Schmidek and Sweet: Operative Neurosurgical Techniques

Description

Schmidek and Sweet has been an indispensable reference for neurosurgery training and practice for nearly 50 years, and the 7th Edition of Operative Neurosurgical Techniques continues this tradition of excellence. A new editorial board led by editor-in-chief Dr. Alfredo Quinones-Hinojosa, along with more than 330 internationally acclaimed contributors, ensures that readers stay fully up to date with rapid changes in the field. New chapters, surgical videos, and quick-reference features throughout make this edition a must-have resource for expert procedural guidance for today’s practitioners. Discusses indications, operative techniques, complications, and results for nearly every routine and specialized procedure for brain, spinal, and peripheral nerve problems in adult patients.   Covers the latest techniques and knowledge in deep brain stimulation for epilepsy, movement disorders, dystonia, and psychiatric disorders; surgical management of blast injuries; invasive electrophysiology in functional neurosurgery; and interventional management of cerebral aneurysms and arterio-venous malformations.  Includes new chapters on bypass techniques in vascular disease, previously coiled aneurysms, CSF diversion procedures, surgical management of posterior fossa cystic and membranous obstruction, laser-ablation techniques, and brain stem tumors.  Explores hot topics such as wide-awake surgery and ventriculo-peritoneal, ventriculoatrial and ventriculo-pleural shunts.  Provides detailed visual guidance with more than 1,600 full-color illustrations and 50 procedural videos.  Contains quick-reference boxes with surgical pearls and complications.  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. i - 0 i. - Front Matter SCHMIDEK & SWEET Operative Neurosurgical Techniques: Indications, Methods, and Results ii. - Copyright Copyright iii. - Dedication DEDICATION ix - Section Editors SECTION EDITORS v - In Memoriam IN MEMORIAM vii. - About The Author_Editor ABOUT THE AUTHOR/EDITOR viii. - Video and Content Associate Editor VIDEO AND CONTENT ASSOCIATE EDITOR xi - Contributors CONTRIBUTORS Xl - Content id=2MsqEAAAQBAJ&pg=PR40&img=1&zoom=3&hl=en&sig=ACfU3U3YspOPWlgy id=2MsqEAAAQBAJ&pg=PR41&img=1&zoom=3&hl=en&sig=ACfU3U2G-7-_gLFW id=2MsqEAAAQBAJ&pg=PR42&img=1&zoom=3&hl=en&sig=ACfU3U2XGfxh9K1A id=2MsqEAAAQBAJ&pg=PR43&img=1&zoom=3&hl=en&sig=ACfU3U1CRAz2vPL- id=2MsqEAAAQBAJ&pg=PR44&img=1&zoom=3&hl=en&sig=ACfU3U27SvLf3bWG id=2MsqEAAAQBAJ&pg=PR45&img=1&zoom=3&hl=en&sig=ACfU3U2WofBl7Sqq id=2MsqEAAAQBAJ&pg=PR46&img=1&zoom=3&hl=en&sig=ACfU3U1FinEe_LSD xlvii - Video Contents VIDEO CONTENTS xxxix. - Preface PREFACE 1149 - Section 6 1149 - Chapter 98 - Laser Interstitial Thermal Therapy for Epilepsy 98 - Laser Interstitial Thermal Therapy for Epilepsy Introduction The Science of Laser Interstitial Thermal Therapy Surgical Procedure Temporal Lobe Epilepsy Illustrative Case Nodular Heterotopias Illustrative Case Hypothalamic Hamartomas Illustrative Case Corpus Callosotomy Summary Key References References 1160 - Chapter 99 - Multidisciplinary Presurgical Evaluation for Epilepsy Surgery 99 - Multidisciplinary Presurgical Evaluation for Epilepsy Surgery Introduction Clinical Diagnosis: Seizure Description Surface Electroencephalogram Continuous Video/Electroencephalogram Monitoring Neuropsychological Assessment in Surgical Candidates Hemispheric Dominance for Language Lateralization of Memory Deficits Imaging Studies Magnetic Resonance Spectroscopy Functional Magnetic Resonance Imaging Diffusion Tensor Imaging Tractography Positron Emission Tomography Single Photon Emission Computed Tomography Invasive Studies Sphenoidal Electrodes Intracranial Electrodes Intracranial Electrodes and Brain Mapping Transoperative Versus Extraoperative Electrocorticography (ECO) and Brain Mapping Surgical Technique for Subdural Electrode Placement Surgical Technique for Intracerebral Electrodes Focal Epilepsy Detected Near Eloquent