A Donnet

Publications (73)108.76 Total impact

• Article: [Migraine and hypothalamus.]

  G Géraud, A Donnet
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  ABSTRACT: Migraine is a complex brain disease. The "generator" of the migrainous attacks remains a subject of debate, but the hypothalamus, with its multiple connections with the other parts of the central nervous system and its controls on the pituitary gland and the autonomic nervous system, is a very serious candidate. Many of the premonitory symptoms of migraine attacks find their origin in the hypothalamus. The hormonal changes which occur during feminine genital life and which impact on the life of the migrainous women have their origin in the hypothalamus. The hypothalamus exerts control over the balance between the parasympathetic and orthosympathetic systems. Orexine, hormones originating in the hypothalamic, are involved in sleep regulation, thermoregulation and neuroendocrine and nociceptive functions. They could play a crucial role in the origin of the migrainous attack and might explain the influence of sleep, eating habits and excessive weight in the occurrence of attacks. Hypothalamic cerebral activation via H2 15OPET activity, suspected by clinical and experimental arguments as a possible trigger for migraine, has been demonstrated during spontaneous attacks. However, no conclusion can be made however as to whether this activation is the cause or the consequence of the migrainous pain.
  Revue Neurologique 04/2013; · 0.49 Impact Factor
• Article: [Guidelines for the diagnosis and management of migraine in adults and children.]

  M Lanteri-Minet, D Valade, G Géraud, C Lucas, A Donnet
  Revue Neurologique 12/2012; · 0.49 Impact Factor
• Article: [Idiopathic intracranial hypertension: Stent or not].

  A Donnet
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  ABSTRACT: The pathogenesis and treatment paradigm for idiopathic intracranial hypertension (IIH) are controversial. Transverse sinus stenosis is seen in the majority of patients with IIH and appears to play a role in the disease process. The debate continues as to whether transverse sinus stenosis is a primary or secondary process relative to raised intracranial pressure. While the role of transverse sinus stenosis in IIH pathogenesis remains controversial, modeling studies suggest that stent placement within a transverse sinus stenosis with a significant pressure gradient should decrease cerebral venous pressure, improve CSF resorption in the venous system, and thereby reduce intracranial (CSF) pressure, improving the symptoms of IIH and reducing papilledema. Beside the classical surgical treatments, venous sinus stenting could be a treatment option for many patients with IIH. However, additional work, preferably controlled prospective studies, needs to be performed to prove its safety and efficacy. The goal of this article is to review the current literature on dural venous sinus stenting.
  Revue Neurologique 09/2012; 168(10):685-90. · 0.49 Impact Factor
• Article: Predilection to deafferentation pain syndrome after radiosurgery in cluster headache.

  A Donnet, R Carron, J Régis
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  ABSTRACT: Cluster-tic syndrome is a rare, disabling disorder. We report the first case of cluster-tic syndrome with a successful response to stereotactic radiosurgery. After failing optimal medical treatment, a 58-year-old woman suffering from cluster-tic syndrome was treated with gamma knife radiosurgery. The trigeminal nerve and sphenopalatine ganglion were targeted with a maximum dose of 85 and 90 Gy respectively. The patient experienced a complete resolution of the initial pain, but developed, as previously described after radiosurgical treatment for cluster headache, a trigeminal nerve dysfunction. This suggests that trigeminal nerve sensitivity to radiosurgery can be extremely different depending on the underlying pathological condition, and that there is an abnormal sensitivity of the trigeminal nerve in cluster headache patients. We do not recommend trigeminal nerve radiosurgery for treatment of cluster headache.
  Cephalalgia 04/2012; 32(8):635-40. · 3.43 Impact Factor
• Source

  Available from: PubMed Central

  Article: Cardiac safety in cluster headache patients using the very high dose of verapamil (≥720 mg/day).

