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Books > Medicine > Surgery > Neurosurgery
Fifty-two patients operated on for this type of spondylogenic myelo- pathy by the anterior approach were reexamined. The male: female re- lation was 2 : 1. Fifty percent were males in the 5th decade. About 20% had a congenital narrow spinal canal with an ap-diameter below the minimal standard values (3). The maximum of spondylogenic narrow- ing was found between C4 and C6 in 2/3 of the cases. Results: good 44%, satisfactory 31%, unchanged 13%, deteriorated 12%, mortality O. The duration of the neurological symptoms before operation had no in- fluence on the surgical results. Final neurological restitution was reached within 1 week to 3 months after the operation. The operative results in patients with congenital narrow spinal canal showed the same percentual distribution as the results of the entire group. No factors could be found to explain the groups of unsatisfactory results. References 1. DECKING, D. , STEEGE, W. ter: Rontgenologische ParametAr der Hals- wirbelsaule im seitlichen Strahlengang. Die Wirbelsaule in Forschung und Praxis, ~ (1975) 2. HERRMANN, H. D. : Neurologie in Praxis und Klinik. HOPF, H. C. , POECK, K. , SCHLIACK, N. (Hrsg. ). Stuttgart: Thieme (in press) 3. PIEPGRAS, U. : Neuroradiologie. S. 88-89. Stuttgart: Thieme 1977 114 Classification and Prognosis of Cervical Myelopathy E. HAMEL, R. A FROWEIN, and A KARIMI-NEJAD Introduction Up to the present, 104 patients with cervical myelopathy caused by cervical disk lesions, have been operated on in our clinic.
The main aim of this study is to define the clinical criteria which must be considered in order to come to an adequate decision whether a patient with intracranial arteriovenous malformation (AVM) should be operated upon or treated conservatively. A special method was used to reduce the effects of selection. This method made it possible to evaluate the therapeutic efficacy of conservative treatment versus surgery. The method implies that patients with equal combinations of variables (risk profiles) were compared in the two treatment lines. The variables building up the risk-profile pattern were chosen by analysing the decision process, as it was originally practiced by the surgeon who selected and treated the patients of this study. The risk profiles thus described relevant characteristics of the patient and his malformation. The variables were assigned numerical values accord ing to their prognostic value. Summation of the variables making up the risk profile then gives each risk profile a certain value. A low value symbolizes a bad prognosis and a high value a good prognosis in both treatment groups. There were many risk profiles with the same value in both groups and a comparison could be made over a large part of the risk-profile scale. This comparison showed that surgical treatment of A VM can always be justified, although the indications for surgery are less strong in patients with low risk profile values."
The Neurosurgeons of Berlin are happy to welcome their colleagues from Germany and from foreign countries to our Annual Meeting, being held in this city once again after many years. The external appearance of the city may have changed in many respects since our winter meeting in 1965. This ist not the case, however, as concerns the outstanding quality of its cultural life. We hope that you take as much profit of it as possible. When choosing the scientific themes of this congress, we were led by the idea that problems should be discussed which are not dealt with at special symposia this year. Thus, the problems related to lumbar disc surgery and its complications were chosen as one main topic. This important chapter of neurosurgery worries (and not seldom depresses) us in our daily work. A joint statistic analysis has been made, for which we are indebted to the colleagues from the following university clinics: Essen, Freiburg, Graz, Hannover, Heidelberg, Kiel, Koln, Mainz, Wiirzburg, Berlin-Charlottenburg, Berlin Steglitz, of the Neurosurgical Department of the BG-U nfallklinik Frankfurt/Main, of the Neurosurgical Department Wagner-J auregg-Krankenhaus Linz, of the Neurosurgical Clinic of the Katharinen-Hospital Stuttgart, and of the Neurosurgical Clinic of the Stadt. Krankenhaus Berlin-N eukolln."
