Youmans and Winn Neurological Surgery
4 - Volume Set
- 8th Edition - January 21, 2022
- Imprint: Elsevier
- Author: H. Richard Winn
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 6 6 1 9 2 - 8
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 6 7 4 9 9 - 7
Widely regarded as the definitive reference in the field, Youmans and Winn Neurological Surgery offers unparalleled, multimedia coverage of the entirety of this complex specialty.… Read more
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Request a sales quoteWidely regarded as the definitive reference in the field, Youmans and Winn Neurological Surgery offers unparalleled, multimedia coverage of the entirety of this complex specialty. Fully updated to reflect recent advances in the basic and clinical neurosciences, the 8th Edition covers everything you need to know about functional and restorative neurosurgery, deep brain stimulation, stem cell biology, radiological and nuclear imaging, and neuro-oncology, as well as minimally invasive surgeries in spine and peripheral nerve surgery, and endoscopic and other approaches for cranial procedures and cerebrovascular diseases. In four comprehensive volumes, Dr. H. Richard Winn and his expert team of editors and authors provide updated content, a significantly expanded video library, and hundreds of new video lectures that help you master new procedures, new technologies, and essential anatomic knowledge in neurosurgery.
- Discusses current topics such as diffusion tensor imaging, brain and spine robotic surgery, augmented reality as an aid in neurosurgery, AI and big data in neurosurgery, and neuroimaging in stereotactic functional neurosurgery.
- 55 new chapters provide cutting-edge information on Surgical Anatomy of the Spine, Precision Medicine in Neurosurgery, The Geriatric Patient, Neuroanesthesia During Pregnancy, Laser Interstitial Thermal Therapy for Epilepsy, Fetal Surgery for Myelomeningocele, Rehabilitation of Acute Spinal Cord Injury, Surgical Considerations for Patients with Polytrauma, Endovascular Approaches to Intracranial Aneurysms, and much more.
- Hundreds of all-new video lectures clarify key concepts in techniques, cases, and surgical management and evaluation. Notable lecture videos include multiple videos on Thalamotomy for Focal Hand Dystonia and a video to accompany a new chapter on the Basic Science of Brain Metastases.
- An extensive video library contains stunning anatomy videos and videos demonstrating intraoperative procedures with more than 800 videos in all.
- Each clinical section contains chapters on technology specific to a clinical area.
- Each section contains a chapter providing an overview from experienced Section Editors, including a report on ongoing controversies within that subspecialty.
- Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
- Instructions for online access
- Cover image
- Title page
- Table of Contents
- How to Use
- Copyright of Volume 1
- Copyright of Volume 2
- Copyright of Volume 3
- Copyright of Volume 4
- Dedication
- Editor-in-Chief
- Section Editors
- Contributors
- Foreword
- Preface
- Volume 1
- Section I & II. Introduction and General Neurosurgery: Overview and Controversies
- Introduction
- Overview
- Controversies and Unresolved Questions
- Part 1. History
- 1. Historical Overview of Neurosurgery
- Neurosurgery in the Prehistoric Period
- Ancient Egyptian Neurosurgery
- Classical Period: Greek and Byzantine Neurosurgery
- Islamic/Arabic Medicine: Prescholastic Period
- Middle ages: the age of Medieval Medical Scholasticism
- Origins of Neurosurgical Practice in the Renaissance
- Surgeons of the Insurgency: Seventeenth Century
- Eighteenth Century: an Enlightened Period for Neurosurgery
- Nineteenth Century: Incunabula Period of Modern Neurosurgery
- Further Advances in Neurosurgery: Twentieth Century
- Concluding Thoughts
- Part 2. Surgical Anatomy
- 2. Surgical Anatomy of the Brain
- Introduction
- Cerebrum
- Posterior Fossa
- 3. Surgical Anatomy of the Skull Base
- Introduction
- The Far Lateral Approach
- The Retrosigmoid Approach
- The Transpetrosal Approaches
- The Orbitozygomatic Approach
- The Endoscopic Endonasal Approach
- 4. Surgical Anatomy of the Spine
- Overview of Spine Anatomy
- Cervical Region
- Thoracic Region
- Lumbar Region
- Part 3. Approach to the Patient
- 5. Precision Medicine in Neurosurgery
- Introduction
- Cancer
- Subspecialty Implications
- Outlook: Clinical Integration into Neurosurgical Practice
- Conclusion
- 6. Improving Patient Safety
- Epidemiology of Patient Safety
- Adverse Events and Errors
- Systems Thinking
- Tools for Improving Patient Safety
- Conclusion
- 7. Neuroanesthesia: Preoperative Evaluation
- General Preanesthetic Evaluation
- Medical History
- Consideration of Specific Neurological Disorders
- Conclusion
- 8. Preoperative Assessment by Navigated Transcranial Magnetic Stimulation
- Basic Principles of nTMS, nTMS Motor and Language Mapping, and Safety Considerations
- Navigated Transcranial Magnetic Stimulation Motor Mapping
- nTMS Language Mapping
- Special Aspects
- Radiotherapy
- Potentials and Limitations
- 9. Classification Systems in Neurosurgery
- Defining Classification Systems
- Methods of Classifying Neurosurgical Classification Systems
- Classification of Neurosurgical Classification Systems
- Future Directions in Classifying Classification Systems in Neurosurgery
- Part 4. Overview of Radiology
- 10. Computed Tomography and Magnetic Resonance Imaging of the Brain
- Computed Tomography of the Brain
- Magnetic Resonance Imaging of the Brain
- 11. Radiology of the Spine
- Modalities and Technical Considerations
- Indications for Imaging and Imaging Findings
- Systematic Approach to Interpreting Imaging Examination
- 12. Physiologic Evaluation of the Brain With Magnetic Resonance Imaging
- Diffusion-Weighted Imaging
- Diffusion Tensor Imaging and Tractography
- Magnetic Resonance Angiography
- Phase-Contrast Magnetic Resonance Imaging of Cerebrospinal Fluid Flow
- Perfusion- and Permeability-Weighted Imaging
- Functional Magnetic Resonance Imaging
- Vessel Wall Imaging
- Proton Magnetic Resonance Spectroscopy
- Magnetic Resonance Elastography
- Combined Positron Emission Tomography/Magnetic Resonance Imaging
- Introduction to Volumetric and Simulation Magnetic Resonance Imaging
- 13. Molecular Imaging of the Brain with Positron Emission Tomography
- Basic Principles of Positron Emission Tomography Imaging
- The Cyclotron and Radiopharmaceutical Production
- The Pet Scanner and Brain-Imaging Principles
- Tracer Kinetic Models
- Pet Imaging for the Assessment of Neurological Disease
- Conclusion
- 14. Diffusion Tensor Imaging
- Introduction
- History of the Invention of Diffusion Tensor Imaging
- The Basis of Diffusion Anisotropy Imaging
- The Bases of Fractional Anisotropy and Tractography in Brain Evaluation
- Connectomics and Constrained Spherical Deconvolution
- Clinical Applications
- Spinal Cord Diffusion Tensor Imaging
- Peripheral Nerve Diffusion Tensor Imaging
- Part 5. Related Systems
- 15. Neuro-ophthalmology
- From the eye to the Visual Cortex: The Afferent Visual System
- Ocular Motility and the Pupil: The Efferent Visual System
- Conclusion
- 16. Neurotology
- Anatomy of the Inner Ear
- The Cochlear System
- Measures of Auditory System Function
- The Vestibular System
- Tests of Vestibular Function
- Differential Diagnosis of Vertigo
- Indications for Vestibular Neurectomy
- Indications for Cochlear and Auditory Brainstem Implantation
- 17. Neurourology
- Urologic Anatomy and Physiology
- Evaluation of Neurourologic Disorders
- Neurourologic Diseases
- Treatment of Neurourologic Diseases
- 18. Coagulation for the Neurosurgeon
- Basic Science of Coagulation
- Antiplatelet Drugs
- Anticoagulant Drugs
- Future Perspectives
- 19. The Microbiome and the Central Nervous System
- 20. Peripheral Venous Disease in the Neurosurgery Patient
- Introduction
- Epidemiology
- Diagnosis and Diagnostic Techniques
- Preoperative Deep Venous Thrombosis Screening
- Inpatient Prophylaxis
- Inpatient Treatment
- Follow-Up For Untreated Extremity Deep Venous Thrombosis
- Outpatient Management
- Part 1. The Operating Room
- 21. Surgical Planning
- Preoperative Evaluation
- Neuroimaging and Other Technologies
- Anesthesia
- General Determination of Surgical Approach
- Conclusion
- 22. Avoidance of Complications in Neurosurgery
- Complications Related to Patient Positioning
- Catastrophic Medical Complications
- Risk Factors Related to Anatomy or Technique in Specific Surgical Procedures
- Conclusion
- 23. Incisions and Closures
- Principles of Wound Healing
- Surgical Anatomy
- Wound Closure and Scalp Reconstruction
- Conclusion
- 24. Positioning for Cranial Surgery
- General Considerations and Guidelines
- Pterional (Frontotemporal) Craniotomy
- Conclusion
- 25. Positioning for Spine Surgery
- Historical Perspective
- Common Positioning Equipment: Cranial Stabilization, Cervical Traction, and Frames
- Patient Positioning
- Reducing Position-Related Complications
- Special Considerations for Unstable Spine Pathology
- Conclusion
- 26. Positioning for Peripheral Nerve Surgery
- Anatomy, Positioning, and Surgical Exposure
- 27. Surgical Simulation
- Simulation
- Other Applications of Neurosurgical Simulation
- The Future of Neurosurgical Simulation
- Conclusion
- 28. Robotics in Cranial Neurosurgery
- Robots Defined
- Robotic Systems in Current Use in Cranial Neurosurgery
- Principles of Robotics Relevant to Surgery
- Limitations of Current Neurosurgical Robotic Systems
- Future Directions and Needs For Future Systems
- 29. Spinal Robotic Surgery
- History
- Genesis of Robotics and Surgery
- Robotics and Spinal Surgery
- Conclusions
- 30. Augmented Reality as an Aid in Neurosurgery
- Introduction
- Prerequisites
- Overview of Current Systems
- Current Applications
- Current Limitations and Future Development
- Conclusion
- 31. Visualization and Optics in Neurosurgery
- Our Understanding of Vision
- Augmentation of Vision
- The Operating Microscope
- New Technologies for Surgical Visualization
- The Visual Record
- Future Directions
- 32. Microscope Integration and Heads-Up Display in Brain Surgery
- What Does Augmented reality Add to Neurosurgery?
- What is Augmented Reality?
- Surgical Planning
- Adjudication and Model Modification
- Practice
- Conclusions
- 33. Brain Retraction
- Historical Perspectives
- Principles of Retractor-Based Surgery and Avoidance of Retractor Injury
- Retraction Injuries
- Future Directions
- Conclusion
- 34. Advantages and Limitations of Cranial Endoscopy
- History of Endoscopy
- Endoscopic Instrumentation and General Principles
- Limitations of use of the Endoscope in Intracranial Surgery
- Conclusion
- Part 2. Intensive Care
- 35. Principles of Neurocritical Care
- Neurocritical Considerations in Ischemic Stroke
- Neurocritical Considerations in Intracerebral Hemorrhage
- Neurocritical Considerations in Aneurysmal Subarachnoid Hemorrhage
- Neurocritical Considerations in Spinal Cord Injury
- Critical Care Bedside Procedures
- 36. The Neurosurgical Intensive Care Unit and the Unique Role of the Neurosurgeon
- History of the Neuro-Icu and Harvey Cushing’s Contributions
- Evaluation of the Neuro-Icu Patient
- The Role of the Icu in the Care of Neurosurgery Patients
- Elements of Neuro-Icu Care
- Neurocritical Care Training
- Models Of Neuro-Icu Care
- Conclusion
- 37. Intracranial Pressure Monitoring
- Historical Perspective
- General Principles and Standard of Intracranial Pressure Monitoring Technology
- Current Intracranial Pressure Monitoring Technology (FIG. 37.1)
- Emerging Technology
- Pediatric Intracranial Pressure Monitoring
- Conclusion
- Part 3. Neurosurgical Care in the Geriatric Patient
- 38. The Geriatric Patient: Age-Related Pathophysiologic Changes and Anesthesia Considerations
- Age-Related Pathophysiologic Changes
- Preoperative Considerations
- Intraoperative Considerations
- Postoperative Considerations in the Elderly
- 39. Brain Tumor Management in the Geriatric Patient
- Introduction
- Glioblastoma Multiforme
- Brain Metastases
- Epilogue
- 40. Traumatic Brain Injury in the Geriatric Patient
- Epidemiology
- Preexisting Conditions, Frailty, and Polypharmacy
- Acute Diagnostic and Management Considerations
- Discharge Planning
- Outcomes
- Long-Term Neurobehavioral Outcomes
- Conclusions
- Normal Pressure Hydrocephalus
- 41. Genetics of Idiopathic Normal Pressure Hydrocephalus
- Pathology of iNPH
- 42. Production and Flow of Cerebrospinal Fluid
- Different fluid-forming capabilities: choroid plexus vs. Brain capillaries
- Cerebrospinal Fluid Ion Homeostasis
- Intricate Fluid Balance Among Central Nervous System Compartments
- Variations in cerebrospinal fluid production: normal vs. Disease
- Mechanisms of Cerebrospinal Fluid Formation by the Choroid Plexus
- Volume Transmission or Bulk Flow of Cerebrospinal Fluid
- Neurohumoral Regulation of Cerebrospinal Fluid Formation Rate
- Pharmacologic Inhibition of Cerebrospinal Fluid Formation
- Lower Cerebrospinal Fluid Formation Rate in Hydrocephalus
- Flow Directionality of Cerebrospinal Fluid
- Impact of Cerebrospinal Fluid Flow on Brain Functions
- Magnetic Resonance Imaging of Cerebrospinal Fluid Hydrodynamics vs. Hemodynamics
- Regionally Interrupted Cerebrospinal Fluid Flow in Normal Pressure Hydrocephalus
- Cerebrospinal Fluid Flow Reversal in Idiopathic Normal Pressure Hydrocephalus
- Cerebrospinal Fluid Stroke Volume Issues in Idiopathic Normal Pressure Hydrocephalus
- Dwindling Cerebrospinal Fluid Turnover Rate in Aging, Normal Pressure Hydrocephalus, and Alzheimer Disease
- Altered Cerebrospinal Fluid and Barrier Clearance Systems in Aging and Neurodegeneration
- Translational Neuroscience to Fortify Cerebrospinal Fluid–Brain Dynamics in Older Adult Patients
- Clinical Challenges to Rectify Distorted Cerebrospinal Fluid–Interstitial Fluid Dynamics In Idiopathic Normal Pressure Hydrocephalus
- 43. Clinical Evaluation of Hydrocephalus in Adults
- Classification of the Adult Hydrocephalus Continuum
- Idiopathic Normal Pressure Hydrocephalus
- Diagnostic Criteria
- Tests Based on Cerebrospinal Fluid Circulatory Physiology
- Treatment Options and Outcomes
- Perioperative Optimization
- Conclusion
- 44. Shunting
- Valve Design and Terminology
- Managing Shunt Overdrainage and Underdrainage
- Valve Selection
- Shunt Configuration
- Infection Avoidance
- Miscellaneous Conditions and Clinical Challenges
- Role of Endoscopic Third Ventriculoscopy
- 45. The Role of Endoscopic Third Ventriculostomy: A Critical Review
- Comparison of Adult and Pediatric Hydrocephalus
- Endoscopic Third Ventriculostomy for Unrecognized Congenital Hydrocephalus
- Endoscopic Third Ventriculostomy for Acquired Hydrocephalus (Usually Noncommunicating)
- Endoscopic Third Ventriculostomy in Normal-Pressure Hydrocephalus
- Secondary Endoscopic Third Ventriculostomy After Shunt Malfunction With an Underlying Diagnosis of Obstructive Hydrocephalus
- Imaging Prior to Endoscopic Third Ventriculostomy
- Postoperative Radiologic Imaging and Outcome Assessment
- Operative Technique for Endoscopic Third Ventriculostomy
- Complications of Endoscopic Third Ventriculostomy
- Conclusion
- Chronic Subdural Hematomas
- 46. Pathophysiology of Chronic Subdural Hematomas
- Definitions
- Epidemiology
- Cause
- Pathology
- Pathogenesis
- Appearance on Computed Tomography and Magnetic Resonance Imaging
- Natural History and Recurrence After Surgery
- Conclusion
- 47. Medical and Surgical Management of Chronic Subdural Hematomas
- Introduction and Epidemiology
- Pathogenesis
- Clinical Presentation
- Diagnosis
- Management
- Future Research Areas
- Conclusion
- Part 4. Neurosurgical Care in the Pregnant Patient
- 48. Systemic and Central Nervous System Changes During Pregnancy
- Introduction
- Systemic Physiologic Changes in Pregnancy
- Maternal Neuroendocrine Alterations and Pituitary Tumors During Pregnancy
- 49. Neuroanesthesia During Pregnancy
- Introduction
- Physiologic Changes of Pregnancy Relevant to Neuroanesthesia
- Anesthetic Considerations Related to the Physiology of Pregnancy
- Perioperative Neuroanesthesia Drugs and Pregnancy
- Specific Neurosurgical Procedures During Pregnancy
- Timing of Neurosurgery and Perioperative Fetal Monitoring
- Conclusion
- 50. Vascular Lesions During Pregnancy
- Stroke
- Vascular Disorders During Pregnancy
- Other Vascular Lesions
- Conclusion
- 51. Brain Tumors During Pregnancy
- Neuroimaging in Pregnancy
- Neuroanesthesia in Pregnancy
- Pituitary Tumors
- Glial Tumors
- Meningiomas
- Other Tumors
- Conclusion
- Part 5. Infections in Neurosurgery
- 52. Basic Science of Central Nervous System Infections
- Routes of central nervous system infection, or “it’s not whom you know, it’s how you get there”
- Role of the Blood-Brain Barrier In Central Nervous System Infections
- Innate Immunity in the Central Nervous System
- Matrix metalloproteinases: “you can’t have your cake and eat it too!”
