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Advances and Technical Standards in Neurosurgery : Advances and Technical Standards in Neurosurgery - J. D. Pickard

Advances and Technical Standards in Neurosurgery

Advances and Technical Standards in Neurosurgery

Hardcover Published: 1st February 2004
ISBN: 9783211140277
Number Of Pages: 310

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Epilepsy surgery is defined as any neurosurgical intervention whose pri­ mary objective is to relieve medically intractable epilepsy (European Fed­ eration of Neurological Societies Task Force 2000). The aim of epilepsy surgery is to reduce the number and intensity of seizures, minimise neuro­ logical morbidity and antiepileptic drug (AED) toxicity, and improve quality of life. By definition, epilepsy surgery does not include normal surgical treatment of intracranial lesions where the primary goal is to di­ agnose and possibly remove the pathological target, often an advancing tumour. In these patients, epileptic seizures are only one symptom of the lesion and will be treated concomitantly as part of the procedure. Temporal lobe epilepsy (TLE) is recognised as the most common type of refractory, focal epilepsy. In one third of all cases the neuronal systems responsible for the seizures that characterise this form of epilepsy fail to respond to currently available AEDs (Andermann F 2002). New imaging methods, especially magnetic resonance imaging (MRI), identify localising abnormalities in an increasing proportion of patients with intractable focal epilepsy. Consequently, the accuracy of the preoperative diagnostic pro­ cedures has been significantly improved during the last decade; and suit­ able candidates for surgery can be selected more reliably. Currently the main resources in most epilepsy surgery centres have been used to evaluate candidates for TLE surgery.

Industry Reviews

"The series should be required reading for all neurosurgeons in training and a core part of every neurosurgical departmental library." British Journal of Neurosurgery