A workshop on Dynamic Aspects of Cerebral Edema was organized to pro vide an opport nitY, for interdisciplinary and detailed consideration of this subject, so crucial in neurology and neurosurgery. The previ ous workshops were held in Vienna in 1965 and in Mainz in 1972. In the meantime, our ideas on mechanisms of resolution of cerebral edema had been changing drastically. Controversy had arisen regarding the role of biogenic amines in the development of edema. Active work in several centers had indicated the possibility of a reversible compo nent in edematous changes associated with ischemia, the control of which could be of therapeutic significance in the problem of stroke. It was felt that a thorough discussion, at this time, by those involv ed in these various studies should help to resolve the controversies, to crystallize the implications of the new findings, and to evaluate their application for patient care. In preparing the proceedings for publication we have edited the manu scripts and selected the discussions with an aim to highlight new find ings, to make this volume readable, and to eliminate duplication. We gratefully acknowledge financial support from the institutions and organizations previously listed. Many individuals contributed to the success of the workshop and the preparation of the proceedings for publication. Doctors J.B. Brierley, I. Klatzo, H.J. Reulen, and A.G."
This book is the first to offer a comprehensive guide to understanding the brain's architecture from a topographical viewpoint. Authored by a leading expert in surgical neuroanatomy, this practical text provides tri-dimensional understanding of the cerebral hemispheres, and the relationships between cerebral surfaces and the skull's outer surfaces through detailed brain dissections and actual clinical cases with operative photographs and correlative neuroimaging. For neurosurgeons, neuroradiologists and neurologists at all levels, this book emphasises the anatomy of the sulci and gyri of the cerebral surface. It is an essential resource for the general neurosurgery practice, and more particularly for planning surgical access routes for intracranial tumors.
This volume contains the papers presented at the 26th Annual Meeting of the Deutsche Gesellschaft fUr Neurochirurgie, held in Heidelberg, Western Germany, on May 1-3,1975. Since at recent meetings of the German Neurosurgical Society central pathophysiological problems such as "central dysregulation" and "brain edema" had been discussed extensively, it seemed appropriate to choose another major area of cerebral patho- physiology for the meeting in Heidelberg. CEREBRAL HYPOXIA is, as LANGFITT once emphasized, "the final common denominator" of various cerebral lesions with which the neurosurgeon is confronted every day. Raised intracranial pressure, respiratory disorders and disturbances in systemic arterial blood pressure, etc. may lead, if not treated, to a focal or global lack of oxygen in the brain tissue. Anoxia finally results in cell death and thus in irreversible cerebral damage or even death. Main interest has therefore been focussed on disturbances in cerebral perfusion pressure ("ischemic hypoxia") and in arterial oxygenation ("hypoxic hypoxia"). The importance of cerebral autoregulatory mechanisms protecting the brain against tissue hypoxia, of patho- morphological alterations of the cerebral vessels (e. g. the "no-reflow-phenomenon") in the course of severe hypoxia, and of changes in brain metabolism have been discussed on a large scale. The organizing committee was particularly happy to have obtained internationally well-known scientists who presented their work in the field of cerebral hypoxia.
Despite enormous advances made in the development of external effector prosthetics over the last quarter century, significant questions remain, especially those concerning signal degradation that occurs with chronically implanted neuroelectrodes. Offering contributions from pioneering researchers in neuroprosthetics and tissue repair, Indwelling Neural Implants: Strategies for Contending with the In Vivo Environment examines many of these challenges, paying particular attention to how the healing of tissues surrounding an implant can impact the intended use of a device. The contributions are divided into four sections * Part one examines wound healing from the initial insertion trauma through the inflammatory and repair process, explaining how the action of healing varies throughout different areas of the body. * Part two considers various performance issues specific to particular implant components, including those that arise from the chemical, mechanical, thermal, and electrical impact on surrounding tissues. It discusses challenges that result from chronic tissue stimulation and heat effects that occur with on-chip and telemetric processing. * Part three presents both in vitro and in vivo approaches to assessing wound healing response to materials. It includes the contribution of the developer of a chronic hollow fiber membrane implant who explains how an in vivo model is used to assess molecular transport in brain tissue surrounding the implant. * The final section evaluates molecular and materials strategies for intervening in CNS wound repair and enhancing the electrical communication between the electrode surface and the surrounding tissue. It also presents novel approaches to nerve regeneration and repair.
