Advances and Technical Standards in Neurosurgery

by Pickard, J. D.; Dolence, V. V.; Antunes, J. Lobo; Reulen, H. J.; Sindou, M.; Strong, A. J.

• ISBN13: 9783211836057
• ISBN10: 3211836055
• Format: Hardcover
• Copyright: 2002-02-01
• Publisher: Springer Nature

Summary

This series, sponsored by the European Association of Neurosurgical Societies, 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 descript 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.

Table of Contents

List of Contributors	xiii
A. Advances
Neurobiology of Epileptogenesis in the Temporal Lobe
L. Jutila
A. Immonen
K. Partanen
J. Partanen
E. Mervaala
A. Ylinen
I. Alafuzoff
L. Paljarvi
K. Karkola
M. Vapalahti
A. Pitkanen
Introduction	4	(1)
Reorganisation of Neuronal Circuitries Underlying Epileptogenesis in the Hippocampus	5	(6)
Anatomy	5	(2)
Neuron al Loss	7	(1)
Neurogenesis	8	(1)
Gliosis	8	(1)
Axonal Plasticity	9	(1)
Dendritic Plasticity	10	(1)
Reorganisation of Neuronal Circuitries in the Amygdala	11	(3)
Anatomy	11	(2)
Neuronal Loss	13	(1)
Reorganisation of Neuronal Circuitries in the Entorinal Cortex	14	(1)
Anatomy	14	(1)
Neuronal Loss and Sprouting	15	(1)
Conclusions	15	(1)
Acknowledgements	16	(1)
References	16	(8)
Diffuse Axonal Injury after Head Trauma. A Review
J. Sahuquillo
M. A. Poca
Introduction	24	(2)
Fundamental Structure and Function of the Central Nervous System Axon	26	(2)
The Axonal Membrane (Axolemma)	28	(1)
Microtubules and Neurofilaments. The Neuronal Cytoskeleton	29	(1)
Axonal Transport and its Mechanisms	29	(1)
Calcium and Calcium-Dependent Breakdown of Neurofilaments	30	(1)
Physiopathology of Head Injury. Diffuse Versus Focal Injuries	31	(1)
Post-Traumatic Cellular Events and the Concept of Traumatic Penumbra	32	(1)
Classical Definition of Traumatic Diffuse Axonal Injury	33	(1)
Biomechanics of Diffuse Axonal Injury	34	(2)
Characteristics of Mechanical Loading	35	(1)
The Centripetal Theory of Ommaya	36	(1)
The Centripetal Theory and the Concept of Primary Brainstem Injury	36	(1)
The Reticular Formation and the Primary Brainstem Damage Saga	37	(1)
Clinical and Experimental Validation of the Centripetal Theory	38	(1)
The Neuropathological Spectrum of DAI	39	(4)
Focal Lesions Observed in the Brain in DAI	40	(2)
Pathogenesis of the Corpus Callosum Hemorrhages	42	(1)
Neuropathological Grading of DAI	43	(1)
Axonal Retraction Balls, Microglial Stars and Wallerian Degeneration	43	(8)
Axonal Retraction Balls	46	(4)
Microglial Clusters (Microglial Stars)	50	(1)
Wallerian Degeneration	50	(1)
Experimental Models of DAI	51	(2)
Marmarou's Rodent Model of DAI	51	(2)
Changing Concepts in Diffuse Axonal Injury. Is DAI Always a Primary Lesion?	53	(1)
Experimental Evidence of Secondary Axotomy in Closed Head Injuries	54	(3)
Pathogenesis of Diffuse Axonal Injury	57	(1)
Stage I: Axonal Membrane Injury and Alterations in Ionic Fluxes	57	(1)
Stage II: Reversible Cytoskeletal Damage	57	(1)
Stage III: Secondary Axotomy	57	(1)
Stage IV: Primary Axotomy	58	(1)
Mechanoporation, Calcium Influx and Cytoskeletal Abnormalities	58	(3)
Is Diffuse Axonal Injury a Universal Finding after Severe Head Injury?	61	(2)
Clinico-Radiological Diagnosis of Diffuse Axonal Injury	63	(6)
Cranial Fractures in Patients with Diffuse Axonal Injury	63	(1)
CT Scan Findings	64	(2)
The Role of MRI in the Study of Postraumatic DAI	66	(3)
Diffuse Axonal Injury in Minor Head Injuries	69	(1)
Late Consequences of DAI	70	(3)
Specific Therapies that may be Effective Against DAI	73	(2)