List of Contributorsp. XIII
Disorders of Consciousness: Anatomical and Physiological Mechanisms
Abstractp. 3
Introductionp. 4
The Wake-Sleep Cyclep. 4
Phenomenologyp. 5
Regulationp. 6
Wakefulness Networkp. 8
The Posterior Hypothalamusp. 11
Histamine Networkp. 11
Orexin/Hypocretin Networkp. 12
Brainstem Acetylcholine and Amine Networksp. 14
The Serotonin Systemp. 15
Tentative Functions of the Wake Systemp. 15
Effect of Sleep Deprivation on Cognitive Performancesp. 17
Referencesp. 18
Advances in Craniosynostosis Research and Management
Abstractp. 24
Introductionp. 24
Normal Craniofacial Embryology and Growthp. 25
Aetiology, Pathogenesis and Functionp. 27
Classification and Diagnosisp. 34
Evolution of Surgical Treatmentp. 35
Recent Advancesp. 39
Molecular Studiesp. 39
Imaging Techniques and Surgical Planningp. 39
Resorbable Fixationp. 40
Bone Substitutes and Tissue Engineeringp. 41
Distraction Osteogenesis and the Spring-Mediated Cranioplastiesp. 43
Resorbable Distractor Devicesp. 46
Minimally Invasive Surgeryp. 47
In Utero Surgeryp. 48
Surgical Techniquesp. 48
Sagittal Synostosisp. 49
Unicoronal Synostosisp. 50
Metopic Synostosisp. 56
Unilambdoid Synostosisp. 58
Bicoronal Synostosisp. 60
Saethre-Chotzen Syndromep. 62
Crouzon and Pfeiffer Syndromesp. 62
Apert Syndromep. 63
Referencesp. 66
Technical Standards
Preoperative Clinical Evaluation, Outline of Surgical Technique and Outcome in Temporal Lobe Epilepsy
Abstractp. 88
Introductionp. 89
Epidemiology of Temporal Lobe Epilepsy (TLE)p. 89
Etiology and Pathology of TLEp. 90
Temporal Lobe Seizure Symptomatologyp. 91
Mesial TLEp. 92
Neocortical TLEp. 92
Selection of Candidates for Preoperative Assessmentp. 92
Neuropsychological Evaluation in TLEp. 93
WADA Testp. 94
Magnetic Resonance Imaging (MRI) in TLEp. 95
Volumetryp. 96
NMR-Spectroscopyp. 97
Lesions in MRIp. 98
Functional MRIp. 98
EEG-Videotelemetry in TLEp. 101
Interictal EEGp. 101
Diagnostic EEG-Videotelemetryp. 101
Intracranial EEG-Monitoring in TLEp. 102
Indications for Intracranial EEGp. 102
Intracranial EEG-Recording in Videotelemetryp. 102
Surgical Technique for Inserting the Electrodesp. 103
Complications of Invasive EEG-Monitoringp. 104
Functional Imaging in TLEp. 106
Positron Emission Tomography, PETp. 107
Single Photon Emission Computed Tomography, SPECTp. 109
Magnetoencephalography, MEGp. 110
Indications for Surgery in TLEp. 111
Surgery in Patients with Temporal Lobe Lesionsp. 112
Technique of Tailored Temporal Lobe Resection with Amygdalo-Hippocampectomyp. 113
Peroperative Electrocorticographyp. 117
Outcome of Surgery with Respect to Seizuresp. 119
Complicationsp. 121
Conclusionsp. 123
Acknowledgementp. 124
Referencesp. 124
Motor Evoked Potential Monitoring for Spinal Cord and Brain Stem Surgery
Abstractp. 134
Introductionp. 134
Intraoperative Neurophysiological Techniquesp. 135
The Pastp. 135
Historical Background on MEP Monitoringp. 135
Misconceptions about MEP Monitoringp. 137
The Presentp. 138
MEP Monitoring Techniques for Spinal Cord and Brainstem Proceduresp. 138
Transcranial Electrical Stimulation of the Motor Cortex and Muscle Recordings (Multipulse Technique)p. 139
Transcranial Electrical Stimulation of the Motor Cortex and Epidural Recordings (Single Pulse Technique)p. 140
Mapping of the Corticospinal Tract During Brainstem Proceduresp. 142
The "Future"p. 143
Mapping of the Corticospinal Tract During Spinal Cord Procedures: The Collision Techniquep. 143
Monitoring of the Corticobulbar Tractsp. 144
Clinical Applicationp. 148
Correlation Between Intraoperative MEP Recordings and Post-Operative Motor Outcomep. 148
How to Avoid Irreversible MEP Lossp. 149
Warning Signalsp. 150
Corrective Measures for the Management of Deteriorating Signalsp. 152
Dose MEP Monitoring Really Make a Difference?p. 153
Illustrative Casesp. 153
Conclusionsp. 161
Referencesp. 165
Acknowledgmentsp. 165
Motor Evoked Potential Monitoring for the Surgery of Brain Tumours and Vascular Malformations
Abstractp. 172
Introductionp. 173
Direct Stimulation Mappingp. 173
Evoked Potentialsp. 174
Motor Evoked Potentialsp. 175
MEP Techniquep. 176
Stimulationp. 177
Recordingp. 183
Safety and Anesthesiap. 184
Equipment and Staffingp. 186
Neurophysiological Functional Mapping of the Pericentral Cortexp. 188
SEP Phase Reversalp. 189
Intraoperative Stimulation Mappingp. 193
Extraoperative Mapping with Grid Electrodesp. 195
Principles of Clinical Applicationp. 196
Indications for MEP Monitoringp. 196
Interpretation of MEP Changesp. 197
Correlation of Intraoperative MEP Changes and Motor Outcomep. 198
Surgical Reactions to MEP Changesp. 200
Influence of MEP Monitoring on Surgical Results and Outcomep. 201
Specific Applicationsp. 202
Supratentorial Tumors and Vascular Malformationsp. 202
Central Tumors and AVMsp. 203
Insular Tumors and Sylvian AVMsp. 204
Infratentorial Surgeryp. 208
Indications for MEP Monitoringp. 208
Impact on Surgical Strategyp. 208
Clinical Experience with MEP Monitoring for Infratentorial Surgeryp. 208
Aneurysmsp. 211
SEP Monitoring for Aneurysm Surgeryp. 211
Conduction of MEP Monitoring for Aneurysm Surgeryp. 212
Clinical Experiencep. 212
Clinical Relevance of Aneurysm Monitoringp. 213
Summary and Conclusionsp. 213
Why MEP Monitoring?p. 213
When to Perform MEP Monitoring?p. 217
How to Achieve Good MEP Monitoring?p. 217
How to Assess and Interpret MEPs?p. 218
Does MEP Monitoring Influence Surgical Strategy and Postoperative Outcome?p. 218
Referencesp. 219
Functional Neuronavigation and Intraoperative MRI
Abstractp. 229
Introductionp. 230
Functional Neuronavigationp. 231
Magnetoencephalographyp. 232
Functional MRIp. 233
Clinical Impact of Functional Imagingp. 234
Comparing MEG/fMRIp. 234
Intraoperative Imagingp. 237
Low-Field MR Imagingp. 237
Clinical Experiencep. 238
Pituitary Tumour Surgeryp. 239
Glioma Surgeryp. 240
Epilepsy Surgeryp. 242
Limitations and Imaging Alternativesp. 242
High-Field MR Imagingp. 244
Integration of a High-Field Scanner into the Operating Roomp. 245
First Clinical Resultsp. 247
Summary & Future Developmentsp. 248
Acknowledgmentsp. 254
Referencesp. 254
Surgical Anatomy of the Insula
Summaryp. 265
Introductionp. 266
Descriptive Anatomy [33, 39]p. 269
The Borders of the Insulap. 269
The Insular Cortex (Fig. 7)p. 270
Relationships (Figs. 8-12)p. 272
The Association Fibersp. 273
Short Association Fibersp. 273
Long Ipsihemispheric Association Fasciclesp. 273
Vascular Anatomy (Figs. 13-15)p. 274
Arterial Relationshipsp. 277
Veinsp. 278
Functional Anatomyp. 278
Connections (Fig. 17) [1, 17, 18]p. 278
Physiological Roles of the Insula [1-3, 13, 14, 22, 23, 27]p. 280
Insula and Painp. 281
The Insula and Epilepsy Surgeryp. 283
Tumoral Surgery in the Insular Regionp. 283
Conclusionp. 285
Referencesp. 285
Table of Contents provided by Rittenhouse. All Rights Reserved.

ISBN: 9783211140277
ISBN-10: 3211140271
Series: Advances and Technical Standards in Neurosurgery : Book 29
Audience: General
Format: Hardcover
Language: English
Number Of Pages: 310
Published: 1st February 2004
Country of Publication: AT
Dimensions (cm): 24.64 x 17.02  x 1.78
Weight (kg): 0.73