On this occasion we look back on 25 years of the Deutsche Gesellschaft fur Neuro chirurgie. They hold a great deal: founding and development of the society, comple tion and extension, communication between the individual members and contacts to other societies beyond our borders. They also stand for close co-operation with those who transfer their patients to u- the neurologists and specialists in internal medicine, the ophthalmologists and ear nose-and throat specialists as well as the general surgeons. This 25th annual meeting will deal with two examples of diseases that present common problems to the neurologist and to the neurosurgeon, namely meningiomas and multiple sclerosis. In view of their long histories often going back over many years, both of these lesions lead to diagnostic errors and indequate treatment. And yet it should be possible to recognize meningiomas at an early date and to initiate the only possible treatment, the operation, if all diagnostic measures are repeatedly carried out. The diagnosis MS, on the other hand, with the multiplicity of symptoms which are peculiar to this disease, should continue to be re-examined until every other lesion has been excluded with certainty. The increasing number of legal proceedings because of diagnostic and therapeutic measures as well as the doctor-patient talk preceding the written consent for these measures are further problems in need of discussion. For this reason, the topic "medical liability in special reference to the neurosurgeon" was chosen for this meeting. Many questions necessitate many answers."
This volume contains the papers presented at the 24th Annual Meeting of the Deutsche Gesellschaft fur Neurochirurgie, held in Mainz, Western Germany, on April 30 - May 3, 1973. Deliberate choice was made of two crucial still hotly debated subjects which, for ages, have meant a source of constant worry, and nights without sleep to every neurosurgeon. Just as long as our special field exists, there have been the problems of how to control brain edema and .of how to reduce lethality and the secondary lesions in surgery of cerebello-pontine angle tumors. Concerning the first subject, new pathological, pathophysiological and chemical aspects, the mechanisms of brain edema formation and resolution are presented in the hope for better understanding. Furthermore, the relationship between brain edema, intracranial pressure, cerebral blood flow and metabolism are discussed. Finally, the therapeutical consequences as well as the results of experimental and clinical work are presented, and a comparison of effects between different methods (hypertonic solutions, diuretics, steroids, controlled hyperventilation, hyperbaric oxygen) is given. Concerning the second main subject, any important contributions to the early diagnosis of cerebello-pontine angle tumors have been included. Nevertheless, it is of utmost interest for the neurosurgeon to know which approach he is to prefer for the different stages of tumor size and to be familiar with the trans labyrinthine approach or the posterior craniotomy, as well as with the importance of the use of the microscope in neurosurgery, the preservation of the facial nerve and, in certain cases, its repair."
The control of brain edema is still one of the major problems in surgical and conservative treatment of various cerebral lesions. Many attempts have been made to develop methods for reducing the high mortality associated with brain edema. Mter many years of using hypertonic solutions it can be stated that this type of therapy has not yielded satisfactory results. During recent years increasing evidence has been accumulated on the efficacy of steroids on brain edema. Steroids were reported to result in rapid relief of signs and symptoms of increased intracranial pressure and neurological dysfunction accompanying cerebral edema. It was the aim of this workshop to evaluate the effect of corticosteroids on brain edema as an advance in therapy. It was hoped that this could be achieved by a multi disciplinary approach. Though, the volume contains the contributions of various experts - internists, neurochemists, neurologists, neuropathologists, neurosurgeons, pharmacologists, physiologists - who have added considerable experimental and clin ical evidence on the action of steroids on brain edema. New pathophysiological aspects regarding the mechanisms underlying the formation and resolution of brain The effectiveness of corticosteroid therapy in various forms edema are presented. of clinical and experimental brain edema, e. g. accompanying brain tumors, head injury, spinal cord injury, cerebrovascular lesions, etc. as well as dosage and duration of treatment are critically discussed.
In this issue of Neurosurgery Clinics, Guest Editor James A. Stadler brings his considerable expertise to the topic of syndromic neurosurgery. Top experts in the field cover key topics such as Syndromic epilepsy, tumor syndromes, syndromic craniosynostosis, and more. Provides in-depth, clinical reviews on syndromic neurosurgery, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 14 relevant, practice-oriented topics including The history of syndromic neurosurgery; Multidisciplinary evaluation of neurosurgical patients with genetic syndromes; Neurosurgical evaluation and management of children with achondroplasia; Neurosurgical evaluation and management of patients with connective tissue disorders; and more.