Areas Complications Paradigm of Surgical Treatment References 1173 - Chapter 100 - Temporal Lobe Operations in Intractable Epilepsy 100 - Temporal Lobe Operations in Intractable Epilepsy Indications and Patient Selection Temporal Lobe Operations in Intractable Epilepsy ANTERIOR TEMPORAL LOBECTOMY Resection of the Uncus and Amygdala Resection of the Hippocampus Selective Amygdalohippocampectomy Trans-­Sylvian Approach to Amygdalohippocampectomy Seizure Reduction Complications Neuropsychological Morbidity Extent of Resection Tailored Resections Selective Mesial Resection Key References References 1183 - CHAPTER 101 - Surgical Management of Extratemporal Lobe Epilepsy 101 - Surgical Management of Extratemporal Lobe Epilepsy History Hippocrates of Kos (460–370 BC) Surgical Management of Extratemporal Lobe Epilepsy Anterior Thalamic Nucleus Stimulation Centromedian Thalamic Stimulation Subthalamic Nucleus Stimulation Other Deep Brain Targets Patient Selection Operative Technique Complications Closed-­Loop Stimulation Conclusions Key References References 1192 - Chapter 102 - Multilobar Resection and Hemispherectomy in Epilepsy Surgery 102 - Multilobar Resection and Hemispherectomy in Epilepsy Surgery Multilobar Resections Noninvasive Investigations Invasive Investigations Presurgical Planning Anesthetic Considerations Surgical Technique Outcome on Seizures Illustrative Case Hemispherectomy and Hemispheric Disconnection Indications Etiologies Acquired Conditions Congenital Conditions Electroclinical Features Neurologic Functions Preoperative Evaluation Peri-­Insular Hemispherotomy Technical Variations of Peri-­Insular Hemispherotomy Vertical Hemispherotomy Technique Selection Outcome on Seizures Functional Outcome Surgical Complications In Memoriam Key References References 1210 - Chapter 103 - Corpus Callosotomy_ Indications and Techniques 103 - Corpus Callosotomy: Indications and Techniques Modern Indications Preoperative Evaluation Rationale Techniques Postoperative Complications Disconnection Syndrome Language Impairment Outcomes Conclusions Key References References 1215 - Chapter 104 - Extratemporal Epilepsy and Neuromodulation 104 - Extratemporal Epilepsy and Neuromodulation Vagal Nerve Stimulation Extratemporal Epilepsy and Neuromodulation Mechanism of Action Patient Selection Surgical Technique Outcomes Responsive Neurostimulation Patient Selection Surgical Technique Outcomes Deep Brain Stimulation Patient Selection Surgical Technique Outcomes Conclusions Key References References 1223 - Chapter 105 - Implantation of Deep Brain Stimulation Electrodes Under General Anesthesia for Parkinson Disease and Essential Tremor 105 - Implantation of Deep Brain Stimulation Electrodes Under General Anesthesia for Parkinson Disease and Essential Tremor Awake Versus Asleep Deep Brain Stimulation implantation Implantation of Deep Brain Stimulation Electrodes Under General Anesthesia for Parkinson Disease and Essential Tremor Safety of Asleep Deep Brain Stimulation Accuracy of Asleep Deep Brain Stimulation Outcomes of Asleep Deep Brain Stimulation Patient Satisfaction With Asleep Deep Brain Stimulation Technique of Asleep Deep Brain Stimulation Conclusions Key References References 1229 - Chapter 106 - Cervical Dystonia and Spasmodic Torticollis_ Indications and Techniques 106 - Cervical Dystonia and Spasmodic Torticollis: Indications and Techniques Epidemiology Classification and Etiology Classification of Dystonic Conditions Cervical Dystonia and Spasmodic Torticollis: Indications and Techniques Age at Onset Distribution of Affected Body Regions Temporal Pattern Associated Features Structural Pathology Inherited Dystonia Acquired Dystonia Idiopathic Dystonia Other Dystonia-­like Conditions Cervical Dystonia Treatment Strategies Surgery for Dystonic Conditions Deep Brain Stimulation for Dystonic Conditions Development Preoperative Assessment Surgical Considerations and Techniques Postoperative DBS Programming and Patient Management Clinical Overview of