- Brain Edema and Neurotoxicity: Consequences of Central Nervous System Infection
- 53. Postoperative Infections of the Head and Brain
- Epidemiology and Etiology
- Risk Factors for Infection and Preventative Strategies
- Principles of Treatment
- Superficial Incisional Infections
- Deep Incisional Infections: Subgaleal Space and Bone Flap
- Deep Organ Space Infections
- Conclusions
- 54. Postoperative Infections of the Spine
- Incidence
- Infectious Risk Factors
- Clinical Findings
- Evaluation
- Bacteriologic Studies
- Treatment
- Prevention
- 55. The Use and Misuse of Antibiotics in Neurosurgery
- The Importance of Antibiotics in Neurosurgery
- Risks of Antibiotic Administration
- General Principles of Antibiotic Use
- Systemic Antibiotic Prophylaxis
- Topical Antibiotic Prophylaxis
- Antibiotic Treatment for Neurosurgical Infections
- Surgical Care Improvement Project Measures
- Conclusion
- 56. Brain Abscess
- Brain Abscess
- Cranial Subdural Empyema and Epidural Abscess
- 57. Meningitis and Encephalitis
- Bacterial Meningitis
- Viral Meningitis and Encephalitis
- Mycobacteria (Tuberculous Meningitis)
- Fungal Meningitis
- Spirochetes
- Protozoa
- Chemical Meningitis
- 58. Neurological Manifestations of HIV and AIDS
- HIV Infection of the Nervous System
- HIV-Associated Neurocognitive Disorders
- Infection
- AIDS-Related Malignancies
- HIV Treatment–Related Neurotoxic Effects
- Conclusion
- 59. Parasitic Infections
- 60. Surgical Risk of Blood-Borne Transmissible Disease
- Hepatitis
- Human Immunodeficiency Virus
- Prevention of Occupational Infection
- The Infected Surgeon
- Legal Issues Pertaining To The United States
- Future Considerations
- Section III. Basic and Clinical Sciences: Overview and Controversies
- Introduction
- Controversies and Unresolved Questions
- 61. Molecular Biological Approaches for Understanding the Nervous System: A Primer for Neurosurgeons
- The Rise of Functional Genomics
- Transcriptomics
- Tools For Modifying Gene Function
- Neuromodulation of the Nervous System
- Proteomics
- Summary
- 62. Optogenetics and Clarity
- Optogenetics
- Genetically Encoded Calcium Indicators
- Enhanced Histologic Examination with Transparent Tissue: CLARITY
- Conclusion and Outlook
- 63. Neuroembryology
- Classical Neuroembryology
- Developmental Organization: Stages, Genes, and Regulatory Factors
- Developmental Patterns and Disorders
- Conclusion
- 64. Stem Cell Biology in the Central Nervous System
- Stem Cells and Progenitors
- Neurogenesis: Location and Function
- Evidence for Adult Human Neurogenesis
- Stem Cells and Cancer
- Stem Cell–Based Therapies
- Stem Cell Imaging
- Cell Engineering
- Conclusion
- 65. Neurons and Neuroglia
- Neurons
- Neuroglia
- Transplantation Therapies
- Toward the Molecular Identity at a Single Cell Level
- 66. Cellular Mechanisms of Brain Energy Metabolism
- Brain Work Supports Information Processing
- Brain Work Maintains Ion Concentrations
- Brain Energy Metabolism Enables Brain Work
- Metabolism Depends On Delivery Of Substrates To The Brain
- Homeostatic Mechanisms Maintain Constant Adenosine Triphosphate
- Metabolic Compartments Exchange Pyruvate And Lactate
- Activation Perturbs Metabolic Compartments Differentially
- Conclusion
- 67. Cellular and Molecular Responses in the Peripheral and Central Nervous System Following Axonal Injury
- Cellular and Molecular Responses in the Peripheral and Central Nervous Systems
- Peripheral Nervous System Response to Injury
- Central Nervous System Response to Axonal Injury
- Opportunities for Intervention
- Conclusion
- 68. The Blood-Brain Barrier
- Functional Anatomy of the Blood-Brain Barrier
- Transport Across the Blood-Brain Barrier
- Tight Junctions
- Tight Junction Regulation
- Pathologic Changes in the Blood-Brain Barrier
- Imaging the Blood-Brain Barrier
- Future Considerations
- 69. Physiology of the Cerebrospinal Fluid and Intracranial Pressure
- Historical Considerations
- General Physiology of Intracranial Pressure
- General Physiology of the Cerebrospinal Fluid
- Steady-State Intracranial Pressure and Cerebrospinal Fluid Dynamics
- Non–Steady-State Dynamics
- Effects of Elevated Intracranial Pressure
- Intracranial Pressure Monitoring
- Physiology of Intracranial Hypertension Therapy
- Multimodal Application of Intracranial Hypertension Therapy
- 70. Cerebral Edema
- Introduction
- Cerebral Fluid Homeostasis
- Pathophysiology of Cerebral Edema
- Imaging of Cerebral Edema
- Management of Cerebral Edema
- Conclusion
- 71. Extracellular Fluid Movement and Clearance in the Brain: The Glymphatic Pathway
- Basic Principals Governing Interstitial Fluid Movement in the Brain
- Physiology of Interstitial Fluid Movement
- Clinical Implications of Glymphatic Pathway Function
- Intrathecal, Intraventricular, and Intraparenchymal Delivery of Medications
- Conclusion
- 72. Altered Consciousness
- A Brief Taxonomy
- An Organizing Strategy to Assess Disorders of Consciousness Based on Anatomic and Physiologic Considerations
- A Guide to Formulating Prognosis in Patients With Disorders of Consciousness
- Emerging Role of Neuroimaging in Altered Consciousness: Opportunities and Limitations
- Cognitive Motor Dissociation
- Conclusion
- 73. Neuropsychological Testing
- Clinical Assessment
- Clinical Interventions
- Quantifying Recovery of Function After Brain Surgery
- Discussion and Future Directions
- 74. Biosensors in Neurosurgery: Wearable and Implantable Devices for Monitoring
- Introduction
- Intracranial Pressure Monitoring
- Body Fluid Composition
- Intraoperative Monitoring
- Movement Disorders
- Other Uses
- Electrical Activity
- Fluid Dynamics
- Conclusion
- 75. Artificial Intelligence and Big Data in Neurosurgery
- Artificial Intelligence and Big Data: A Historical Overview
- AI Techniques
- Why Neurosurgery is Suitable for AI and Big Data Applications
- Diagnosis
- Treatment
- Follow-Up
- Training
- Future Directions
- 76. Neurosurgical Epidemiology, Research, and Biostatistics
- Introduction
- Diagnostic and Screening Tests
- Determining Causation
- Evaluating Interventions
- Biostatistics
- Conclusion
- Section IV. Epilepsy: Overview and Controversies
- Introduction
- Overview
- Controversies in Epilepsy
- Part 1. Basic Science of Epilepsy
- 77. Electrophysiologic Properties of the Mammalian Central Nervous System
- Introduction
- Electrical Properties of Mammalian Cells
- Ion Channels in Neurons and Glia
- Intercellular Communication: Electrical and Chemical Synaptic Transmission
- Maintenance of Extracellular Homeostasis
- Electrophysiologic Monitoring and Recording in Neurosurgery
- 78. Animal Models of Epilepsy
- Developmental Equivalency Across Species
- Electrical Stimulation Models of Temporal Lobe Epilepsy or Limbic Epileptogenesis
- Models of Posttraumatic Epilepsy
- Models of Cortical And Brain Malformations
- Early-Onset Epilepsies
- Models with Relevance to Epilepsy Surgery
- Conclusion
- Acknowledgments
- 79. Malformations of Cortical Development
- Classification of Malformations of Cortical Development
- Surgery for Malformations of Cortical Development
- Conclusion
- Part 2. Approach to the Epileptic Patient
- 80. Diagnosis and Classification of Seizures and Epilepsy
- Approach to New-Onset Seizure
- Seizure and Epilepsy Classification
- Conclusions
- 81. Antiseizure Medications: Principles of Clinical Use
- Overview of AED History, Mechanism, and Efficacy
- When to Start Antiepileptic Drug Therapy
- Antiepileptic Drug Selection
- When and How to Stop Antiepileptic Drug Therapy
- Antiepileptic Drug Use Coordination With Neurologists
- Conclusion
- 82. Electroencephalography in Outpatient, Epilepsy Monitoring Unit, and Intensive Care Unit Settings
- Introduction
- Electroencephalography in Outpatients
- Electroencephalography in the Epilepsy Monitoring Unit
- Techniques or Activation Maneuvers Implemented for Increasing Outpatient and Epilepsy Monitoring Unit Electroencephalographic Yield
- The Electroencephalogram in Epilepsy
- Electroencephalography in the Intensive Care Unit Setting
- Conclusion and Future Directions
- Part 3. Preoperative Evaluation for Epilepsy
- 83. Evaluation of Patients for Epilepsy Surgery
- Goals of Presurgical Evaluation of Patients With Epilepsy
- Clinical Approach and Techniques Used in the Presurgical Evaluation
- Conclusion
- 84. Magnetic Resonance Imaging for Epilepsy Surgery
- Indications
- Structural Cerebral Abnormalities Identified with Magnetic Resonance Imaging
- Functional Imaging
- Magnetic Resonance Spectroscopy
- Multimodality Imaging in Epilepsy Surgery
- Interventional Magnetic Resonance Imaging
- Conclusion
- 85. Single-Photon Emission Computed Tomography in Epilepsy Surgery Evaluation
- ICTAL Single-Photon Emission Computed Tomography
- ICTAL and Interictal Single-Photon Emission Computed Tomography
- SISCOM
- Statistical Parameter Mapping Statiscom
- Limitations of Single-Photon Emission Computed Tomography
- Outcome Procedures Associated With Single-Photon Emission Computed Tomography
- 86. Magnetoencephalography/Magnetic Source Imaging
- Magnetoencephalography Principles
- Brief Overview of Clinical Magnetoencephalography
- Role of Magnetoencephalography in Epilepsy Surgery
- Applications of Magnetoencephalography in Functional Mapping in Neurosurgery
- Multimodal Integration of Magnetoencephalography With Other Diagnostic Tests
- Future Directions In Clinical Magnetoencephalography
- Conclusion
- 87. Wada Testing
- Procedures
- Interpretation of Wada Testing Results
- Anesthetic Agents and Dosages
- Safety
- Wada Testing in Children
- Perfusion Patterns
- Reliability
- Validity
- Changes in the Use of Wada Testing and Possible Alternatives
- Closing Comments
- 88. Preoperative Functional Localization
- Principles and Limitations of Functional Magnetic Resonance Imaging
- Language Lateralization
- Localization and Prediction of Language Outcome After Surgery
- Memory Processes
- Lateralization of Memory Functions
- Localization of Memory Functions
- Prediction of Memory Outcome After Epilepsy Surgery
- Postoperative Memory Network Plasticity
- Future Directions for Language and Memory Functional Magnetic Resonance Imaging
- Motor Functional Magnetic Resonance Imaging
- Sensory Functional Magnetic Resonance Imaging
- Interpretation in a Clinical Context
- Vision
- Diffusion and Tractography
- Tractography
- Conclusions
- Part 4. Intracranial Recordings
- 89. Intracranial Monitoring with Subdural Grids and Strips
- Introduction
- History
- Generators For Electroencephalographic Signals
- Recording Technology
- Clinical Use of Subdural Electrodes
- Cortical Stimulation For Localization of Eloquent Cortex
- Safety and Complications of Subdural Electrodes
- Research Applications of Subdural Electrodes
- Conclusions
- 90. Intracranial Monitoring: Stereo-electroencephalography Recording
- Brief Historical Perspective of Stereotactic Epilepsy Surgery
- Developing The Hypotheses and Implantation Planning
- Seeg Implantation Patterns
- Technical Nuances
- Orthogonal (Cartesian) Versus Oblique (Non-Cartesian) Implantations
- Seeg-Guided Resections: General Considerations
- Clinical Scenarios: Seeg Implantation Planning and Resections in the “Nonlesional Scenario”
- Seeg Implantation Planning and Resections in the “Lesional Scenario”
- Conclusions
- 91. Intraoperative Electrocorticography and Strategy in Tailored Lesionectomies
- History of Lesionectomy and Electrocorticography
- Indications for Intraoperative Electrocorticography and Technique
- Anesthetic Protocols for Effective Electrocorticography
- Application of Electrocorticography to Functional Mapping
- Focal Resection for Epilepsy
- Utilization of Electrocorticography with Lesional Epilepsy
- Conclusions
- 92. Intraoperative Mapping and Monitoring for Cortical Resection
- Introduction
- Anatomic Considerations
- Indications
- Preoperative Functional Imaging
- Preoperative Preparations
- Considerations During the Craniotomy
- Intraoperative Stimulation Mapping
- Surgical Pearls
- Postoperative Considerations
- 93. Investigation of Human Cognition in Epilepsy Surgery Patients
- Methods
- Cognitive Studies
- Conclusion
- Part 5. Specific Operative Approaches
- 94A. Anteromedial Temporal Lobectomy
- Historical Perspective
- Preoperative Evaluation
- Surgical Decision Making
- Surgical Technique
- Postoperative Follow-Up
- Surgical Complications
- Outcomes
- 94B. Selective Amygdalohippocampectomy
- Selective Approaches for Mesial Temporal Epilepsy
- Technique for Subtemporal Selective Amygdalohippocampectomy
- Evidence for Selective Approaches
- Acknowledgments
- 95. Resections for Extratemporal Epilepsy
- Introduction
- Frontal Lobe Epilepsy
- Occipital Lobe Epilepsy
- Parietal Lobe Epilepsy
- Insular and Perisylvian Epilepsy
- Perirolandic Epilepsy
- Conclusion
- 96. Palliative Procedures for Drug-Resistant Epilepsy
- Corpus Callosotomy
- Multiple Subpial Transections
- Topectomy
- 97. Radiosurgical Treatment for Epilepsy
- Radiosurgery as a Neuromodulation Therapy
- Preclinical Evidence
- Clinical Evidence
- Medial Temporal Lobe Epilepsy
- Hypothalamic Hamartomas
- Cavernous Malformations
- Radiosurgical Corpus Callosotomy
- 98. Laser Interstitial Thermal Therapy in Epilepsy
- History of Lasers and Use in Surgical Cases
- Development of Interstitial Thermal Therapy and Magnetic Resonance Imaging Guidance
- Applications to Medically Intractable Epilepsy
- Conclusions
- 99. Hemispheric Disconnection Procedures
- Definition
- Development
- Indications, Patient Selection, and Timing
- Presurgical Evaluation
- Goals of Surgery
- Side Effects and Complications
- Surgical Techniques
- Postoperative Management
- Choice of Surgical Procedure
- Outcome and Factors of Influence
- Conclusion
- 100. Electrical Stimulation for Epilepsy (VNS, DBS, and RNS)
- Cortical-Subcortical Networks in Epilepsy
- Mechanisms of Action of Electrical Neuromodulation
- Targets For Electrical Stimulation in Epilepsy
- Conclusion and Future Directions
- 101. Epilepsy Surgery: Outcomes and Complications
- Basic Principles and Pitfalls of Outcomes Assessment For Epilepsy Surgery
- Resective or Ablative Surgery
- Resective or Ablative Surgery for Catastrophic Epilepsies
- Complications of Diagnostic Procedures
- Psychiatric Outcomes After Epilepsy Surgery
- Cost-Effectiveness of Surgical Treatment
- Neuromodulation for Epilepsy
- Stereotactic Radiosurgery
- Section V. Functional Neurosurgery: Overview and Controversies
- Introduction
- Overview
- Controversies and Unanswered Questions
- Part 1. Basic Science of Movement Disorders
- 102. Anatomy and Synaptic Connectivity of the Basal Ganglia
- Functional Circuitry of the Basal Ganglia
- The Striatum: An Entrance to the Basal Ganglia Circuitry
- Direct and Indirect Pathways of the Basal Ganglia
- The Hyperdirect Corticosubthalamic System
- The Pedunculopontine Nucleus as an Integrative Component of the Basal Ganglia
- Basal Ganglia Output to the Thalamus and Brainstem
- Conclusion
- Acknowledgment
- 103. Rationale for Surgical Interventions in Movement Disorders
- Key Concepts
- Introduction
- Relevant Anatomic and Physiologic Features of Brain Motor Systems
- Movement Disorders: Clinical Characteristics, Medical Treatment, and the Role of Surgery
- Surgical Treatment of Movement Disorders
- Conclusion
- 104. Neuropathology of Movement Disorders
- Functional Anatomy of Basal Ganglia
- α-Synucleinopathies
- Hypokinetic-Rigid Movement Disorders
- Lewy Body–Associated Disorders
- Tauopathies
- Hyperkinetic Movement Disorders
- Conclusion
- Part 2. Neurology of Movement Disorders
- 105. Clinical Overview of Movement Disorders
- Phenomenology: Defining Symptoms Through Observation
- Hyperkinesias
- Hypokinesias
- Disorders With Mixed Hypokinesia And Hyperkinesia
- Disorders Of Coordination
- Movement Disorders Caused By Systemic Disease: Toxic/Metabolic And Autoimmune
- 106. Patient Selection Criteria for Deep Brain Stimulation in Movement Disorders
- General Selection Process
- Specific Indications For Deep Brain Stimulation
