Fundamentals of Neurosurgery. A Guide for Clinicians and Medical Students

Description

Foreword Preface Acknowledgments Contents Contributors 1: Neuroanatomy Applied to Clinical Practice Introduction Objective The Central Nervous System Morphological Aspects of the Encephalon or Telencephalon The Brain The Frontal Lobe The Temporal Lobe The Parietal Lobe The Occipital Lobes The Insular Lobes The Limbic Lobe The Diencephalon The Basal Nuclei The Cerebellum The Brainstem Vascularization Suggested Readings and References 2: Basic Neuroimaging Computed Tomography Magnetic Resonance Imaging (MRI) T1 T2 FLAIR Fat Suppression T1 Postcontrast (Gadolinium) Advanced Sequences Susceptibility Sensitive Sequence (T2∗, SWI) DWI and DTI MR Perfusion-Weighted Imaging Spectroscopy Steady-State Gradient Echo Acquisition for CSF Cisternography (FIESTA, CISS) MR Angiography 3: The Basic Neurological Examination Introduction Objective Rationale for Diagnosis in Neurology/Neurosurgery The Neurological Examination “Eloquent” Brain Areas Consciousness and Cognition Gait and Balance Muscular Examination Sensory Evaluation Pupil Examination Coma Cranial Nerves Conclusion Suggested Readings and References 4: Intracranial Hypertension Definition Background Pathophysiology Physical Examination and Clinical Features Additional Work-Up and Monitoring Treatment General Management First Level Measures Second-Line Measures Suggested Readings and References 5: Traumatic Brain Injury Overview and Practice Parameters Traumatic Brain Injury Mechanism Severity Clinical Evaluation First Step: Bedside Physical Exam General Examination Neurological Examination Special Considerations in Examining TBI Patients Pupils Motor Function Imaging and Diagnostic Procedures First Steps and Considerations Computed Tomography Intracranial Lesions (Fig. 5.1a) Epidural Hematoma (Fig. 5.1b) Subdural Hematoma (Fig. 5.1c) Contusions/Intracerebral Hemorrhage (Fig. 5.1d) Penetrating Injury (Fig. 5.1e) Treatment Medical Versus Surgical Management Medical Therapy Blood Pressure and Oxygenation Airway Cardiopulmonary Hyperosmolar Therapy Prophylactic Hypothermia Infection Prophylaxis Deep Venous Thrombosis Prophylaxis Intracranial Pressure Monitoring Intracranial Pressure Monitor Technology Treatment Thresholds and Optimal Cerebral Perfusion Pressure Brain Oxygenation Monitoring and Threshold for Treatment Anesthesia, Analgesics, and Sedatives Nutrition Antiseizure Prophylaxis Hyperventilation Steroids Surgical Therapy Indications for Surgery Special Consideration: Surgery for Diffuse Brain Injury or ICP control Special Considerations: Penetrating Head Injury Ongoing Care Beyond Initial Interventions Imaging Modalities That May Assist in Prognosis and Other TBI-Related Care Computed Tomography Angiography Magnetic Resonance Imaging Clinical Electrophysiology Cerebral Blood Flow Long Term Sequelae of Brain Injury Suggested Readings and References 6: Spinal Trauma Introduction Rationale Epidemiology Diagnosis Radiologic Assessment Classification and Definitive Treatment Upper Cervical Spine/Craniovertebral Junction (CVJ) Subaxial Cervical Spine (C3 to C7) Thoracic and Lumbar Fractures (from T1 to L5) Sacral Fractures Classification According to Injury Morphology and Mechanism Important to Notice Pearls and Important Messages Conclusion Suggested Readings and References 7: Thoracolumbar Spine Trauma Background of Thoracolumbar Spine Thoracolumbar Spine Classification Systems for Thoracolumbar Trauma Brief History of Previous Classification Systems Magerl (AO) Thoracolumbar Injury Classification System AOSpine Thoracolumbar Injury Classification System Burst Fractures Classification Imaging Treatment Chance Fractures Classification Imaging Treatment Thoracolumbar Fracture-Dislocation Classification Imaging Treatment Osteoporotic Vertebral Compression Fracture Classification Imaging Treatment Conclusion Suggested Readings and References 8: Subarachnoid Hemorrhage Introduction Intracranial Aneurysms Epidemiology and Pathophysiology Signs and Symptoms Diagnosis Management and Treatment Initial Medical Management Ruptured Intracranial Aneurysm Treatment Management After Aneurysm Treatment Outcomes Non-aneurysmal Spontaneous SAH Conclusions Suggested Readings and References 9: Neurosurgery for Ischemic and Hemorrhagic Stroke Introduction Ischemic Stroke Acute Management of Ischemic Stroke Mechanical Clot Retrieval Carotid Endarterectomy Carotid Stenting Extra-intracranial Bypass Decompressive Craniectomy Surgery for Hemorrhagic Stroke Acute Management of Hemorrhagic Stroke Intraparenchymal Hematoma Evacuation Arteriovenous