Globus Pallidus Internus Deep Brain Stimulation for Cervical Dystonia Conclusion Key References References 1236 - Chapter 107 - Novel Targets and Techniques in Deep Brain Stimulation for Movement Disorders 107 - Novel Targets and Techniques in Deep Brain Stimulation for Movement Disorders Introduction Physiology of the Motor System Adaptive Deep Brain Stimulation Zona Incerta Rostral Zona Incerta Posterior Subthalamic Area/Caudal Zona Incerta Pedunculopontine Nucleus Substantia Nigra Pars Reticulata Centromedian—Parafascicular Complex Conclusions References 1244 - Chapter 108 - Molecular Therapies for Movement Disorders 108 - Molecular Therapies for Movement Disorders Drug/Chemical Infusions Growth Factors/Recombinant Proteins Gene Therapy Basic Science of Gene Therapy Viral Vectors Gene Therapy in Parkinson Disease Future Key References References 1253 - Chapter 109 - Lesion Procedures for Psychiatric Disorders 109 - Lesion Procedures for Psychiatric Disorders Historical Background Lesion Procedures for Psychiatric Disorders Development of Psychiatric Lesion Procedures Obsessive-­Compulsive Disorder Capsulotomy for Obsessive-­Compulsive Disorder Cingulotomy for Obsessive-­Compulsive Disorder Limbic Leucotomy for Obsessive-­Compulsive Disorder Major Depressive Disorder Capsulotomy for Major Depressive Disorder Cingulotomy for Major Depressive Disorder Limbic Leucotomy for Major Depressive Disorder Subcaudate Tractotomy for Major Depressive Disorder Other Psychiatric Indications Conclusion Key References References 1262 - Chapter 110 - Deep Brain Stimulation for Intractable Psychiatric Illness 110 - Deep Brain Stimulation for Intractable Psychiatric Illness Introduction Obsessive-­Compulsive Disorder Depression Tourette Syndrome Issues and Future Directions Key References References 1272 - Chapter 111 - Brain-Computer Interfacing_ Prospects andTechnical Aspects of Functional CranialImplants 111 - Brain-­Computer Interfacing: Prospects and Technical Aspects of Functional Cranial Implants Background Introduction Implantable Neurotechnologies Neuroprosthetics Neuroplastic and Reconstructive Surgery Neuro-­Biohacking Conclusion Key References References 1283 - Chapter 112 - Thoracoscopic Sympathectomy for Hyperhidrosis 112 - Thoracoscopic Sympathectomy for Hyperhidrosis Anatomy and Physiology Thoracoscopic Sympathectomy for Hyperhidrosis Patient Selection Anesthesia Instruments Positioning Procedure Outcomes Complications Conclusions Key References References 1288 - Chapter 113 - Surgery for Intractable Spasticity 113 - Surgery for Intractable Spasticity 1307 - Chapter 114 - Retrogasserian Glycerol Rhizolysis in Trigeminal Neuralgia 114 - Retrogasserian Glycerol Rhizolysis in Trigeminal Neuralgia Probable Mechanisms of Action of Glycerol Retrogasserian Glycerol Rhizolysis in Trigeminal Neuralgia Morphologic Effects of Glycerol Indications Preoperative Evaluation Technique Anesthesia and Sedation Positioning Anatomic Landmarks and Important Structures Trigeminal Cisternography Specific Difficulties Contrast Evacuation Glycerol Injection Branch Selectivity Permanent Marking of the Cistern Special Considerations for Repeated Injection Postoperative Management Results Evaluation of Different Series Short-­ and Long-­Term Results Side Effects and Complications Postoperative Facial Sensory Disturbance Hypesthesia Dysesthesia Infectious Side Effects Herpes Activation Aseptic Meningitis Bacterial Meningitis Special Considerations in Patients With Multiple Sclerosis Glycerol Rhizolysis in the Treatment of Other Types of Facial Pain Retrogasserian Glycerol Rhizolysis Versus Other Operative Treatments for Trigeminal Neuralgia Conclusion Key References References 1323 - Chapter 115 - Percutaneous Stereotactic Rhizotomy in the Treatment of Intractable Facial Pain 115 - Percutaneous Stereotactic Rhizotomy in the Treatment of Intractable Facial Pain Cannulation, Stimulation, and Lesion Production Percutaneous Stereotactic Rhizotomy in the Treatment of Intractable