This is the second part in a two-volume work on neuromodulation. It describes the techniques and procedures applied by direct contact with the central nervous system or cranial nerves (in order to modulate the function of neural networks) or in deeply located structures inside the nervous system (in order to alter the function on specific networks).

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno, M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore, progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis, itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied, thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for ''evidence-based medicine'' is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe''Decadeof limitsoffeasibility, especiallywherecontrolledthe- theBrain''. Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide, accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control, paincontrol, aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology, forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree cientpreventionin many of these processes involve the major tra- thefuture, themeasuresthatstandrightatthefore- mitters. Furthermore, biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells, bone-marrowcells, macrophages, andother withthemoretask-speci?c, intensive, andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade, andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients."

This volume contains 93 papers from internationally recognized experts in the field of brain edema and brain injury. The papers include human and animal studies on edema following stroke, cerebral hemorrhage, traumatic brain injury, spinal cord injury and hydrocephalus. Papers also address fluid dynamics in the brain (including the role of aquaporins).

This is the first book to cover minimal-invasive treatment of osteoporotic, tumorous and traumatic vertebral fractures in the English language. In addition to detailed descriptions of the techniques, including tips and tricks from experts, the book contains a chapter about the medical treatment of osteoporosis, which is indispensable in the interdisciplinary approach to osteoporosis. This acclaimed innovative concept unites several treatment aspects. More conservative treatment methods are also presented in this work.

All chapters reflect new developments and clinical findings in the field of orthopaedics, surgery, traumatology and neurosurgery.

To date, more than three thousand brain and skull base tumors, along with various vascular problems, have been treated by using advanced, fully endoscopic, minimally invasive surgical techniques. In this book, Dr. Hrayr K. Shahinian, director of the Skull Base Institute, compiles these techniques. The book is highly specific and amply illustrated. The step-by-step operating room procedures provide a definitive guide to the difficult yet essential art of skull base surgery.

Neurovascular diseases and conditions, and their associated risk factors, represent a significant cause of cognitive disability in the United States and throughout the world. In the USA alone there are 750,000 new strokes each year, representing the number one cause of disability in the country. Hypertension, found in approximately 50 million Americans, has been shown to be associated with alterations of cognitive function, even in the absence of stroke and dementia. Recent studies of neurovascular disease have now revealed that neuropsychological function may be a more sensitive measure of brain integrity than coordination, motor or sensory function and correlates will with functional outcome measures.

Neurovascular Neuropsychology focuses on focal and diffuse neurovascular disease in addition to systemic conditions in which cognition and behavior have been uniquely associated with different pathologic states. With an increasing number of patients being treated by healthcare professionals, Neurovascular Neuropsychology will prove to be a strong reference to consult in regards to neuropsychological syndromes.

International experts present in this volume advances in reconstructive neurosurgery focusing on the fields of neurotrauma and neurodegenerative disorders. The highlights include building an international strategy for risk reduction, documentating an multidisciplinary approach towards restoration of function in paraplegic spinal cord-injured patients, describing a new approach for statistical analysis in traumatic brain injury trials, describing blood flow changes in diffuse brain injury, discussing rehabilitation programs in Germany following acute brain injury, describing research data form Taiwan on neurotrauma, showing the neuropsychiatric effects from deep brain stimuation fro ovement disorders, difining the role played by imanging for deep brain stimulation targeting in mental illness, using radiosurgery in decompresssion in the treatment of trigeminal neuralgia, describing the development of radiosurgery from brain to the spine, listing new transgenic animal models of Parkinson's disease, discussing gene therapy for neuropathic pain and Parkinson's disease, and finally, discussing constrained-induced movement therapy fro stroke patients, and endovascular therapy for cerebrovenous disorders.

88 short papers originating from the 12th International Symposium on Intracranial Pressure and Brain Monitoring held in August 2004 in Hong Kong present experimental as well as clinical research data on invasive and non-invasive intracranial pressure and brain biochemistry monitoring. The papers have undergone a peer-reviewing and are organized in nine sections: ICP management in head injury, neurochemical monitoring, intracranial hypertension, neuroimaging, hydrocephalus, clinical trails, experimental studies, brain compliance and biophysics.

The overall incidence of meningiomas, particularly in the developed countries, is rising due to a growing size of the aging population, with people living longer and enjoying healthier lives than ever before. Additionally, an increased utilization of imaging studies such as computer tomography (CT) and magnetic resonance (MR) for routine evaluation of closed head injuries, paranasal sinus problems and various non-specific neurological symptoms, ranging from headaches to dizziness, has contributed to enhanced detection of incidental meningiomas.