Malformation (AVM) Resection Intracranial Aneurysm Clipping/Reconstruction Cavernous Malformation Resection Pearls of Wisdom Suggested Readings and References 10: Hydrocephalus Basic Concepts and Initial Management Introduction Epidemiology Classification Communicating Hydrocephalus Noncommunicating or Obstructive Hydrocephalus Congenital Hydrocephalus Acquired Hydrocephalus Clinical Presentation Radiological Investigation Brain CT Scan Brain Magnetic Resonance Imaging (MRI) Treatment Third Ventriculostomy Normal Pressure Hydrocephalus (NPH) Etiology Neurological Symptoms Diagnosis Treatment Suggested Readings and References 11: Tethered Cord Syndrome Definition Background Etiology Clinical Presentation Additional Work-Up Investigation of Spinal Dysraphism Ultrasound (US) MRI Urological Evaluation Classification Open NTD Myelomeningocele Myelocele and Congenital Kyphosis Closed DNT Without Subcutaneous Mass Filum Terminale Disorders Congenital Dermal Sinus and LDM Split Cord Malformation (SCM) Caudal Regression Syndrome With Subcutaneous Mass Meningocele Terminal Myelocystocele Lipomas Treatment Open NTD: Myelomeningocele Closed NTD Outcome and Prevention Conclusion Suggested Readings and References 12: Craniosynostosis Introduction Cranial Anatomy Craniosynostosis General Diagnostic Approach Sagittal Synostosis Coronal Synostosis Metopic Synostosis Lambdoid Synostosis Positional Plagiocephaly Conclusion Suggested Readings and References 13: Management of Low Back Pain Introduction Rationale Epidemiology Diagnosis Physical Examination Radiologic Assessment Laboratory Assessment Management of Acute Low Back Pain General Aspects Pharmacological Treatment Nonpharmacological Treatment Other Treatment Modalities Management of Chronic Low Back Pain General Aspects Pharmacological treatment Nonpharmacological treatment Outcomes Pearls and Important Messages Conclusions Suggested Readings and References 14: Peripheral Nerve Surgery Definition Background Etiology Epidemiology (Classification) Physical Examination Additional Work-Up Electromyoneurography Entrapment Syndromes Treatment Entrapment Syndromes Peripheral Nerve Traumatic Injury Outcome Suggested Readings and References 15: Degenerative Lumbar Spine Disease Definition Background Etiology Epidemiology Clinical and Radiological Diagnosis Radiological Diagnosis of Lumbar Degenerative Disease Additional Work-Up Evaluation Treatment Axial chronic back pain Lumbar disc herniation Lumbar stenosis Pearls and Important Messages Suggested Readings and References 16: Degenerative Cervical Spine Disease Definition Background Etiology Epidemiology Clinical and Radiological Diagnosis Cervical Axial Pain Cervical Radiculopathy Cervical Myelopathy Radiological Diagnosis of Cervical Degenerative Disease Additional Work-Up Evaluation Treatment Surgical Treatment Pearls and Important Messages Suggested Readings and References 17: Brain Tumors in Adults Epidemiology, Classification, and Diagnosis of Brain Tumors Epidemiology Classification WHO Grading of Tumors of the Central Nervous System Clinical Presentation Management Suggested Readings and References 18: Brain Tumors in Children Epidemiology Clinical Presentation and Diagnosis Treatment and Prognosis of the Most Common Pediatric Tumors Primitive Neuroectoderm Tumors (PNETs) Medulloblastomas Atypical Teratoid Rhabdoid Gliomas Low-Grade Gliomas Brain Stem Tumors High-Grade Gliomas Ependymomas Introduction Pathology Clinical Presentation Radiological Diagnosis Treatment Prognosis Germ Cell Tumors Teratomas Tumor of the Yolk Sac Choriocarcinoma Embryonal Carcinoma Craniopharyngioma Pathology Clinical Presentation Radiological Diagnosis Treatment Prognosis Suggested Readings and References 19: Determination of and Difficulties with Brain Death Definition Historical Perspective International Perspective Causes of Brain Death Special Considerations: The Mimics Hypothermia Drug Intoxication Clinical Determination Special Considerations Apnea Testing Ancillary Testing Electroencephalography Assessment of Brain Blood Flow Radionuclide Imaging of Brain Perfusion Transcranial Doppler Other Ancillary Testing Special Consideration: Children Conclusions Suggested Readings and References 20: The Frontiers of Neurosurgery Introduction Frontiers of Neurosurgery: Neurosurgeon’s Profile Frontiers of Neurosurgery: Technology Frontiers of Neurosurgery: Neuroanatomy Frontiers of Neurosurgery: Functional Surgery Frontiers of Neurosurgery: Neurovascular Surgery Frontiers in Neurosurgery: Neuroocology Frontiers of Neurosurgery: Spine Surgery Conclusions Suggested Readings and References Index