Glutamate is the major excitatory neurotransmitter in the mammalian central nervous system (CNS). It regulates normal CNS function, is a major participant in pathology, and serves learning, memory, and higher cognitive functions. The 12 chapters of this book provide the first comprehensive coverage of all the major features of glutamate as excitatory neurotransmitter. The book begins with a valuable historical backdrop. Building from a chapter on the common structure of glutamate receptors, several others cover the major ionotropic receptors, their structure, function, and pharmacology. A follow-up chapter discusses the metabotropic receptors that are directly coupled to second messenger metabolism. A central theme of the book is the capacity of the excitatory amino acid system to contribute to the diverse array of signaling systems in the CNS as a direct result of the large assortment of receptors (including, for the ionotropic receptors, various subunits) the combination of which determine distinct functional properties. A recent development in the field discussed in several chapters is the biochemical characterization of a supermolecular protein complex, the post-synaptic density, that makes the unique structure of excitatory synapses. This complex subserves the experience-dependent modulation of synaptic strength and synaptic plasticity, and gives the synapse the capacity to change dynamically in both structure and receptor composition. Drawing on the individual properties of the receptors, transporters, and functional architecture of the synapse, the concluding chapters describe the functional integration of these components in the more complex physiological processes of plasticity and pathology. Recognition that the regulation of excitatory amino acid receptor activity underlies the pathology of many neurological diseases, including stroke, Alzheimer's disease and schizophrenia, has opened up an exciting frontier that will allow the translation of our understanding of these basic mechanisms into new concepts of pathology and new therapeutic strategies. This book will be invaluable for neuroscientists, pharmacologists, neurologists, and psychiatrists, and for their students and trainees.

This book gathers the proceedings of the 17th International Conference on Intracranial Pressure and Neuromonitoring, held in Leuven, Belgium in September 2019. It provides an overview of the current understanding, underlying research and future perspectives concerning pathophysiology, biophysics, monitoring and management in traumatic and non-traumatic acute brain injury, hydrocephalus and spinal cord injury, including cerebrovascular autoregulation impairment in neurological as well as non-neurological diseases. The peer-reviewed contributions were prepared by specialists in neurosurgery, neurointensive care and neuroanesthesiology, as well as prominent experts from the fields of physiology, clinical and biomedical engineering, mathematics and informatics. The book continues the time-honored tradition of publishing key presentations from the ICP Conferences in order to facilitate their dissemination within the clinical and research community.

Fully illustrated and enhanced with accompanying video clips, this comprehensive text presents the clinical evaluation and management of brachial plexus injuries and reconstruction, both for adult patients and birth injuries. Divided into two main sections, part one covers adult brachial plexus injuries, discussing the relevant anatomy and biology, epidemiology, and associated injuries. The main focus, however, is on diagnosis - the clinical exam as well as neurodiagnostic and radiographic evaluation - and surgical management approaches and techniques, including nerve grafting and transfers, tendon and muscle transfers, and joint fusion. Related topics are presented in chapters on sensory reinnervation, neuropathic pain management, the role of amputation and prosthetics, and pre- and post-surgical therapy protocols. Brachial plexus birth injury is described in part two, also focusing mainly on diagnosis and management but with an emphasis on the fact that babies are not small adults and special considerations are warranted. This section concludes with chapters on the management of late complications and long-term sequelae. A comprehensive surgical text on brachial plexus injuries has not been previously attempted. Filling a large gap in the literature, Operative Brachial Plexus Surgery is the go-to resource for adult and birth related brachial plexus reconstruction for orthopedic surgeons, neurosurgeons, plastics surgeons, and their trainees.

This updated second edition provides a practical and succinct overview of basic neuropathology. Key concepts and basic principles are covered and discussed with particular focus on recent advances, classification, and genetics. Practical points are included to detail how to best use the neuropathology service and interpret the results of pathological tests. Neuropathology Simplified aims to aid the development of multidisciplinary teams and help clinical trainees understand recent advances in neuropathological disorders. The book is also relevant to trainee and resident neurologists, pathologists, and neurosurgeons.

This book provides a comprehensive overview of the management of brain and skull base tumors. It features detailed insight into the intrinsic molecular biology, anatomical foundation, radiological planning, surgical execution, and the novel therapeutics that guide today's treatment regimens. The first section features concepts related to the epidemiology and pathological basis of disease processes, including relevant cellular and molecular biology. In the second section, integral anatomical foundations and principles are covered including microsurgical anatomy of the cerebrum, white matter tracts, ventricles, brainstem, skull base, advancements in radiological imaging, and cognitive examinations. Surgical approaches and how to execute these procedures are then subsequently discussed in the third part of the work. Principles of Neuro-Oncology: Brain & Skull Base is a practically applicable guide to the latest treatment techniques available to treat these patients. Therefore, it is an indispensable resource for all physicians who utilize these methodologies in their day-to-day practice.

