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.

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."

Authored by experienced surgeons and key innovators in the fast-moving field of LIF surgery, Lumbar Interbody Fusions provides an in-depth, focused approach to recent advances in surgical techniques and technology. Covering both minimally invasive and open procedures, this comprehensive reference provides step-by-step details for proven techniques, including extreme lateral, oblique lateral, and direct lateral approaches; intertransverse approaches; axial approaches; and endoscopic approaches. Focuses on the technical nuances, pearls and pitfalls of each procedure, as well as complication avoidance and management. Features high-quality radiographs and intraoperative images for superb visual guidance throughout. Covers topics that have as-yet unsettled surgical management, such as thoracolumbar and lumbosacral overlap diseases. Includes a concise review of evidence-based spine literature at the end of each procedural chapter. Features chapters on adjunct instrumentation such as pedicle screw and facet fixation, as well as graft selection and revision surgeries. Provides real-time guidance in video: Open Transforaminal Lumbar Interbody Fusion, MIDLIF Operative Technique, L5-S1 OLIF, Aspen Surgical Technique, and many more. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

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.

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.

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.

Drawing from original correspondence penned by lobotomy patients and their families as well as from the professional papers of lobotomy pioneer and neurologist Walter Freeman, The Lobotomy Letters gives an account of the widespread acceptance of this controversial procedure. The rise and widespread acceptance of psychosurgery constitutes one of the most troubling chapters in the history of modern medicine. By the late 1950s, tens of thousands of Americans had been lobotomized as treatment for a host of psychiatric disorders. Though the procedure would later be decried as devastating and grossly unscientific, many patients, families, and physicians reported veritable improvement from the surgery; some patients were even considered cured. The Lobotomy Letters gives an account of why this controversial procedure was sanctioned by psychiatrists and doctors of modern medicine. Drawing from original correspondence penned by lobotomy patients andtheir families as well as from the professional papers of lobotomy pioneer and neurologist Walter Freeman, the volume reconstructs how physicians, patients, and their families viewed lobotomy and analyzes the reasons for its overwhelming use. Mical Raz, MD/PhD, is a physician and historian of medicine.

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.

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.

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

Part of the Neurosurgery by Example series, this volume on neurotrauma presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within neurotrauma, including hematoma, injury to the sinuses, concussion, orbital trauma, penetrating brain injuries, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Neurotrauma is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

The perioperative care of individuals with neurologic compromise is critically important, yet it is only one dimension of the rich relationship between anaesthesiology and the neurosciences. The mechanism of everyday therapeutic interventions such as anaesthesia and analgesia is exciting neuroscience in its own right. At the new frontier of outcomes studies lies the question of how the perioperative period might impact the brain. For example, questions related to anaesthetic neurotoxicity, delirium, and cognitive dysfunction pose critical challenges for the field. The Oxford Textbook in Neuroscience and Anaesthesiology addresses the exciting field of neuroanaesthesiology in a new and stimulating way. In twenty eight chapters, the neuroscientific basis of anaesthesiology, the full spectrum of clinical neuroanaesthesia, and the care of neurologic patients undergoing non-neurologic surgery are explored in one comprehensive textbook for the first time. The first section considers the neural mechanisms of general anaesthetics, cerebral physiology, the neurobiology of pain, and more. The second section explores the care of patients with neurologic disease in the operating room or intensive care unit. These clinical chapters systematically treat the perioperative considerations of both brain and spine surgery, and provide introductions to neurocritical care and pediatric neuroanaesthesia. The final section outlines the care of neurologic patients undergoing non-neurologic surgery. It examines key connections of neurology and anaesthesiology, examining how conditions such as dementia, stroke, or epilepsy interface with the perioperative period. Each chapter has been carefully crafted to be concise yet highly informative, reflecting the cutting edge of neuroscience and neuroanaesthesiology. This international textbook gathers the best available expertise of authors and leaders worldwide. Includes access to online-only content, including more than 20 cases and more than 90 questions that can be used in presentations and teaching sessions. By activating your unique access code, you can access and use the material.

