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Books > Medicine > Surgery > Neurosurgery
Brain resuscitation is the therapeutic intervention for critically ill patients with severe brain damage, particularly the types caused by ischemia and hypoxia. The The objective of the International Symposium on Brain Resuscitation held in Ube, Yamaguchi Japan October 31 to November 2 1988, and sponsored by Yamaguchi University and the Japanese Ministry of Education, was to review our recent progress in brain resuscitation and to discuss controversies both basic and clinical. To my knowledge, this symposium was the first held in Japan. Our understanding of neuronal dysfunction due to ischemic/hypoxic insults at organ, cellular, and molecular levels has advanced significantly in the last two decades. We had therefore intended that this international symposium should broadly cover the topics which are of interest to both basic researchers and clinicians. Three hundred and twenty-five attendants, including twenty scientists from eight different countries, actively participated in discussion and exchange of new ideas and thoughts concerning brain resuscitation. This book comprises the re ports presented during the symposium which consisted of two main parts: basic and clinical. Although one single meeting can never be expected to solve any problems, meetings often highlight areas of ignorance and problems which are ripe for solving. It has been hard to review all the papers because of the multi plicity of the discussed topics, but the overview on brain resuscitation by Profes sor Bo K. Siesjo and the summary by Professor J."
Language and Speech has been selected for the Fifth Convention of the Academia Eurasiana Neurochirurgica as a topic closely related to neurosurgery but also to philosophy, art, culture and humanity and treated by various experts of the field of this interdisciplinary subject. The volume has a certain structure: Language is evaluated as a tool of the Homo Artis in the introduction, which is followed by chapters focusing the language in history, in linguistics, as well as in music and that of the animals. In the next part speech is dealt with as a physiological process. It is followed by papers on three different but uniformly neurosurgical representation of speech in gliomas, AVMs, and focal epilepsies. Neurologists compiled papers on clinical forms of aphasia, and that among bilinguists as well as on lateralisation of speech centres in relation of handedness followed by rehabilitation of speech disorders. Two papers on language and computers complete the volume.
Neurophysiological recording is the major neuromonitoring technique employed in ICU. In addition, continuous recording of intracranial pressure has proved to provide infomation useful for critical care of the patient with severe brain damage. It is, however, difficult to assess neurochemical and/or metabolic environments of the brain with these conventional neuromoni toring techniques. Information regarding these changes, if available on a real-time basis, is undoubtedly useful for patient care. Many important developments in bedside techniques to monitor these changes have been achieved during the last few years. It was the consensus of the editors that a symposium to exchange knowledge concerning recent advances in such techniques would be valuable. With this background, the First International Symposium of Neuro chemical Monitoring in ICU held May 20-21, 1994, in Tokyo, Japan. It was not the intention of the organizers that this symposium should survey the whole field of neuromonitoring in ICU. The symposium was thus focused on clinical application of microdialysis, jugular venous oximetry, and near infrared spectroscopy, which currently appear to be the most promising techniques for monitoring neurochemical and metabolic changes in the brain in a clinical setting. We termed these techniques collectively as neuro chemical monitoring, contrasting them with neurophysiological monitoring in ICU. The concept that has motivated this symposium was to provide an opportunity to exchange up-to-date summaries on issues currently debated for these techniques. This volume is based on the papers presented at the symposium."
Endoscopic neurosurgical interventions gain in importance. This book gives adetailed description of the recent indi- cations of endoscopic procedures inmodern neurosurgery. They include endoscopic stereotaxy, endoscopic evacuations of intracerebral hematomas, cysts and abscesses as well as endoscopic interventions on brain tumors. An extended over- view about the usable endoscopes and the operative equipment is pointed out
Some 29 scientists from the fields of neuroanatomy, neurochemistry, neu rophysiology, neuropharmacology, and behavior have contributed their ef forts to this testimonial on behalf of the contributions made by Dr. F. W. L. Kerr to science and to those with whom he interacted. The intention of the contributors to this volume was to deal with the manifold advances that pertain to the substrates in spinal cord relating to the processing of sensory infor mation, a subject that in one form or another provoked time and again Kerr's native enthusiasm for research. The organization of the book follows a natural course from the peripheral innervation of the somatic and visceral organs (Winkelmann, Chapter 2) to the effective stimuli that activate these fibers and give rise to sensation under normal and pathological conditions (Campbell and Meyer, Chapter 3; Dubner and colleagues, Chapter 13; Dyck, Chapter 14) to the course these afferent systems take to enter the spinal cord (Coggeshall, Chapter 4) and to the organization of the systems through which this afferent information reaches the brain (Willis, Chapter 11; Vierck and colleagues, Chapter 12)."