Facial Pain Step 1: Cannulation of the Foramen Ovale Step 2: Stimulation of the Trigeminal Nerve Step 3: Lesion Production Results Recurrence of Trigeminal Neuralgia Sensory Ocular Motor Paresis Herpes Simplex Discussion Technique Refinement of Percutaneous Radiofrequency Rhizotomy Considerations for Other Approaches Summary Key References References 1333 - Chapter 116 - Neurovascular Decompression in Cranial Nerves V, VII, IX, and X 116 - Neurovascular Decompression in Cranial Nerves V, VII, IX, and X Clinical Features General Clinical Presentation Multiple Sclerosis Other Diagnoses Neurovascular Decompression in Cranial Nerves V, VII, IX, and X Imaging First-Line Medications Surgical Indications Positioning Operative Technique Postoperative Care Operative Findings Outcomes Factors Associated with Outcome Repeat Microvascular Decompression for Trigeminal Neuralgia Surgical Complications Conclusions Clinical Features General Clinical Presentation Electromyographic Findings Differential Diagnosis Imaging Botulinum Toxin Other Medications Surgical Indications Preoperative Considerations Operative Technique Operative Findings Outcomes Factors Associated With Outcomes Repeat Microvascular Decompression for Hemifacial Spasm Surgical Complications Conclusion Trigeminal Neuralgia and Hemifacial Spasm Clinical Features General Clinical Presentation Diagnosis Differential Diagnosis Imaging Medical Management Surgical Indications Preoperative Considerations Operative Technique Outcomes Surgical Complications Conclusion Conclusions Key References References 1344 - Chapter 117 - Deep Brain Stimulation for Chronic Pain 117 - Deep Brain Stimulation for Chronic Pain Introduction and History Deep Brain Stimulation Targets Patient Selection Operative Technique Efficacy Phantom Limb Pain Brachial Plexus Avulsion Poststroke Pain Neuropathic Facial Pain and Anesthesia Dolorosa Failed-­Back-­Surgery-­Syndrome Anterior Cingulate Cortex Stimulation Cluster Headache Definitions of Success Conclusion References 1348 - Chapter 118 - Mesencephalic Tractotomy and Anterolateral Cordotomy for Intractable Pain 118 - Mesencephalic Tractotomy and Anterolateral Cordotomy for Intractable Pain Anatomic Background Current Indications for Stereotactic Mesencephalic Tractotomy Preoperative Preparation Operative Procedure Results and Complications Anatomic Background Historical Evolution Current Indications for Stereotactic Percutaneous Cordotomy Surgical Technique Preoperative Preparation Operative Procedure Results and Complications Future of Neuroablative Stereotactic Pain Procedures Conclusions Acknowledgments Key References References 1359 - Chapter 119 - Spinal Cord Stimulation for Chronic Pain 119 - Spinal Cord Stimulation for Chronic Pain New Spinal Cord Stimulation Algorithms Spinal Cord Stimulation for Chronic Pain Conventional Spinal Cord Stimulation for Neuropathic Pain Peripheral Vascular Disease (Peripheral Arterial Occlusive Disease) Conventional Spinal Cord Stimulation for Complex Regional Pain Syndrome Conventional Spinal Cord Stimulation for Angina Pectoris High-­Frequency Spinal Cord Stimulation for Neuropathic/Nociceptive Pain Burst Spinal Cord Stimulation for Neuropathic/Nociceptive Pain Moderate Adaptation of Spinal Cord Stimulation Parameters Electrode Placement and Design Pulse Generators Computerized Methods Screening Protocols Indications for Spinal Cord Stimulation for Pain Neuropathic Pain Failed Back Surgery Syndrome Peripheral Nerve Injury Peripheral Arterial Occlusive Disease Angina Pectoris Neuropathic Pain Failed Back Surgery Syndrome Peripheral Nerve Injury High-­Frequency Spinal Cord Stimulation Clinical Outcomes With Burst Spinal Cord Stimulation Intermediate Spinal Cord Stimulation Frequencies Peripheral Vascular Disease Angina Pectoris Cost Effectiveness Failed Back Surgery Syndrome Peripheral Nerve Injury Peripheral Vascular Disease Angina Miscellaneous Cost Studies Conclusion References 1378 - Chapter 120 - Spinal Cord Stimulation and Intraspinal