Part of the Neurosurgery by Example series, this volume on surgical neuro-oncology presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore a number of different types of nervous systems tumors, including glioblastoma, medulloblastoma, skull tumors, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Surgical Neuro-Oncology is appropriate for neurosurgeons who wish to learn more about this subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

This book is a complete review of the indications, techniques and outcomes of minimally invasive spine surgery (MISS) for neuro- and orthopaedic surgeons. Divided into seven sections the text begins with an overview of the fundamentals of MISS, explaining the development of techniques, anatomy, and imaging. The next chapters cover MISS for numerous disorders in both the cervical and lumbar spine followed by sections on surgery for tumours, infections and osteoporosis, and pain management. The book concludes with discussion on recent advances in the field of MISS, including robotics. The comprehensive text is highly illustrated with nearly 400 surgical images and tables. Key points Comprehensive review of minimally invasive spine surgery (MISS) In depth discussion on procedures for cervical and lumbar spine disorders Covers recent advances in MISS including robotics Highly illustrated with nearly 400 surgical images and tables

A large number of neurological conditions result in abnormal movements of the body; these are often characterized by changes in coordination and altered speed of voluntary movement. Many obscure diseases, conditions and environmental insults can cause movement disorders but these are often overlooked. This volume expands and differentiates the many varied clinical presentations of movement disorders. Written by an international team of authors, including some of the most prominent clinicians in the field, disorders are defined and expanded in a clinically useful manner. Pathophysiological theories, genetic discoveries, new classifications, differential diagnoses and therapies are discussed extensively. Uncommon Causes of Movement Disorders provides a broad and comprehensive review of the field, concentrating on conditions infrequently seen but essential for practitioners to recognize in order to implement appropriate management. This is a key text for movement disorders specialists and general neurologists at all stages of their career.

There are few books devoted to the topic of brain plasticity and behavior. Most previous works that cover topics related to brain plasticity do not include extensive discussions of behavior. The first to try to address the relationship between recovery from brain damage and changes in the brain that might support the recovery, this volume includes studies of humans as well as laboratory species, particularly rats. The subject matter identifies a consistent correlation between specific changes in the brain and behavioral recovery, as well as various factors such as sex and experience that influence this correlation in consistent ways.
Evolving from a series of lectures given as the McEachran Lectures at the University of Alberta, this volume originally began as a summary of the lectures, but has expanded to include more background literature, allowing the reader to see the author's biases, assumptions, and hunches in a broader perspective. In writing this volume, the author had two goals in mind:
* to initiate senior undergraduates or graduate psychology, biology, neuroscience or other interested students to the issues and questions regarding the nature of brain plasticity, and
* to provide a monograph in the form of an extended summary of the work the author and his colleagues have done on brain plasticity and recovery of function.

The pituitary gland is a very small-sized gland which plays an important role in regulating human well-being by controlling many activities of other hormone-secreting glands. It embeds in a midline, bony hollow of the cranial base and is surrounded by vital structures (eg: optic apparatus, cavernous sinuses, internal carotid arteries, and cranial nerves that control extraocular muscles). Adenoma of this gland is a challenging problem for neurosurgeons. Some are best managed with medication alone, but some are more responsive to surgery. Numerous refinements in surgical approaches to the pituitary gland have been proposed for decades. Advancements in modern surgical equipment and state-of-the-art technology of highly precise tools have given neurosurgeons a new, minimally invasive approach. Since the era of image-guided surgery, neurosurgeons have been offered many chances in innovating high precision surgical techniques via a very small incision or no incision at all. Patients received many benefits from the so-called minimally invasive surgery, particularly less side effects with greater patient comfort. Better outcome, little or no scarring, and lower complication rates of pituitary adenoma surgery resulted from little tissue manipulation by cutting-edge technology. However, the revolutionized pituitary surgery is still going ahead. Starting with the microscopic era, followed by image-guidance and then by endoscopic maneuver, all of these give neurosurgeons a streamlined, multidisciplinary approach in treatment of the pituitary adenoma. Another groundbreaking development in minimally invasive treatment for pituitary adenoma is robotic surgery. Robotic surgery of pituitary adenoma offers a wide range of treatment: passive, semiactive, active robots, and remote manipulators. Some of them are non-invasive alternatives to surgery such as Gamma Knife (R), LINAC, Cyberknife (R); they provide pain-free, non-surgical alternative treatment for surgically complex and invasive adenomas or inoperable patients. The era of robotic surgery is going to innovate pituitary glands surgery; as a technique, it is to become the gold standard treatment. Future progress will turn minimally invasive surgery into non-invasive treatment of pituitary adenoma sooner or later. This book examines all these issues and provides a prediction of what will happen in the future in the field of minimally invasive surgery, particularly for pituitary adenoma.

The perioperative neuroscience is a specialty that is continuously evolving. This specialty depends on the integration of neuroanaesthesiology, neurology, neurointensive care, neuroradiology, neurointeventional radiology and neurosurgery. This book provides in-depth information for the most recent evidence-based advances in perioperative neurosciences. It includes research on postoperative cognitive dysfunctions, the effect of anaesthetics on the growing brain, the new theories for the development of cerebral aneurysm and cerebral vasospasm, and many more. A unique feature of the book is the world-renowned authorities in anaesthesiology, neurosurgery, neurointensive care, neurology, and neuroradiology and neurointeventional radiology who helped compile it. Consequently, this book will give the reader a unique opportunity to have in-depth coverage for the most recent advances in this very important specialty.