This volume contains the proceedings of the latest in a series of international symposia on advances in neuro-oncology, held September 26-29, 1990, in San Remo, Italy and sponsored by the University of Pavia, I.R.C.C.S. Policlinico San Matteo (Pavia, Italy) and the Giovanni Lorenzini Medical Foundation (Milan-Houston). It drew papers from six continents of the world, was attended by over 500 investigators, and demonstrated the extraordinary vitality, depth and breadth of research which characterizes modem neuro-oncology. Over the course of the last decade, there has been a remarkable shift in research carried out in the heterogeneous field of neuro-oncology, which appears to be away from clinical descriptive studies, and toward more basic and fundamental investigation of the pathology, immunohis tochemistry, biochemical and cellular subsets of brain tumors. Besides the traditional fields of neurology, neurosurgery, neuropathology, and radiation therapy, there has been an increased interest and involvement by investigators in the fields of medical oncology, neuroradiology, immunology, and many areas of fundamental neurobiology. It has become evident that interest has also been exhibited in a broader spectrum of tumors than just the malignant glial series, and studies in meningioma, craniopharyngioma, neurinomas, and the pituitary tumors were reported. Several sessions were devoted to the special problems of pediatric brain tumors."
A brain-computer interface (BCI) establishes a direct output channel between the human brain and external devices. BCIs infer user intent via direct measures of brain activity and thus enable communication and control without movement. This book, authored by experts in the field, provides an accessible introduction to the neurophysiological and signal-processing background required for BCI, presents state-of-the-art non-invasive and invasive approaches, gives an overview of current hardware and software solutions, and reviews the most interesting as well as new, emerging BCI applications. The book is intended not only for students and young researchers, but also for newcomers and other readers from diverse backgrounds keen to learn about this vital scientific endeavour.
Surgical repair of cerebral aneurysms is a core aspect of neurosurgical practice. While open microvascular technique has dominated Western surgical practice, surgeons in the former USSR have developed endovascular techniques that have gained acceptance among surgeons here. This text demonstrates both surgical and endovascular approaches, written and illustrated by surgeons with vast experience in both, in a comparative context. The work is extensively illustrated with full-color surgical illustrations, line drawings, and radiographs.
The human nervous system-that most complex organization of energy and matter-has yielded a few glimmers of understanding of its operational me chanics during the last two decades. These have mostly been at the biochemical level of structure and function. Throughout history, as one of the mysteries of nature begins to yield some insights into its function, it has been beneficial to look at it from different points of view. We have developed a volume on movement disorders that is primarily directed toward the biochemical understanding of these disorders and their treatment. Each disorder is presented from several points of view. Although this approach leads to some repetition, it is our aim that the final outcome be a more complete understanding. Much has been written about movement: the beauty of the prima ballerina, the strength of the olympic athlete, and the agility of the surgeon. Seldom do we stop to look beneath the surface-the coordination of muscle groups, the finely tuned balance allowing rapid response in either direction, the individual muscle fibers coordinated to maximize strength and agility, and the nerve fibers connecting muscle with nerve centers. Some of these communicate sensory input of position to the centers while others communicate directions of move ment to muscles. We encourage our readers to be constantly alert to the possibility of in creasing their understanding of other nervous system functions, including thought disorder, through an understanding of movement, either in general principle or by specific chemical interaction."
In this volume, world authorities on spinal surgery from the fields of Neurosurgery, Orthopaedic Surgery, and Neuroscience present current data on the basic science and clinical management of the unstable spine. Unique to this book: a frank presentation of controversies in the field.
