G Brassier

Université de Rennes 1, Roazhon, Brittany, France

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Publications (101)121.1 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We report the results of an investigation carried out on the activity of functional neurosurgery of the cranial nerves in the French-speaking countries, based on the analysis of a questionnaire addressed to all the members of the SNCLF. Eighteen centers responded to this questionnaire, which showed that activities and indications varied greatly from one unit to another. The results appear homogeneous and comparable with those reported in the literature. The questionnaire sought to provide a global perspective, open to the comments and questions of all responders on the various techniques raised, with the objective of establishing a common decisional tree for these pathologies and providing if possible to a consensus for better dissemination of these therapies.
    Neurochirurgie 04/2009; 55(2):282-90. DOI:10.1016/j.neuchi.2009.02.005 · 0.47 Impact Factor
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    ABSTRACT: The subthalamic nucleus (STN) has become an effective target of deep-brain stimulation (DBS) in severely disabled patients with advanced Parkinson’s disease (PD). Clinical studies have reported DBS-induced adverse effects on cognitive functions, mood, emotion and behavior. STN DBS seems to interfere with the limbic functions of the basal ganglia, but the limbic effects of STN DBS are controversial. We measured prospectively resting regional cerebral metabolism (rCMb) with 18-fluorodeoxyglucose and PET, and resting regional cerebral blood flow (rCBF) with HMPAO and SPECT in six patients with Parkinson’s disease. We compared PET and SPECT 1month before and 3months after STN DBS. On cerebral MRI, 13 regions of interest (ROI) were manually delineated slice by slice in frontal and limbic lobes. We obtained mean rCBF and rCMb values for each ROI and the whole brain. We normalized rCBF and rCMB values to ones for the whole brain volume, which we compared before and following STN DBS. No significant difference emerged in the SPECT analysis. PET analysis revealed a significant decrease in rCMb following STN DBS in the superior frontal gyri and left and right dorsolateral prefrontal cortex (p<0.05). A non-significant decrease in rCMb in the left anterior cingulate gyrus appeared following STN DBS (p=0.075). Our prospective SPECT and PET study revealed significantly decreased glucose metabolism of the two superior frontal gyri without any attendant perfusion changes following STN DBS. These results suggest that STN DBS may change medial prefrontal function and therefore the integration of limbic information, either by disrupting emotional processes within the STN, or by hampering the normal function of a limbic circuit. KeywordsDeep brain stimulation-Functional imaging-Limbic system-Parkinson’s disease-Subthalamic nucleus
    Journal of Neurology 03/2009; 257(3):375-382. DOI:10.1007/s00415-009-5327-8 · 3.84 Impact Factor
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    ABSTRACT: Metastatic spreading is a rare complication of meningioma. We report a subcutaneous metastasis from an atypical meningioma of the tentorium. A 69-year-old man presented with a meningioma of the tentorium. The tumor was totally resected. The histological diagnosis was atypical meningioma. The tumor recurred two years later and was irradiated. Despite irradiation, the tumor progressed and was resected three years later. Five months following the second surgery, an isolated subcutaneous mass developed at the skin incision and was resected. The histological examination of the subcutaneous tumor showed histological features of atypical meningioma. Surgery of atypical meningioma carries the risk of iatrogenic metastasis, despite previous irradiation.RésuméNous rapportons le cas d’un patient ayant présenté une métastase sous-cutanée d’un méningiome atypique de la tente du cervelet. Il s’agit d’un homme de 69 ans, opéré d’un méningiome de la tente du cervelet avec exérèse totale (Simpson II). Deux ans après, la tumeur a récidivé. Le patient a été irradié après refus d’une nouvelle intervention. Trois ans après la radiothérapie, et devant la poursuite évolutive tumorale, le patient a été réopéré avec une exérèse totale (Simpson I). Cinq mois plus tard, il est réopéré pour une masse sous-cutanée en regard de la voie d’abord. L’examen histologique confirme le diagnostic de métastase d’un méningiome atypique. La chirurgie des méningiomes atypiques comporte un risque de métastases iatrogènes, même après une radiothérapie préalable.