This issue of Neurosurgery Clinics, guest edited by Dr. Domagoj Coric, provides an Update on Motion Preservation Technologies. This issue is one of four selected each year by our series consulting editors, Drs. Russell R. Lonser and Daniel K. Resnick. This issue discusses state-of-the-art indications, technique, devices, complications and evidence basis for motion preserving technologies in the cervical and lumbar spines. Topics covered in this issue will include: Cervical Total Disc Replacement: Indications and Technique, Cervical Total Disc Replacement: Off-label and Expanded Indications, Cervical Total Disc Replacement: FDA-approved Devices, Cervical Total Disc Replacement: Novel Devices, Cervical Spine Surgery: Arthroplasty versus Fusion versus Posterior Foraminotomy, Cervical Total Disc Replacement: Complications and Complication Avoidance, Cervical Total Disc Replacement: Long-term Outcomes, Biomechanics of Cervical Arthroplasty Devices, Adjacent-level Disease following Spinal Arthroplasty, Lumbar Total Disc Replacement: Current Usage, and Posterior Lumbar Facet Replacement and Arthroplasty. Provides in-depth, clinical reviews on the latest updates in Motion Preservation Technologies, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.
Essential prep for maintenance of certification exams as well as neurosurgery boards Comprehensive, but small enough to take on rounds, the updated second edition of this popular neurosurgical board review provides a robust study companion for the American Board of Neurological Surgery (ABNS) primary examination. The text includes an impressive number of questions with concise and well-delineated explanations. Suitable for thorough board preparation, the question and answer format enables busy neurosurgical residents to efficiently practice, review, and improve upon their comprehension. In addition to all the fundamental disciplines that are relevant to the practice of neurosurgery, this edition encompasses the latest advances in the field including endovascular approaches, minimally invasive spinal surgery techniques, and genetics. The diverse and challenging questions encourage the acquisition of factual knowledge and application of logic. This is the definitive ABNS study book because it most closely mimics the written board examination format. Key Highlights: Multiple choice Q&A format provides highly effective study tool Questions organized randomly, thereby simulating the written examination Short explanations provide readers with a clear understanding of the correct answers This is a must-have primer that will help neurosurgeons and neurosurgical residents study and pass the rigorous written board exam. Board-certified neurosurgeons will also find it a handy and useful resource to prepare for MOC examinations or to brush up on clinical know-how.
This book aims to provide an overview of the basics of anesthesia for neurotrauma. It showcases how management of different neurotrauma cases may differ, especially those involving spine and or polytrauma. It provides quick and easy access to understand anesthesia for neurotrauma.
Over the last 18 years, there have been many advances in the field of intraoperative monitoring. This new edition of Neurophysiology in Neurosurgery: A Modern Approach provides updates on the original techniques, as well as other more recent methodologies that may either prove beneficial or are commonly used in neuromonitoring. The purpose of this book is to describe the integration of neuromonitoring with surgical procedures. Each methodology is discussed in detail as well as chapters describing how those methodologies are applied to multiple surgical procedures and the evidence used to support those uses. The second edition features a surgical procedure section, which focuses on specific surgical procedures and the type of monitoring used during these procedures. The original chapters have been updated, expanded, and the structure modified to ensure the book is beneficial to both physiologists and surgeons. This book is written for neurosurgeons, neurophysiologists, neurologists, anesthesiologists, interventional neuroradiologists, orthopedic surgeons, and plastic surgeons.
d Guide to Diagnosis and Management d Guide to Diagnosis and Management
Surviving Neurosurgery: Vignettes of Resilience is a practical guide to the inner workings of the lives of neurosurgeons, healthcare partners, and patients. To this end, this text serves as a first-hand documentary of the unique challenges faced as one progresses through their career. It is a snapshot in time capturing the experiences of both patients and providers. The text is divided into seven parts that run the gamut of a neurosurgeon's career symbolic of the seven years of neurosurgical training. These narratives include, but are not limited to, residency challenges, surgical nuances, research and funding, embracing humanity, patient experiences, and overcoming hurdles along the journey. Chapters share the wisdom and experiences of over 100 authors consisting of patients, trainees, advanced practice providers, and attending neurosurgeons.