- 107. Functional Imaging in Movement Disorders
- Molecular Imaging
- MRI Of Blood Oxygen Level–Dependent Signals
- Applications to Movement Disorders
- Conclusion
- 108. Neuroimaging in Stereotactic Functional Neurosurgery
- Image-Guided Surgery
- Magnetic Resonance Connectivity and Imaging of Brain Activity
- Image-Verified Surgery
- Safety of Magnetic Resonance Imaging in Patients with Implanted Deep Brain Stimulation Hardware
- Gamma Knife and Magnetic Resonance–Guided Focused Ultrasonography
- Conclusion
- Part 3. Surgery for Movement Disorders
- 109. Surgical Management of Tremor
- Definition and Classification of Tremor
- Pathophysiology and Circuitries of Tremor
- Ablative Procedures
- 110. Ablative Procedures for Parkinson Disease
- Historical Background
- Physiologic Basis for Ablation Procedures for Parkinson Disease
- Indications and Contraindications
- Surgical Techniques
- Clinical Outcomes
- Alternative Approaches
- Conclusion
- 111. Deep Brain Stimulation for Parkinson Disease
- Brief Historical Overview
- Anatomy and Physiology of Targets
- Patient Selection
- Target Selection Factors
- Selection of Surgical Technique
- Awake Surgical Technique
- Asleep Interventional Magnetic Resonance Imaging Surgical Technique
- Results
- Complications
- Future Directions
- 112. Deep Brain Stimulation for Dystonia
- Diagnosis and Classification of Dystonia
- Pathophysiology
- Medical Therapy for Dystonia
- Surgical Therapy for Dystonia
- The Deep Brain Stimulation Procedure
- Clinical Results
- Complications of Deep Brain Stimulation Therapy
- Alternative Targets for Deep Brain Stimulation in Dystonia
- Conclusion
- 113. Deep Brain Stimulation: Mechanisms of Action
- Introduction
- Neural Responses To Deep Brain Stimulation
- Changes in Somatic Activity in the Stimulated Nucleus
- Axonal Output From the Stimulated Nucleus
- Activation of Fiber Tracts
- Effects of Deep Brain Stimulation on Distal Brain Regions
- Therapeutic Mechanisms of Deep Brain Stimulation
- Therapeutic Targets of Deep Brain Stimulation
- Conclusion
- 114. Complication Avoidance in Deep Brain Stimulation Surgery
- Procedure-Related Complications
- Hardware-Related Complications
- Stimulation-Related Complications
- Avoiding Complications
- Conclusion
- 115. Neurophysiologic Monitoring for Movement Disorder Surgery
- General Overview of Surgery
- Internal Globus Pallidus Procedures
- Ventrolateral Intramedial Nucleus Procedures
- Subthalamic Nucleus Procedures
- Data Analysis
- Conclusion
- 116. Emerging and Experimental Neurosurgical Treatments for Parkinson’s Disease
- Scientific Background
- Refinements in the Understanding of Mechanisms and Anatomic Targets for Electrical Stimulation
- Advances in Neurostimulation Technology for Deep Brain Stimulation
- Image-Guided Ultrasound Lesioning Techniques for the Treatment of Parkinson’s Disease
- Transplantation of Fetal Neurons for the Treatment of Parkinson’s Disease
- Stem Cell Therapies for Parkinson’s Disease
- Progress in Gene Therapy for the Treatment of Parkinson’s Disease
- Conclusions
- 117. Transcranial Magnetic Resonance–Guided Focused Ultrasound Thalamotomy for Tremor
- Historical Uses of Focused Ultrasonography in the Brain
- Ultrasound Properties
- Modern Transcranial Focused Ultrasonography
- Magnetic Resonance Thermography
- Thermal Dose
- Technique: Transcranial Magnetic Resonance–Guided Focused Ultrasound Thalamotomy
- Results
- Future Directions
- Conclusion
- 118. Selective Peripheral Denervation for Cervical Dystonia
- Clinical and Phenomenologic Aspects of Cervical Dystonia
- Evolution of Surgical Techniques
- Selective Peripheral Denervation: Indications and Patient Selection
- Operative Techniques
- Clinical Outcome: Results and Side Effects
- Future Concepts
- 119. Thalamotomy for Focal Hand Dystonia
- History
- Diagnosis of Focal Hand Dystonia
- Conclusion
- Part 4. Surgery for Psychiatric Disorders
- 120. History and Ethical Considerations in Functional Neurosurgery
- The Early Days of Functional Neurosurgery: Psychosurgery
- A History of Surgery for Movement Disorders
- A History of Stereotactic Neurosurgery
- Ethical Considerations in Functional Neurosurgery
- Conclusions
- 121. Surgery for Tourette Syndrome
- Pathophysiology
- Treatment
- Surgical Treatment
- Patient Selection and Ethical Considerations
- Surgical Technique
- Conclusions And Future Directions
- 122. Surgery for Obsessive-Compulsive Disorder
- Introduction
- History of Psychosurgery
- Neural Circuits and Pathophysiology
- Patient Selection, and Team Approach
- Surgical Management of Obsessive-Compulsive Disorder
- Conclusion
- 123. Surgery for Major Depressive Disorder
- Introduction
- Diagnosis and Treatment
- Circuitry of Mood and Depression
- The Ablative Experience
- Deep Brain Stimulation
- Future Directions
- 124. Surgery for Anorexia Nervosa
- Introduction
- Severe and Enduring Anorexia Nervosa
- Etiopathology and Neurocircuitry of Anorexia Nervosa
- Nonsurgical Management of Anorexia Nervosa
- Surgical Management of Anorexia Nervosa
- Perioperative Patient Management
- Adverse Events Associated with Surgery for Anorexia Nervosa
- Conclusion and Perspective
- 125. Surgery and Neuroscience of Addiction
- Epidemiology of Addiction
- Methods for Circuit Mapping in Animal Models of Addiction
- Animal Models of Addiction
- Biologic and Anatomic Pathways Mediating Addictive Responses in the Brain
- Neurosurgical Interventions for Addiction
- Summary
- Part 5. Surgical Interventions for Spasticity
- 126. Lesioning Surgery for Spasticity
- Peripheral Neurotomies
- Surgery on the Spinal Roots, Dorsal Root Entry Zone, and Spinal Cord
- Orthopedic Surgery
- Other Methods
- Patient Selection
- Conclusion
- 127. Management of Spasticity by Central Nervous System Infusion Techniques
- Definition of Spasticity
- Physiologic Basis of Spasticity
- Measurement of Spasticity
- Treatment of Spasticity
- Part 6. Surgery for Vertigo, Cortical Stimulation, Obesity, Alzheimer Disease, and Neuroprosthetics
- 128. Treatment of Intractable Vertigo
- Classification of Vestibular Disorders
- Nonsurgical Management of Vertigo
- Surgical Management of Intractable Vertigo
- 129. Motor Cortex Stimulation for Pain and Movement Disorders
- Introduction
- Methods: Surgical and Cortical Mapping Technique
- Discussion
- 130. Deep Brain Stimulation for Obesity
- Anatomy
- Deep Brain Stimulation Theory
- Animal Studies
- Human Studies
- Ethics of Deep Brain Stimulation for Obesity
- Summary
- 131. Deep Brain Stimulation for Alzheimer Disease
- Introduction
- History of Surgical Intervention for Alzheimer Disease
- Pathologic Process in Alzheimer Disease
- Conclusion and Future Directions
- 132. Neuroprosthetics
- Interface Modalities
- Electroencephalography
- Intraparenchymal Electrodes
- Electrocorticography
- Spinal Cord Stimulation
- Peripheral Nerve Interfaces
- Cochlear Implant
- Industry Involvement
- Conclusion
- Volume 2
- Section VI. Oncology: Overview and Controversies
- Introduction
- Overview
- Controversies
- Acknowledgments
- Part 1. Basic Science of Neurooncology
- 133. Brain Tumors: An Overview of Current Histopathologic and Genetic Classifications
- Astrocytomas
- Oligodendroglial Tumors
- Ependymal Tumors
- Choroid Plexus Tumors
- Other Neuroepithelial Tumors
- Neuronal and Mixed Neuronal-Glial Tumors
- Pineal Region Tumors
- Germ Cell Tumors
- Embryonal Tumors
- Tumors of the Meninges
- Tumors of the Sellar Region (Excluding Pituitary Adenoma)
- Lymphoma
- Metastatic Tumors of the Central Nervous System
- Intraoperative Consultation (Frozen Section) in Neuro-Oncology
- 134. Brain Tumor Immunology and Immunotherapy
- Introduction to Brain Tumor Immunology and Immunotherapy
- Antigen-Driven Therapies
- Immune-Checkpoint Inhibitors
- Nonreplicative Viral Therapies
- Summary
- 135. Brain Tumor Stem Cells
- The Neurosphere Assay and the Discovery of Adult Neurogenesis
- Development of the Brain Tumor Stem Cell Hypothesis
- Markers for Neural Stem Cells and Brain Tumor Stem Cells
- Brain Tumor Stem Cell of Origin
- Molecular Pathways Altered in Brain Tumor Stem Cells
- Clinical Implications and Future Directions
- Conclusion
- 136. Molecular Genetics and the Development of Targets for Glioma Therapy
- World Health Organization Molecular Classification for Gliomas
- Detecting Molecular Alterations in Cancer
- Glioma Analysis Using Molecular Tools
- Models for Evaluating Molecular Alterations in Glioma
- Targeted Therapy for Glioma: Progress and Failures
- Clinical Research: Designing Effective Clinical Trials Based on Molecular Targets in Gliomas
- Conclusion
- 137. The Genetic Origins of Brain Cancers
- Introduction
- Clonal Expansion of Malignant Tumors
- Inherited Mutations and Familial Syndromes
- Tumor Suppressors, Oncogenes, and Mutator Genes
- Different Types of DNA Mutations and Alterations
- The Spectrum of Mutations That Underlie Brain Cancers
- Perspectives in Brain Tumor Genomics and Genetics
- 138. Malignant Glioma Microenvironment
- Introduction: the Tumor Microenvironment
- Malignant Glioma Invasion
- Conclusions and Future Perspectives
- 139. Basic Science of Brain Metastases
- Diagnosis of Brain Metastases
- Cancer Type and Propensity of Brain Metastasis
- Theories of Metastasis
- Anatomic Avenues for Dissemination
- Barriers to Entry
- Role of Neural Input in Tumorigenesis and Metastasis
- Molecular Considerations for Metastasis
- Therapeutic Perspectives in Brain Metastases
- Use of Immunotherapy in Treating Brain Metastasis
- 140. Angiogenesis and Brain Tumors: Scientific Principles, Current Therapy, and Future Directions
- Historical Perspective
- Angiotherapy: A Novel Approach To Glioma Therapy
- Mechanisms of Tumor Angiogenesis
- Reduction of Vasogenic Edema, Radioprotection, and Radiosensitization
- Clinical Experience With the Use of Bevacizumab
- Bevacizumab Resistance and Glioma Recurrence
- The Role of Anti-Vegf Therapy For Other CNS Tumors
- Brain Metastases
- Pediatric Brain Tumors
- Current Trends and Future Directions
- Conclusion
- Online Resources of Angiogenesis in Brain Tumors
- 141. Delivery of Therapy to Brain Tumors: Problems and Potentials
- Physiologic Barriers to Delivery
- The Blood-Tumor Barrier
- The Blood–Cerebrospinal Fluid Barrier
- Drug Modifications For Enhanced Drug Delivery to Brain Tumors
- Barrier Disruption
- Direct Delivery to the Brain
- Other Approaches For Enhancing Drug Delivery to the Brain
- Conclusion
- 142. Epidemiology of Brain Tumors
- Descriptive Epidemiology
- Survival and Prognostic Factors for Glioma and Meningioma
- Genetic Risk Factors
- Environmental and Developmental Risk Factors in Glioma and Meningioma
- Conclusion
- Part 2. Approach to the Neuro-Oncology Patient
- 143. Clinical Features: Neurology of Brain Tumor and Paraneoplastic Disorders
- Basis for Neurological Dysfunction in Patients with Malignancies of the Nervous Systems
- Presenting Symptoms of Central Nervous System Malignancies
- Paraneoplastic Syndromes
- Subacute Sensory Neuronopathy
- Summary and Conclusion
- 144. Radiologic Features of Central Nervous System Tumors
- Imaging Diagnosis of Central Nervous System Tumors
- Imaging Characteristics of Brain Tumors Based on Anatomic Location
- Presurgical Planning
- Postoperative Imaging
- Therapeutic Monitoring
- Conclusion
- 145. Endovascular Techniques for Tumor Embolization
- Background and Indications
- Rationale and Evidence
- Principles and Techniques
- Anatomic Considerations
- Timing
- Complication Avoidance
- Indications for Tumor Embolization
- Conclusion
- 146. Genetic Syndromes of Brain Tumors
- Neurofibromatosis Type 1
- Neurofibromatosis Type 2
- Tuberous Sclerosis Complex
- Von Hippel-Lindau Disease
- Li-Fraumeni Syndrome
- Cowden Disease
- Conclusion
- 147. Principles of Chemotherapy
- Introduction
- Basic Concepts
- Concepts in Chemotherapy
- Delivery of Chemotherapy to the Brain
- Chemotherapeutic Agents in Central Nervous System Tumors
- Conclusion
- 148. Brain Tumor Outcome Studies: Design and Interpretation
- Defining the Patient Population
- Describing Treatment: Extent of Resection
- Describing Outcomes of Brain Tumor Therapy: End Point Choices and Definitions
- Special Considerations in Specific Phases of Drug or Technology Testing
- Special Considerations in Specific Types of Brain Tumor Study Design
- 149. Neurocognition in Brain Tumor Patients
- Cognitive Function in Brain Tumor Patients
- Methodology for Assessing Cognitive Function
- Specific Causes of Cognitive Dysfunction in Brain Tumor Patients
- Cognitive Preservation in Brain Tumor Patients
- Specific Types of Tumors and Cognitive Impairment
- Summary
- 150. Frame and Frameless Stereotactic Brain Biopsy
- Historical Landmarks
- Background
- Indications for Stereotactic Biopsy
- Technical Considerations
- Sampling Error
- Complications of Stereotactic Biopsy
- Comparison of Frame-Based and Frameless Methods
- Intraoperative Magnetic Resonance Imaging–Guided Brain Biopsy
- Stereotactic Biopsy of Brainstem Lesions
- Conclusion
- Part 3. Surgical Considerations in Neuro-Oncology
- 151. Basic Principles of Cranial Surgery for Brain Tumors
- Preoperative Evaluation And Management
- Preoperative Imaging Interpretation
- Timing of Surgery
- Surgical Planning: Imaging Studies
- Surgical Preparation
- Positioning
- Incision
- Craniotomies
- Tumor Removal
- Postoperative Care
- Conclusion
- 152. Basic Principles of Skull Base Surgery
- History of Skull Base Surgery
- Overview of Skull Base Surgery
- Preoperative Surgical Planning
- Operative Considerations and Approach Selection
- Tumor Resection
- The Role of Spinal Fluid Diversion in Skull Base Surgery
- Intraoperative Navigation and Intraoperative Magnetic Resonance Imaging
- Neuroendoscopy
- Extent of Surgical Resection and Role of Radiation Therapy
- Complication Avoidance and Management
- 153. Risks of Intrinsic Brain Tumor Surgery and Avoidance of Complications
- Defining a Complication
- Classification Schemes
- Patient Selection and Avoidance of Complications
- Conclusion
- 154. Surgical Navigation for Brain Tumors
- Fundamentals
- Role of Neuronavigation in Brain Tumor Surgery
- Brain Shift and its Impact on Neuronavigation
- How it Works
- 155. Endoscopic Approaches to Brain Tumors
- General Principles of Neuroendoscopy
- Endoscope-Assisted Surgery in Transcranial Approaches
- Endoscopic Endonasal Approaches to Sellar and Skull Base Tumors
- Endoscopic Management of Intraventricular Tumors
- Conclusion
- 156. Awake Craniotomy and Intraoperative Mapping
- Preoperative Mapping of Function
- Awake Intraoperative Mapping Techniques
- Functional Outcomes
- Conclusions
- 157A. Intraoperative Magnetic Resonance Imaging
- Gliomas
- Pediatric Brain Tumors
- Downsides
- Future Directions
- 157B. Fluorescence-guided Brain Tumor Surgery
- Fluorophores and Glioma Fluorescence-Guided Surgery
- 5-Aminolevulinc Acid
- Fluorescein
- Indocyanine Green
- Fluorescence-Guided Surgery for Nonglial Tumors
- BLZ-100 Fluorescence-Guided Surgery
- Tumor-Targeted Alkylphosphocholine Analogues Fluorescence-Guided Surgery
- Cetuximab-IRDye 800
- Conclusions and Future Directions
- Part 4. Intrinsic and Ventricular Tumors
- 158. Low-Grade Gliomas: Diffuse Astrocytoma and Oligodendroglioma
- Introduction and Epidemiology
- Clinical Presentation
- Conventional and Emerging Neuroimaging
- Histologic Features of Diffuse Low-Grade Gliomas
- Immunohistochemical Assessment of Diffuse Low-Grade Gliomas
- Molecular Pathogenesis and Integrated Diagnosis of Diffuse Low-Grade Gliomas
- Management and Survival
- Conclusion
- 159. Malignant Gliomas: Anaplastic Astrocytoma, Glioblastoma, Gliosarcoma, and Anaplastic Oligodendroglioma
- Introduction
- Malignant Astrocytomas
- Gliomatosis Cerebri
- Anaplastic Oligodendrogliomas
- Midline Gliomas
- Future Directions for Malignant Gliomas
- 160. Radiologic and Clinical Criteria of Treatment Response
- Introduction
- Findings in the Imaging of Brain Tumors are Nonspecific
- Drugs Interfering With Contrast Uptake on Imaging
- Imaging
- Nonenhancing Tumors
- Postsurgical Imaging