Until recently, monitoring of cerebral blood flow and metabolism was an unattained goal. Determination of cerebral blood flow was limited to intermittent measurements and particularly difficult to perform in critically ill patients. Meanwhile there are techniques available, however, to monitor cerebral blood flow and cerebral oxygenation, both globally and regionally. Therefore we thought it worthwhile to discuss these new continuous techniques and to compare them with well-known techniques which discontinuously measure CBF. For that purpose, an international workshop with some leading experts in the field was held in October 1992 in Berlin. The workshop consisted of about 20 lectures, either reviews on a special topic, or latest results. These contributions were given by invitation and were extensively discussed. Unfortunately it is impossible to reproduce the discussions. On the other hand, all speakers delivered a manuscript promptly after the meeting so that we were able to edit them within a short time. Since monitoring of cerebral blood flow in intensive care is a rapidly growing and changing topic, the written contributions should be quickly available. Authors, editors and publishers have tried to come close to this ideal. As editors we would like to thank the authors and the publishers who enabled us to come out with this volume of the proceedings as early as possible.
In July 2008, European and Japanese specialists in neurosurgery, neurology, interventional neuroradiology and neurointensive care joined together to discuss the latest developments in the management of cerebrovascular disorders at the 4th European Japanese Joint Conference on Stroke Surgery, held in Helsinki, Finland. This collection of papers from the meeting deal with aneurysm surgery and management of subarachnoid hemorrhage and stroke, arterial dissection, intracranial arteriovenous malformations and fistulas, and microneurosurgical bypass and revascularization techniques.
Primary reconstructive surgery is assuming increasing importance in the management of fractures of the spine. Analysis of the injury and thus surgical decision-making are greatly facilitated by the diagnostic power of CT and MRI. This volume provides a systemic introduction to the interpretation of CT and MRI images of injuries to the spinal column and the spinal cord, with special emphasis on the assessment or residual stability. Since survey X-rays remain the indispensable first step in radiodiagnosis, the typical appearances of spinal injuries on conventional films are also shown. This will help the reader interpret the CT and MRI images and also reflects the procedure in radiologic practice. The books classification of spinal fractures, together with the attempt to conclude how the injury happened by analyzing the damage caused, paves the way for individually oriented therapy.
There are two important reasons for publishing this new series entitled "Advances and Technical Standards in Neurosurgery" 1. the lack of any or ganized common European postgraduate training system for young neurosurgeons and 2. the language barriers, which impede the exchange of neurosurgical findings in Europe more than in other parts of the world. 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 the Editors 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 publi cation 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 train ing. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons."
In recent years much progress has been made in the field of neurochemical monitoring for the acutelly injured brain. The development of safe continuous microdialysis techniques coupled with microanalytical methodology can generate semi-continuous time profiles of the changes in numerous brain analytes such as lactate, glucose, pyruvate, excitatory amino acids, structural amino acids, indicators of free radical generation, cytokines, adenosine, and neuroprotective drugs. Descriptive studies have shown profound, prolonged, and severe abnormalities in many of the analytes measured and the next phase is to determine the effects of therapeutic interventions upon these parameters. This field of research has contributed tremendously to our understanding of pathomechanisms in acute human brain damage.
Despite recent technological innovations in neuroradiology, the ultimate diagnosis of brain tumors is still based on the histopathological findings from specimens taken during surgery. The material in this atlas represents approximately 700 brain tumor specimens collected mainly in the authors' own clinics. In most cases, complementary light-and-electron-microscopic images of the same case are presented. This volume is a clear and comprehensive guide to the pathology of tumors arising from the central nervous system and should prove useful to pathology residents, neurologists, neurosurgeons, neuroradiologists, and senior medical students.
