Maxime Delavallee
Cliniques Universitaires Saint-Luc
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Featured researches published by Maxime Delavallee.
Neurosurgery | 2008
Maxime Delavallee; Basel Abu-Serieh; Marianne de Tourchaninoff; Christian Raftopoulos
OBJECTIVE In certain chronic neuropathic pain (CNP) conditions, extradural electrode implantation is preferred to a subdural location for motor cortex stimulation (MCS) therapy, but the rationale for this preference remains debatable. We provide documented long-term results of subdural MCS in CNP. METHODS Our eight consecutive patients (five men, three women; age range, 45-81 yr) had either central or peripheral CNP. We localized the central sulcus using anatomic landmarks and three-dimensional neuronavigation and by detecting the N20 wave inversion. We then created an elongated craniotomy (3 cm long x 1 cm wide), followed by a linear incision of the dura. An eight-polar plate electrode was slipped in subdurally. We used motor-evoked potentials to choose the optimal electrode position before fixing the electrode to the dura. RESULTS Six patients had favorable outcomes, and two had poor outcomes at the time of the last assessment (mean, 54 mo; range, 19-69 mo). Three patients experienced five transient complications, each having an episode of partial motor seizure, one that evolved into a secondary generalized seizure. Seizures were related to an abrupt increase in stimulation intensity. Two of these three patients also had hardware infections that required system replacement, with the electrode implanted extradurally at the second implantation in one case because of severe arachnoiditis. This change necessitated a greater intensity and a longer duration of stimulation to deliver a therapeutic effect equivalent to that with subdural MCS. CONCLUSION In this small series, subdural MCS seemed a tolerable approach in the long term for CNP patients. In addition, subdural MCS provided a therapeutic effect comparable to that obtained with extradural placement.
Journal of Neurosurgery | 2013
Guus Koerts; Vincent Vanthuyne; Maxime Delavallee; Herbert Rooijakkers; Christian Raftopoulos
Spinal dural arteriovenous fistulas are rare lesions with an annual incidence of 1 per 100,000 population. In patients with this disease, an abnormal vascular dural shunt exists between a dural branch of a segmental artery and a subdural radicular vein that drains the perimedullary venous system, leading to venous hypertension and secondary congestive myelopathy. Generally, patients present with progressive paraparesis, urinary disturbances, and gait ataxia. In this report the authors describe a 61-year-old woman with a spinal dural arteriovenous fistula who developed an acute paraplegia after a nontraumatic lumbar puncture. The possible underlying mechanisms and treatment options are discussed.
Neurosurgery | 2011
Maxime Delavallee; Herbert Rooijakkers; Guus Koerts; Christian Raftopoulos
BACKGROUND AND IMPORTANCE:Motor cortex stimulation (MCS) is an accepted treatment in neuropathic pain syndromes. Use of MCS for trigeminal neuropathic pain (TNP) caused by a malignant glioma or in a child has not previously been reported in the literature. CLINICAL PRESENTATION:A 3-year-old boy presented to our department with a right temporal tumor with extension into the cavernous sinus and along the root of the trigeminal nerve up to the protuberance. Six weeks after removal of the temporal part of the tumor, the patient developed medically refractory trigeminal pain associated with tumor progression into the posterior fossa. We decided to remove the tumor from the cerebellopontine angle and residual tumor in the pericavernous area and then gave postoperative radio- and chemotherapy. Five months later, the patient developed unbearable refractory neuropathic pain characterized by a burning sensation in the first and second trigeminal areas. After a multidisciplinary discussion, MCS was recommended. We performed subdural MCS after localization of the central sulcus via anatomic landmarks, neuronavigation, peroperative sensory evoked potentials, and motor evoked potentials. The mother estimated a 75% reduction in the childs pain at 48 hours postoperatively, which continued until the child was pain-free. CONCLUSION:MCS is a minimally invasive surgical technique that seems to be a potential treatment for carefully selected children experiencing very severe and medically refractory neuropathic pain, even in the context of a neoplasm.
Neurosurgery | 2006
Maxime Delavallee; Christian Raftopoulos
Accepted, November 19, 2005. OBJECTIVE AND IMPORTANCE: Myotonic dystrophy (MD) is the most common adult muscular dystrophy involving multiple organs. Normal pressure hydrocephalus (NPH) is characterized by gait apraxia, urinary incontinence, and dementia. NPH in association with MD has been reported in only three cases. This report provides for the first time the complete evaluation, treatment, and long-term follow-up of a patient with NPH and MD. CLINICAL PRESENTATION: A 61-year-old man known to have MD complained of 4 years of progressive deterioration of long-term memory and gait disturbance, which was the main clinical feature. Computed tomography scan and magnetic resonance imaging showed ventricular enlargement. Intracranial pressure monitoring showed B waves with amplitude superior to 9 mm Hg in more than 5% of the recording. TECHNIQUE: We performed a ventriculoperitoneal shunt with clear postoperative improvement, confirming the diagnosis of NPH. The clinical improvement has remained stable through prolonged follow-up. CONCLUSION: Association between MD and NPH could be more than coincidental, and it is important to recognize this potential insidious association because a ventriculoperitoneal shunt can provide excellent long-term clinical improvement.OBJECTIVE AND IMPORTANCE:Myotonic dystrophy (MD) is the most common adult muscular dystrophy involving multiple organs. Normal pressure hydrocephalus (NPH) is characterized by gait apraxia, urinary incontinence, and dementia. NPH in association with MD has been reported in only three cases. This report provides for the first time the complete evaluation, treatment, and long-term follow-up of a patient with NPH and MD. CLINICAL PRESENTATION:A 61-year-old man known to have MD complained of 4 years of progressive deterioration of long-term memory and gait disturbance, which was the main clinical feature. Computed tomography scan and magnetic resonance imaging showed ventricular enlargement. Intracranial pressure monitoring showed B waves with amplitude superior to 9 mm Hg in more than 5% of the recording. TECHNIQUE:We performed a ventriculoperitoneal shunt with clear postoperative improvement, confirming the diagnosis of NPH. The clinical improvement has remained stable through prolonged follow-up. CONCLUSION:Association between MD and NPH could be more than coincidental, and it is important to recognize this potential insidious association because a ventriculoperitoneal shunt can provide excellent long-term clinical improvement.
Acta Neurochirurgica | 2015
Patrice Finet; Maxime Delavallee; Christian Raftopoulos
Idiopathic intracranial hypertension (IIH) is a syndrome characterized by an increased intracranial pressure of unknown origin arising mainly in overweight females. The typical symptoms of IIH are headaches and papilledema associated with visual disorders, which can often evolve to blindness. We describe the first patient who developed a clinical syndrome related to an IIH following a bilateral subthalamic deep brain stimulation (DBS) procedure for Parkinson’s disease with the particularity that the clinical expression of the IIH syndrome was atypical because of the presence of intracerebral electrodes.
Acta Neurochirurgica | 2014
Maxime Delavallee; P Finet; Marianne de Tourtchaninoff; Christian Raftopoulos
Neurochirurgie | 2014
Maxime Delavallee; Anne Jeanjean; Christian Raftopoulos
World Neurosurgery | 2013
Maxime Delavallee; M. de Tourtchaninoff; Christian Raftopoulos
World Neurosurgery | 2013
V. Vanthuyne; G. Koerts; H. Rooijakkers; Maxime Delavallee; Christian Raftopoulos
Neurochirurgie | 2010
Maxime Delavallee; M. de Tchourchaninoff; P. Finet; Christian Raftopoulos