- Clinical Assessment of Tumor Response and Nonsurvival End Points
- Some Practical Considerations on Brain Tumor Outcome Assessment
- 161. Unusual Gliomas
- Subependymal Giant Cell Astrocytoma
- Angiocentric Glioma
- Astroblastoma
- Pilomyxoid Astrocytoma
- Pleomorphic Xanthoastrocytoma
- Ganglioglioma
- Papillary Tumor of the Pineal Region
- Dysembryoplastic Neuroepithelial Tumor
- Chordoid Glioma of the Third Ventricle
- Papillary Glioneuronal Tumor
- Diffuse Leptomeningeal Glioneuronal Tumor
- Conclusion
- 162. Local Therapies for Gliomas
- Introduction
- Local Therapies for Gliomas
- Conclusion
- 163. Central Nervous System Embryonal Tumors
- History
- Incidence
- Pathology
- Clinical Evaluation
- Treatment
- Complications
- Outcomes and Adjuvant Therapy
- Conclusion
- 164. Pineal Tumors
- Historical Perspective
- Anatomy
- Pathology
- Clinical Features
- Treatment
- Surgical Techniques
- Patient Positioning
- Operative Approaches
- Postoperative Care
- Complications
- Surgical Outcome
- Postoperative Workup
- Outcomes and Follow-Up Care Based on Pathology
- Conclusion
- 165. Medulloblastomas in Adults
- Introduction And Epidemiology
- Clinical Presentation
- Future Perspectives
- 166. Intracranial Ependymomas in Adults
- Introduction
- Pathology and Molecular Characteristics
- Clinical Presentation
- Imaging
- Staging
- Treatment
- Prognosis
- 167. Hemangioblastomas
- Epidemiology
- Imaging Findings
- Clinical Findings
- Peritumoral Cyst Formation
- Von Hippel-Lindau Disease
- Natural History
- Pathologic Findings
- Pathogenesis
- Management
- Surgical Technique
- Conclusion
- 168. Primary Central Nervous System Lymphomas
- Introduction
- Epidemiology
- Pathobiology
- Clinical Manifestations
- Diagnosis
- Treatment
- Neurotoxicity
- Monitoring and Follow-Up
- 169. Metastatic Brain Tumors
- Pathophysiology of Brain Metastases
- Epidemiology
- Treatment Modalities
- Whole-Brain Radiation Therapy
- Patient Parameters and Prognostic Factors
- Whole-Brain Radiotherapy Dose-Fractionation Schemes
- Altered Fractionation Schemes
- Radiation Sensitizers
- Prophylactic Cranial Irradiation for Small Cell Lung Cancer
- Complications of Whole-Brain Radiotherapy
- Hippocampal-Avoidance Whole-Brain Radiotherapy
- Surgical Resection
- Patient Selection and Prognostic Factors
- Surgical Techniques
- Reoperation for Recurrent Metastases
- Outcome and Prognosis with Surgery
- Stereotactic Radiotherapy
- Stereotactic Radiosurgery vs. Conventional surgery
- Stereotactic Radiosurgery Plus Whole-Brain Radiotherapy
- Postoperative Radiotherapy
- Novel Therapies
- Metastases From Renal Cell Carcinoma, Melanoma, and Sarcoma
- Leptomeningeal Disease
- Reirradiation
- Chemotherapy
- Conclusion
- 170. Ventricular Tumors
- General Epidemiology and Classification
- Surgery of the Lateral Ventricle
- Surgery of the Third Ventricle
- Surgery of the Fourth Ventricle
- Intraventricular Tumor Pathology
- 171. Colloid Cysts of the Third Ventricle
- Introduction
- Histogenesis
- Natural History of Colloid Cysts
- Neuroimaging for Colloid Cysts
- Surgical Decision Making
- Surgical Anatomy
- Surgical Approaches
- Complications and Pitfalls
- Part 5. Extrinsic Tumors
- 172. Meningiomas
- Historical Background
- Epidemiology
- Pathology
- High-Grade Meningiomas
- Multiple Meningiomas
- Collision Tumors
- Immunohistochemistry and Molecular Diagnostics
- Genetic Aspects
- Meningiomas and Receptors
- Etiology
- Radiology
- Observation for Meningiomas
- Surgical Therapy and Tumor Recurrence
- Embolization
- Radiation Therapy
- Medical Management
- Meningiomas by Location and their Surgical Management
- 173. Mesenchymal Nonmeningothelial Tumors
- Epidemiology
- Solitary Fibrous Tumor/Hemangiopericytoma
- Chondrosarcoma
- Fibrosarcoma
- Angiosarcoma
- Rhabdomyosarcoma
- Malignant Fibrous Histiocytoma
- Primary Meningeal Osteosarcoma
- Hemangioblastoma
- Other Sarcomas
- Conclusion
- 174. Vestibular Schwannomas
- Introduction
- Historical Perspective
- Natural History and Epidemiology
- Neurofibromatosis 2
- Histopathology
- Clinical Presentation and Diagnosis
- Management of the Asymptomatic Patient
- Intraoperative Neuromonitoring
- Surgical Approaches
- Radiosurgery, Radiotherapy, and Adaptive Hybrid Surgery
- Complications and Their Management
- Conclusion
- 175. Pituitary Tumors: Functioning and Nonfunctioning
- Epidemiology
- Embryology, Morphology, and Anatomy of the Normal Pituitary Gland
- Classification of Pituitary Tumors
- Clinical Presentation
- Evaluation and Diagnosis
- Surgical Management
- Radiotherapy
- Specific Considerations for Pituitary Adenoma Subtypes
- Conclusion
- 176. Craniopharyngiomas in Adults
- Epidemiology And Pathology
- Goals of Treatment
- Approach Selection
- Conclusions
- 177. Epidermoid, Dermoid, and Neurenteric Cysts
- Introduction
- Epidermoid Cysts
- Dermoid Cysts
- Neurenteric Cysts
- Conclusion
- 178. Endoscopic Endonasal Surgery for Skull Base Tumors
- Endoscopic Endonasal Corridors
- Endoscopic Endonasal Approaches
- Different Pathologies Treated with Endoscopic Approaches
- Reconstruction of the Skull Base Defect
- Associated Complications and Management
- Part 6. Skull and Skull Base Tumors
- 179. Overview of Skull Base Tumors
- Classification
- Epidemiology
- Meningiomas
- Pituitary Adenomas
- Craniopharyngiomas
- Schwannomas
- Epidermoid and Dermoid
- Chordomas and Chondrosarcomas
- Paraganglioma (Chemodectomas or Glomus Tumors)
- Skull Base Metastases
- Conclusion
- 180. Chordomas and Chondrosarcomas
- Introduction
- Epidemiology and Predictors of Survival
- Surgical Evaluation
- Chordoma
- Chondrosarcoma
- Conclusion
- 181. Head and Neck Paragangliomas
- Nomenclature
- General Overview
- Historical Background
- Tumor Characteristics
- Typical Aspects According to Origin, Clinical Signs, and Symptoms
- Diagnosis
- Treatment
- Conclusion
- 182. Neoplasms of the Paranasal Sinuses
- Background
- Pathogenesis
- Pathologic Features
- Diagnostic Evaluation
- Classification
- Treatment Principles
- Outcome
- Conclusion
- 183. Esthesioneuroblastoma
- Introduction
- Pathology
- Presentation
- Patient Evaluation
- Treatment
- Surgical Technique
- Complications
- Outcomes
- Summary
- 184. Trigeminal Schwannomas
- Introduction, Epidemiology, and History
- Tumor Biology, Pathology, and Pathogenesis
- Clinical Findings
- Diagnostic Imaging
- Surgical Treatment
- Role of Radiosurgery and Radiotherapy
- Outcome
- Summary
- 185. Juvenile Nasopharyngeal Angiofibromas
- Introduction and Epidemiology
- 186. Tumors of the Orbit
- Clinical Manifestations
- Surgical Anatomy
- Surgical Approaches (“Around the Clock”)
- Lateral Corridors
- Medial Corridors
- Complications and Their Management
- Choice of Approach
- Conclusion
- 187. Skull Tumors
- Primary Skull Neoplasms
- Secondary (Metastatic) Skull Neoplasms
- Reactive, Proliferating, and Non-Neoplastic Lesions
- 188. Scalp Tumors
- Introduction
- Keratoses
- Nonmelanoma Skin Cancers
- Nevi
- Melanoma
- Soft Tissue Lesions
- Lesions of Vascular Tissue
- Lesions of Nervous Tissue
- Adnexal Tumors
- Dural Involvement
- Reconstruction
- Radiation Therapy
- Part 7. Nonneoplastic Disorders Mimicking Brain Tumors
- 189. Pseudotumor Cerebri
- Terminology
- Epidemiology
- Symptoms and Signs
- Diagnosis
- Secondary Pseudotumor Cerebri
- 190. Sarcoidosis, Tuberculosis, and Demyelinating Disease
- Clinical Approach
- Imaging
- Sarcoidosis
- Tuberculosis
- Demyelinating Disease
- Section VII. Pain: Overview and Controversies
- Introduction
- Historical Overview of Neurosurgical Management of Pain
- Current status of neurosurgery for pain. Controversies and the role of evidence-based medicine
- Future Perspectives
- Conclusion
- Part 1. Basic Science
- 191. Anatomy and Physiology of Pain
- Primary Afferent Nociceptors
- Dorsal Horn and Ascending Pathways
- Supraspinal Nociceptive Targets
- Cortical Processing
- Sensitization of Ascending Pain Transmission Pathways
- Descending Modulatory Systems
- Conclusion
- 192. Molecular Basis of Nociception
- Activation of Primary Afferents
- Modulation of Primary Afferent Firing
- Transmission of Pain Signals to the Central Nervous System
- Part 2. Nonsurgical Therapy
- 193. Approach to the Patient With Chronic Pain
- Introduction
- Before the Patient’s Arrival
- The Initial Visit
- 194. Pharmacologic Treatment of Pain
- Introduction
- Pathophysiology
- Pharmacologic Treatment of Pain
- Conclusion
- 195. Management of Pain by Percutaneous Anesthetic Injections and Neurolysis
- Considerations for Diagnostic and Therapeutic Injections
- Imaging Guidance and Anatomic Considerations
- Conclusion
- Part 3. Treatment of Trigeminal Neuralgia
- 196. Evidence-Based Approach to the Treatment of Facial Pain
- The Benefit of Evidence-Based Medicine
- Implementation of Evidence-Based Medicine in Surgery for Facial Pain
- Other Trial Options
- Conclusion
- 197. Trigeminal Neuralgia: Diagnosis and Nonoperative Management
- Introduction
- Diagnostic Criteria and Classification
- Epidemiology and Risk Factors
- Etiology
- Nonoperative Management
- Timing of Surgical Consultation
- Conclusion
- 198. Percutaneous Procedures for Trigeminal Neuralgia
- Historical Development Of Percutaneous Procedures For Trigeminal Neuralgia
- Trigeminal Anatomy
- Diagnosis
- Surgical Treatment
- Percutaneous Preoperative Considerations
- Percutaneous Surgical Procedures
- Radiosurgery
- Results And Complications
- Special Considerations
- Conclusion
- 199. Stereotactic Radiosurgery for Trigeminal Neuralgia
- Introduction
- Historical Perspective of Gamma Knife in Trigeminal Neuralgia
- Rationale of Radiosurgery For Trigeminal Neuralgia
- Radiosurgical Targeting
- Clinical and Radiologic Follow-Up After Radiosurgery
- Pain Control After Radiosurgery
- Adverse Radiation Effects
- Recurrence and Re-Treatment
- Comparison of Radiosurgery and Open Surgery For Trigeminal Neuralgia
- Future of Stereotactic Radiosurgery For Trigeminal Neuralgia
- Conclusions
- 200. Microvascular Decompression for Trigeminal Neuralgia
- History
- Pathophysiology
- Alternative Treatments
- Patient Selection and Classification of Facial Pain
- Preoperative Imaging
- Operative Technique
- Postoperative Care
- Complications
- Results
- Other Neurovascular Facial Pain Syndromes
- Conclusion
- Part 4. Surgical Procedures for Nontrigeminal Pain
- 201. Neurosurgical Management of Intractable Pain
- Prelude to Surgical Treatment
- Patient Selection for Surgical Pain Therapies
- Neurosurgical Therapies for Intractable Pain
- Conclusion
- Neuromodulation
- 202. Evidence-based Neurostimulation for Pain
- Introduction
- Spinal Cord Stimulation
- Deep Brain Stimulation
- Motor Cortex Stimulation
- Peripheral Nerve Stimulation
- Conclusion
- 203. Peripheral Nerve Stimulation for Neuropathic Pain
- Theory and Application
- Indications
- Technique
- Outcome
- Dorsal Root Ganglion Stimulation
- Advances and Future Direction
- 204. Spinal Cord Stimulation
- Introduction
- Mechanism of Action
- Indications and Outcomes
- Spinal Cord Stimulation Leads
- Laminectomy Versus Percutaneous Placement
- Generators
- Constant Current Versus Constant Voltage
- Patient Programmers
- Stimulation Parameters
- Surgical Technique
- Complications
- Cautions and Contraindications
- New Directions
- Destructive Procedures
- 205. Evidence Base for Destructive Procedures
- Methods
- Results
- Discussion
- Conclusion
- 206. Dorsal Rhizotomy and Dorsal Root Ganglionectomy
- Indications for Dorsal Rhizotomy and Ganglionectomy
- Surgical Technique
- Conclusion
- 207. Diagnosis and Management of Painful Neuromas
- Pathophysiology
- Clinical Presentation
- Diagnosis
- Treatment
- Prevention Of Secondary Neuroma
- Poor Surgical Candidates
- Future Directions
- 208. Dorsal Root Entry Zone Lesions for Pain
- Rationale
- Indications
- Conclusion
- 209. Percutaneous Cordotomy and Trigeminal Tractotomy for Pain
- History And Introduction
- Results
- Trigeminal Tractotomy-Nucleotomy
- Results
- Conclusion
- Section VIII. Pediatrics: Overview and Controversies
- Introduction
- In Memoriam
- Overview
- Controversies
- Acknowledgments
- Part 1. Approach to the Pediatric Patient
- 210. Neuroanesthesia in Children
- Preoperative Evaluation and Preparation
- Intraoperative Management
- Postoperative Management
- Conclusion
- 211. Neurocritical Care in Children
- Neurological Assessment in the Pediatric Intensive Care Unit
- Airway Management and Respiratory Failure
- Stroke in Children
- Fluids, Electrolytes, and Nutrition
- Intracranial Hypertension
- Seizures
- Infections
- Prevention of Secondary Insults to the Brain
- The Diagnosis of Brain Death in Children
- eAppendix 211.1: Postoperative Protocol for Diabetes Insipidus
- Part 2. Cranial Development Abnormalities
- 212. Neuroembryology and Molecular Genetics of the Brain
- Early Embryonic Development and Induction
- Early Brain Induction
- Neurulation
- Segmentation
- Secondary Organizers
- Rhombencephalon/Hindbrain
- Isthmic Organizer
- Rhombic Lip
- Cerebellum
- Prosencephalon
- Diecephalon
- Cerebral Cortex
- Embryonic Ventricular System
- Development of Ependymal Cells
- Development of Choroid Plexus
- 213. Cranial Dysraphisms: Encephaloceles, Meningoceles, and Cranial Dermal Sinus Tracts
- Introduction
- Nosology
- Classification and Nomenclature
- Embryology
- Epidemiology
- Genetics
- Pathologic Features
- Diagnosis
- Management
- Cranial Meningoceles
- Cranial Dermal Sinus Tracts
- 214. Dandy-Walker Syndrome
- History and Embryology
- Terminology and Differential Diagnosis
- Clinical Features
- Treatment
- Prognosis
- Conclusion
- 215. Arachnoid Cysts in Childhood
- Histopathology and Pathophysiology
- Clinical Presentation
- Imaging
- Supratentorial Arachnoid Cysts
- Infratentorial Arachnoid Cysts
- Conclusion
- 216. Chiari Malformations
- History
- Terminology
- Signs and Symptoms
- Diagnostic Studies
- Pathophysiology
- Chiari I Malformation
- Treatment
- Complications
- Results and Prognosis
- Follow-Up
- Controversial Topics
- Conclusion
- 217. Craniopagus Twins
- Introduction
- Historical Perspective
- Classification and Demographics
- Surgical Separation
- Inoperable Craniopagus
- Conclusion
- Part 3. Craniosynostosis
- 218. Molecular Genetics and Principles of Craniosynostosis
- Suture Morphogenesis
- Syndromic Craniosynostosis
- Nonsyndromic Craniosynostosis
- Value of Molecular Genetics to the Craniofacial Surgeon
- Conclusion
- 219. Nonsyndromic Craniosynostosis: Introduction and Single-Suture Synostosis
- Nonsyndromic and Syndromic Craniosynostosis
- Diagnosis
- Operative Timing and Approaches
- Neurocognitive Considerations
- Etiology of Neurocognitive Disabilities
- Effect of Surgical Technique and Timing
- Operative Treatment
- Operative Complications
- Philosophy of Treatment
- 220. Syndromic Craniosynostosis
- Craniofacial Syndromes and Genetics
- Apert Syndrome
- Crouzon Syndrome
- Pfeiffer Syndrome
- Muenke Syndrome
- Saethre-Chozen Syndrome
- Craniofrontonasal Dysplasia
- Carpenter Syndrome
- Other Syndromes
- Problems and Functional Complications
- Operative Management
- Conclusion
- 221. Endoscopic Treatment of Craniosynostosis
- Instrumentation
- Anesthesia
- Sagittal
- Coronal
- Metopic
- Lambdoid
- Nonsyndromic Multiple Suture Synostosis
- Conclusion
- Literature Review
- 222. Nonsynostotic Plagiocephaly
- History
- Scope and Impact
- Incidence
- Pathogenesis and Pathology
- Evaluation of the Infant With Plagiocephaly
- Treatment
- Conclusion
- Part 4. Hydrocephalus in Children
- 223. Hydrocephalus in Children: Etiology and Overall Management
- Etiology
- Presentation
- Diagnostic Studies
- Management
- Follow-Up
- 224. Infantile Post-hemorrhagic Hydrocephalus
- Intraventricular Hemorrhage in Preterm Infants
- Intraventricular Hemorrhage in Term Infants
- 225. Cerebrospinal Fluid Disorders and Transitional Neurosurgery
- Evolving Cerebral Fluid System Concepts
- Transitional Hydrocephalus and Cerebral Fluid System Disorders of Young Adults
- Conclusion
- 226. Experimental Hydrocephalus
- Experimental Models
- Conclusion