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.

Many neurological conditions are caused by damage to neurons and glial cells. For most of these diseases there are at present no effective treatments to minimize the extent of neuronal and glial loss, and no effective way of replacing what has been lost. This picture is rapidly changing. Developments in basic neuroscience have produced various potential therapies that can protect neurons and glia following traumatic, anoxic, infectious and immunological damage. The old doctrine that axons cannot be made to regenerate, and dead neurons cannot be replaced is no longer tenable, and a wide variety of reconstructive techniques for the nervous system are under development. These and other basic science discoveries will progress into clinical practice, and lead to a revolution in neurology and neurosurgery. This book describes the various conditions that lead to damage to the nervous system, and the ways in which they may be ameliorated. It covers the burgeoning science of reconstruction of the nervous system, through neuronal, glial and stem cell transplantation, axon regeneration, remyelination, plasticity and pharmacological interventions.

This book integrates neuroscience research on neuroplasticity with clinical investigation of reorganization of function after brain injury, especially from the perspective of eventually translating the findings to rehabilitation. Historical foundationw in neuroplasticity research are presented to provide a perspective for recent findings. Leading investigators synthesize their work with research from other laboratories to provide a current update on neuroanatomic features which enhance enuroplasticity and provide a substrate for reorginaization of function. The capacity for recovery from brain injury associated with focal lesions as compared to diffuse cerebral insult is discussed. Interventions such as environmental enhancement and drugs to enhance reorganizatioin of function after brain injury have been studied in animalmodels and in human studies. Methodologies to study neurophysiological measures, trancranial magnetic stimulation, and computational modeling. Implications of neuroplasticity research for innovations in rehabilitation of persons with brain injury are critically reviewed.

This book, written by renowned experts from across the world, provides readers with a detailed and up-to-date understanding of posterior circulation stroke and its management. Anatomy, pathophysiology, clinical syndromes, and imaging findings are clearly and thoroughly described with the aid of illustrative cases and schematic drawings. The management-oriented chapters explain all forms of treatment, including the use of antiplatelet agents and anticoagulants, thrombolysis, mechanical thrombectomy, stenting, and surgical therapy, i.e., bypass and decompression. Throughout, full account is taken of recent significant advances in knowledge and clinical practice. Stroke affecting the posterior circulation continues to pose particular challenges for clinicians. This book will help readers to avoid misdiagnosis, which still occurs far too frequently, and to manage individual patients optimally. It will be an excellent learning resource for residents in neurology, neurosurgery, radiology, interventional radiology, and vascular surgery, as well as an ideal reference for more experienced practitioners in these specialties.

The aim of this book is to educate and train practitioners in the safe and professional use of diagnostic ultrasound imaging in the visualization and interpretation of various cerebral conditions not only in neurointensive care, but also in the operating room and, in general, cardiothoracic and neurocritical care settings. It is chiefly intended for anaesthetists and intensivists with a basic knowledge of ultrasound physics, but also for neurosurgeons and neurologists. All chapters were coordinated by the Editors, with experiences in hands-on courses on Echography and Doppler of the Brain, and prepared by international experts. The book covers from basic principles to estimation of intracranial pressure and cerebral perfusion. The topics cover emergency department and prehospital brain US as part of POCUS and US multiorgan evaluation to general intensive care, neurointensive care and anesthesia, including special populations as pregnant and children and setting as LMIC. Clinical scenarios complete the book. An innovative and unique guide that equips readers to perform bedside and non-invasive assessments for a range of cerebrovascular diseases.