The XIV International Symposium on Brain Edema and Brain Tissue Injury took place in Warsaw, Poland, on 11-14 June 2008. Two prominent members of the International Society for Brain Edema: Dr. Igor Klatzo and Dr. Julien Hoff have passed away after the last 2005 Symposium in Ann Arbor, USA. Dr. Igor Klatzo was actually the founder of the Society, and the Advisory Board decided to commemorate Dr. Igor Klatzo by introducing a lecture named after him to be given at the Symposium. Prof. Dr. Hans-Jurgen Reulen has been honored to give the frst Igor Klatzo lecture entitled "Bulk Flow and Diffusion revisited, and Clinical Applications". This volume contains 65 out of the 104 papers presented at the Symposium as lectures or posters. The topics of the Symposium were similar to those discussed at the previous ones. Many discussions focused on clinical work especially diagnosis, subarachnoid hemorrhage, hydrocephalus, and traumatic brain injury. Diagnosis and therapy, including surgical methods, have also been verifed. Much attention was drawn to the application of decompressive craniectomy in the treatment of posttr- matic intracranial hypertension. The pathomechanisms of brain edema and tissue injury studied in experimental models have been also presented.
Selected papers from the prestigious Stonwin Medical Conference, which each summer invites a small group of neurosurgical investigation. This volume presents recent advances in research and practice of surgery of the severed spinal cord. Future volumes will treat similarly focused, cutting-edge topics. In terms of editorial strategy, this series will afford Springer entree to a select groups of neurosurgeons.
This monograph analyses all aspects related to the etiopathogenesis, pathomorphology, diagnosis and treatment of lumbar disc herniation. It includes 24 chapters, over 500 illustrations, partly in colour, and 2800 bibliographic entries, going from the historical to the most recent ones. Five chapters are dedicated to biological and pathomorphologic aspects both of lumbar disc herniation and the conditions most often associated with herniation. The etiopathogenesis is analysed in the light of the most significant and recent studies. Five chapters deal with the clinical presentation and diagnostic tests in an extremely wide and detailed way. Large space is reserved to conservative management. The chapters on invasive treatments and on the results and complications of surgery define the advantages and limitations of the old and new percutaneous or surgical treatments. Two chapters are dedicated to surgical management of patients with spinal conditions associated with herniation, and two other deal with the surgical failure. This monograph is aimed at satisfying the requirements of both experts and young doctors. Some chapters are of particular interest to the spine specialist, whilst others are useful to the novice to acquire a general knowledge of the subject.
Great progress has been made in the understanding and prevention of secondary brain damage from acute cerebral disorders, such as trauma and ischemia. Advances may be concerned in particular with better organization and logistics of preclinical emergency care, including rapid arrival of well-trained medical staff on the scene of an accident and of transportation to a competent hospital. Nevertheless, it is a safe assumption that development of secondary brain damage from both intra- and extracranial causes still represents a major factor for the final outcome in severe head injury. Thus, exchanges of experiences and information between various disciplines involved with this important clinical problem - trauma still assumes the number one position as a cause of morbidity and mortality up to an age of 45 years - may provide a basis for in-depth analysis of remaining problems as well as of methods of their solution. This exactly is the purpose of the present publication on concepts and findings pertinent for the general subject of secondary brain damage from various experimental as well as clinical viewpoints. An internationally high-ranking group of experts has been contributing to this collection of reviews on cerebral trauma and ischemia and its adverse sequelae, including cerebral exploration by most modern technologies, such as NMR spectroscopy or PET scanning, among others.
These collected papers represent only a small part of the large amount of new work in the field of stereotaxy. The number of contributions to the Birmingham meeting was such that only selected papers, chosen as representative of advances in the field, could be printed. These papers present the most up to date accounts of major advances in stereotactic imaging and the renewed interest in the stereotactic treatment of movement disorders. Contents Section I. Stereotactic Imaging, Tumours and Haematomas Lipinski, H. G., Struppler, A., Birk, P.: Transformation Modes in Computerized Human Thalamic Brain Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3 . . . Giunta, F., Marini, G., Bertossi, M.: Stereotactic Computer Graphic System with Brain Maps. . ., 7 Giorgi, c., Cerchiari, U., Broggi, G., Contardi, N., Birk, P., Struppler, A: An Intraoperative Interactive Method to Monitor Stereotactic Functional Procedures . . . . . . . . . . . . . ., . . . 10 Giorgi, c., Cerchiari, u., Broggi, G., Passerini, A.: 3-D Reconstruction of Cerebral Angiography in Stereotactic Neurosurgery . . . . . . . . . . . . . . . . . . . . . . .. . . . 13 . . Vandermeulen, D., Suetens, P., Gybels, J., Oosteriinck, A: Angiographic Localizer Ring for the BRW Stereotactic System . . . . . . . . . . . . . . . . . . . . . . . . . ., . . 15 . . . Uematsu, S., Rosenbaum, A. E., Erozan, Y. S., Gupta, P. K., Moses, H., Nauta, H. J., Rigsby, W. H., Wang, A, Weiderman, L., Kumar, A J.: Intraoperative CT Monitoring During Stereotactic Brain Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 18 . . .
