spine but many other non-traumatic causes have been described. Intradural thoracic disc herniation (TDH) is one of the rare aetiologies of this syndrome. Despite progress in imaging techniques, diagnosis and treatment remain difficult. We retrospectively reviewed one of the largest reported series of six patients with BSS revealing intradural TDH between 2003 and 2007. There was a marked female predominance and the mean age was 44 years. Before surgery, half of the patients had a severe neurological deficit. The mean duration of symptoms until surgery was 8.5 months (range 0.5-24 months). Spine magnetic resonance imaging (MRI) or spine computer tomography scan showed calcified TDH between T5-T6 and T9-T10. The intradural location of the thoracic herniation was strongly suspected from the clinical data. All the patients underwent posterolateral transpedicular surgery with an operative microscope to open the dura mater. The intradural location of the herniation was overlooked in one case and the patient underwent a second procedure. The dura mater was carefully closed. Two patients' condition worsened immediately after the surgery before slowly improving. All the other patients improved their neurological status immediately after the surgery and at 12 months follow-up. BSS with TDH on the spine MRI scan may be a warning symptom of the intradural location of the herniated disc. In such cases, spine surgeons are advised to use an operative magnification and to open the dura mater to avoid missing this potentially curable cause of severe myelopathy.
    European Spine Journal 01/2011; 20(1):65-70. DOI:10.1007/s00586-010-1498-3 · 2.07 Impact Factor
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    ABSTRACT: I tumori spinali e intrarachidei sono suscettibili di causare una morbilità neurologica importante. Questi tumori si rivelano, il più delle volte, con un dolore vertebrale, vero e proprio sintomo cardine che può associarsi a un deficit motorio e/o sensitivo di comparsa progressiva o subacuta e associato a disturbi vescicosfinterici. La risonanza magnetica è l’esame chiave nella valutazione di questi tumori che possono essere vertebrali ossei, epidurali o intradurali o strettamente intramidollari. Essa permette uno studio anatomico preciso del rachide, del suo contenuto e delle parti molli circostanti. La TC conserva la sua utilità per lo studio dei tumori a componente ossea. Le neoplasie vertebrali ed epidurali sono essenzialmente delle metastasi, il cui programma terapeutico è molto progredito nei tempi recenti. Se possibile, è proposta in prima intenzione una chirurgia circonferenziale con stabilizzazione, seguita da una radioterapia e/o dalla chemioterapia. I meningiomi e gli schwannomi sono i tumori intradurali ed extramidollari più frequenti. Essi sono, generalmente, benigni, e il loro trattamento è essenzialmente chirurgico, con un’exeresi spesso completa. I tumori intramidollari sono molto rari e sono rappresentati soprattutto dagli astrocitomi e dagli ependimomi, la cui rimozione chirurgica è più difficile pur restando il solo trattamento efficace.
    01/2011; 11(3):1–22. DOI:10.1016/S1634-7072(11)70656-0
  • Neurochirurgie 12/2010; 56(6):538-538. DOI:10.1016/j.neuchi.2010.10.043 · 0.41 Impact Factor
  • Neurochirurgie 12/2010; 56(6):528-528. DOI:10.1016/j.neuchi.2010.10.013 · 0.41 Impact Factor
  • Neurochirurgie 12/2010; 56(6). DOI:10.1016/j.neuchi.2010.10.019 · 0.41 Impact Factor
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    ABSTRACT: Olfactory ensheathing cell tumour (OECT) and olfactory groove schwannoma (OGS) are among the rarest intracranial tumour types that develop within anterior cranial fossa. These tumours share several similarities, including radiological and histological aspects, and only immunohistochemical staining can differentiate between them. We report a case of OECT occurring in a 28-year-old woman with a history of complex partial seizures, emotional lability and anosmia. Radiological features showed a predominantly left subfrontal extra-axial mass. Total excision of the tumour, connected to the cribriform plate and contiguous to the left olfactory bulb, was performed. Histological examination suggested an atypical schwannoma; however, immunohistochemical staining was strongly positive for S-100 protein but negative for both epithelial membrane antigen (EMA) and CD 57 (Leu-7). The final diagnosis was olfactory ensheathing cell tumour. We describe the third case of OECT and emphasize the important role of immunohistochemical staining in diagnosis: awareness of this entity, and use of immunohistochemistry help to distinguish it from OGS.
    Journal of Neuro-Oncology 04/2010; 100(2):285-9. DOI:10.1007/s11060-010-0162-4 · 3.07 Impact Factor

Publication Stats

670 Citations
121.02 Total Impact Points


  • 2001–2012
    • Université de Rennes 1
      • Faculty of Medicine
      Roazhon, Brittany, France
  • 2003–2007
    • Centre Hospitalier Universitaire de Rennes
      • Service de neurochirurgie
      Roazhon, Brittany, France
  • 2004
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 1999–2004
    • Université de Rennes 2
      Roazhon, Brittany, France