The earliest human known to have the capability of walking erect on two legs is Sahelanphropus, who lived 6 million years ago. The ability to stand erect led to required extensive changes in the human skeleton, including significant changes in the cervical spine. In modern humans, the cervical spine holds the head upright and gives it great mobility. The combination of great mobility in this spinal segment combined with the requirement that it carry significant weight makes the cervical spine susceptible to a wide variety of pathologies. The cervical spine not only supports the head upright, but acts as a channel for the full set of neural elements connecting the brain with all near and distant parts of the body; thus, pathologies involving the spinal column in this segment directly affect the cervical spinal cord and exiting nerve roots. Today, excellence in spine surgery requires a thorough understanding of spinal anatomy, relevant neurology, and biomechanics, as well as skilled use of a variety of surgical techniques. The surgeon must master the ability to effectively select from a wide and constantly changing variety of alternative instrumentations and surgical approaches. In addition, the trend towards reducing the invasiveness of surgical procedures has led to the use of smaller and smaller tools and smaller surgical incisions with more limited views of the relevant anatomy. As a result of the rapid pace of change, the choice of an optimal technique in any given situation is increasingly complex. In this book, we begin with a basic review of anatomy, neurology, neurophysiology, and biomechanics. We also discuss clinical and radiological assessment required for a differential diagnosis, and present a thorough discussion of the importance of sagittal alignment of the spine and the utility of gait analysis. We proceed with a thorough discussion of nontraumatic pathologies causing cervical myelopathy, beginning with the craniocervical junction down through the subaxial spine, in pediatric and adult populations. This discussion includes steps in the differential diagnosis for specific pathologies, surgical techniques and nuances, radiation-based treatment alternatives, and special topics ranging from the use of stem cells to robotics and endoscopic surgery. We have attempted to provide both fundamental and state-of-the-art knowledge and to share the rich experience of some of the leading spine surgeons worldwide, with the aim of enabling surgeons at all levels to advance their own capabilities for performing safe and successful procedures in this area of complex anatomy.

The quintessential guide to state-of-the-art instrumentation in minimally invasive spine surgery In recent decades, technological innovations in minimally invasive surgery (MIS) have revolutionized spine surgery. The integration of devices tailored to MIS spine techniques has allowed spine surgeons to tackle more complex spinal pathologies and generate new ways to improve clinical outcomes. Instrumentation for Minimally Invasive Spine Surgery by renowned orthopaedic surgeon Kern Singh and esteemed collaborators, provides practical, evidence-based insights into important surgical decisions spine surgeons face every day. The primary goal of this book is to help spine surgeons navigate a daunting number of available devices and leverage the optimal ones to achieve improved patient outcomes. Organized in 3 parts and 16 chapters, the text starts with the past, present, and future of MIS spinal instrumentation. The first two parts detail cutting-edge posterior and lateral approaches with discussion of required devices. The final part covers percutaneous cement augmentation, biologics, and navigation systems. The text combines a thorough review of empirical literature with expert experience and manufacturer specifications to elucidate the advantages and capabilities of currently available instrumentation. Key Highlights Discussion of commonly used MIS spinal instrumentation including retractors; percutaneous pedicle, cortical, and facet screw systems; interbody cages; and fixation systems Concise, yet in-depth technical descriptions include an introduction and potential complications, followed by design features, modular aspects, applicable procedures, and compatible devices for each type High-quality detailed images provide greater understanding of techniques This unique book is an essential surgical companion for orthopaedic and neurosurgical residents and fellows, as well as spine surgeons who wish to incorporate MIS techniques into clinical practice. This book includes complimentary access to a digital copy on https://medone.thieme.com.

This is the second in a sesries of books dealing with the enormous clinical problem of spinal cord dysfunction. Volume I discussed assessment; this book focuses on intervention. There are three main approaches to the restoration of function after damage to the spinal cord: the prevention of seconday pathological events; the identification of impaired or absent functions in nerve cells and processes that survive the initial injury; and restoration of severed neuronal connections. This book addresses the first two of these approaches. It contains a discussion of the arguments about early decompression of the spinal cord following injury, therapy of acute spinal injury, and the effects of early treatment and local cooling on spinal cord blood flow. The management of specific problems associated with spinal cord dysfunction is addressed; these problems include cardiovascular abnormalities due to autonomic dysfunction, bladder control, pain, and sexual function. Current procedures of rehabilitation (particularly the management of chronic problems and the treatment of complications) are summarized, and ideas on motor control and learning are discussed.

This book is a comprehensive, focused resource on intraoperative neurophysiological monitoring (IOM). This rapidly evolving field has created a demand for an up-to-date book such as this that builds on foundational concepts necessary to the practice of IOM in the context of anatomy and physiology. Each chapter is designed to not only inform the reader, but to also test the reader on the information presented - therefore promoting practical, problem-based learning. Surpassing the quality of its successful predecessor, Principles of Neurophysiological Assessment, Mapping, and Monitoring, Second Edition, is positioned to suit the needs of residents and fellows studying for the IOM certificate programs, physicians and anesthesiologists practicing IOM, and neurotechnologists both experienced and in training.