    Neurochirurgie 08/2008; 54(4):556-560. DOI:10.1016/j.neuchi.2008.02.065 · 0.47 Impact Factor
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    ABSTRACT: Metastatic spreading is a rare complication of meningioma. We report a subcutaneous metastasis from an atypical meningioma of the tentorium. A 69-year-old man presented with a meningioma of the tentorium. The tumor was totally resected. The histological diagnosis was atypical meningioma. The tumor recurred two years later and was irradiated. Despite irradiation, the tumor progressed and was resected three years later. Five months following the second surgery, an isolated subcutaneous mass developed at the skin incision and was resected. The histological examination of the subcutaneous tumor showed histological features of atypical meningioma. Surgery of atypical meningioma carries the risk of iatrogenic metastasis, despite previous irradiation.
    Neurochirurgie 07/2008; 54(4):556-60. · 0.47 Impact Factor
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    ABSTRACT: The aim of this report is to illustrate the successful surgical management of five patients with suprasellar retrochiasmatic and diencephalo-mesencephalic tumours, using a trans-amygdala extension of the trans-temporal/trans-choroidal fissure approach. The procedure is described for five surgically treated patients with such lesions that includes three retrochiasmatic craniopharyngiomas, one hypothalamic hamartoma, and one pilocytic astrocytoma in the left crus cerebri. The management procedure included computed tomography scan (CT scan) and magnetic resonance imaging (MRI). The trans-temporal/trans-choroidal fissure approach enabled us to perform total tumour resection in four patients and a subtotal resection in one. Some technical aspects and pitfalls of the procedure are discussed. This method creates optimum conditions for a radical excision of various suprasellar retrochiasmatic and diencephalo-mesencephalic tumours without mortality and only minimum morbidity. However, no single surgical approach can provide access to the entire variety of tumours located in the suprasellar retrochiasmatic and diencephalo-mesencepalic region. Surgical approaches must be tailored to the site, type of lesion, and its extensions. This method is only another surgical option. Its successful use requires a familiarity with the anatomy of these regions and an understanding of its specificity for a radical excision of some selected tumours, as well as its limitations to access others types of lesions. Although, it seems effective, this approach needs to be evaluated by further experience, owing to the small number of patients reported in this series.
    Acta Neurochirurgica 05/2008; 150(4):317-27; discussion 327-8. DOI:10.1007/s00701-007-1460-2 · 1.79 Impact Factor
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    ABSTRACT: This study of 25 brains at the pontomedullary junction defined the different possible origins of the perforating arteries and lateral spinal arteries in relation to the posterior inferior cerebellar arteries (PICAs). - If the PICA emerges from the common trunk of the AICA-PICA coming from the basilar artery, it never gives perforating arteries or a lateral spinal artery on the lateral surface of the brain stem but supplies blood to a part of the ipsilateral cerebellar hemisphere. - If the PICA arises extradurally at C1, it never gives perforating arteries for the lateral surface of the brain stem, but it gives pial branches for the posterior surface of the medulla oblongata and is always the origin of the lateral spinal artery. - If the PICA emerges in the intradural vertebral artery, it is the source of the perforating arteries for the lateral surface of the brain stem and of the blood supply of the ipsilateral cerebellum.
    Interventional Neuroradiology 03/2008; 14(1):49-58. · 0.73 Impact Factor
  • Morphologie 07/2007; 91(293):98-98. DOI:10.1016/j.morpho.2007.09.039
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    ABSTRACT: There is few published series dealing on the long-term outcome of the adult-onset craniopharyngiomas. We report the long term clinical, tomodensitometric and MRI data outcome of 35 (23 woman and 12 men) consecutive adult-onset cured for craniopharyngiomas between 1983 and 2002, and followed-up in Rennes University Hospital. The operation was performed via frontopterional approach in 59% and transphenoïdal approach in 41% of cases. Their age at the time of diagnosis was 44.7+/-15.1 years (21-74). The average postoperation follow-up was 7.4+/-7.0 years (0.1-19.1). Recurrence of tumour occurred in 8 patients (25.8%) and a tumor progression in 1 case. The delay of recurrence after initial surgery was 4.1+/-1.3 years (1.4-6.3). Two patients had 5 and 6 years treatment by growth hormone (GH), without tumor recurrence. The observed increase of weight after the surgical cure of craniopharyngiomas concerned 22 patients (63%). The average weight gain was 17.5+/-14.7 kg (1.5-58). In 7 cases (20%) neuropsychological disorders were noted, of which 2 with lost of professional activity. Three patients died. In conclusion the craniopharyngiomas recurrence is frequent and can appear in very prolonged deadlines after the initial surgery.