  M Lanteri-Minet, F Silhol, V Piano, A Donnet
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  ABSTRACT: Use of high doses of verapamil in preventive treatment of cluster headache (CH) is limited by cardiac toxicity. We systematically assess the cardiac safety of the very high dose of verapamil (verapamil VHD) in CH patients. Our work was a study performed in two French headache centers (Marseilles-Nice) from 12/2005 to 12/2008. CH patients treated with verapamil VHD (≥720 mg) were considered with a systematic electrocardiogram (EKG) monitoring. Among 200 CH patients, 29 (14.8%) used verapamil VHD (877±227 mg/day). Incidence of EKG changes was 38% (11/29). Seven (24%) patients presented bradycardia considered as nonserious adverse event (NSAE) and four (14%) patients presented arrhythmia (heart block) considered as serious adverse event (SAE). Patients with EKG changes (1,003±295 mg/day) were taking higher doses than those without EKG changes (800±143 mg/day), but doses were similar in patients with SAE (990±316 mg/day) and those with NSAE (1,011±309 mg/day). Around three-quarters (8/11) of patients presented a delayed-onset cardiac adverse event (delay ≥2 years). Our work confirms the need for systematic EKG monitoring in CH patients treated with verapamil. Such cardiac safety assessment must be continued even for patients using VHD without any adverse event for a long time.
  The Journal of Headache and Pain 01/2011; 12(2):173-6. · 2.43 Impact Factor
• Article: [Optical coherence tomography in following up papilledema in idiopathic intracranial hypertension treated with lateral sinus stent placement].

  G Alessi, O Levrier, J Conrath, L Hoffart, A Donnet, L L'attention, P Metellus, R Giorgi, F Matonti, B Ridings
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  ABSTRACT: To quantify the course of papilledema using the OCT 3 Stratus (Carl Zeiss Meditec, Dublin, CA, USA) after lateral sinus stent placement in patients with idiopathic intracranial hypertension (IIH). Ten consecutive patients with a diagnosis of IIH underwent OCT examination before and after lateral sinus stenting, between March 2006 and April 2008, in Timone Hospital's Ophthalmology Department (Marseille, France). All patients had criteria for IIH (International Headache Society, 2004) and sinus abnormalities were diagnosed using three-dimensional rotational gadolinium-enhanced MR venography. In all cases, a direct retrograde cerebral venography with manometry was performed. We used the Cordis PRECISE® RX Nitinol Stent system (ref. 10136245-3, Johnson & Johnson), 30-40 mm in length and 8 mm in diameter, all placed by a single operator via a femoral venous puncture. For each eye, the mean retinal nerve fiber layer thickness was noted using the RNFL Thickness (3.4) strategy, before stenting, and three times after stent placement. The other parameters considered were age, sex, weight, height and body mass index. A significant decrease in retinal nerve fiber layer thickness was observed after stent placement. This parameter was considered normal 3 months after stent placement for eight of ten patients. Even though this pathology remains misunderstood, we observed a significant decrease in papilledema in IIH after lateral sinus stent placement, suggesting that high intracranial venous pressure could play a role in this pathology.
  Journal francais d'ophtalmologie 11/2010; 33(9):637-48. · 0.51 Impact Factor
• Article: [Radiosurgery in trigeminal neuralgia: long-term results and influence of operative nuances].

  J Regis, Y Arkha, S Yomo, N Murata, P Roussel, A Donnet, J-C Peragut
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  ABSTRACT: Stereotactic radiosurgery is an alternative to conventional surgery for the treatment of trigeminal neuralgia. To better define the safety of radiosurgery and optimal technical choices, we reviewed our patient records and the literature. A total of 334 patients presenting with trigeminal neuralgia were treated between December 1992 and September 2005. A minimum of 1 year of follow-up was available for 262 patients. The mean age was 68 years (range: 30-90); 128 patients were male and 134 female. A neurovascular conflict was clearly visualized on MRI in 167 patients. Twenty-one had a past history of multiple sclerosis and 110 had already received conventional surgical treatment for trigeminal neuralgia. The intervention consisted of gamma knife radiosurgery (GKS) to the retrogasserian cisternal portion of the Vth cranial nerve. The median maximal dose used was 85Gy (range: 70-90). Actuarial curves show a plateau at 5 years for both the risk of hypoesthesia and recurrence. At 5 years, 58% of the patients remain pain-free and 83% have no trigeminal nerve disturbance. The median delay for pain cessation was 15 days. The initial pain-relief rate was 89%. None of the complications reported for the other techniques were observed. Patient selection (typical versus atypical, age, past surgery, multiple sclerosis) and details of operative technique (maximum dose, volume of nerve treated, target location, etc.) had a major influence on the probability of pain relief and toxicity risk. The details of operative technique are turning out to have a major influence on the clinical results. In our experience, high-dose (80-90Gy) retrogasserian (7-8mm from the brainstem) GKS provides the patient with a better chance of long-term pain relief and a lower risk of trigeminal nerve functional disturbance. GKS applied to the cisternal anterior trigeminal nerve using high doses provided safe and effective treatment for trigeminal neuralgia over the long term.
  Neurochirurgie 04/2009; 55(2):213-22. · 0.34 Impact Factor
• Article: A consecutive series of 22 cases of hypnic headache in France.

