Advances and Technical Standards in Neurosurgery

ISBN-13: 9783709170489 / Angielski / Miękka / 2011 / 328 str.

Opis

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the Euro pean Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their postgraduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons."

Spis treści

A. Advances.- Empty Sella and Benign Intrasellar Cysts..- Definition and History.- Classification.- Primary Empty Sella or Intrasellar Arachnoidocele.- Empty sella secondary to: Pituitary Infarction or atrophy.- Spontaneous Necrosis of Pituitary Tumours.- Pituitary Surgery.- Pituitary Radiotherapy.- Benign Intrasellar Cysts.- Arachnoid Cysts.- Pituitary Cysts.- Rathke’s Cleft Cysts.- Symptomatology.- Neurological Syndrome.- Eye Signs.- Diencephalic Signs.- Signs of Pituitary Endocrine Dysfunction.- CSF Rhinorrhoea.- Benign Intrasellar Cysts.- Radiological Features.- Plain Films and Tomography.- Carotid Angiography.- Pneumoencephalography.- CT Scan.- Cisternography.- Venography of Cavernous and Intercavernous Sinuses.- Treatment.- Prevention.- Indications for Active Treatment.- Surgical Techniques.- Case Reports.- Conclusions.- References.- Profound Arterial Hypotension (MAP ?50mm Hg) Induced with Neuroleptanalgesia and Sodium Nitroprusside (Series of 531 Cases). Reference to Vascular Autoregulation Mechanism and Surgery of Vascular Malformations of the Brain..- 1. Historical Notes.- 2. Profound Arterial Hypotension: Definition and Materials.- 3. Protective Mechanisms of Brain Function During Profound Hypotension.- a) Experimental Evidence of Vascular Autoregulation.- b) Regional Cerebral Blood Volume Variations.- Material.- Methodology.- Characteristics of the Regional Blood Volume.- Results in the Normal Brain.- Results in AVM and Meningiomas.- c) Cerebral Angiography Under Hypotension.- Material and Methodology.- Results.- 4. Technique of Arterial Hypotension.- a) Hypotension with Neuroleptanalgesia.- Preparation of the Patient.- The Operation.- b) Hypotension with Sodium Nitroprusside (SNP).- Preparation of the Patient.- The Operation.- Monitoring of Vascular Status.- Permanent Control of the SNP Dosage.- I. Cyanide Intoxication.- II. Decrease in the Duration of Hypotension.- III. Potentiation of SNP.- IV. Adjustable Programming of Hypotension.- V. Post-Operative Follow-Up.- VI. Complications.- VII. Contra-Indications.- 5. Profound Hypotension During Radical Surgery of Intracranial Vascular Malformations.- a) Saccular Aneurysms.- Technical Facilities Obtained from Hypotension.- (1) Control of the Sac Rupture During Operation.- (2) Reduction of the Sac by Electrocoagulation.- (3) Replacement of the Clip.- (4) Closure of an Arterial Injury.- Planning the Hypotension During Operation.- Special Cases.- Aneurysms of the Posterior Fossa.- Results.- b) Arteriovenous Malformations.- Planning the Hypotension During Operation.- Results.- 6. Conclusion.- References.- Morphological and Biological Basis for the Classification of Brain Tumors. With a Comment on the WHO-Classification 1979..- A. Introduction.- B. New Methods of Investigation. Their Results.- 1. Electron Microscopy.- 2. Tissue Culture.- 3. Enzyme Histochemistry.- 4. Immunocytochemistry.- C. Classification of Brain Tumors.- 1. Introductory Remarks.- 2. Remarks on the WHO Classification.- 3. Remarks on the Grading of the WHO Classification.- 4. Remarks on Some Factors Probably Affecting Survival in Glioblastomas and Medulloblastomas.- D. Concluding Remarks.- References.- B. Technical Standards.- Surgical Treatment of Spondylotic Vertebral Artery Compression..- Anatomy and Pathological Anatomy.- 1. The Special Anatomical Relations of Vertebrae.- 2. Anatomy of the Vertebral Artery.- 3. Pathological Anatomy of the Cervical Vertebrae.- 4. Pathological Anatomy of Vertebral Artery.- Mathematical and Physical Considerations Regarding Circulation of the Compressed Vertebral Artery.- Vertebro-Basilar Circulatory Disorder.- 1. Completed Stroke.- 2. Transient Ischaemic Attack.- Symptoms and Signs of Vertebro-Basilar Insufficiency Caused by Cervical Spondylosis.- Why is Vertebro-Basilar Circulatory Impairment Relatively Uncommon in Cervical Spondylosis?.- Methods of Investigation.- 1. Neurological Investigation.- 2. X-Ray Investigations.- A. Spinogram.- B. Tomographic Films.- C. Computed Tomography.- D. Angiography.- E. Myelography.- 3. Noninvasive Investigation of Blood Flow in the Vertebral Artery.- A. Rheography.- B. Vertebral Artery Doppler Test.- 4. Functional EEG Investigations.- 5. EMG Investigations.- 6. Nystagmus Analysis.- 7. Registration of Somatosensory Potentials.- Differential Diagnosis.- 1. Arteriovenous Fistulae of the Vertebral Artery.- 2. Sequelae of Posttraumatic Changes of the Cervical Spine.- 3. Tumors of the Vertebral Body and Paravertebral Tumors.- Hazards of Neglected Vertebral Arterial Compression.- Nonsurgical Treatment.- Indications for Surgical Decompression of the Vertebral Artery.- Methods of Operation for Decompression of Vertebral Artery.- Surgical Technique of Vertebral Decompression from Antero-Lateral Approach.- 1. Positioning the Patient.- 2. Surgical Technique.- 3. Postoperative Care.- Material and Operative Results.- Concluding Remarks: The Two Phases of Uncovertebral Arthrosis.- Summary.- References.- Reconstructive Surgery of the Head..- The Scalp.- Congenital Lesions.- Neoplasms.- Trauma (Including Burns).- Operative Techniques.- Future Developments.- Skull Defects.- Aetiology.- Head Injury.- Following Craniotomy.- Neoplasms.- Infections.- Congenital.- Indications for Cranioplasty.- Choice of Material for Cranioplasty.- Technical Aspects of Cranioplasty.- Post-Traumatic Deformity.- Complications of Cranioplasty.- Congenital Deformities.- General Considerations.- Craniosynostosis.- Unilateral Coronal Craniosynostosis.- Method of Correction.- Bilateral Coronal Synostosis.- Metopic Craniosynostosis.- Older Patients.- Apert’s and Crouzon’s Syndromes.- Hypertelorism.- Telecanthus.- Surgical Correction.- Subcranial Correction.- Hypotelorism.- Frontonasal Encephalocele.- Correction.- Age for Surgery.- Discussion.- Craniofacial Tumours.- Frontal and Ethmoid Sinuses.- Orbital.- Base of Skull.- Treatment.- Anterior Segment.- Central Segment.- Posterior Segment.- Fibrous Dysplasia.- Complications of Craniofacial Surgery.- Conclusion.- References.- Operative Management of Craniopharyngiomas..- Classification of Craniopharyngiomas.- Endo-Suprasellar Craniopharyngiomas.- Surgical Methods.- Approach.- Suprasellar-Extraventricular Craniopharyngiomas.- Intraventricular Craniopharyngiomas.- Removal.- Giant Craniopharyngiomas.- Reoperations.- Palliative Operations.- Results of Surgical Treatment.- References.- Author Index.