    Annales d Endocrinologie 07/2007; 68(2-3):186-90. · 0.66 Impact Factor
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    ABSTRACT: There is few published series dealing on the long-term outcome of the adult-onset craniopharyngiomas. We report the long term clinical, tomodensitometric and MRI data outcome of 35 (23 woman and 12 men) consecutive adult-onset cured for craniopharyngiomes between 1983 and 2002, and followed-up in Rennes University Hospital. The operation was performed via frontopterional approach in 59% and transphenoïdal approach in 41% of cases. Their age at the time of diagnosis was 44.7±15.1 years (21–74). The average postoperation follow-up was 7.4±7.0 years (0.1–19.1). Recurrence of tumour occurred in 8 patients (25.8%) and a tumor progression in 1 case. The delay of recurrence after initial surgery was 4.1±1.3 years (1.4–6.3). Two patients had 5 and 6 years treatment by growth hormone (GH), without tumor recurrence. The observed increase of weight after the surgical cure of craniopharyngiomas concerned 22 patients (63%). The average weight gain was 17.5±14.7 kg (1.5–58). In 7 cases (20%) neuropsychological disorders were noted, of which 2 with lost of professional activity. Three patients died. In conclusion the craniopharyngiomas recurrence is frequent and can appear in very prolonged deadlines after the initial surgery.
    Annales d Endocrinologie 06/2007; 68(2):186-190. DOI:10.1016/j.ando.2007.04.001 · 0.66 Impact Factor
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    ABSTRACT: The authors document a rapid development, within 3 weeks, of hydromyelia in a 12 year-old boy. The boy was admitted to a local hospital because of drowsiness and persistent severe neck pain. Neurological examination disclosed a lethargic boy with no neurological deficit other than Parinaud's sign. During his transfer to our department, he presented a cardio-respiratory arrest with coma and bilateral mydriasis. External ventricular drain and craniocervical decompression achieved excellent clinical and neuroradiological outcomes. The development of hydromyelia in this case is caused by obstruction to the natural cerebrospinal fluid pathway at the craniocervical junction and the cardio-respiratory arrest is provoked by a brain stem compression against the clivus and odontoid process. This report illustrates that hydromyelia may complicate acute obstructive hydrocephalus due to acquired Chiari malformation.
    Acta Neurochirurgica 11/2006; 148(10):1117-21; discussion 1121. DOI:10.1007/s00701-006-0875-5 · 1.79 Impact Factor
  • Annales d Endocrinologie 10/2006; 67(5):410-410. DOI:10.1016/S0003-4266(06)72681-6 · 0.66 Impact Factor
  • Annales d Endocrinologie 10/2006; 67(5):415-415. DOI:10.1016/S0003-4266(06)72694-4 · 0.66 Impact Factor
  • Annales d Endocrinologie 10/2006; 67(5):411-411. DOI:10.1016/S0003-4266(06)72684-1 · 0.66 Impact Factor
  • Annales d Endocrinologie 10/2006; 67(5):415-415. DOI:10.1016/S0003-4266(06)72693-2 · 0.66 Impact Factor
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    ABSTRACT: But de l’étude une meilleure connaissance micro-anatomique du cercle veineux pour permettre l’interprétation des anastomoses veineuses profondes angiographiques. Matériel et méthodes 25 cerveaux préalablement injectés au latex bleu et rouge. Dissection micro-anatomique sous microscope opératoire Wild Leitz et Zeiss. Photographies 2D et 3D. Résultats le cercle veineux est formé par 2 systèmes anastomotiques transversaux antérieurs et postérieurs (veines communicantes antérieure et postérieure) et 2 vaisseaux longitudinaux paramédians (les veines basales) qui comportent 4 portions distinctes) et se terminent en arrière dans la grande veine cérébrale. La veine communicante antérieure court sur le chiasma optique en arrière de son homologue artériel. La veine communicante postérieure située en arrière de l’artère basilaire réunit les 2 veines mésencéphaliques latérales à la veine mésencéphalique antérieure. L’absence fréquente d’une partie de la veine basale peut entraîner un drainage veineux vers le sinus caverneux ou vers le sinus pétreux inférieur homo ou controlatéral. Conclusions cette étude micro-anatomique du cercle veineux de la base du cerveau permet de comprendre les variations du drainage veineux cérébral profond.