Part of the Challenging Concepts in series, this book is a case-based guide to challenging clinical scenarios in neurosurgery covering the major sub-speciality areas of oncology, vascular neurosurgery, brain and spine trauma, paediatrics, spinal degenerative disease, peripheral and cranial nerves, functional neurosurgery and infection. Specific cases are examined with consideration of clinical presentation, diagnostics, and surgical principles, with a summary of evidence from the neurosurgical literature highlighting areas of interest and controversy. This book serves as a useful and engaging resource for consultants and trainees in neurosurgery as well as in the disciplines of neurology, maxillofacial surgery, spinal surgery and neuro-oncology.

Clinical neurophysiologic testing plays a critical role as a complement to the clinical assessment in patients who are being evaluated for a variety of neurologic symptoms. Many different techniques and methods of assessment can be used to evaluate the function of the nervous system, including electroencephalography, electromyography, evoked potentials, movement disorder studies, and sleep studies. An accurate understanding of the role of these tests and reliable technical performance and interpretation of these studies is critical in clinical practice. This new edition in the Contemporary Neurology Series remains an essential resource for physicians and technologists learning or utilizing clinical neurophysiology in their training or practice. This fifth edition updates the basic concepts underlying each of the techniques used in clinical neurophysiology and provides detailed descriptions of the methods, findings, studies, and value of the wide range of electrophysiologic testing available for patients with epilepsy and spells, neuromuscular diseases, movement disorders, demyelinating diseases, sleep disorders, autonomic disorders, and those undergoing orthopaedic and neurosurgical procedures in the operative setting. The role of each type of study, the interpretation of findings, and the application of the studies to different types of clinical problems are detailed throughout the text. It is a practical textbook for neurologists, physiatrists and clinical neurophysiologists in clinical or research practice or in training.

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 volume contains selected contributions from the XIth Meeting of the European Society for Stereotactic and Functional Neurosurgery held in September 1994 in Antalyaffurkey. Most of the papers deal with the many therapeutic and technical advancements made in this field of neurosurgery. The emergence of new stereotactic methodologies such as frameless stereotaxy and other forms of neuronavigation have become an indispensable tool for all types of neurosurgical operations. An increasing number of young neurosurgeons takes an interest in the neurosurgical approaches to the treatment of movement disorders, chronic pain and epilepsy. This is a clear sign ofthe growing awareness of the long neglected fact that these neurosurgical treatments can be offered to large patient populations. Neurotransplantation as a novel treatment of Parkinson's disease has paved the way for the application of this technology for other indications. The pioneering work performed by the late Edward Hitchcock is reviewed here. There is a renewed interest in pallidotomy for dealing with certain forms of Parkinson's disease and certain aspects of this operation are discussed in another paper. Progress in the neurosurgical treatment of pain is dealt with by contributions on refined techniques of percutaneous cordotomy, DREZ operations and critical evaluations of spinal cord stimulation. A novel approach is a report on the experiences of treating cancer pain by intraspinal implantation of chromaffin cells. Several contributions cover the important issues of novel techniques for the study of neural dysfunction, peroperative monitoring with PET, microrecording, magneto-encephalography and other techniques.

Peripheral nerves are biologic wires that convey the desire for motion from brain to muscle, and the experience of touch from skin to brain. When a nerve is cut, the individual fibers, or axons, must regenerate from the site of injury to reconnect with their skin and muscle targets. Nerve regeneration is a process of bewildering complexity that requires the coordinated action of multiple biologic systems. Gene expression within the neuron is altered to support axon growth, regenerating axons must cross the complex environment of the nerve injury and enter pathways that lead to functionally appropriate end organs, Wallerian degeneration clears these pathways of axon debris, and Schwann cells in the distal nerve must produce growth factors to support regeneration. In spite of this complexity, the surgical repair of transected nerve remains a mechanical process that has changed little in the last century, and that restores normal function to only 10% of adults with nerve injuries. Improving the outcome of nerve repair will require close cooperation between surgeon and scientist. Skyrocketing clinical demands on the surgeon and the rapidly increasing sophistication of neuroscience have interacted to form two distinct cultures. Nerve Repair bridges these cultures by providing a translational review of the clinical and basic science relevant to nerve repair. It provides the clinician with an understanding of pertinent research, and the basic scientist with an overview of the clinical manifestations of nerve injury and regeneration. It is also grounded in the history of peripheral nerve surgery and biology so that modern concepts can be understood in the context of their origins.

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.