Mild traumatic brain injury can happen to anyone, anytime; in cars, sports, or workplace accidents, falls, or through physical assault, including domestic violence and shaken-baby syndrome. The National Center for Injury Prevention and Control estimates that 1.4 million Americans sustain a traumatic brain injury (TBI) each year, and that at least 5.3 million Americans currently have long-term or lifelong need for help to perform activities of daily living as a result of a TBI. "Brainlash" provides the tools and facts to make the recovery process more intelligible-- and to support the wide range of people affected by MTBI. For patients, family members, physicians and other health care providers, attorneys, health insurance companies, employers and others, it covers options and services, health and vocational issues, medicolegal topics, psychological and emotional implications, and more
The field of neural transplantation is at a crucial stage, with important clinical trials on transplantation in patients with Parkinson's disease nearing completion and novel, alternative approaches to fetal transplantation being developed. This timely book brings together leading neuroscientists, clinicians, and cell and developmental biologists to discuss the use of neural transplants in neurodegenerative disorders, such as Parkinson's disease, Huntington's chorea, amyotrophic lateral sclerosis, multiple sclerosis and spinal cord injury. There is also extensive coverage of the potential alternatives to freshly derived fetal tissue as the source of transplants, for example xenografts, encapsulated cells and immortalized stem cells. With authoritative contributions and lively discussion sections, this book presents much new and exciting work in this field and identifies promising new research directions.
Ideal for both neurosurgical residents and recertifying neurosurgeons, Neurosurgery Self-Assessment: Questions and Answers offers the most comprehensive, up to date coverage available. Over 1,000 clinically relevant multiple-choice questions across 46 topic areas test the candidate's knowledge of basic neuroscience and neurosurgical subspecialties to an unparalleled degree and provide detailed answer explanations to facilitate learning and assessment. Over 700 histology, pathology, radiology, clinical and anatomical images serve as an index of routinely tested-on images in neurosurgical examinations with high-yield summaries of each pathology to reinforce and simplify key concepts. Includes only multiple choice questions in both single-best-answer and extended matching item (10-20 options) format increasingly adopted by neurosurgery certification boards worldwide. Questions are organized by topic and classified by degree of difficulty through a highly visual "traffic light system" which codes each question in green, amber, or red. Includes coverage of the landmark studies in areas such as vascular, stroke, spine and neurooncology. Practical tips facilitate study with test-taking strategies and things to consider before sitting for an exam. Utilizes Imperial and SI units throughout. Expert Consult eBook version included with purchase. This enhanced eBook experience acts an interactive question bank which automatically scores and provides immediate answer feedback, as well as allowing you to search all of the text, figures, and references from the book.
This book covers the explosion of new information about the relationship between the brain and its blood supply since the first edition was published in 2009. With new knowledge and its impact on clinical care, neurovascular neuropsychology has become a recognized sub-specialty that has been integrated into health care systems in the US and abroad. The second edition brings to this larger audience the latest word on these matters, with new emphasis on women's issues, relevance to the pediatric population, insights from modern imaging, and advances in medical and surgical treatments such as heart transplantation, cardiovascular transarterial therapies, and noninvasive brain stimulation in connection with neurocognitive outcomes.
Neurosurgical Neuropsychology: The Practical Application of Neuropsychology in the Neurosurgical Practice comprehensively explains the use of neuropsychology in neurosurgical settings. The book covers various preoperative techniques that may benefit neurosurgeons, such as functional neuroimaging (fMRI, SPECT, MEG) for presurgical cognitive mapping, as well as more traditional methods to predict outcomes after surgery, including neurocognitive testing and the Wada procedure. The book's editors discuss why neuropsychologists add considerable value to the neurosurgical team. A wide range of patient populations are covered, ranging from Deep Brain Stimulation candidates for Parkinson's disease, to adult and pediatric epilepsy candidates and neuro-oncology cases. This book is ideal for neurosurgeons, neuropsychologists, neuro-oncologists, epileptologists, general neurologists, and others who want to know more about the use of neuropsychology as a tool in the presurgical and postoperative phases of neurosurgery. |
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