Infusions for Pain 120 - Spinal Cord Stimulation and Intraspinal Infusions for Pain Mechanism of Action and Device Characteristics Indications and Specific Selection Criteria Description of Technique Complications and Troubleshooting Summary Introduction and General Selection Criteria Drug Selection and Systems Trial, Implantation, and Complications Summary Key References References 1391 - Section 7 1391 - Chapter 121 - Surgical Management of Severe Closed Head Injury in Adults 121 - Surgical Management of Severe Closed Head Injury in Adults Epidemiology Classification Schemes for Traumatic Brain Injury Traumatic Brain Injury Classification Systems for Targeted Therapies Classification Schemes According to Injury Severity Classification Schemes by Pathophysiology Classification Schemes by Prognostic Modeling Biomechanics of Traumatic Brain Injury Neuropathology of Traumatic Brain Injury Specific Features of Traumatic Brain Injury in Elderly People Traumatic Intracranial Hemorrhages Cerebral Contusions: Major Gray Matter Focal Lesions After Traumatic Brain Injury Surgical Treatment of Cerebral Contusions Diffuse Axonal Injury: Basic Concepts Diagnosis of Diffuse Axonal Injury Neuroradiologic Diagnostic Methods in Traumatic Brain Injury Computed Tomography Scanning Magnetic Resonance Imaging Advanced MRI Techniques Non-­Radiologic Diagnostic Methods in Traumatic Brain Injury Serum Biomarkers of Diffuse Axonal Injury Microdialysis in Traumatic Brain Injury Traumatic Brain Injury Monitoring Intracranial Pressure Monitoring: Indications and Methods Surgical Treatment of Traumatic Brain Injury Surgical Treatment of Depressed Skull Fractures Posttraumatic Intracranial Hematomas: Surgical Versus Nonoperative Management Surgical Timing in Posttraumatic Lesions Acute Epidural Hematomas Surgical Technique for Evacuation of Epidural Hematomas Acute Subdural Hematomas Surgical Technique for Evacuation of Acute Subdural Hematomas Traumatic Parenchymal Lesions Hemorrhagic Progression of Contusion/Traumatic Intracerebral Hematoma Surgical Technique for Evacuation of Traumatic Hemorrhagic Parenchymal Lesions Posterior Fossa Hematomas Surgical Technique for Evacuation of Posterior Fossa Hematomas Decompressive Craniectomy Prognosis of Severe Head Injury Predictive Outcome Factors After Severe Head Injury Key References Neuroscience of Traumatic Brain Injury: Structural and Functional Properties of Brain Tissue Determining the Mechanisms of Traum... Cerebral Metabolism and Local Blood Flow Coupling Consciousness Impairment in Traumatic Brain Injury Neurophysiologic Systems Supporting Consciousness Ascending Arousal System Mechanisms of Structural Coma in Traumatic Brain Injury High Intracranial Pressure After Traumatic Brain Injury Brain Herniation Patterns Caused by Intracranial Mass Lesions Diffuse Axonal Injury: The Major White Matter Diffuse Lesion After TBI Axonal Transport: Physiologic Mechanisms Dynamic Process of Traumatic Axonal Injury Mechanisms of Traumatic Axonal Injury: The New Concept of Mechanoporation Axonal Membrane Repair as a Therapeutic Strategy for Diffuse Axonal Injury Traumatic Brain Edema: The Major Gray Matter Diffuse Lesion After Traumatic Brain Injury Types of Brain Edema Cellular Edema in Traumatic Brain Injury: The Role of Astroglia Roles of Aquaporins in The Development of Traumatic Brain Edema Treatment of Traumatic Brain Edema Secondary Brain Damage Caused by Cerebral Ischemia Molecular Cell Pathophysiology of Traumatic Brain Injury Neuronal Dysfunction in Traumatic Brain Injury Glial Dysfunction in Traumatic Brain Injury Reactive Astrogliosis After Traumatic Brain Injury Beneficial Roles of Glial Scar in Central Nervous System Repair Axonal Regeneration After Traumatic Brain Injury Axonal Regeneration Through Well-­Structured White Matter References 1419 - Chapter 122 - Perioperative Management of Severe Traumatic Brain Injury in Adults 122 - Perioperative Management of Severe Traumatic Brain Injury in Adults Perioperative