The book contains the most up-to-date information in all matters related to meningiomas, and is written by multiple contributors - internationally recognized experts in their respective fields from Asia, USA and Europe.

This is an essential reference guide to neurosurgeons and neurologists (in training and in practice), as well as medical libraries, throughout the world.

Written by internationally renowned experts, this volume is a collection of chapters dealing with imaging diagnosis and interventional therapies in neuroradiology and diseases of the spine. The different topics are disease-oriented and encompass all the relevant imaging modalities including X-ray technology, nuclear medicine, ultrasound and magnetic resonance, as well as image-guided interventional techniques. It represents a unique experience for residents in radiology as well as for experienced radiologists wishing to be updated on the current state of the art.

A medical degree opens many doors, but how do you decide which is the right one to go through? Whether you are wondering how to choose a career or want to know how to follow a particular path, you'll find the answers in this book. Deciding which medical career to pursue has a huge impact on your future, and yet few doctors or medical students ever receive formal careers advice. Fortunately help is at hand: this book has been fully rewritten to include the latest information on training and career progression, as well as summaries of over 100 different careers open to medical graduates. Whether you aspire to be a general practitioner, medical manager, forensic pathologist or even a brain surgeon, you'll find details on the job, lifestyle, and specific career route. Each career chapter has been written by specialists in their field to give you a unique 'insider's opinion', resulting in the most complete and up to date medical careers guide ever published. Alongside the careers chapters there are new and updated sections on the Foundation Programme, Core Training, Specialty Training, and Academic Training. These describe the major hurdles in each area and how to overcome them. In addition, alternatives and adaptations to formal training are explored, including taking time out, working outside the UK, and working less than full time. From choosing jobs and filling application forms, to interviews and improving your CV, this book covers every aspect in detail.

Der Weg zur richtigen Therapieentscheidung in der HWS-Chirurgie. Zur Behandlung degenerativer Erkrankungen der Halswirbelsaule hat sich eine Vielzahl unterschiedlicher Verfahren mit spezifischen Indikationen, Vor- und Nachteilen entwickelt. Neben der konservativen Therapie steht die operative Stabilisierung der Halswirbelsaule mit Diskusprothesen, Cages und Wirbelkoerperersatz im Vordergrund. Basierend auf ihrer Erfahrung sowie biomechanischen und klinischen Studien stellen die Autoren eine klare Strategie bei der Auswahl des operativen Zugangswegs und des Implantats vor. Neben den anatomischen, biomechanischen und klinischen Grundlagen beschreiben sie im einzelnen - die Auswahl des operativen Zugangswegs - die Auswahl des Implantats - die Operationstechnik bei den einzelnen Verfahren. Zahlreiche Abbildungen illustrieren die Befunde, die zur Therapieentscheidung fuhren, und Schritt fur Schritt die operativen Verfahren. Empfehlungen zur Aufklarung und Beratung des Patienten, zum wichtigen Aspekt der Implantatsicherheit und zu den moeglichen Komplikationen sowie ein Ausblick auf zukunftige Entwicklungen runden die Darstellung ab. Umfassend, fundiert und reich illustriert - alle Aspekte der operativen Behandlung degenerativer Erkrankungen der Halswirbelsaule

Joint replacement is a logical step in the treatment of severe joint pathologies with irreversible lesions resisting conservative therapy. At the spinal level, arthrodesis became, very early, the gold standard of treatment for severe intervertebral disc pathologies. The next logical step was to envision functional replacement, and this step was taken as early as 1956, when the first intervertebral implant was described. However, it took many more years and a great variety of proposed implant designs before clinical applications could be attempted.

Praise for "The Lobotomist"

"Written with such clarity and engaging detail that a reader has difficulty in putting it down."
--"The New York Review of Books"

"One of the many virtues of El-Hai's text is the rich detail he provides about Freeman's life and ideas."
--"Los Angeles Times"

"Fascinating . . . an important and disturbing contribution to the history of psychiatry."
--"New Statesman"

"Captivating. . . . No history of modern psychiatry is complete without this story."
--Andrew Solomon, author of "The Noonday Demon"

"The Lobotomist" explores one of the darkest chapters of American medicine: the desperate attempt to treat the hundreds of thousands of psychiatric patients in need of help during the middle decades of the twentieth century. Into this crisis stepped Walter Freeman, M.D., who saw a solution in lobotomy, a brain operation intended to reduce the severity of psychotic symptoms. Although many patients did not benefit from the thousands of lobotomies Freeman performed, others believed their lobotomies changed them for the better.