- 227. Ventricular Shunting Procedures
- History
- Components of Shunt Systems
- Shunt Surgery
- Outcomes of Ventricular Shunting
- Conclusion
- 228. Neuroendoscopy
- History
- Anatomic Considerations for Ventriculoscopic Surgery
- Indications
- Hydrocephalus
- Intraventricular Hemorrhage
- Conclusion
- 229. Cerebrospinal Fluid Devices
- Introduction
- History of Cerebrospinal Fluid Shunt Devices
- Cerebrospinal Fluid Shunt Hydrodynamics
- Cerebrospinal Fluid Devices
- Valve Design Trials
- Conclusion
- 230. Management and Prevention of Shunt Infections
- Features of Shunt Infections
- Risk Factors
- Evaluating Infections
- Treatment
- Outcomes of Infection and Treatment
- Preventive Measures
- Conclusion
- Part 5. Pediatric Cranial and Intracranial Tumors
- 231. Genetics of Pediatric Brain Tumors
- Introduction
- Definitions
- Pediatric Gliomas
- Embryonal Tumors
- Ependymal Tumors
- Germ Cell Tumors of the Central Nervous System
- Other Pediatric Central Nervous System Tumors
- Conclusion
- 232. General Approaches and Considerations for Pediatric Brain Tumors
- Epidemiology
- Clinical Features
- Classification
- Diagnostic Evaluation
- Treatment
- 233. Optic Pathway Hypothalamic Gliomas
- Background
- Clinical Presentation
- Radiologic Imaging
- Screening Of Patients With Neurofibromatosis Type 1
- Treatment
- Functional Outcome
- Conclusion
- 234. Thalamic Tumors
- Epidemiology And Incidence
- Surgical Anatomy
- Growth Patterns
- Presentation
- Histopathology
- Molecular Drivers
- Treatment
- Outcomes
- Future Directions
- 235. Choroid Plexus Tumors
- Epidemiology
- Pathology
- Treatment
- Choroid Plexus Carcinoma and Atypical Choroid Plexus Papilloma
- Outcomes
- Conclusion
- 236. Pediatric Craniopharyngiomas
- Introduction
- Epidemiology
- Histopathology
- Biologic Characteristics of ACP
- Imaging
- Clinical Presentation and Evaluation
- Surgical Management
- Radiation Therapy
- Stereotactic Radiosurgery
- Intracystic Therapy
- Recurrent Craniopharyngiomas
- Conclusion
- 237. Pediatric Supratentorial Hemispheric Tumors
- Background
- Clinical Presentation
- Low-Grade Tumors
- High-Grade Tumors
- Conclusion
- 238. Ependymomas
- Clinical Overview
- Prognostic Factors
- Hereditary Tumor Syndromes
- Cancer Genetics
- Stem Cell Biology
- Ependymoma Variants
- Neuroimaging
- Initial Surgery
- Surgery For Residual or Recurrent Tumor
- Surgical Technique
- Treatment of Hydrocephalus
- Radiotherapy
- Chemotherapy
- Conclusion
- 239. Medulloblastomas in Children
- Historical Perspective
- Epidemiology
- Pathology
- Genetics and Molecular Subgroups of Medulloblastoma
- Clinical Presentation
- Diagnostic Imaging
- Staging and Prognostic Factors
- Treatment
- Surveillance Imaging and Disease Prognosis
- Quality of Life in Medulloblastoma Survivors
- Future Directions
- 240. Cerebellar Astrocytomas
- Historical Perspective
- Clinical Findings
- Conclusion
- 241. Brainstem Gliomas
- Historical Background and Epidemiology
- Advancement in Imaging Technologies and Intraoperative Facilities
- Focal Brainstem Glioma
- Diffuse Intrinsic Pontine Glioma
- Conclusion
- 242. Intracranial Germ Cell Tumors
- Epidemiology and Classification
- Molecular Pathogenesis
- Presentation
- Diagnostic Evaluation
- Surgical Management
- Adjuvant Therapy
- Conclusions
- 243. Neurocutaneous Tumor Syndromes
- Type 1 Neurofibromatosis
- Type 2 Neurofibromatosis
- Tuberous Sclerosis Complex
- Von Hippel-Lindau Disease
- 244. Pediatric Intraventricular and Periventricular Tumors
- Introduction
- Surgical Management Strategies
- Microsurgical Approaches to Tumors of the Lateral and Third Ventricles
- Anterior Third Ventricular Approaches Revisited in the Endoscopic Era
- Intraventricular Tumor Subtypes Classified by Surgically Relevant Anatomic Regions
- Conclusion
- 245. Skull Lesions in Children
- Inclusion Cysts
- Langerhans Cell Histiocytosis
- Fibrous Dysplasia
- Juvenile Ossifying Fibromas
- Intraosseous Lipomas of the Skull
- Part 6. Vascular Disease in Children
- 246. Moyamoya Disease in Children
- Epidemiology
- Associated Conditions
- Pathophysiology
- Genetics
- Clinical Findings
- Natural History and Prognosis
- Diagnosis
- Screening and Genetic Testing
- Treatment
- Conclusion
- 247. Vein of Galen Aneurysmal Malformation
- Diseases Causing Dilation of the Vein of Galen
- Clinical Manifestations
- Treatment
- Treatment Results
- Follow-Up
- Conclusion
- 248. Pediatric Cerebral Aneurysms
- Pathophysiology of Pediatric Aneurysms
- Natural History And Demographics
- Location and Size of Pediatric Aneurysms
- Clinical Presentation
- Preoperative Studies
- Treatment
- Follow-Up Imaging Recommendations
- Conclusion
- Acknowledgments
- 249. Pediatric Arteriovenous Malformations
- Pathology
- Presentation
- Location
- Natural history
- Mortality
- Diagnostic Decision Making
- Therapeutic Decision Making
- Surgery
- Recurrence
- Special Considerations
- Conclusion
- Part 7. Head and Brain Trauma in Children
- 250. Management of Head Injury: Special Considerations in Children
- Epidemiology
- Types of Head Injury
- Initial Evaluation
- Management of Traumatic Brain Injury
- Surgical Indications and Preoperative Considerations
- Intensive Care Unit Management
- Physiology
- Medical Treatment of Intracranial Hypertension
- Outcomes
- Conclusion
- 251. Inflicted Trauma (Child Abuse)
- Clinical Constellations and “Syndromes,” Mechanisms, and Evaluation
- Physical Abuse in Older Children
- Medicolegal Considerations in Child Abuse
- 252. Growing Skull Fractures
- History and Pathogenesis
- Epidemiology
- Classification
- Evaluation, Diagnosis, and Treatment
- Treatment
- Conclusion
- 253. Neonatal Brain Injury
- Hypoxia-Ischemia and Neonatal Encephalopathy
- Neonatal Seizures
- Intracranial Hemorrhage in Newborns
- Conclusion
- 254. Birth Brachial Plexus Injury
- Introduction
- Pathophysiology
- nAtural History
- Clinical Presentation
- Patient Evaluation
- Surgical Treatment
- Conclusion
- Part 8. Spine Disorders in Children
- 255. Myelomeningocele and Myelocystocele
- Myelomeningocele
- Myelocystocele
- 256. Fetal Surgery for Myelomeningocele
- Early Experience
- Management of Myelomeningocele Study
- Benefits of Fetal Surgery
- Risks of Fetal Surgery
- Prenatal Counseling for Fetal Surgery
- Surgical Technique
- Innovations and What Lies Ahead
- 257. Lipomyelomeningocele
- Definition/Classification
- Embryology
- Epidemiology
- Patient Presentation
- Evaluation
- Surgical Treatment
- Conclusion
- 258. Split Spinal Cord
- Epidemiology of Split Cord Malformations
- Embryogenesis
- Signs and Symptoms
- Imaging
- Surgical Management
- Outcomes
- Conclusion
- 259. Tethered Spinal Cord: Fatty Filum Terminale, Meningocele Manqué, and Dermal Sinus Tracts
- Incidence and Epidemiology
- Embryologic Overview
- Imaging Considerations
- Fatty Filum Terminale
- Meningocele Manqué
- Dermal Sinus Tracts
- Conclusion
- 260. Developmental Anomalies of the Craniovertebral Junction and Surgical Management
- Introduction
- Anatomy of the Craniovertebral Junction
- Embryology and Development of Craniovertebral Junction Disorders
- Implications of Craniovertebral Abnormalities
- Biomechanics
- Biomechanical Comparison of Cervical Orthoses
- Classification of Craniovertebral Junction Abnormalities
- Epidemiology
- Clinical Presentation
- Neurodiagnostic Imaging
- Treatment
- Developmental Abnormalities Affecting the Craniovertebral Region
- Anomalies of the Odontoid Process
- 261. Achondroplasia and Other Dwarfisms
- Genetics and Epidemiology
- Clinical Manifestations
- Evaluation and Diagnosis
- Operative Management
- Outcome
- Conclusion
- 262. Surgical Management of the Pediatric Subaxial Cervical Spine
- Introduction
- Biomechanics
- Clinical Presentation of Subaxial Cervical Spine Disorders
- Management of Subaxial Cervical Spine Lesions
- 263. Tumors of the Spine, Spinal Canal, and Spinal Cord in Children
- Introduction
- Epidemiology
- Pathology
- Presentation
- Diagnostic Evaluation
- Treatment: Surgery
- Treatment: Alternative and Adjuvant Therapeutics
- Complications
- Outcomes
- Conclusion
- 264. Introduction to Spinal Deformities in Children
- History and Physical Examination in Pediatric Spinal Deformities
- Radiographic Assessment of Pediatric Spinal Deformity
- Etiology and Classification of Pediatric Spinal Deformities
- Conclusion
- 265. Thoracolumbar Spinal Disorders in Pediatric Patients
- Clinical Evaluation
- Imaging Evaluation
- Principles of Management
- Congenital Disorders
- Neuromuscular Disorders
- Idiopathic Scoliosis
- Conclusion
- 266. Pediatric Vertebral Column and Spinal Cord Injuries
- Introduction
- Epidemiology
- Anatomic Considerations
- Initial Management of a Child with a Spinal Injury
- Cervical Spine Injuries
- Thoracolumbar Spinal Column Injuries
- Surgical Treatment Of Spinal Column Injuries
- Rehabilitation
- Future Directions
- Summary
- Part 9. Functional Disorders in Children
- 267. Pediatric Epilepsy Surgery
- Epilepsy and the Developing Brain
- The Path to Pediatric Epilepsy Surgery
- Epilepsy Classification: Modern Approaches
- Presurgical Evaluation
- Surgical Approaches: Diagnostic and/or Therapeutic
- Conclusion
- 268. Clinical Features and Management of Cerebral Palsy
- Diagnosis and Classification
- Associated Impairments
- Improving Mobility and Motor Function (“I Want to Walk”): how do we Help Them?
- Conclusion
- 269. Intrathecal Baclofen Therapy for Cerebral Palsy
- Introduction
- Patient Selection
- Screening Tests
- Pump and Catheter Implantation
- Dosing
- Outcomes In Intrathecal Baclofen Therapy
- Complications of Intrathecal Baclofen Therapy
- Approach to the Patient with Baclofen Overdose
- Approach to the Patient in Baclofen Withdrawal
- Future Directions
- Conclusions
- 270. Selective Dorsal Rhizotomy for Spastic Cerebral Palsy
- Harmful Effects of Cerebral Palsy Spasticity
- Indications for Selective Dorsal Rhizotomy
- Contraindications for Selective Dorsal Rhizotomy
- Preoperative Evaluation
- Surgical Technique (see Video 270.1)
- St. Louis children’s hospital experience
- Volume 3
- Section IX. Peripheral Nerve Disorders: Overview and Controversies
- Introduction
- Overview
- Controversies in Peripheral Nerve Surgery
- Part 1. Basic Science of Peripheral Nerve Disorders
- 271. Pathophysiology of Surgical Nerve Disorders
- Introduction and Overview
- Grading of Peripheral Nerve Injuries
- Mechanisms of Nerve Injuries
- Neurobiology of Peripheral Nerve Injury
- Pathophysiologic Basis of Surgical Management for Nerve Injuries
- Conclusion and Future Directions
- Part 2. Approach to the Patient With Peripheral Nerve Disorders
- 272. Peripheral Nerve Examination, Evaluation, and Biopsy
- Setting
- Obtaining the Medical History
- Physical Examination
- Diagnostic Confirmation
- Nerve Biopsy
- Conclusion
- 273. Peripheral Neuropathies
- Introduction
- Anatomy and Physiology of Peripheral Nerves
- Clinical Evaluation of Peripheral Neuropathy
- Electrodiagnostic Evaluation
- Laboratory, Radiologic, and Other Studies in Peripheral Neuropathy
- Metabolic Neuropathies
- Immune-Mediated Neuropathies
- Hereditary Neuropathies
- Infectious Neuropathies
- Environmental and Toxic Neuropathies
- Critical Illness Neuropathy
- Skin and Peripheral Nerve Biopsy
- Conclusion
- 274. Monitoring of Neural Function: Electromyography, Nerve Conduction, and Evoked Potentials
- Electromyography
- Nerve Conduction Studies
- Other Peripheral Neurodiagnostics
- Combined Central and Peripheral Tests
- Common Clinical Disorders
- Surgical Applications
- General Use of Intraoperative Neurodiagnostic Monitoring
- 275. Imaging for Peripheral Nerve Disorders
- Technical Aspects of Magnetic Resonance Neurography
- Classes of Image Findings
- Imaging in the Setting of Nerve Entrapment and Pain
- Nerve Trauma
- Nerve Tumors
- Magnetic Resonance Findings in Systemic Neuropathies
- Diagnosis of Diseases Affecting Muscle
- Conclusion
- Part 3. Management of Peripheral Nerve Entrapment
- 276. Distal Entrapment Syndromes: Carpal Tunnel, Cubital Tunnel, Peroneal, and Tarsal Tunnel
- Median Nerve
- Ulnar Nerve
- Common Peroneal Nerve
- Posterior Tibial Nerve
- Double Crush Syndrome
- 277. Brachial Plexus Nerve Entrapments and Thoracic Outlet Syndromes
- Subcategorization in the Definition of Thoracic Outlet Syndrome
- Neurogenic, Vascular, and Nonspecific Thoracic Outlet Syndrome
- Brachial Plexus Nerve Entrapment Syndromes
- Diagnostic Imaging in Thoracic Outlet Syndrome
- Image-Guided Injections of the Scalene Muscles and Distal Plexus
- Conclusion
- 278. Piriformis Syndrome, Obturator Internus Syndrome, Pudendal Nerve Entrapment, and Other Pelvic Entrapments
- Distinguishing Among Spinal Versus Pelvis Peripheral Nerve Etiologies by Physical Examination
- Nerve Entrapments of the Posterior Pelvis: Superior Gluteal Nerve and Sciatic Entrapment by the Piriformis Muscle
- Nerve Entrapments of the Lower Pelvis: Entrapments of the Pudendal Nerve and the Nerve to the Obturator Internus
- Nerve Entrapments of the Anterior Pelvis: Ilioinguinal, Femoral, Obturator, and Lateral Femoral Cutaneous Nerves
- Part 4. Management and Repair of Peripheral Nerve Injuries
- 279. Techniques in Nerve Reconstruction and Repair
- Functional Anatomy
- Pathologic Principles and Surgical Indications
- General Considerration for Surgery and Operative Principles
- Nerve Repair Technique
- Postoperative Care
- Envisioning of Prospects for How to Improve Results of Nerve Repair
- Conclusion
- 280. Nerve Transfers
- Intercostal Transfer
- Spinal Accessory Transfer
- Contralateral C7 Transfer
- Other Commonly Used Transfers
- Conclusion
- 281. Management of Acute Peripheral Nerve Injuries
- Classification of Acute Nerve Injuries
- Pathophysiology of Nerve Injuries
- Management of Acute Nerve Injuries According to the Biomechanical Classification
- Conclusion
- 282. Early Management of Brachial Plexus Injuries
- Introduction
- Anatomy
- Pathophysiology and Classification
- Brachial Plexus Injuries in Adults
- Birth-Related Brachial Plexus Injuries
- 283. Secondary Procedures for Brachial Plexus Injuries
- Tendon Transfer
- Functioning Free Muscle Transfer
- Arthrodesis
- Tenodesis
- Corrective Osteotomy
- Amputation/Prostheses
- Rehabilitation
- Pain Management
- Conclusion
- 284. Nerve Injuries of the Lower Extremity
- Epidemiology
- Lumbosacral Plexus Injuries
- Conclusion
- Part 5. Management of Peripheral Nerve Tumors
- 285. Benign and Malignant Tumors of the Peripheral Nerve
- Benign Tumors of Neural Sheath Origin
- Benign Tumors of Non–Neural Sheath Origin
- Malignant Peripheral Nerve Sheath Tumors
- Part 6. Management of Pain and Complications in Peripheral Nerve Surgery
- 286. Avoiding Iatrogenic Injury Affecting Nerves and Treatment of Consequent Symptoms
- Neurological Symptoms After Nerve Injury
- Iatrogenic Nerve Injuries
- Iatrogenic Injury During Peripheral Nerve Surgery and Complication Avoidance
- Conclusion
- Part 7. Peripheral Nerve Treatments in Neurologic Therapeutics
- 287. Neuroelectronic Systems
- Patient Population
- Targeted Muscle Reinnervation
- Surgery
- Bionic Reconstruction
- Postoperative Rehabilitation
- Implantable Neuroelectronic Interfaces
- Conclusion
- 288. Peripheral Nerve Surgery for Central Nervous System Disorders
- Spinal Cord Injury
- Spasticity
- Dystonia
- Contralateral Nerve Transfers for Spastic Hemiplegia
- Potential Role for Nerve Transfers in Acute Flaccid Myelitis
- Potential Role for Nerve Transfers in Brainstem Lesions
- Conclusion
- 289. Peripheral Nerve Treatments for Central and Autonomic Disorders
- Vagus and Glossopharyngeal Nerve Entrapments
- Section X. Radiation: Overview and Controversies
- Introduction
- Overview
- Controversies
- Part 1. Science of Radiation Techniques
- 290. General and Historical Considerations of Radiotherapy and Radiosurgery
- The Beginning
- The Search for Energy and Penetration
- The Organization of Clinical Investigation and Practice
- Emergence of Radiobiology and Limitation of Radiation Injury
- Imaging and Targeting
- Computational Advances