  A Donnet, M Lantéri-Minet
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  ABSTRACT: A series of 22 patients was consecutively diagnosed with hypnic headache (HH) from June 2007 to June 2008 in two headache specialty centres participating in the French Observatory of Migraine and Headaches. Patients and headache characteristics were compared with the 2004 International Classification of Headache Disorders, 2nd edn (ICHD-II) criteria for HH and published series of HH patients. One-third of HH patients reported migraine-like headaches (pulsating/unilateral/stabbing) and > 20% were aged < 50 years at symptom onset. Of note, HH patients displayed typical motor activities during the headache (getting up, eating/drinking especially a cup of coffee, reading/watching television) that differentiate HH from migraine and suggest relationships between HH and trigeminal autonomic cephalalgias. The functional and emotional impact of HH appears low and similar to that of migraine in patients consulting in primary care practice. Improvements in ICHD-II criteria are suggested, especially to introduce the typical motor behaviour acted out by HH patients.
  Cephalalgia 02/2009; 29(9):928-34. · 3.43 Impact Factor
• Article: Possible precipitation of migraine attacks with prophylactic treatment.

  A Donnet, E Vuillaume De Diego, M Lanteri-Minet
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  ABSTRACT: The initiation of a prophylactic treatment in a migraine sufferer depends upon the stratification of the patient's frequency of attacks and the disability they cause, as well as the patient's acute consumption and comorbid diseases. We report on 14 patients who were among a group of 618 migraine sufferers who received a new preventative treatment. These 14 patients developed an increase in the frequency of their migraine attacks that was possibly induced by this new prophylactic treatment. The clinical description of the migraine attacks remained the same but the frequency of the attacks of migraine without aura was dramatically increased. This is, to our knowledge, the first description of a possible precipitation of attacks of migraine without aura with a prophylactic treatment. There is no link with a specific class of prophylactic treatment. We hypothesize that the migraine sufferers who experienced aggravation after the new prophylactic drug had been introduced had a paradoxical decrease in the induction threshold for cortical spreading depression (CSD). Mechanisms of such a decrease are unknown and are probably multifactorial, but changes in serotonin neurotransmission have been experimentally demonstrated to modify cortical excitability and favour CSD. The aggravation was described only for attacks without aura. However, with only 14 patients, it is not possible to predict whether suffering from that the type of migraine is a factor that predisposes a patient to aggravation. While additional cases are necessary, physicians should be aware of the possibility that prophylactic treatment may exacerbate migraine attacks.
  European Neurology 11/2008; 61(1):23-6. · 1.81 Impact Factor
• Article: Exertional headache: a new venous disease.

  A Donnet, H Dufour, O Levrier, P Metellus
  Cephalalgia 08/2008; 28(11):1201-3. · 3.43 Impact Factor
• Article: Endovascular treatment of idiopathic intracranial hypertension: clinical and radiologic outcome of 10 consecutive patients.