Magnesium-the Magic Bullet?	73	(1)
Neuroprotective Effects of Hypothermia	74	(1)
Cyclosporin-A and its Effect on DAI	75	(1)
Hope for the Future	75	(2)
Acknowledgments	77	(1)
References	77	(11)
Multi-Modal Monitoring of Acute Brain Injury
R. Kett-White
P. J. Hutchinson
M. Czosnyka
S. Boniface
J. D. Pickard
P. J. Kirkpatrick
Abstract	88	(1)
Introduction	88	(3)
Aspects of Cerebral Pathophysiology	91	(13)
Relationships Between ICP, CPP and Cerebral Blood Flow	91	(6)
Transcranial Doppler Ultrasonography for Assessing Autoregulation	97	(1)
Static Test of Autoregulation	98	(1)
TCD Reactivity of Changes in Arterial Carbon PaCO2	99	(1)
Dynamic Test of Autoregulation	99	(1)
Transient Hyperaemic Response Test	99	(1)
Continuous analysis of TCD Using Respiratory Waves	100	(1)
Continuous analysis of TCD Flow Velocity Waveform	101	(1)
Non-Invasive Assessment of Brain Perfusion	101	(1)
Computer Support for Data Analysis	101	(2)
Continuous EEG monitoring	103	(1)
Aspects of Cerebral Oxygenation-Brain Gas Analysis	104	(13)
Jugular Bulb Oximetry	105	(1)
Normal Values and Ischaemic Thresholds	105	(1)
Arteriovenous Difference in Oxygen Content	105	(1)
Factors which influence SjvO2	106	(1)
Arterial Oxygen Content	106	(1)
Cerebral Blood Flow and Perfusion Pressure	106	(1)
Cerebral Metabolic Rate	107	(1)
Clinical Use of SjvO2	107	(1)
Brain Tissue Oxygen Probes	108	(1)
Normal Values for PtiO2	109	(1)
Ischaemic Thresholds of PtiO2	109	(3)
Factors that Influence PtiO2	112	(1)
Hypoxia	112	(1)
Cerebral Perfusion Pressure	112	(1)
Hypocapnia	113	(1)
Cerebral Blood Flow	114	(1)
Cerebral Metabolic Rate	115	(1)
Hyperoxia	116	(1)
Probe Depth	116	(1)
Aspects of Cerebral Metabolism-Microdialysis	117	(5)
Methodology	117	(1)
Microdialysis Pumps	118	(1)
Microdialysis Catheters	118	(1)
Chemical Analysis	119	(1)
Catheter Fixation	119	(1)
Clinical Applications	120	(2)
Conclusion	122	(2)
Acknowledgements	124	(1)
References	124	(13)
B. Technical Standards
Endoscopic Endonasal Transsphenoidal Surgery
E. de Divitiis
P. Cappabianca
Introduction	137	(1)
History	138	(1)
Pre-Operative Study	139	(6)
Indications	145	(2)
Surgical Technique	147	(11)
Nasal Phase	152	(1)
Natural Ostium Enlargement	153	(1)
Preparation of the Sphenoid Sinus and Opening of the Sella	154	(1)
Tumor Removal	154	(4)
Clinical Material	158	(5)
Discussion	163	(7)
Acknowledgments	170	(1)
References	170	(9)
Extracranial Vertebral Artery Anatomy and Surgery
B. George
Introduction	179	(1)
Surgical Anatomy	180	(4)
Surgical Exposure	184	(6)
Anterolateral Approach (ALA)	184	(1)
First Segment	185	(1)
Second Segment	186	(2)
Third Segment	188	(1)
Posterolateral Approach (PLA)	189	(1)
Indications of VA Surgical Exposure	190	(20)
Intrinsic Lesions	190	(3)
Extrinsic Lesions	193	(1)
Intermittent Compression	194	(1)
Permanent Compression	195	(3)
Improvement of Exposure	198	(1)
Anterior Part of the Spinal Canal	198	(3)
Foramen Magnum	201	(5)
Jugulare Foramen Tumors - Juxtacondylar Approach	206	(3)
Personal Experience	209	(1)
Conclusion	210	(1)
References	211	(6)
Neurosurgical Management of Pineal Tumours
Y. Sawamura
N. de Tribolet
Introduction	217	(3)
Incidence of Pineal Tumours	220	(1)
Surgical Strategy with Consideration of Postsurgical Adjuvant Therapies	220	(4)
Surgical Anatomy	224	(3)
Selection of Approaches	227	(2)
Surgical Approaches	229	(10)
Instrumentation	229	(1)
Occipital Transtentorial Approach	229	(6)
Infratentorial Supracerebellar Approach	235	(4)
Complications	239	(1)
Conclusion	240	(1)
Acknowledgment	241	(1)
References	241