- Robotic Positioning and Automated Collimation
- Brachytherapy
- Stereotactic Radiosurgery
- Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy
- Particulate and Other Novel Radiation Systems
- Exporting Radiosurgery from Brain to Body
- Conclusion
- 291. Radiobiology of Radiotherapy and Radiosurgery
- Basic Principles of Radiation Therapy
- Direct and Indirect Effects of Radiation
- The Five Rs of Radiobiology
- Radiobiologic Considerations for Different Radiation Techniques
- Conclusion
- 292. Radiation Therapy Techniques
- Radiation Modalities
- Two-Dimensional And Three-Dimensional Techniques
- Conventionally Fractionated Radiotherapy
- Whole-Brain Radiotherapy Versus Partial-Brain Radiotherapy
- Intensity-Modulated Radiotherapy
- Stereotactic And Image-Guided Radiotherapy
- Stereotactic Radiosurgery
- Hypofractionated Stereotactic Radiotherapy
- Charged-Particle Therapy
- Brachytherapy
- 293. Radiosurgery Technique
- History of Radiosurgery
- Radiation Sources for Radiosurgery
- Radiosurgical Devices
- The Gamma Knife Radiosurgical Procedure
- The Linear Accelerator–Based Radiosurgical Procedure
- Proton Beam Radiosurgery
- Conclusion
- 294. Radiology of Radiation Techniques
- Introduction
- Vestibular Schwannoma
- Meningioma
- Arteriovenous Malformation
- Intracranial Metastasis
- 295. Combining Ionizing Radiation and Systemic Therapies for Treatment of Brain Metastases
- Introduction
- Cytotoxic Chemotherapy And Radiation
- Targeted Therapy And Radiation
- Immunotherapy And Radiation
- Recommendations
- Part 2. Fractionated Radiation Therapy
- 296. Fractionated Radiotherapy for Brain Tumors
- Radiobiology
- Radiation Delivery: Technical Issues
- Clinical Applications
- Complications
- 297. Fractionated Radiotherapy for Spine Tumors
- Radiation Tolerance of the Spinal Cord
- Radiotherapy Techniques
- Intramedullary Tumors
- Extramedullary Tumors
- Extradural Tumors
- Conclusion
- Part 3. Intracranial Stereotactic Radiosurgery
- 298. Radiosurgery for Malignant Intracranial Tumors
- Radiosurgery for Brain Metastases
- Radiosurgery for Primary Malignant Tumors
- 299. Radiosurgery for Benign Intracranial Tumors
- Introduction
- History
- Definition
- Radiobiology
- Topologic Differential Effect
- Long-Term Complications
- Vestibular Schwannomas
- Meningiomas
- Pituitary Tumors
- Other Benign Tumors
- Future Indications
- Conclusion
- 300. Radiosurgery for Intracranial Vascular Malformations
- Arteriovenous Malformations
- Dural Arteriovenous Fistulas
- Cavernous Malformations
- 301. Radiosurgery for Functional Disorders
- Craniofacial Neuralgias
- Movement Disorders
- Psychiatric Disorders
- Summary
- Part 4. Extracranial Stereotactic Radiosurgery
- 302. Radiosurgery for Benign Spine Tumors and Spinal Vascular Malformations
- Arteriovenous Malformations
- Spinal Hemangioblastomas
- Intradural Extramedullary Tumors, Meningiomas, and Nerve Sheath Tumors
- Conclusion
- 303. Radiosurgery for Malignant Axial Spine Tumors
- Introduction
- Limitations of Conventional External Beam Radiation Therapy
- The Development of Spine Radiosurgery Technique
- Outcomes of Spine Radiosurgery
- Radiosurgery as Neoadjuvant and Definitive Therapy
- Radosurgery as A Postsurgical Adjuvant Treatment
- Radiosurgery in the Setting of Reirradiation
- Radiosurgery Combined with Percutaneous and Minimally Invasive Techniques
- Radiosurgery for High-Grade Spinal Cord Compression
- Complications of Spine Radiosurgery
- Conclusion
- Section XI. Spine: Overview and Controversies
- Introduction
- Overview
- Controversies and Unresolved Questions
- Part 1. Basic Science of the Spine
- 304. Spinal Anatomy
- General Features
- Further Ligamentous Anatomy
- Nervous Anatomy: The Spinal Cord and Spinal Nerves
- Vascular Anatomy
- 305. Spinal Imaging
- Imaging Modalities
- Clinical Considerations
- Conclusion
- 306. Spinal Biomechanics and Basics of Spinal Instrumentation
- Anatomy and Physiology
- Energy Transfer and Pain
- Spinal Alignment and Pelvic Parameters
- Kinematics and Kinetics
- Implant Properties
- Conclusion
- 307. Disk Degeneration and Regeneration
- Intervertebral Disk Anatomy
- Intervertebral Disk Degeneration
- Regeneration
- Regeneration Under Dynamic Microenvironment
- Gene Therapy
- Conclusion
- 308. Pathophysiology and Treatment of Spinal Cord Injury
- Epiemiology of Spinal Cord Injury
- Phases of Spinal Cord Injury
- Barriers to Regeneration
- Classification of Spinal Cord Injury
- Treatment Strategies
- Emerging Therapies
- Conclusion
- 309. Electrophysiologic Studies and Monitoring
- Evidence For Neuromonitoring
- Somatosensory Evoked Potentials
- Motor Evoked Potentials
- Electromyography
- Lateral Monitoring
- Anesthetic Considerations and Troubleshooting
- Conclusion
- 310. Bone Metabolism and Osteoporosis
- Biology of the Bone
- Regulators of Bone Homeostasis
- Diagnosis of Osteoporosis
- Prevention and Treatment
- Important Secondary Causes of Osteoporosis and Associated Treatment Options
- Effect of Osteoporosis on Surgical Implications and Treatment Options
- Looking Ahead: What’s Next for Osteoporosis Treatments?
- Conclusion
- Part 2. Approach to the Patient With a Spinal Disorder
- 311. Differential Diagnosis of Spinal Disease
- Introduction
- Clinical Presentation
- Pain
- Neurological Deficit
- 312. Nonsurgical and Postsurgical Management of Low Back Pain
- Epidemiology of Low Back Pain
- Pathophysiology of Low Back Pain
- Nonoperative Management of Lower Back Pain
- Postoperative Pain Management in Spine Surgery
- Conclusions
- 313. Complication Avoidance in Spine Surgery
- Introduction
- Infection
- Venous Thromboembolism
- Vision Loss
- Spinal Cord Injury and Other Neurologic Injury
- Approach-Specific Complications
- Conclusion
- 314. Predictive Analytics in the Treatment of Spinal Disorders
- Introduction to Advanced Analytics: Artificial Intelligence and Machine Learning
- Potential Applications for Spinal Disorders
- Machine Learning Methodology: Strengths, Limitations, and Pitfalls
- Developing Novel Indices for Predictive Utility
- Overview of Predictive Models for Spine Surgery
- Conclusion
- Part 3. Degenerative Disease of the Spine
- 315. Evaluation and Treatment of Cervical Disk Herniations
- Historical Background
- Anatomy and Pathophysiology
- Epidemiology
- Clinical Findings
- Diagnostic Studies
- Conservative Management
- Operative Management
- Conclusion
- 316. Evaluation and Treatment of Ossification of the Posterior Longitudinal Ligament
- Epidemiology
- Pathophysiology
- Mechanism: Histologic Analysis
- Pathologic Features of Spinal Cord Lesions Caused by Ossification of the Posterior Longitudinal Ligament
- Diagnostic Imaging
- Natural History and Progression
- Treatment and Decision Making
- Conclusion
- 317. Evaluation and Treatment of Thoracic Disk Herniation
- Epidemiology
- Symptoms
- Radiographic Analysis
- Conservative Management
- Operative Management
- Surgical Techniques
- Summary
- 318. Evaluation and Treatment of Lumbar Disk Disease
- Clinical Evaluation
- Therapy
- Conclusion
- 319. Cervical, Thoracic, and Lumbar Stenosis
- Cervical Spinal Stenosis
- Thoracic Spinal Stenosis
- Lumbar Spinal Stenosis
- Tandem Stenosis
- 320. Evaluation and Treatment of Degenerative Lumbar Spondylolisthesis
- Epidemiology
- Biomechanics
- Natural History
- Evaluation
- Treatment
- Conclusion
- 321. Evaluation and Treatment of Degenerative Cervical Myelopathy
- Introduction
- Epidemiology
- Pathophysiology
- Evaluation
- Natural History
- Nonoperative Treatment
- Operative Treatment
- Treatment Outcomes
- Part 4. Infection of the Spine
- 322. Evaluation and Treatment of Spinal Epidural Abscess
- Introduction
- Clinical Presentation
- Management and Outcomes
- Complications
- Discussion
- 323. Treatment of Pyogenic Spondylodiscitis
- Introduction
- Presentation and Diagnosis
- Nonoperative Treatment
- Operative Treatment
- Conclusions
- 324. Evaluation and Treatment of Fungal and Tubercular Infections of the Spine
- Historical Background
- Epidemiology and Pathology of Spinal Tuberculosis
- Epidemiology and Pathology of Fungal Infections
- Clinical Features of Spinal Tuberculosis
- Diagnosis of Spinal Tuberculosis
- Clinical Features and Diagnosis of Fungal Infections
- Management of Spinal Tuberculosis
- Treatment of Fungal Infections of Spine
- Conclusions
- Part 5. Tumors of the Spine
- 325. Evaluation and Treatment of Benign Tumors of the Axial Skeleton
- Clinical Features
- Evaluation
- Histopathologic Diagnosis
- Diagnosis and Management by Histology
- Chemotherapy and Radiotherapy
- Surgical Management
- Conclusion
- 326. Evaluation and Treatment of Primary Malignant Tumors of the Axial Skeleton
- Epidemiology and Clinical Presentation
- Approach to Primary Tumors of the Spine
- Radiologic Assessment
- Obtaining a Diagnosis
- Oncologic Staging
- Surgical Planning
- Malignant Primary Spinal Tumors
- Conclusion
- 327. Evaluation and Treatment of Benign Intradural Extramedullary Tumors
- Histology and Gross Pathology
- Epidemiology
- Imaging
- Presentation and Indications for Surgery
- Surgical Considerations
- Surgery For Intradural Nerve Sheath Tumors
- Surgery for Dumbbell Tumors and Extradural Nerve Sheath Tumors
- Surgery for Spinal Meningiomas
- Surgery for Tumors of the Filum Terminale
- Adjuvant Therapy and Radiosurgery
- Outcomes
- Conclusion
- 328. Evaluation and Treatment of Metastatic Spinal Lesions
- Epidemiology
- Clinical Presentation
- Management
- Conclusion
- 329. Evaluation and Treatment of Malignant PrimarySpinal Tumors
- Introduction
- Malignant Astrocytomas: Anaplastic Astrocytomas and Spinal Glioblastoma Multiforme
- Anaplastic Ependymomas
- Rare Malignant Intradural Intramedullary Tumors: Anaplastic Oligodendrogliomas and Anaplastic Gangliogliomas
- Spinal Malignant Peripheral Nerve Sheath Tumors
- Malignant Meningioma
- Primary Spinal Cord Melanoma
- Conclusion
- Part 6. Inflammatory Diseases of the Spine
- 330. Evaluation and Treatment of Rheumatoid Arthritis and Inflammatory Spinal Diseases
- Epidemiology
- Pathophysiology Specific to Spinal Ligaments
- Clinical Features
- Assessment
- Imaging
- Modern Medical Treatment
- Indications for Surgical Intervention
- 331. Evaluation and Treatment of Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis
- Ankylosing Spondylitis
- Diffuse Idiopathic Skeletal Hyperostosis
- Clinical Features And Diagnosis
- Imaging
- Pathophysiology
- Primary Management
- Trauma Management
- Surgical Management
- Part 7. Congenital Anomalies of the Spine
- 332. Adult Congenital Malformations of the Thoracic and Lumbar Spine
- Epidemiology and Associated Disorders
- Imaging
- Embryology
- Congenital Scoliosis
- Congenital Kyphosis and Lordosis
- Congenital Thoracolumbar Stenosis
- Spondylolysis and Spondylolisthesis
- Sacral Agenesis and Caudal Regression Syndrome
- Sacrococcygeal Teratoma
- Spinal Dysraphism
- Diastematomyelia and Diplomyelia
- Conclusion
- 333. Adult Tethered Cord Syndrome
- Incidence and Epidemiology
- Developmental Considerations
- Pathophysiology of Tethered Cord Syndrome
- Symptomatology and Clinical Presentation
- Etiology
- Treatment
- Conclusions
- 334. Adult Syringomyelia
- Incidence and Epidemiology
- Pathophysiology and Classification
- Symptomatology and Clinical Presentation
- Radiologic Evaluation
- Specific Etiologies of Adult Syringomyelia
- Treatment
- Conclusion
- Part 8. Spinal Trauma
- 335. Evaluation and Classification of Spinal Instability
- Definition of Spinal Instability
- Anatomy and Biomechanics of Spinal Stability
- Assessment of Spinal Instability
- Classification of Spinal Instability
- 336. Medical Management of Spinal Cord Injury
- Pathophysiology
- Initial Care and Assessment of Acute Spinal Cord Injury
- Critical Care Management of Acute Spinal Cord Injury
- Principles of Surgical Management
- Pharmacotherapy
- Emerging Therapies
- Management of Subacute Complications
- Prognosis
- Conclusion
- 337. Prognosis in Spinal Trauma
- Mortality in Spinal Trauma
- Neurology in Spinal Trauma
- Conclusion
- 338. Classification and Treatment of O–C1 Craniocervical Injuries
- Isolated Ligament Injuries
- Isolated Osseous Injuries
- 339. Evaluation and Treatment of C2 (Axis) Fractures and Instability
- Anatomy Of C2
- Common C2 Fractures
- Conclusion
- 340. Evaluation, Classification, and Treatment of Subaxial Cervical (C3–C7) Injuries
- Incidence
- Age Distribution
- Anatomy and Biomechanics
- Evaluation
- Classification
- Treatment
- Conclusion
- 341. Evaluation and Treatment of Cervicothoracic Junction Injuries
- Biomechanics of the Cervicothoracic Junction
- Injuries
- Construct Design
- Conclusion
- 342. Evaluation and Management of Athletic Injuries of the Cervical Spine
- Background
- Classification of Athletic Spinal Injuries
- Etiologic Forces
- Injury Location
- Return-to-Play Criteria Following Cervical Spine Injury
- Conclusion
- 343. Evaluation, Classification, and Treatment of Thoracolumbar Spine Injuries
- Classification Schemes in Thoracic and Lumbar Spine Injuries
- Anatomy
- Initial Assessment and Evaluation
- Classifications
- Updated Aospine Thoracolumbar Spine Injury Classification System
- Operative Versus Nonoperative Management
- Conclusion
- 344. Evaluation and Treatment of Osteoporotic Fractures (Cement Augmentation)
- Epidemiology
- Bone Cement Reinforcement
- Definitions and Terminology
- Height Restoration
- Indication For Treatment and Patient Selection
- Treatment Modalities For Osteoporotic Vertebral Fractures
- Complex Fractures Requiring Surgical Stabilization
- Controversies
- Complications and Their Avoidance
- 345. Rehabilitation of Acute Spinal Cord Injury
- Introduction
- Prediction of Outcomes in sci Rehabilitation
- Outcome Prediction of Lower Extremity Function
- Outcome Prediction of Upper Extremity Function
- Bladder and Sexual Dysfunction
- Neurogenic Bowel Dysfunction
- Sci-Associated Secondary Conditions
- Outlook of Advanced Interventions in Rehabilitation
- Conclusion
- Part 9. Spinal Deformities
- 346. Classification of Spinal Deformity
- Introduction
- Adolescent Idiopathic Scoliosis Classification
- Adult Spinal Deformity Classifications
- Conclusion
- 347. Evaluation of Spinal Alignment
- Introduction
- Sagittal Alignment: A Slope To Slope Concept
- Global Alignment
- Clinical Relevance of Parameters
- Systematic Approach to Investigate Sagittal Alignment
- Conclusion
- Case Presentations
- 348. Evaluation and Treatment of Cervical Deformity
- Biomechanics
- Etiology and Epidemiology
- Evaluation
- Treatment
- Outcomes
- Conclusion
- 349. Evaluation and Treatment of Adolescent Idiopathic Scoliosis
- Introduction
- Epidemiology
- Etiology
- Natural History
- Evaluation
- Treatment
- Postoperative Care/Outcomes
- Complications
- Conclusion
- 350. Evaluation and Treatment of Scheuermann Kyphosis
- Introduction
- Etiology
- Evaluation
- Nonsurgical Management
- Surgical Approaches
- Outcomes
- Conclusions
- 351. Evaluation and Treatment of Adult Scoliosis and Sagittal Plane Deformity
- Evolutionary Basis for Spinal Deformity: Bipedalism and the Perils of Erect Posture
- Prevalence and Presentation
- Nonoperative Management
- Indications for Surgery
- Outcomes
- Complications
- Conclusion
- 352. Evaluation and Treatment of Proximal Junctional Kyphosis
- Introduction
- Prevention Strategies
- Evaluation And Treatment
- Representative Cases
- 353. Treatment of High-Grade Spondylolisthesis
- Epidemiology
- Pathophysiology and Etiology
- Risk Factors for Progression
- Clinical Presentation
- Classification System for Spondylolisthesis: History and Current Status
- Treatment Strategy for High-Grade Spondylolisthesis
- Surgery for High-Grade Spondylolisthesis
- Conclusion
- Part 10. Techniques for Spinal Procedures
- 354. Bone Graft Options, Graft Substitutes, and Harvest Techniques
- Introduction
- Bone Healing Overview
- Bone Graft Considerations for Spinal Fusion
- Types of Bone Graft
- Autograft
- Autograft Harvest Techniques
- Allograft
- Synthetics
- Algorithm for Selection of Bone Graft
- Arthrodesis Technique