  A Donnet, P Metellus, O Levrier, C Mekkaoui, S Fuentes, H Dufour, J Conrath, F Grisoli
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  ABSTRACT: To explore the relation between venous disease and idiopathic intracranial hypertension. Optic nerve sheath fenestration and ventricular shunting are the classic methods when medical treatment has failed. Idiopathic intracranial hypertension is caused by venous sinus obstruction in an unknown percentage of cases. Recently, endoluminal venous sinus stenting was proposed as an alternative treatment. Ten consecutive patients with refractory idiopathic intracranial hypertension underwent examination with direct retrograde cerebral venography and manometry to characterize the morphologic features and venous pressures in their cerebral venous sinus. All patients demonstrated morphologic obstruction of the venous lateral sinuses. The CSF pressure was measured in all patients. The CSF pressure on lumbar puncture ranged from 27 to 45 mm Hg with normal composition. All patients had headache, and visual acuity loss was noted in eight patients. Funduscopic examination demonstrated papilledema for all patients. All patients had stenting of the venous sinuses. Intrasinus pressures were recorded before and after the procedure and correlated with clinical outcome. Intrasinus pressures were invariably reduced by stenting. For headache, six patients were rendered asymptomatic, two were improved, and two were unchanged after venous sinus stenting for a mean (+/- SD) follow-up of 17 +/- 10.1 months (range 6 to 36 months). Papilledema disappeared in all patients. In all cases, CSF pressure was normalized at 3-month follow-up. In all patients, direct retrograde cerebral venography or multidetector row CT angiography was performed at 6-month follow-up and demonstrated the absence of stent thrombosis. The importance of venous sinus disease in the etiology of idiopathic intracranial hypertension is probably underestimated. Patients with idiopathic intracranial hypertension in whom a venous sinus stenosis is demonstrated by a noninvasive radiologic workup should be evaluated with direct retrograde cerebral venography and manometry. In patients with a lesion of the venous sinuses who experienced medical treatment failure, endovascular stent placement seems to be an interesting alternative to classic surgical approaches.
  Neurology 03/2008; 70(8):641-7. · 8.31 Impact Factor
• Article: Orofacial pain and foreign body in maxillary sinus: case report without sinusitis.

  F Turner, F Facon, A Donnet, P Dessi
  Cephalalgia 03/2008; 28(2):196-8. · 3.43 Impact Factor
• Article: Chronic cluster headache: a French clinical descriptive study.

  A Donnet, M Lanteri-Minet, E Guegan-Massardier, G Mick, N Fabre, G Géraud, C Lucas, M Navez, D Valade
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  ABSTRACT: Cluster headache (CH) is a relatively rare disease and episodic CH is more frequent than chronic CH. Few studies have described the characteristics of patients with chronic CH. This was a descriptive study carried out by eight tertiary care specialist headache centres in France participating in the Observatory of Migraine and Headaches (OMH). From 2002 to 2005, OMH collected data from 2074 patients with CH, of whom 316 had chronic CH. From January to June 2005, 113 patients with chronic CH were interviewed using standardised questionnaires during a consultation. The male to female ratio was 4.65:1. Median age was 42 years. The majority of patients were smokers or former smokers (87%). 46% had primary chronic CH (chronic at onset) and 54% secondary chronic CH (evolving from episodic CH). Most patients had unilateral pain during attacks and 7% had sometimes bilateral pain during an attack. 48% reported a persisting painful state between attacks. Symptoms anteceding pain onset (mainly discomfort/diffuse pain, exhaustion, mood disorders) and auras were reported by 55% and 20% of patients, respectively. The functional impact of chronic CH was estimated as severe by 74% of patients, and 75.7% suffered from anxiety, as assessed by the Hospital Anxiety and Depression scale. There was no substantial difference in clinical presentation between primary and secondary CH. This study confirms the existence of auras and interictal signs and symptoms in patients with chronic CH, and male sex and smoking as CH risk factors. Primary and secondary chronic CH appear equally prevalent. Male sex does not appear to favour the shift from episodic to chronic CH.
  Journal of neurology, neurosurgery, and psychiatry 01/2008; 78(12):1354-8. · 4.87 Impact Factor
• Article: [Endovascular treatment of idiopathic intracranial hypertension. Analysis of eight consecutive patients].

