Advances and Technical Standards in Neurosurgery

Volume 34

By: John D. Pickard (Editor), Nejat Akalan (Editor), Concezio Di Rocco (Editor)

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Hardcover | 19 February 2009

At a Glance

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228 Pages

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24.77 x 17.15 x 1.27

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. . . . . . . . . . . . . . . . 6 Patternsofcelldeath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Autophagy:apotentialTrojanhorseformalignantgliomas. . . . . . . . . . . . . . . . 11 Therapeuticbene?tsoftemozolomide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Localtherapiesforglioblastomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Ongoingclinicaltrialsforglioblastomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Growthfactorreceptorinhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 PI3K=Akt,mTORandNF- Binhibitors. . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Matrixmetalloproteinase(MMP)inhibitors(MMPI). . . . . . . . . . . . . . . . . . . 18 Angiogenesistargeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Cellularandvaccinationtherapies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Genetherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Thesodiumpump. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Cardiotonicsteroids:ligandsofthesodiumpump. . . . . . . . . . . . . . . . . . . . 24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas. . . . . . . 26 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Historyofdeepbrainstimulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 PrinciplesofDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 NeurobiologyofdepressionandOCD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Neurobiologyofdepression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 NeurobiologyofOCD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 StudiesofDBSandpsychiatricdisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Problemsintargetselection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Targetsindepression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 TargetsinOCD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 SafetyandadvantagesofDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 EthicalaspectsandstandardsinDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Ethicalconsiderations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders. . . . . . . . 52 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 ThefutureofDBS. . . . . . . . . . . . . . . .