- Conclusion
- 355. Cervical Arthroplasty
- Rationale
- Indications
- Techniques
- Outcomes
- Conclusion
- 356. Lumbar Disk Arthroplasty
- Introduction
- History
- Implant Design
- Clinical Outcomes
- Cost-Effectiveness
- Patient Selection
- Surgical Technique
- Postoperative Management
- Complications
- Conclusion
- 357. Occiput, C1, and C2 Instrumentation
- Craniovertebral Instability
- Atlantoaxial Dislocation
- Basilar Invagination
- Chiari Formation and Syringomyelia
- Idiopathic Syringomyelia
- Os Odontoideum
- Central Atlantoaxial Dislocation in Association with Cervical Myelopathy Related to Multisegmental Cervical Spondylosis, Ossification of the Posterior Longitudinal Ligament, and Hirayama Disease
- Conclusion
- 358. Anterior Cervical Instrumentation
- History
- Biomechanics
- Indications for Anterior Cervical Screw-Plate Fixation
- Operative Technique
- Complications
- Orthoses and Postoperative Follow-Up
- Evolution of Screw-Plate Systems
- Conclusion
- 359. Posterior Subaxial and Cervicothoracic Instrumentation
- Indications
- Anatomy/Exposure
- Techniques of Instrumentation
- Cervicothoracic Junction
- Other Fixation Techniques
- Biomechanical Considerations
- Conclusion
- 360. Anterior Thoracic Instrumentation
- Introduction
- Historical Perspective: History of Anterior Spinal Surgery
- Indications for Anterior Thoracic Spine Surgery
- Surgical Approach
- Biomechanical Considerations
- Instrumentations
- Complications
- Conclusion
- 361. Anterior and Lateral Lumbar Instrumentation
- Surgical Approaches
- Minimally Invasive Transpsoas Approach
- Mini-Open Anterolateral Approach for Corpectomies
- Anterior Lumbar Interbody Fusion
- Single-Position Lumbar Instrumentation
- Conclusion
- 362. Posterior Thoracic and Lumbar Instrumentation
- Historical Overview of Posterior Thoracic and Lumbar Instrumentation
- Anatomic and Biomechanical Considerations for Pedicle Screw Insertion in the Thoracic and Lumbar Vertebrae
- Indications for Posterior Thoracic and Lumbar Instrumentation
- Surgical Techniques for Posterior Thoracic and Lumbar Fixation
- Complications and Their Avoidance
- 363. Posterior, Transforaminal, and Anterior Lumbar Interbody Fusion: Techniques and Instrumentation
- Indications
- Patient Selection
- Interbody Grafts
- Technique
- Complications
- Conclusion
- 364. Image-Guided Spinal Navigation: Principles and Clinical Applications
- Introduction
- History of Spinal Navigation
- Principles of Image-Guided Spinal Navigation
- Spinal Navigation Techniques
- Clinical Applications and Results
- Conclusion
- 365. Sacropelvic Fixation: Anterior and Posterior Options
- History
- Spinopelvic Anatomy
- Biomechanics
- Indications for Sacropelvic Fixation
- Long-Term Outcomes
- Techniques for Pelvic Fixation
- Conclusion
- 366. Spinal Osteotomies
- Introduction
- Preoperative Planning
- Osteotomy Indications
- Grade 1 Osteotomy (Partial Facet Joint Resection)
- Grade 2 Osteotomy (Complete Facet Joint Resection)
- Grade 3 Osteotomy
- Grade 4 Osteotomy (Pedicle, Partial Body, and Disk Resection)
- Grade 5 Osteotomy
- Grade 6 Osteotomy (Multiple Vertebral Body and Disk Resections)
- Complications
- Conclusion
- 367. Evaluation, Indications, and Techniques of Revision Spine Surgery
- Initial Evaluation
- General Surgical Principles
- Postoperative Spinal Instability and Deformity
- Pseudarthrosis
- Postarthrodesis Adjacent Segment Degeneration and Disease
- Cervical Spine Revision
- Lumbar Spine Revision
- Thoracic Spine Revision
- Conclusion
- Part 11. Minimally Invasive Techniques for Spinal Procedures
- 368. Minimally Invasive Decompression Techniques
- Background
- Instruments and Setup
- Minimally Invasive Lumbar Decompression
- Minimally Invasive Cervical Decompression
- Management of Dural Tears in Minimally Invasive Spine Surgery Unilateral Laminotomy for Bilateral Decompression
- Minimizing Postoperative Instability
- Tubular Versus Specular Retractors
- 369. Minimally Invasive Lateral and Anterolateral Approaches to the Lumbar Spine
- Overview
- Lateral Lumbar Interbody Fusion
- Antepsoas or Anterior to the Psoas Technique
- Conclusion
- Chapter 370. Minimally Invasive Transforaminal Lumbar Interbody Fusion and Posterior Approaches to Spine
- Introduction
- General Indications
- Evidence-Based Data
- Surgical Procedure
- Outcomes
- Complications
- Future Directions
- Conclusions
- 371. Endoscopic Approaches and Applications for Lumbar Spinal Procedures
- Nomenclature
- Endoscopic Instruments
- Principles of Endoscopic Spine Surgery
- Transforaminal Endoscopic Lumbar Approaches
- Transforaminal Surgical Technique Modification
- Pearls and Pitfalls of Transforaminal Approaches
- Interlaminar Endoscopic Lumbar Approaches
- Resection of a Disk Sequester
- Interlaminar Technique Modifications
- Pearls and Pitfalls of Interlaminar Approaches
- 372. Minimally Invasive Spine Surgery for Adult Spinal Deformity: Principles and Applications
- Introduction
- Miss Versus Open Deformity Surgery
- Miss Posterior Approaches
- Miss Lateral Approaches
- Miss Anterior Approaches
- Conclusions and Future Directions
- Volume 4
- Section XII. Trauma: Overview and Controversies
- Introduction
- Overview
- Controversies and Unresolved Questions Related to Traumatic Brain Injury
- Future Directions
- Part 1. Basic and Clinical Science of Neurotrauma
- 373. Epidemiology of Traumatic Brain Injury
- Introduction
- The Effect of Traumatic Brain Injury From a Global Perspective
- Classification of Traumatic Brain Injury
- Prevalence of Traumatic Brain Injury
- Incidence of Traumatic Brain Injury
- Mortality Rates
- Cause of Injury
- Limitations and Gaps In Knowledge of Epidemiology in Traumatic Brain Injury
- The Long and Winding Road of the Epidemiology of Traumatic Brain Injury
- 374. Biomechanical Basis of Traumatic Brain Injury
- Overview
- Clinical Classification of Brain Injuries
- Biomechanical Mechanisms of Injury
- Mechanistic Causes of Head Injuries
- Predominant Clinical Consequences of Injury Mechanisms
- Conclusion
- 375. Neuropathology of Traumatic Brain Injury
- Increased Intracranial Pressure and Herniation
- Brain Herniation Syndromes
- Anatomic Structures Involved in Traumatic Brain Injury
- Conclusion
- 376. Animal Models of Traumatic Brain Injury
- Type of Injury
- Size, Age, and Species
- Outcome Measures
- Caveats and Conclusions
- 377. Genetics of Traumatic Brain Injury
- Introduction
- Neurodegeneration Pathways
- Inflammatory Pathways
- Oncogene Pathways
- Neuroprotective Pathways
- Neurotransmitter Pathways
- Conclusion
- 378. Neurochemical Pathomechanisms in Traumatic Brain Injury
- Primary and Secondary Brain Injury
- Relationship Between Mechanical Forces and Brain Injury
- Primary Injury: Molecular and Microscopic Aspects
- Secondary Injury Processes
- Cell Death
- Neuroinflammation
- Modifiers of Response to Traumatic Brain Injury
- Conclusion
- 379. Traumatic Brain Injury: Proteomic Biomarkers
- Clinical Basis for the Importance of Biomarkers in Traumatic Brain Injury
- Pathophysiology of Biomarkers for Traumatic Brain Injury
- Protein Biomarkers of Traumatic Brain Injury
- Proteomic Approach to tbi Biomarker Analysis
- Conclusion
- 380. Therapeutic Strategies for Repair and Regeneration Following Traumatic Brain Injury
- Trauma-Induced Plasticity
- The Injury Microenvironment: A Double-Edged Sword
- Endogenous Neurogenesis After Traumatic Brain Injury
- Evidence for Functional Recovery
- Developing Therapies for Functional Recovery After Traumatic Brain Injury
- Conclusion
- 381. International Initiatives to Advance Knowledgein Traumatic Brain Injury
- Introduction
- Generation of Evidence: Randomized Controlled Trials and Comparative Effectiveness Research
- Large-Scale Collaborative Studies and Their Potential
- Conclusion
- Part 2. Radiology in Traumatic Brain Surgery
- 382. Structural Neuroimaging of Traumatic Brain Injury
- Structural Neuroimaging: Modalities
- Imaging Findings in Acute Traumatic Brain Injury
- Blunt Cerebrovascular Injury
- Conclusion
- 383. Advanced Structural and Functional Imaging of Traumatic Brain Injury
- Types of Structural and Functional Imaging Techniques to Study Brain Connectivity After Traumatic Brain Injury
- Structural Imaging Findings in Traumatic Brain Injury
- Functional Imaging Findings in Traumatic Brain Injury
- Part 3. Management of Traumatic Brain Injury
- 384. Clinical Pathophysiology of Traumatic Brain Injury
- Mechanisms of Brain Injury
- Classification of Head Injury
- Focal Brain Injury
- Diffuse Brain Injury
- Cerebral Circulation and Metabolism After Severe Head Injury: Mechanisms of Secondary Injury
- Significance of Extracranial Injury
- Conclusion
- 385. Sport-Related Concussion
- Definitions
- Epidemiology
- Concussion Diagnosis
- Concussion Management
- Outcomes
- 386. Initial Resuscitation, Prehospital Care, and Emergency Department Care in Traumatic Brain Injury
- Prehospital Management
- General Trauma Resuscitation and the Trauma Team
- Primary Survey
- Secondary Survey and Neurological Assessment
- Radiographic Evaluation
- Acute Trauma Management
- Conclusion
- 387. Critical Care Management of Traumatic Brain Injury
- Epidemiology of Traumatic Brain Injury
- Traumatic Brain Injury Classification
- Pathophysiology of Traumatic Brain Injury
- Neurological Intensive Care Management of Traumatic Brain Injury
- 388. Invasive Physiologic Monitoring for Traumatic Brain Injury
- Introduction
- Intracranial Pressure Monitoring
- How to Treat Elevated Intracranial Pressure—A Tiered Therapy Approach
- Multimodal Monitoring
- Monitoring Brain Oxygenation
- Cerebral Blood Flow Monitoring
- Cerebral Metabolic Monitoring: Cerebral Microdialysis
- Future Directions in Cerebral Monitoring: Bioinformatics
- Conclusion
- 389. Noninvasive Neuromonitoring for Traumatic Brain Injury
- Introduction
- Basic Cerebral Ultrasonography in the Neuro-ICU
- Optical Pupillometry
- Noninvasive Intracranial Pressure Monitoring
- Near-Infrared Spectroscopy use in Traumatic Brain Injury
- Transcranial Doppler use in Traumatic Brain Injury
- Conclusion
- 390. Electrophysiologic Monitoring for Traumatic Brain Injury
- Introduction
- Methodology and Procedures for Electrophysiologic Monitoring
- Normal and Background Electrophysiology
- Seizures
- Spreading Depolarizations
- Conclusions
- 391. Surgical Management of Traumatic Brain Injury
- Introduction
- Evaluation of Imaging Findings
- Medical Versus Surgical Treatment of Traumatic Brain Injury
- Perioperative Management of Traumatic Brain Injury
- Intracranial Pressure Monitoring
- External Ventricular Drain
- Exploratory bur Holes
- Extradural Hematoma
- Acute Subdural Hematoma
- Intraparenchymal Lesions
- Posterior Fossa Hematoma
- Depressed Skull Fracture
- Diffuse Brain Injury
- 392. Traumatic Brain Injury Care in Resource-Challenged Environments
- Introduction
- Epidemiology
- Prehospital Care
- Emergency Care
- Surgical Care
- Advanced Medical Treatment (Surgical Wards, Intermediate Units, Intensive Care Units)
- Postacute Care
- 393. Surgical Management and Prognosis of Penetrating Brain Injury
- Gunshot Wound to the Head
- Management of Gunshot Wound to the Head
- Prognosis Following Gunshot Wound to the Head
- 394. Cranioplasty
- Clinical Indications for Cranioplasty
- Timing of Cranioplasty
- Preoperative Management
- Cranioplasty Material Options
- Operative Technique
- Postoperative Care
- Complications After Cranioplasty
- Conclusion
- 395. Surgical Considerations for Patients With Polytrauma
- Introduction
- Evaluation of Patients with Traumatic Brain Injury and Multiple Injuries
- Rapid Identification and Triage of Extracranial Injuries
- Musculoskeletal Injuries and Orthopedic Triage Considerations
- Damage Control Surgery for Life-Threatening Injuries
- Delayed Treatment of Non–Life-Threatening Injuries Until Stabilization of Traumatic Brain Injury
- Concomitant Operative Management of Intracranial and Extracranial Injuries
- Traumatic Brain Injury with Associated Spinal Cord Injury
- Critical Care Considerations in Patients with Polytrauma
- Conclusion
- 396. Blast-Induced Neurotrauma
- Physics of Blast
- Blast-Brain Interaction
- Pathobiology of Blast-Induced Neurotrauma
- Modifying Potential of Systemic Changes Caused by Blast
- Blast-Induced Neurotrauma Versus Traumatic Brain Injury
- Diagnosis of Blast-Induced Neurotrauma
- Clinical Management of Severe Blast-Induced Neurotrauma
- Conclusion
- 397. Indications and Techniques for Cranial Decompression After Traumatic Brain Injury
- Introduction
- Background
- Indications
- Technique
- Complications
- Outcomes
- Conclusion
- 398. Craniofacial Injuries
- Epidemiology
- Functional Anatomy
- Pathophysiology
- Mechanisms of Injury
- Initial Management
- Clinical Assessment
- Investigations
- Management
- Definitive Repair
- Surgical Principles
- Specific Fracture Patterns
- Fractures of the Mandible
- Multiple and Panfacial Fractures
- Infancy and Childhood
- Senescence
- Gunshot Wounds
- Soft Tissue Injury
- Complications
- Impairments and Disabilities
- Part 4. Sequelae and Outcome in Traumatic Brain Surgery
- 399. Prognosis After Traumatic Brain Injury
- Approaches to Prognostic Analyses
- Methodologic Challenges in Prognostic Studies
- Prognostic Models
- Future Directions
- 400. Traumatic Cerebrospinal Fluid Fistulas
- Introduction
- Pathophysiology
- Complications of Cerebrospinal Fluid Fistula
- Clinical Features
- Medical Management
- Surgical Management
- Conclusion
- 401. Rehabilitation of Patients With Traumatic Brain Injury
- Role of Rehabilitation
- Mechanisms of Recovery After Traumatic Brain Injury
- Prognosis and Recovery of Brain Injury
- Cognitive Dysfunction in Traumatic Brain Injury
- Agitation and Aggression
- Sleep Disturbance
- Depression
- Apathy
- Upper Motor Neuron Sequelae
- General Supportive Measures
- Pain Syndromes
- Specific Syndromes
- The Future of Rehabilitation
- 402. Long-term Sequelae of Traumatic Brain Injury
- Introduction
- Functional Outcome
- Cognitive Outcomes After Traumatic Brain Injury
- Psychological and Behavioral Sequelae of Traumatic Brain Injury
- Special Topics
- Conclusions
- Section XIII. Microsurgical and Interventional Treatment of Vascular Diseases: Overview and Controversies
- Introduction
- Overview
- Controversies and Updates
- Part 1. Basic and Applied Science of Vascular Disorders
- 403. Cerebral Blood Flow and Metabolism and Cerebral Ischemia
- Cerebral Metabolism
- Cerebral Blood Flow
- Clinical Measurement of Cerebral Blood Flow and Metabolism
- Cerebral Ischemia
- Conclusion
- 404. Intraoperative Cerebral Protection
- Pathophysiology of Ischemic Injury
- Cerebroprotective Strategies for Focal Ischemia
- Suggested Surgical Protocol For Vessel Occlusion
- Conclusion
- Part 2. Approach to the Patient: Evaluation and Management of the Vascular Patient
- 405. Acute Medical Management of Ischemic and Hemorrhagic Stroke
- Introduction
- Clinical Presentation
- Initial Workup
- Ischemic Stroke
- Hemorrhagic Stroke
- Conclusion
- 406. Acute Surgical and Endovascular Management of Ischemic and Hemorrhagic Stroke
- Ischemic Stroke
- Hemorrhagic Stroke
- 407. Antiplatelet and Anticoagulation Therapy for Interventional and Microvascular Procedures and Patients
- Digital Subtraction Angiography: Antiplatelet and Anticoagulation Therapy as Prevention
- Aneurysm Embolization: Antiplatelet and Anticoagulation Therapy as Prevention And Rescue
- Carotid Disease: Antiplatelet and Anticoagulation in Stroke Prevention
- Intracranial Atherosclerotic Disease/Stenosis
- Conclusion
- 408. Neuroanesthesia for Microvascular and Interventional Cerebrovascular Procedures
- General Principles
- Common Goals
- Microvascular Procedures
- Final Considerations
- 409. Vascular Access for Neuroendovascular Procedures
- Introduction
- Transfemoral Approach
- Transradial Approach
- Distal Transradial Approach
- Transbrachial Approach
- Transcervical Approach
- Superior Ophthalmic Vein Approach
- Part 3. Diagnostic Evaluation
- 410. Diagnostic and Therapeutic Neurosonology