Drawing on a rich collection of documents Freeman left behind and interviews with Freeman's family, Jack El-Hai takes a penetrating look into the life of this complex scientific genius and traces the physician's fascinating life and work.

The book provides a general understanding of the biology of spinal cord injury (SCI) in animal models and their relationship to naturally occurring injury in man, and secondly reviews novel means to induce functional recovery from spinal cord injury based on developmental biophysics and physiology.

During the 1940s and 1950s, tens of thousands of Americans underwent some form of psychosurgery; that is, their brains were operated upon for the putative purpose of treating mental illness. From today's perspective, such medical practices appear foolhardy at best, perhaps even barbaric; most commentators thus have seen in the story of lobotomy an important warning about the kinds of hazards that society will face whenever incompetent or malicious physicians are allowed to overstep the boundaries of valid medical science. Last Resort challenges the previously accepted psychosurgery story and raises new questions about what we should consider its important lessons.

Peripheral nerve injury and entrapment neuropathy often are complicated by injury to adjacent tissue such as bone, joints, blood vessels, and tendons. Clinicians who provide primary care in these areas require extensive knowledge of methods for treating wounds and nerve injuries. The most important element in the treatment of peripheral nerve injury is appropriate surgical repair or functional reconstruction; postoperative physical and occupational therapy are also necessary. This book summarizes current topics in Japan and other countries in the field of surgical nerve repair, including selection of treatment methods for peripheral nerve paralysis, practical issues in surgery, and aspects of postoperative care. The importance of evidence-based medicine is emphasized, with appropriate therapy decided on the basis of objective data. The book has a broad appeal to include general clinicians, clinical trainees, and allied health-care professionals.

Rapid progress in technology and its application to diagnosis and monitoring of brain tissue temperature and metabolism have resulted in advances in therapy for critically brain-injured patients and breakthroughs in understanding the pathophysiology of brain damage. The latest concept of brain hypothermia therapy clarifies targets such as brain thermal pooling, masking brain hypoxia associated with catecholamine surge, the metabolic shift from glucose to lipids, and selective radical damage of dopamine in the central nervous system. This volume explains the mechanism of brain injury and how brain hypothermia treatment differs from other hypothermia therapy in four major sections: Brain Injury Mechanism, Pathophysiology of Hypothermia, Basic Research of Hypothermia Treatment, and Clinical Studies of Brain Hypothermia. The book is a valuable source for practitioners and researchers in neurosurgery and neurology and in critical care and emergency medicine.

The first monograph dealing exclusively with the neuropsychological and psychosocial sequelae of subarachnoid hemorrhage (SAH) and its treatment. It provides an overview of basic treatment modalities and functional outcome after SAH with special emphasis on aneurysm surgery. In the methods section, neuropsychological, neuropsychiatric and capacity of daily life assessment issues in patients after SAH are reviewed, and the neuroanatomical basis of the neurobehavioral abnormalities after SAH is critically discussed. Furthermore, the frequently overseen aspects of psychological adjustment including quality of life after SAH, the hemorrhage as a psychological trauma, and rehabilitational issues are met in this book.

In the last decade, a significant paradigm shift has occurred in the way complex spinal disorders are treated. Historically, after patients failed conservative treatments-largely consisting of therapy, medications, and injections-they would be left with only highly invasive open surgical options. Now, with the development of minimally invasive surgical techniques, patients often have significantly more effective and safer treatment options available. Minimally Invasive Surgical Procedures for Pain looks at the minimally invasive approaches that can be done percutaneously and under image guidance, instead of the traditional open approaches under direct visualization. The book discusses the basic concepts of spinal surgical approaches combined with an in-depth approach to the various techniques, with the overall goals of enhancing physician knowledge and leading to improved patient outcomes and safety. Topics include decompressive procedures, spinal implants, vertebral autmentation procedures, sacroiliac joint therapies, neuromodulation procedures, and more. The topics covered in the book are important to interventionalists, as well as physicians from traditional surgical backgrounds like neurosurgery and orthopedics. A first of its kind, this text details a balanced look at the proper surgical techniques for pain, as well as best practices.