  P Metellus, O Levrier, S Fuentes, N N'Doye, M Laghmari, T Adetchessi, H Dufour, A Donnet, J Conrath, F Grisoli
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  ABSTRACT: Optic nerve sheath fenestration or ventricular shunting are classically proposed after failure of medical treatment. Idiopathic intracranial hypertension is caused by venous sinus obstruction in an unknown percentage of cases. Recently, endoluminal venous sinus stenting was proposed as an alternative treatment. Between September 2003 and December 2004, eight consecutive patients with a diagnosis of idiopathic intracranial hypertension underwent MRI venography and direct retrograde cerebral angiography. There were five females and three males aged 22 to 55 years. All patients had vision disorders. The cerebrospinal fluid pressure ranged from 27 to 45 mmHg with normal composition. All patients presented at least one sinus stenosis. Endovascular stenting of the stenotic venous sinus was performed under intravenous heparin administration. Anti-platelet therapy was administered for 3 months post treatment. Intra-sinus pressures were invariably reduced by stenting. Mean follow-up was 18 months. All patients improved clinically. The cerebrospinal fluid pressure had normalized at 3-month follow-up in all patients. In all patients, multidetector row CT-angiography or MRI venography was performed at 3-, 6- and 12-month follow-up and demonstrated the patency of the stent. The importance of venous sinus disease as a cause of idiopathic intracranial hypertension is probably underestimated. Patients with idiopathic intracranial hypertension should be evaluated with direct retrograde cerebral venography and manometry. In patients with venous sinus lesions, treatment by an endoluminal venous sinus stent is a safe and effective alternative for amenable lesions.
  Neurochirurgie 03/2007; 53(1):10-7. · 0.34 Impact Factor
• Article: [Endoscopic treatment of a voluminous benign symptomatic cyst of the pineal region responsible for an obstructive hydrocephalus].

  Ph Metellus, S Fuentes, O Levrier, T Adetchessi, H Dufour, A Donnet, F Grisoli
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  ABSTRACT: Asymptomatic non neoplastic cysts of the pineal region are common incidental findings in adults. On the contrary, voluminous and symptomatic cysts of the pineal region are rare and their management are not well defined. We present the case of a 32-year-old woman suffering who suffered from mild intracranial hypertension, gait disturbance and vertigo for one year. The neuroradiological workup showed a voluminous cyst of the pineal region responsible for an obstructive hydrocephalus. An endoscopic etiological treatment was decided. The operation consisted in a marsupialization of the cyst in the third ventricle with a stereotactic guidance system. A frozen section of the cyst wall failed to show tumoral cells. Immediate postoperative course was uneventful. Intracranial hypertension symptoms resolved in 24 hours. Clinical examination and neuropsychological testing were normal at two years postoperatively. The two years follow-up cerebral MRI demonstrated a remnant cystic cavity without mass effect and the patency of the aqueduct of Sylvius. Endoscopic treatment of symptomatic pineal cysts constitutes an interesting therapeutic alternative in the management of this pathology.
  Neurochirurgie 10/2005; 51(3-4 Pt 1):173-8. · 0.34 Impact Factor
• Article: [Endovascular treatment of benign intracranial hypertension by stent placement in the transverse sinus. Therapeutic and pathophysiological considerations illustrated by a case report].

  Ph Métellus, O Levrier, S Fuentes, T Adetchessi, H Dufour, A Donnet, F Grisoli
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  ABSTRACT: We report a case of benign intracranial hypertension in a 31-year-old man treated by endovascular stent placement in the right transverse sinus. The patient presented with a typical benign intracranial hypertension syndrome. Ophthalmologic findings showed bilateral papilledema with a 7/10 loss visual acuity loss in the right eye and 2/10 in the left eye. At lumbar puncture, cerebrospinal fluid (CSF) pressure was 40 mmHg. Magnetic resonance imaging (MRI) showed slit ventricles and dilatation of optic nerve sheaths. optiques. After failure of medical treatment, the patient was referred to our neurosurgical department for therapeutic decision. Direct retrograde cerebral venography showed predominant cerebral venous drainage via the right transverse sinus which exhibited stenosis in its proximal third. Mamometry revealed a 25 mmHg pressure gradient across the point of stenosis. Due to possible venogenic benign intracranial hypertension, endovascular stent placement was proposed and accepted by the patient. At 3 months follow-up, the patient was symptoms free, papilledema had disappeared and visual acuity was 10/10 on both eyes. CSF pressure on lumbar puncture was 11 mmHg. The pathophysiological aspects and therapeutic management of this pathology illustrated by this are discussed along with a careful and exhaustive review of the literature.
  Neurochirurgie 06/2005; 51(2):113-20. · 0.34 Impact Factor
• Article: Gamma knife treatment for refractory cluster headache: prospective open trial.