- Background and Principles of Ultrasonography
- Intraoperative Ultrasonography
- Applications of Duplex Scanning in Cerebrovascular Disease
- Applications of Transcranial Doppler Imaging in Stroke and Cerebrovascular Disease
- Transcranial Doppler Applications in Neurosurgery and Neurocritical Care
- Posttraumatic Vasospasm
- Vascular Dissection
- Therapeutic Neurosonology
- Conclusions
- 411. Neurovascular Imaging
- Historical Background
- Computed Tomography–Based Techniques
- Magnetic Resonance Imaging–Based Techniques
- Intraoperative Imaging
- 412. Frontal Electroencephalography for Anesthetic Management in Neurosurgery
- Introduction
- Electroencephalography
- Clinical Uses of Frontal Electroencephalography
- Future Directions
- Conclusions
- Part 4. Occlusive Vascular Disease
- 413. The Natural History and Medical Management of Carotid Occlusive Disease
- Pathologic Mechanisms of Atherosclerosis
- Clinical Manifestations of Carotid Atherosclerosis
- Natural History of Extracranial Carotid Disease
- Medical Management of Extracranial Carotid Disease
- Surgical Management of Extracranial Carotid Disease
- 414. Carotid Endarterectomy
- History
- Preoperative Evaluation
- Surgical Indications and Decision Making
- Carotid Artery Stenting
- Surgical Technique
- Complications
- Conclusion
- 415. Carotid Artery Angioplasty and Stenting
- Introduction
- Historical Perspective
- Carotid Endarterectomy Trials
- Carotid Artery Stenting Trials and Registries
- Indications for Carotid Artery Angioplasty and Stenting
- Procedural Technique
- Device and Procedure Selection
- Periprocedural Management
- Procedural Durability
- Complications and their Management
- New Frontiers
- Conclusion
- 416. Blunt Cerebrovascular Injury
- Introduction
- Traumatic Cerebrovascular Injury as a Distinct Clinical Entity
- Epidemiology
- Pathophysiology
- Risk Factors and Screening Protocols
- Presentation
- Imaging
- Injury Classification
- Management
- Prognosis
- Conclusion
- 417. Nonatherosclerotic Carotid Lesions
- Spontaneous Carotid Artery Dissection
- Extracranial Carotid Artery Aneurysms
- Fibromuscular Dysplasia
- Radiation-Induced Stenosis
- Carotid Body Tumors
- 418. Extracranial Vertebral Artery Diseases
- Historical Background
- Clinical Presentation
- Anatomy of the Extracranial Vertebral Artery
- Pathophysiology of Extracranial Vertebral Artery Disease
- Diagnostic Evaluation
- Medical Management
- Endovascular Management
- Surgical Management
- Conclusion
- 419. Microsurgical Management of Intracranial Occlusion Disease
- Epidemiology
- Pathophysiology
- Natural History
- Risk Factors/Progression
- Radiographic Evaluation
- Treatment
- Outcomes
- Conclusion
- 420. Endovascular Management of Intracranial Occlusion Disease
- Introduction
- Endovascular Techniques and Management
- Conclusion
- 421. Adult Moyamoya Angiopathy
- Introduction
- Epidemiology
- Pathophysiology and Etiology
- Clinical Presentation
- Neuroimaging
- Treatment
- Prognosis
- Conclusion
- 422. Cerebral Venous and Sinus Thrombosis
- History and Clinical Significance
- Pathogenesis
- Incidence
- Clinical Presentation
- Diagnostic Evaluation
- Treatment
- Treatment Guidelines
- Outcome
- Conclusion
- Part 5. Nonlesional Spontaneous Intracerebral Hemorrhage
- 423. Nonlesional Spontaneous Intracerebral Hemorrhage
- Epidemiology and Prognosis
- Pathoetiology
- Hematoma Location and Clinical Presentation
- Medical Management
- Surgical Management
- Management of Cerebellar Hematomas
- Management of Intraventricular Hemorrhage
- Conclusion
- Part 6. Aneurysms
- 424. Genetics of Intracranial Aneurysms
- Introduction
- Systemic Heritable Disorders Associated With Intracranial Aneurysms
- Approaches to Study the Contribution of Genetic Factors to Intracranial Aneurysm Pathophysiology
- Inherited Susceptibility to Intracranial Aneurysms
- Genome-Wide Association Studies for Common Variants in the General Population
- Conclusion
- 425. The Natural History of Cerebral Aneurysms
- Introduction
- Natural History of Unruptured Aneurysms
- Natural History of Ruptured Intracranial Aneurysms
- 426. Pathobiology of Intracranial Aneurysms
- Histology and Mechanisms of Aneurysm Wall Degeneration and Rupture
- Initiating Events and Genetic Analysis of Aneurysm Formation
- Conclusion
- 427. Surgical Decision Making for the Treatment of Intracranial Aneurysms
- Introduction
- Decision Making
- The Unruptured Aneurysm
- The Ruptured Aneurysm
- Institutional Considerations in Surgical Decision Making for Cerebral Aneurysms
- Special Circumstances
- Endovascular Aneurysm Occlusion
- 428. Perioperative Management of Subarachnoid Hemorrhage
- Definitions and Epidemiology
- Pathophysiology
- Patient Evaluation
- Diagnosis
- General Management
- Specific Complications of Subarachnoid Hemorrhage
- Medical Complications
- Postoperative Deterioration
- Special Considerations
- Follow-Up After Aneurysmal Subarachnoid Hemorrhage
- 429. Open Versus Endovascular Treatment of Ruptured Aneurysms: 10-Year BRAT Report and Overview of Other Trials
- Introduction
- Barrow Ruptured Aneurysm Trial
- International Subarachnoid Aneurysm Trial
- Other Trials
- Summary and Future Directions
- Interventional Therapy
- 430. Endovascular Approaches to Intracranial Aneurysms
- Core Principles Of Endovascular Aneurysm Treatment
- Fundamental Tenets of Safe and Effective Constructs
- Tenet 4: Plan For The Unexpected
- Conclusion
- 431. Endovascular Approaches to Narrow-necked Intracranial Aneurysms
- Indications for Treatment
- Narrow-Necked Aneurysms
- Technique of Primary Embolization
- The Balloon Microcatheter
- Endovascular Approaches to Cerebral Aneurysms
- Effect of Coils on Aneurysmal Hemodynamics
- Flow Diverters for Narrow-Necked Aneurysms
- Occlusion and RETREATMENT Rates
- Conclusion
- 432. Endovascular Approaches to Wide-Necked Intracranial Aneurysms
- Introduction
- Endovascular Versus Open Surgical Management
- Ruptured Aneurysms
- Unruptured Aneurysms
- Conclusion
- 433. Endovascular Flow Diversion for Intracranial Aneurysms
- Flow Diversion Concepts
- General Flow Diverter Procedural Principles
- Conclusion
- 434. Endovascular Hunterian Ligation
- Introduction
- History
- Indications
- Approaches to the Occlusion of Specific Cerebral Vessels
- Endovascular Tools For Vessel Sacrifice
- Cerebral Reserve Testing
- Complications
- Case Examples
- Conclusion
- Microvascular Surgery
- 435. Surgical Approaches to Intracranial Aneurysms
- Basic Tenets of Cerebrovascular Surgery
- Common Surgical Approaches to Intracranial Aneurysms
- 436. Microsurgery of Paraclinoid Aneurysms
- Anatomy and Embryology
- Aneurysm Classification
- Indication for Treatment
- Preoperative Evaluation
- Operative Procedure
- Surgical Complications and Outcome
- Conclusion
- 437. Intracranial Internal Carotid Artery Aneurysms
- Endovascular Approach to Internal Carotid Artery Aneurysms
- Surgical Approach to Internal Carotid Artery Aneurysms
- Endovascular Versus Surgical Approach
- Treatment of Aneurysm by Location
- Conclusion
- 438. Microsurgery of Anterior Communicating Artery Aneurysms
- Introduction
- History of Surgical Approaches for Anterior Communicating Artery Aneurysms
- Embryology of the Anterior Communicating Artery Region
- Microsurgery Anatomy of the A1 Segment–Anterior Communicating Artery–A2 Segment
- Clinical and Radiographic Presentation of Anterior Communicating Artery Aneurysm
- Operative Technique for Anterior Communicating Artery and Proximal Anterior Cerebral Artery Aneurysms
- Outcomes of Anterior Communicating Artery Aneurysms
- Endovascular Versus Microsurgical Treatment
- 439. Microsurgery of Distal Anterior Cerebral Artery Aneurysms
- Introduction
- Surgical Anatomy
- Clinical Presentation and Preoperative Imaging
- Advantages of Microsurgery
- Craniotomy Options
- Clinical Series
- Conclusion
- 440. Surgical Management of Middle Cerebral Artery Aneurysms
- Middle Cerebral Artery Anatomy
- Classification of Middle Cerebral Artery Aneurysms
- Presentation and Evaluation of Middle Cerebral Artery Aneurysms
- Treatment of Middle Cerebral Artery Aneurysms
- Surgical Treatment of Middle Cerebral Artery Aneurysms
- Conclusion
- 441. Microsurgery of Vertebral Artery and Posterior Inferior Cerebellar Artery Aneurysms
- Introduction
- Anatomy
- Epidemiology
- Clinical Presentation
- Preoperative Evaluation
- Surgical Technique
- Treatment Decision Making
- Conclusions
- 442. Microsurgery of Basilar Apex Aneurysms
- Basilar Apex Aneurysm Surgery: Clinical Experience
- Microsurgical Clipping Versus Endovascular Options
- Microsurgical Anatomy of the Interpeduncular Cistern
- Surgical Strategies
- Timing of Treatment
- Temporary Occlusion
- Complication Avoidance
- Future of Basilar Apex Aneurysm Surgery
- Conclusion
- 443. Microsurgical Management of Giant Intracranial Aneurysms
- Introduction
- Historical Considerations
- Epidemiology and Incidence
- Pathophysiology
- Clinical Presentation
- Diagnosis
- Management
- Anterior Circulation Approaches
- Posterior Circulation Approaches
- Operative Techniques
- Endovascular Treatment
- Recent Advances
- Summary
- 444. Medical, Microsurgical, and Interventional Treatment of Infectious Aneurysms
- Epidemiology
- Pathophysiology
- Microbiology
- Clinical Findings
- Natural History
- Diagnostic Evaluation
- Treatment
- Outcomes
- Conclusion
- 445. Revascularization Techniques for Complex Aneurysms and Skull Base Tumors
- Revascularization in the Treatment of Intracranial Aneurysms
- Revascularization for the Treatment of Skull Base Tumors
- When is the Collateral Circulation Inadequate and Bypass Necessary?
- Surgical Technique
- Types of Revascularization Procedures
- Outcomes
- Conclusion
- 446. Multimodality Treatments of Cerebrovascular Disorders
- Introduction
- Multimodal Treatment of Parenchymal Brain Arteriovenous Malformations
- Multimodality Treatment of Dural Arteriovenous Fistulas
- Multimodality Treatment of Intracranial Aneurysms
- 447. Traumatic Cerebral Aneurysms Secondary to Penetrating Intracranial Injuries
- Pathology
- Clinical Findings
- Diagnosis
- Treatment
- Conclusion
- Postprocedural Therapy
- 448. Medical Management of Cerebral Vasospasm
- Introduction
- Vasospasm in Conditions Other Than Aneurysm Rupture
- Epidemiology of Vasospasm
- Prediction of Vasospasm
- Pathogenesis
- Clinical Features and Investigation
- Prevention of Vasospasm and Cerebral Protection
- Reversal of Vasospasm and Cerebral Ischemia: Rescue Treatments
- Suggested Approach to Prevention and Treatment of Cerebral Vasospasm
- 449. Endovascular Management of Cerebral Vasospasm
- Clinical Indications and Efficacy
- Techniques and Devices
- Complication Avoidance and Management
- Conclusion
- Part 7. True Arteriovenous Malformations
- 450. Pathobiology of True Arteriovenous Malformations
- Introduction
- Arteriovenous Malformations
- Venous Angioma
- Cavernous Malformation
- Capillary Telangiectasia
- Mixed Lesions: True Arteriovenous Malformations with Other Vascular Malformations
- Genetics of Arteriovenous Malformations
- Biology of Vasculogenesis and Angiogenesis
- Conclusion
- 451. Epidemiology and Natural History of Cerebral Vascular Malformations
- Introduction
- Arteriovenous Malformation
- Dural Arteriovenous Fistula
- Cavernous Malformation
- Developmental Venous Anomaly
- Capillary Telangiectasia
- Biases and Caution in Interpreting Epidemiology and Natural History Studies
- 452. Therapeutic Decision Making in the Management of Arteriovenous Malformations of the Brain
- Introduction
- Management Pathway
- Other Factors Considered in Management Decisions
- Summary of Management Recommendations (See Fig. 452.6)
- 453. Adjuvant Endovascular Management of Brain Arteriovenous Malformations
- Historical Overview
- Treatment Goals
- Angioarchitecture
- Embolic Agents
- Embolization Before Microsurgery
- Embolization Before Radiosurgery
- Newer Techniques of Endovascular Embolization
- Safety and Efficacy of Endovascular Embolization
- Complications of Endovascular Treatment
- Conclusion
- 454. Endovascular Management of Arteriovenous Malformations for Cure
- Aruba and the Debate About Unruptured Arteriovenous Malformations
- Goals of Endovascular Embolization
- Factors Associated With Endovascular Management as Cure
- Efficacy of Endovascular Management for Cure
- Complications Associated With Endovascular Management for Cure
- Technical Details Facilitating Endovascular Management for Cure
- Conclusion
- 455. Microsurgery of Arteriovenous Malformations
- Classification of Cerebrovascular Malformations
- Epidemiology and Relationships to Other Vascular Malformations and Congenital Syndromes (see also Chapters 450 and 451)
- Clinical Presentation and Pathophysiology
- Natural History (see also Chapter 451)
- Imaging
- Grading of Arteriovenous Malformations
- Decision Making (see also Chapter 452)
- Treatment
- Conclusion
- 456. Surgical and Radiosurgical Management of Grade IV and V Arteriovenous Malformations
- Natural History and Hemorrhage Risk
- Clinical Findings and Preoperative Evaluation
- Hemodynamics
- Evaluation
- Treatment
- Special Perioperative Equipment and Techniques
- Surgical Outcome
- Complications
- Conclusion
- Part 8. Arteriovenous Fistulas
- 457. Carotid-Cavernous Fistulas
- Introduction
- Anatomy
- Direct or True Carotid-Cavernous Fistulas
- Indirect Carotid-Cavernous Fistulas
- Conclusion
- 458. Treatment of Other Intracranial Dural Arteriovenous Fistulas
- Clinical Presentation
- Classification
- Natural History
- Diagnostic Imaging
- Treatment
- Dural Arteriovenous Fistula by Location
- Outcomes
- Conclusion
- Part 9. Cavernomas
- 459. Natural History of Cavernous Malformations
- Introduction
- Epidemiology
- Clinical Presentation
- Natural History
- Treatment Considerations
- Conclusion
- 460. Genetics of Cerebral Cavernous Malformations
- Introduction
- Genetics of Cerebral Cavernous Malformations
- Clinical Genetics
- Molecular Biology of the Cerebral Cavernous Malformation Genes
- Cerebral Cavernous Malformation Protein Expression
- Cellular Integration of Cerebral Cavernous Malformation Protein Functions
- Mechanisms of Disease Pathogenesis
- Development of Therapeutic Approaches
- Conclusion and Future Directions
- 461. Microsurgery for Cerebral Cavernous Malformations
- Radiographic Presentation
- Surgical Indications
- Microsurgical Considerations, Approaches, and Techniques
- Clinical Outcomes
- Conclusion
- Part 10. Arteriovenous Malformations and Fistulas of the Spine
- 462. Classification of Spinal Arteriovenous Lesions
- Introduction
- Historical Classification Systems
- Spetzler Classification System
- Conclusion
- 463. Endovascular Treatment of Spinal Vascular Malformations
- Introduction
- Vascular Anatomy
- Diagnostic Imaging of Spinal Vascular Malformations
- Classification of Spinal Vascular Malformations
- Principles of Endovascular Therapy
- Endovascular Treatment of Spinal Arteriovenous Malformations
- Radiation Therapy and Radiosurgery for Spinal Cord Arteriovenous Malformations
- Endovascular Treatment of Spinal Arteriovenous Fistulas
- Endovascular Treatment of Spinal Cord Aneurysms
- Complications
- Conclusions
- 464. Microsurgical Treatment of Spinal Vascular Malformations
- Historical Perspective
- Anatomy
- Classification
- Etiology, Pathophysiology, Clinical Presentation, and Natural History
- Diagnostic Imaging
- Adjuncts to Surgery
- Conclusion
- Index
- Edition: 8
- Published: January 21, 2022
- Imprint: Elsevier
- Language: English
- Hardback ISBN: 9780323661928
- eBook ISBN: 9780323674997
HW
H. Richard Winn
Affiliations and expertise
Professor and Director of Neurosurgery, Lenox Hill Hospital, New York, New York; Hofstra University, Hempstead, New York; Adjunct Professor, Department of Neurological Surgery, University of Iowa, Iowa City, Iowa; Clinical Professor, Weill Medical College, Columbia University, Mount Sinai School of Medicine, New York, New York; Visiting Professor of Surgery (Neurosurgery), Tribhuvan University Teaching Hospital, Kathmandu, Nepal