    Morphologie 06/2006; 90(289):90-90. DOI:10.1016/S1286-0115(06)74410-1
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    ABSTRACT: The concept of hemorrhage in a preexisting syringomyelic cavity was first described by Gowers in 1904. Since its first description only 13 cases have been reported. The aims of this report are to describe a new case, bring this entity to wider attention, and summarize the existing literature on the subject. This 36-year-old woman presented with progressive gait disturbance and unsteadiness. Physical examination revealed incomplete quadriparesis, predominantly on the left side, and hypesthesia below C-7. Magnetic resonance imaging revealed hematomyelia characterized by a heterogeneous hyperintense signal within the central cervical cord. A liquefied well-limited hematoma was evacuated. The postoperative course was uneventful; a near-complete recovery was observed at the 7-year follow-up examination. Most cases of intrasyringal hemorrhage (ISH) have occurred in syringomyelic cavities associated with scoliosis or Chiari malformation Type I. Although there is no specific clinical picture associated with this entity, it can be characterized by three neurological forms: 1) sudden onset or rapid development of signs and symptoms, 2) acute worsening of symptoms that may improve but leaving greater neurological dysfunction than before the previous episode, and 3) ISH may initiate progressive deterioration in a patient with known syringomyelia. Intrasyringal bleeding is most probably caused by a sudden dilation of the syringomyelic cavity, which may provoke rupture of the intrasyringal vessels by an acute distension of the accompanying strands. Magnetic resonance imaging is the most accurate diagnostic modality, and recognition of ISH can lead to early, safe, and efficient surgical treatment.
    Journal of Neurosurgery Spine 01/2006; 3(6):477-81. DOI:10.3171/spi.2005.3.6.0477 · 2.36 Impact Factor
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    ABSTRACT: Adjacent to the arterial circle of Willis at the base of the brain, there is an anastomotic circle of veins linking the right and left halves of the cerebral deep venous system. This venous circle is formed by anterior and posterior transverse anastomotic channels (the anterior and posterior communicating veins), and paramedian longitudinal vessels (the basal veins of Rosenthal). This collateral venous network has received considerably less attention than its arterial counterpart, but is its functional homologue. Although inconstant, it can be seen readily with current neuroimaging techniques including three-dimensional digital subtraction venographic phase 3D arteriography (3D-DSV) and CT venography (CTV). The venous circle represents a route of contralateral venous drainage that may become important, particularly when segments of the basal vein are absent (with or without complex DVA), or in high flow states including arteriovenous shunts that access the deep venous system.We review the gross anatomy and provide examples of the radiologic imaging of this venous circle.
    Interventional Neuroradiology 12/2005; 11(4):325-32. DOI:10.1177/197140099500800404 · 0.73 Impact Factor
  • Neurochirurgie 11/2005; 51(5):529-530. DOI:10.1016/S0028-3770(05)83554-4 · 0.47 Impact Factor
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    ABSTRACT: Up to now, extra-dural haematomas (EDH) in elderly patients have been known for their poor prognosis and few studies have focused on the particularity of EDH in the elderly. Most clinical studies relating to EDH have generally focused on its occurrence in children and the middle-aged, grouping people of over 50 and 60 years together as the elderly. The purpose of this paper is to present a series of EDH cases in the elderly. 500 EDH patients (of all ages) were admitted to our Department from January 1990 to December 2003 and this is a retrospective study of 14 of those patients who were aged 70 years and over. The study consists of 8 women and 6 men with an average age of 74 years. A high incidence of disease predisposes elderly to falls, which are the most frequent cause of head trauma. The elderly are less likely to manifest signs or symptoms of increased intracranial pressure due to cerebral atrophy, and almost all haematomas occurred in the parietal area. Post-operative results were satisfactory and only one death was recorded. This study shows that the elderly, presenting EDH after a fall, have a better prognosis than is often feared.
    Acta Neurochirurgica 11/2005; 147(10):1055-60; discussion 1060. DOI:10.1007/s00701-005-0601-8 · 1.79 Impact Factor
  • Neurochirurgie 11/2005; 51(5):529-529. DOI:10.1016/S0028-3770(05)83553-2 · 0.47 Impact Factor

Publication Stats

634 Citations
121.10 Total Impact Points

Institutions

  • 2001–2012
    • Université de Rennes 1
      • Faculty of Medicine
      Roazhon, Brittany, France
  • 2008
    • University of Angers
      • Laboratoire d'anatomie
      Angers, Pays de la Loire, France
  • 1990–2007
    • 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