Spinal Cord Injuryor disease can happen to anyone at any time and the effectscan be devastating. Ifound this outpersonallywhen Iwas thrown from the back ofa pick up truck at age 15 was left paralyzed from the waistdown. It was during my recuperation as a young teenager that I first gained insight into the importance ofrehabilitation. My family, doctors, nurses, fellow patients and researchers who were dedicated to helping me over- come my personal tragedy helped me pull through. Today, rehabilita- tion medicine is taking great strides and empowering the person with the injury to take control oftheir future, overcome their setbacks and, through collaborativesupport, reach their personal goals and potential. Since 1987 the Legacy raised by my Man in Motion World Tour (24901 miles wheeled around the world March 1985-May 1987) has pro- vided over $13 million dollars to research and rehabilitation in the areas of spinal cord injury. I hope that in some small way this funding has contributed to the development ofthe vital programmes that supported me andmanyothers. The effects ofspinal cord injury are traumatic and life-shattering and require a skilled interdisciplinary approach. I congratulate those who have contributed to this book and challenge each one ofyou to never give up on yourdreams to find the answers to the optimum treatment of spinal cord injuryand disease.

Rontgenthoraxaufnahmen richtig interpretieren

Thoraxaufnahmen, die auf der Intensivstation aufgenommen werden, unterscheiden sich in der Aufnahmetechnik und in den veranderten physiologischen und anatomischen Verhaltnissen von Standard-Thoraxaufnahmen, die am Rasterwandstativ angefertigt werden. Die Interpretation dieser Bilder bereitet selbst erfahrenen Radiologen und Intensivmedizinern haufig Schwierigkeiten.

Der Weg zur korrekten Interpretation: - Rontgen- und Aufnahmetechnik - Strahlenschutz und -belastung - Klinische Problematik und Interpretation von Thoraxaufnahmen auf der Intensivstation.

Neu in der 2. Auflage:

Bildmaterial moderner Aufnahmeverfahren

Indikationsstellung fur CT-Aufnahmen

Vergleich von Projektionsradiographie und Schnittbildradiographie und mogliche Pitfalls

Ein Praxisbuch von Radiologen, Intensivmedizinern und Medizinphysikern zum Lernen und Nachschlagen. Ein Muss fur jeden auf der Intensivstation tatigen Arzt "

Spinal cord injury produces a unique multiplicity of problems which must be clearly understood by the considerable numbers of health care and rehabilitation professionals involved in their lifetime management. This book assumes an educational approach to spinal cord injury management, in which the individual becomes an active participant in goal setting, problem solving, and in assuming self responsibility. Rehabilitation is discussed in terms of client empowerment, client-professional partnerships and examines the client in the context of his unique socio-cultural environment.;This book attempts to present an educational and psychosocial model for the rehabilitation of people with spinal cord injuries. In line with this approach, the first chapters present a concept of empowerment in rehabilitation and of an educational view of the process of learning to live with a suddenly acquired disability. The medical aspects of spinal cord injury follow, with a study of aetiology, impairments, acute care, disability reduction and engagement in self care activities. The management of high lesions in a rehabilitation context is examined separately, since this is a highly specialised area and one which is largely ignored both in therapy literature and in professional practice. The final chapters focus upon psychological issues, and upon such issues as productivity, leisure, socialization which are important both in early phases of management and in the long term.

On the threshold of an exciting new era for acute stroke diagnosis and treatment, the Third International Symposium on Thrombolytic Therapy in Acute Ischemic Stroke was held in Nara, Japan, in April 1994. The symposium brought together some 200 basic and clinical scientists for presentations and discussions of issues vital to the understanding of thrombolytic therapy. This volume compiles the major presentations of the symposium, with attention to applications of new diagnostic measures such as diffusion and perfusion MRI, contrast-enhanced transcranial Doppler and angioscopy. Other presentations examine the mechanisms of ischemia/reperfusion injury, hemorrhagic transformation, and reocclusion, with reviews of recent developments in thrombolytic agents. The proceedings of the symposium will be of special interest to researchers, physicians, and students in the fields of neurology, neurosurgery, and nuclear medicine, as well as those in pharmacology, critical care medicine, and related fields.

The approach in this book is direct and simple. The author deals only with nerve block for the "most common" pain syndromes that the average practitioner will encounter frequently. This option is highly effective, but often not used simply because oral analgesics and anti-inflammatories are more familiar methods. The clear writing style leads step-by-step to the appropriate nerve block procedure. The author also discusses succinctly practical psychological issues of pain, placebos, etc.