Management of Severe Traumatic Brain Injury in Adults Pupillary Examination Motor Examination Primary Brain Injury Secondary Brain Injury Pathophysiology Cerebral Blood Flow and Cerebral Perfusion Pressure Systemic Contributors to Ischemia: Hypotension and Hypoxia Monitoring Brain Oxygen Monitoring Assessment of Cerebral Blood Flow via Other Modalities Management Principles Pathophysiology Monitoring Intracranial Pressure Monitoring Devices, Indications, and Techniques of Usage Management Principles Positioning Cervical Collar Removal Maintenance of Normocapnia Sedation Hyperosmolar Therapy Osmotic Diuretics Hypertonic Saline Intracranial Hypertension Refractory to First-­Line Treatment Modalities: Second-­Line Treatments Neuromuscular Paralysis Hyperventilation Barbiturate-­Induced Burst Suppression Decompressive Craniectomy Surgical intervention is often performed to reduce ICP in the setting of severe TBI and medically refractory intracranial hypert... Adjunctive Therapy: Lumbar Cerebrospinal Fluid Drainage Therapies to Avoid Steroids Prophylactic Hypothermia Management Paradigms The Use of a Brain-­Tissue Oxygen-­Directed Paradigm in Severe Traumatic Brain Injury Patients Systemic Medical Management Electrolytes and Fluid Balance Glycemic Control Hyperpyrexia Altered Endocrine Function Nutrition Infections Pharmacologic Prophylaxis Prevention of Venous Thromboembolism Traumatic Brain Injury and the Elderly Neuroprotective Interventions in Traumatic Brain Injury Key References References 1438 - Chapter 123 - Decompressive Craniectomy for Traumatic Brain Injury 123 - Decompressive Craniectomy for Traumatic Brain Injury Introduction Historical Perspective Current Evidence Indications and Timing Prognostic Factors Preoperative Evaluation Technique Decompressive Hemicraniectomy Bifrontal Craniectomy Dural Opening and Wound Closure Complications Cerebrospinal Fluid Absorption Disorders Expanding Hematomas Syndrome of the Trephined Future Directions Conclusions Key References References 1445 - Chapter 124 - Management of Skull Base Trauma 124 - Management of Skull Base Trauma Anesthesia and Perioperative Considerations Graft Repair Options Management of Skull Base Trauma Traumatic Skull Base Cerebrospinal Fluid Fistula Indications for Surgery Methods of Surgical Repair Perioperative Considerations Craniotomy for Open Repair of Traumatic Anterior Cranial Skull Base Cerebrospinal Fluid Fistula Skull Base Fractures: Types and Surgical Repair Options Anterior Skull Base Fractures Indications for Surgery Frontal Sinus Repair Options Details of Operative Technique and Surgical Pearls Extracranial Paranasal Repair of Traumatic Skull Base CSF Fistula Diagnosis and Clinical Signs/Symptoms Temporal Bone Surgical Repair Options Suboccipital Skull Base Fractures Suboccipital Decompression for Posterior Fossa Trauma Diagnosis and Clinical Signs and Symptoms Surgical Technique and Pearls Ancillary Cerebrospinal Fluid Diversion Procedures Conclusions Key References References 1458 - Chapter 125 - Surgical Management of Chronic Subdural Hematoma in Adults 125 - Surgical Management of Chronic Subdural Hematoma in Adults Introduction Epidemiology Pathogenesis Clinical Features Radiologic Evaluation Treatment Twist-­Drill Craniostomy Technique Burr-­Hole Craniostomy Technique Craniotomy Technique Comparison of Techniques Drains Irrigation Number of Burr Holes Postoperative Care Outcome Conclusion Key References References 1465 - Chapter 126 - Principles of Neuroplastic Surgery_ Management of Scalp Defects and Neurocranial Reconstruction 126 - Principles of Neuroplastic Surgery: Management of Scalp Defects and Neurocranial Reconstruction Scalp Anatomy Principles of Neuroplastic Surgery: Management of Scalp Defects and Neurocranial Reconstruction Soft Tissue Temporal Hollowing Neuroplastic Principles for Incision Planning Neurosurgical Scalp Closure Evaluation and Treatment Selection Neuroplastic Classification of Scalp Closure/Reconstruction Class 1: Small-­Size Defects (