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List of contributors	p. XIII
Advances
Present and potential future adjuvant issues in high-grade astrocytic glioma treatment
Abstract	p. 4
Introduction	p. 5
Natural resistance of migrating malignant glioma cells to apoptosis (radiotherapy and chemotherapy)	p. 6
Patterns of cell death	p. 8
Autophagy: a potential Trojan horse for malignant gliomas	p. 11
Therapeutic benefits of temozolomide	p. 13
Local therapies for glioblastomas	p. 15
Ongoing clinical trials for glioblastomas	p. 16
Growth factor receptor inhibitors	p. 17
PI3K/Akt, mTOR and NF-kB inhibitors	p. 17
Matrix metalloproteinase (MMP) inhibitors (MMPI)	p. 18
Angiogenesis targeting	p. 19
Cellular and vaccination therapies	p. 20
Gene therapy	p. 20
Reducing malignant glioma cell motility in order to restore pro-apoptotic drug sensitivity	p. 20
The sodium pump constitutes a potential target to combat malignant gliomas	p. 21
The sodium pump	p. 22
Cardiotonic steroids: ligands of the sodium pump	p. 24
The sodium pump is involved in cancer cell proliferation, migration and death	p. 24
Brain tumor stem cells a potential target to combat malignant gliomas	p. 26
Conclusions	p. 27
References	p. 28
Deep brain stimulation for psychiatric disorders - state of the art
Abstract	p. 37
Introduction	p. 38
History of deep brain stimulation	p. 39
Principles of DBS	p. 40
Neurobiology of depression and OCD	p. 41
Neurobiology of depression	p. 41
Neurobiology of OCD	p. 42
Studies of DBS and psychiatric disorders	p. 43
Problems in target selection	p. 43
Targets in depression	p. 43
Targets in OCD	p. 46
Safety and advantages of DBS	p. 47
Ethical aspects and standards in DBS	p. 51
Ethical considerations	p. 51
The path towards mandatory standards for DBS in psychiatric disorders	p. 52
Conclusions	p. 53
The future of DBS	p. 54
References	p. 54
Standards
High flow extracranial to intracranial vascular bypass procedure for giant aneurysms: indications, surgical technique, complications and outcome
Abstract	p. 61
Introduction	p. 62
Surgical technique	p. 67
Cranial exposure	p. 69
Cervical exposure	p. 70
Saphenous vein exposure	p. 71
Pre auricular tunnel	p. 72
Anastamoses	p. 73
Distal anastamosis	p. 73
External carotid anastamosis	p. 74
Closure and post operative care	p. 77
Discussion	p. 77
Comparison of outcomes	p. 77
Choosing the type of graft	p. 78
Long term patency of grafts	p. 79
Ischaemic complications	p. 79
Anticoagulation related morbidity	p. 81
Conclusion	p. 81
References	p. 81
Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review)
Abstract	p. 86
Introduction/Definition	p. 86
Generalities	p. 87
Chiari type I-malformation pathophysiology	p. 87
Syringomyelia pathophysiology	p. 88
Neuro-imaging	p. 88
Overview of the various technical modalities	p. 90
Decompression with extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation	p. 91
Personal series	p. 91
Technical description	p. 93
Discussion from literature review	p. 96
Chiari type I malformation without syringomyelia	p. 97
Chiari type I malformation with syringomyelia	p. 100
Conclusion	p. 105
Acknowledgements	p. 106
References	p. 106
Vagal nerve stimulation - a 15-year survey of an established treatment modality in epilepsy surgery
Abstract	p. 111
Introduction	p. 112
Mechanism of action	p. 115
Clinical efficacy and safety	p. 120
Randomised controlled trials	p. 120
Prospective clinical trials with long-term follow-up	p. 122
Prospective clinical trials in children	p. 122
Clinical trials in specific patient groups	p. 123
Generalized epilepsy	p. 123
Status epilepticus	p. 123
Lennox-Gastaut syndrome	p. 124
Other patient groups	p. 124
Safety, side effects and tolerability	p. 125
Perioperative side effects	p. 125
Ramping up and long-term stimulation	p. 126
Miscellaneous side effects	p. 131
MRI/3 Tesla MRI	p. 131
Teratogenic effects of VNS	p. 134
Discussion	p. 135
Conclusion	p. 137
References	p. 137
Surgical anatomy and surgical approaches to the lateral ventricles
Abstract	p. 148
Embryology	p. 149
Anatomy	p. 152
The cavity of the lateral ventricle	p. 152
The walls of the lateral ventricle	p. 152
The anterior frontal horn	p. 152
The body of the frontal horn or central part of the LV	p. 154
The atrium	p. 155
The occipital diverticulum (or occipital horn)	p. 155
The temporal horn	p. 157
The interventricular foramen	p. 157
Choroid plexus and CSF circulation	p. 157
Arterial vasculature of the VL	p. 158
Anterior choroid artery (AChA)	p. 159
Posterior choroid artery (PChA)	p. 160
The veins of the lateral ventricles	p. 160
Relationships of the lateral ventricles	p. 163
Cortical eloquent areas	p. 163
Distances between cortex and ventricular cavity	p. 164
Relationships with the cortical sulci	p. 166
Relationships with white matter fascicles	p. 167
Surgical approaches	p. 171
General considerations	p. 171
Tumors of the frontal horn	p. 173
Transventricular transfrontal approach	p. 173
Anterior transcallosal approach	p. 176
Tumors of the temporal horn	p. 179
Tumors of the ventricular atrium	p. 181
Transparietal route (qualified through P2)	p. 181
Posterior transparietal approach (qualified through P1)	p. 182
Interhemispheric parasplenial approach	p. 182
Variants of atrium tumors	p. 184
Tumors of the atrium extending to the frontal horn	p. 184
Tumors of the atrium extending to the temporal horn	p. 184
Tumors of the atrium extending to the occipital horn	p. 184
Conclusion	p. 184
Annexe	p. 185
References	p. 185
Author index	p. 189
Subject index	p. 201
Table of Contents provided by Ingram. All Rights Reserved.

Advances and Technical Standards in Neurosurgery

Volume 34

At a Glance

Hardcover

Shipping

How to return your order

Defective items

You Can Find This Book In

Other Editions and Formats

Paperback

Paperback

Paperback

More in Neurosurgery

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