The quintessential guide to endoscopic skull base reconstruction from multidisciplinary experts Due to close collaboration between otorhinolaryngologists and neurosurgeons, endoscopic endonasal brain surgery has become part of the surgical armamentarium for successful treatment of various cranial base pathologies. Today, it is considered the gold standard surgical technique for many types of skull base tumors. Techniques and Key Points for Endoscopic Cranial Base Reconstruction by pioneering otorhinolaryngologist Carlos D. Pinheiro-Neto and neurosurgeon Maria Peris-Celda, co-editor of Thieme's acclaimed Rhoton's Atlas of Head, Neck, and Brain, encompasses the most important endoscopic cranial base reconstruction techniques performed in the last two decades. The book features contributions from an impressive group of additional experts in this field. Comprised of 26 reader-friendly chapters divided into seven sections, the book starts with discussion of general principles of endoscopic cranial base reconstruction. Sections II through VI provide step-by-step descriptions of reconstructive approaches utilizing diverse flaps including nasoseptal, intranasal, extranasal, and free grafts, followed by free flaps. The final section details management of seven challenging cases that enrich practical clinical experience, from free flap reconstruction to recalcitrant cerebrospinal fluid leak. Key Highlights Decision-making rationales and pearls regarding selection of the most efficacious reconstructive techniques. Consistently formatted chapters feature a succinct review of anatomical concepts integral to each procedure, detailed descriptions for each surgical step, and alternative options. High-quality and meticulous anatomical dissections performed at the editors' anatomy laboratory and beautiful illustrations depict the flow of operations essential to understanding surgical nuances. Nineteen narrated videos visually demonstrate techniques and consolidate learning. This must-have, comprehensive resource will help skull base surgeons master the latest techniques, avoid complications, and achieve improved outcomes for their patients. This book includes complimentary access to a digital copy on https://medone.thieme.com.

This issue of Neurosurgery Clinics, guest edited by Dr. Michael A. Vogelbaum, is devoted to Glioblastoma, Part I: Surgical Management and Adjuncts. This is one of four issues selected each year by the series Consulting Editors, Russell R. Lonser and Daniel K. Resnick. Articles in this issue include: Perioperative Management of Patients with Glioblastoma, Role of Resection in Glioblastoma Management, Advancing Imaging to Enhance Surgery, Intraoperative Imaging for High-Grade Glioma Surgery, Use of Intraoperative Fluorophores, Extent of Resection of Glioblastoma, Functional Mapping for Glioma Surgery: Preoperative Mapping Tools, Functional Mapping for Glioma Surgery: Intraoperative Mapping Tools, Surgical Adjuncts for Glioblastoma, Window of Opportunity Clinical Trials to Evaluate Novel Therapies for Brain Tumors, Stereotactic Laser Ablation of Glioblastoma, Radiosurgery for Glioblastoma, Challenges Associated with Reoperation in Patients with Glioma, and Surgery for Glioblastoma in Elderly Patients.

This book presents a comprehensive interdisciplinary team approach to the rehabilitation of acquired brain injury (ABI) survivors. Medical and clinical specialists will receive a deeper understanding of not only each other's roles but of their complementary functions in this field. Many case examples are provided, illustrating a wide range of challenges and stages of recovery. This edition features 3 entirely new chapters and multiple updated chapters by new and returning authors. Featured in the coverage: The role of Robotics in acquired brain injury A comprehensive chapter on physical therapy in ABI Outstanding recoveries woven together by a video news producer who recovered from a meningioma State of the art updates on neurosurgery, neurology, physiatry, neuropsychiatry and neuro-optometry. Updated chapters on neuropsychology, speech-language and occupational therapies including new technology and approaches as well as evidence based practices Psychosocial challenges and treatment following ABI The importance of family as team members Post rehabilitation options and experiences Acquired Brain Injury: An Integrative Neuro-Rehabilitation Approach, 2nd edition provides clarity and context regarding the rehabilitation goals and processes for rehabilitation specialists, interdisciplinary students of neuro-rehabilitation as well as practicing clinicians interested in developing their knowledge in their field.

Here is the first biography to appear in fifty years of Harvey Cushing, a giant of American medicine and without doubt the greatest figure in the history of brain surgery. Drawing on new collections of intimate personal and family papers, diaries and patient records, Michael Bliss captures Cushing's professional and personal life in remarkable detail. Bliss paints an engaging portrait of a man of ambition, boundless, driving energy, a fanatical work ethic, a penchant for self-promotion and ruthlessness, more than a touch of egotism and meanness, and an enormous appetite for life. Equally important, Bliss traces the rise of American surgery as seen through the eyes of one of its pioneers. The book describes how Cushing, working in the early years of the 20th century, developed remarkable new techniques that let surgeons open the skull, expose the brain, and attack tumors-all with a much higher rate of success than previously known. Indeed, Cushing made the miraculous in surgery an everyday event, as he and his team compiled an astonishing record of treating more than two thousand tumors. Moreover, Cushing was also a leading authority on the pituitary gland and a pioneer of endocrinology. And in his spare time, he won a Pulitzer Prize for his massive two-volume biography of William Osler, who was Cushing's colleague. This is the definite Cushing biography, an epic narrative of high surgical adventure. Written by a prize-winning medical historian and acclaimed author, it captures the highs and lows of an extraordinary life, illuminating the contributions of a surgeon who has earned an enduring place in the pantheon of medical history.