  A Donnet, D Valade, J Régis
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  ABSTRACT: Since the initial report of Ford et al in 1998 no further study has evaluated radiosurgery of the trigeminal nerve in chronic cluster headache (CCH). We carried out a prospective open trial of neurosurgery and enrolled 10 patients (nine men, one woman; mean age 49.8 years, range 32-77) presenting with severe and drug resistant CCH (mean duration 9 years, range 2-33). The cisternal segment of the nerve was targeted with a single 4 mm collimator (80-85 Gy max). The mean follow up was 13.2 months. No improvement was observed in two patients and three patients had no further attacks. Three patients showed dramatic improvement with a few attacks per month or very few attacks over the last six months. Two patients were pain free for only one and two weeks and their headaches recurred with the same severity as before. Three patients developed paraesthesia with no hypoaesthesia, one developed hypoaesthesia, and one developed deafferentation pain. The rate and severity of trigeminal nerve injury appeared to be significantly higher than in trigeminal neuralgia, and this study does not support the positive results of the study of Ford et al. We consider the morbidity to be significant for the low rate of pain cessation, making this procedure less attractive even for the more severely affected subgroup of patients.
  Journal of Neurology Neurosurgery &amp Psychiatry 03/2005; 76(2):218-21. · 4.76 Impact Factor
• Article: Differential patterns of cognitive impairment in patients with aqueductal stenosis and normal pressure hydrocephalus.

  A Donnet, A Schmitt, H Dufour, R Giorgi, F Grisoli
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  ABSTRACT: We report a preoperative neuropsychological evaluation for ten adult patients with aqueductal stenosis, and compare the results of this group with a normal pressure hydrocephalus group. For executive functions, aqueductal stenosis patients failed on isolated tests and results were heterogeneous; the normal pressure hydrocephalus group was more impaired, except for tasks which required memory processing. Memory deficits in aqueductal stenosis group are qualitatively dissimilar and more homogeneous and severe, despite the younger age, than in the normal pressure hydrocephalus group. These findings indicate that neuropsychological deficits of patients with aqueductal stenosis are linked with fornix damage and frontal dysfunction. In the normal pressure hydrocephalus group, deficits could be linked with a prefrontal lobe disconnection.
  Acta Neurochirurgica 01/2005; 146(12):1301-8; discussion 1308. · 1.52 Impact Factor
• Article: The red ear syndrome.

  A Donnet, D Valade
  Journal of Neurology Neurosurgery &amp Psychiatry 08/2004; 75(7):1077. · 4.76 Impact Factor
• Article: [Primary leiomyosarcoma of the cavernous sinus associated with Epstein-Barr virus in a kidney graft].

  E Kaphan, A Eusebio, T Witjas, A Donnet, H Vacher-Coponat, D Figarella-Branger, A Ali Chérif
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  ABSTRACT: Immunodeficient patients have an increased incidence of neoplasms, whether the immunodeficiency is due to genetic disorder, the acquired immunodeficiency syndrome (AIDS), or immunosuppressive therapy. Leiomyosarcoma (LMS) is a rare neoplasm, even if its incidence has increased because of AIDS. Less than fifteen cases were described after organ transplantation. An intracranial localization is exceptional (five cases in the literature) and was never described after organ transplantation, to our knowledge. Our present report focuses on a 45-year-old immunocompromised patient, who received immunosuppressive therapy for renal transplantation. He suffered from atypical peri-orbital headaches six months after transplantation and a mass involving the cavernous sinus was identified. Surgical biopsy was performed. Histologic examination revealed a LMS. Epstein-Barr virus was identified by quantitative polymerase chain reaction in the LMS. Immunosuppression was reduced, the patient received adriamycin and protontherapy was realized. He died two years after the transplantation because of tumor progression and kidney failure.
  Revue Neurologique 12/2003; 159(11):1055-9. · 0.49 Impact Factor