The dawn of neurosurgery can be traced back to the first description preserved in the Edwin Smith papyrus' (3000 Be) which dealt with head and spinal injury. In the course of 5000 years, since the first record in Egypt, advances in lifestyle and technology have brought about our modern civilized society. However, as a result of civilization, currently the total number of severe head injuries worldwide is believed to exceed 10000000 and the number of severe spinal injuries is believed to be more than 75 000 each year. This means that central nervous system injury is not only the oldest topic in neurosurgery, but that it is also of critical importance in modern life. Taking these problems into consideration, the International Neurotraumatology Committee was organized in 1965 as an affiliated Committee of the World Federation of Neurosurgical Societies. The first scientific meeting was convened by the Committee in Marseilles in 1970. Nine further meetings were subsequently held, in Europe, Africa, and South America. The meeting was first named "International Conference on Recent Advances in Neurotrauma tology" (ICRAN) by Professor Phillip Harris, when the scientific meeting was held in Edinburgh in 1982. The tenth meeting, (ICRAN 1992), the first one in Asia, was held at Karuizawa, Japan, from September 23rd to 26th, 1992."
This monograph presents a comprehensive review of the clinical experience in surgical repair of cranial defects which the author has gained during a period of over ten years. Particular problems of patients undergoing cranioplasty, such as neurological impairments, EEG changes, variations of intracranial pressure, and sinking skin flap syndrome are described and discussed. The author presents convincing evidence of the importance of cranioplasty in improving the quality of life of patients with large and disfiguring cranial defects. Unfortunately, cranioplasty still ameliorates only to a minimal extent the general condition in patients suffering of major cerebral lesions. I am convinced that this volume will serve the purpose it was designed for : that it will be a most helpful introduction into the problems related to reconstructive surgery. Basel, August 1984 Otmar Gratzl Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 A. History of Cranioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. Clinical Aspects of Cranial Bone Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 I. Origin of Cranial Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1. Acquired Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. Congenital Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3. Demographic and Other Characteristics of Patients . . . . . . . . . . . . . . . . . 9 II. Neurological and Psychic Changes Before and After Cranioplasty . . . . . . . 11 1. Classification of Neurological Deficits and of the Skin Flap Types . . . . . 13 2. The "Sinking Skin Flap Syndrome" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 3. The Influence of Cranioplasty Upon Neurological and Psychic Changes 17 III. Electroencephalographic (EEG) Changes in Patients with Cranial Defects 21 1. EEG Recordings and Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2. Evaluation of EEG Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 IV. Scintigraphy Findings in Patients with Cranial Bone Defects . . . . . . . . . . . . 26 1. Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 2. Results and Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
From its discovery in 1929 by Hans Berger until the late 1960s, when sensory visual and auditory evoked potentials were dis covered and became popular, the EEG was the most important method of neurophysiological examination. W-ith the advent of computer technology in the 1980s, it became possible to plot the potential fields of the EEG onto models of the scalp. This plot ting of information as neuroimages followed the structural and functional techniques of Cf, MRI, PET and SPECf. The success of this method, which began in the early 1980s, has led to the brain mapping of EEGs and EPs being increasingly used for di agnosistic purposes in neurology, psychiatry and psychopharma cology. The pioneers of this method believed in it and were commit ted to its success. However, many traditionalists felt that it gave no new information and so regarded the method with scepticism. Some found both the coloured maps and the mapping technique misleading, which led to unnecessary conflict between mappers and their chromophobic oponents. Emotions have run so high that some professional bodies have justifiably adopted guidelines and warned of the misuse of the method." |
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