A state-of-the-art resource on current and future advances in the treatment of intradural spinal tumors Tumors of the spinal canal provide unique challenges in terms of surgical approaches and oncological treatment. Management requires in-depth knowledge of the intricate anatomical relationships between the tumors and normal spinal pathways, restricted corridors of entry, and limitations of drug penetration. Over the past few decades, significant strides have been made in the treatment of these tumors. Development of minimally invasive techniques and greater understanding of these pathologies has resulted in improved safety, precision, and outcomes. Tumors of the Spinal Canal: Surgical Approaches and Future Therapies by Ankit I. Mehta and esteemed contributors is the most comprehensive textbook written to date on this topic. The book starts with two opening chapters covering an overview and anatomy, followed by three sections and 11 chapters on intramedullary spinal tumors, intradural extramedullary tumors, and peripheral nerve tumors. The comprehensive review encompasses anatomy, pathophysiology, therapeutic and surgical advances, diverse surgical techniques, and future directions. Throughout the text, readers are provided with the necessary tools to master management of these clinically difficult tumors, from both a medical and surgical standpoint. Key Highlights Treatment algorithms, clinical study summaries, and differential diagnoses presented in reader-friendly tables enhance acquisition and retention of knowledge Comprehensive analyses and pearls from masters provide insights on how to manage complications and improve patient outcomes Discussion of current research innovations, clinical trials, and future directions that have the potential to change the treatment paradigm Neurosurgical residents, spine fellows, and complex spine surgeons will benefit from reading this resource, while the intradural spinal tumor treatment paradigms provide an invaluable clinical tool for neurooncologists and oncologists. This book includes complimentary access to a digital copy on https://medone.thieme.com.

Spinal Cord Injury (SCI) Repair Strategies provides researchers the latest information on potential regenerative approaches to spinal cord injury, specifically focusing on therapeutic approaches that target regeneration, including cell therapies, controlled drug delivery systems, and biomaterials. Dr. Giuseppe Perale and Dr. Filippo Rossi lead a team of authoritative authors in academia and industry in this innovative reference on the field of regenerative medicine and tissue engineering. This book presents all the information readers need to understand the current and potential array of techniques, materials, applications and their benefits for spinal cord repair.

Part of the Neurosurgery by Example series, this volume on pain neurosurgery 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 pain neurosurgery, including trigeminal neuralgia, postherpetic neuralgia, occipital neuralgia, percutaneous cordotomy for cancer-associated pain, chronic lumbar radiculopathy, 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, Pain Neurosurgery is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

This series has already become a classic. In general, one volume is published per year. The advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The technical standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions are written by experienced clinicians and are reviewed by all members of the editorial board.

Providing practical, multidisciplinary coverage of the latest diagnostic and multidisciplinary therapeutic approaches for head and neck cancer, the 5th Edition of this award-winning text helps you achieve the best possible surgical outcomes and preserve and restore form and function. Internationally renowned surgeon Dr. Jatin P. Shah, joined by colleagues Snehal G. Patel, Bhuvanesh Singh, and Richard Wong, guides you step by step through every aspect of this challenging field, helping you take advantage of every multidisciplinary management approach available for your patients. Offers complete coverage of the scalp, skull base, paranasal sinuses, oral cavity, pharynx, larynx, cervical lymph nodes, thyroid, salivary glands, and soft tissue and bone tumors - from incidence, diagnosis, and work up through treatment planning, operative techniques, rehabilitation, and outcomes. Features new diagnostic approaches, staging, algorithmic thought processes for therapy selection, and outcomes of treatment for head and neck tumors, allowing for a better overall understanding of head and neck oncology. Includes new information on multimodal management of head and neck cancer; a new Radiation Therapy Glossary; and hundreds of new surgical photographs presented in sequential order from the surgeon's point of view. Provides outcomes of therapy data from the NCDB, institutional data from MSKCC, and evidence-based information throughout. Covers key topics such as radiation oncology, medical oncology including targeted therapies, and maxillofacial prosthodontics and dental oncology. Addresses the day-to-day, practical care of patients with basic operating room techniques and technology, intraoperative decisions, and post-operative care for patients undergoing head and neck surgery. 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.