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Medicine - Surgery | Advances and Technical Standards in Neurosurgery

Advances and Technical Standards in Neurosurgery

Cohadon, F. (Ed.)

1998, XIII, 314 p.

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As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbiihl. Thus were established the principles of European co­ operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publi­ cation of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume.

Content Level » Professional/practitioner

Keywords » Arteriovenous Malformations - Intracranial Aneurysms - Intracranial Hypertension - Neuronavigation - glioma - neurology - neurosurgery - psychiatry - surgery - technical standards

Related subjects » Neurology - Oncology & Hematology - Radiology - Surgery

Table of contents 

A. Advances.- The Septal Region and Memory.- Introductory Remarks.- Anatomy of the Septal Region.- Cortical Component: Brodman Area 25.- The Precommissural Septum.- Cholinergic Cell Groups.- Non-cholinergic Neurotransmitters.- Cholinergic-Dopaminergic Interactions.- Major Fiber Tracts Traversing the Septal Region.- Arterial Territories within the Septal Area.- The Anterior Communicating Artery (ACoA).- Branches of the ACoA.- Supply Area of the ACoA Branches.- The Septal Region in Animal Research.- Septal Lesions and Hippocampal Theta Activity.- Electrical Stimulation of the Medial Septum.- The Medial Septum in Aged Animals.- Septal Lesions and Cognition.- Intraseptal Drug Manipulation.- Lesions of Fiber Tracts Traversing the Septal Region.- The Septal Region in Human Research.- Aneurysms of the Anterior Communicating Artery.- Neurosurgical Outcome Studies.- Neuropsychological Case Studies.- Basal Forebrain Tumors.- Anterior Fornical Lesions.- Conclusions.- References.- The in vivo Metabolic Investigation of Brain Gliomas with Positron Emission Tomography.- I. Introduction.- II. Perfusion and Oxygen Metabolism.- III. Glucose Metabolism.- IV. Amino Acids Uptake.- V. Nucleic Acids Metabolism.- VI. Miscellaneous Parameters.- 1. Blood-Tissue Permeability.- 2. Acid-Base Equilibrium.- 3. Receptor Studies.- 4. Polyamine Metabolism.- 5. Tissue Pharmacokinetics of Antimitotic Drugs.- VII. The Contribution of PET to Clinical Neurooncology.- 1. To Establish the Diagnosis.- 2. To Define the Prognosis.- 3. To Predict and Assess the Response to Therapy.- 4. To Differentiate Between Tumor Recurrency and Other Late Processes.- VIII. Conclusions: Specificity of PET and Alternative Methods.- 1. SPECT.- 2. NMRS.- IX. Conclusions.- Acknowledgements.- References.- Use of Surgical Wands in Neurosurgery.- Image Acquisition and Registration.- Registration Methods.- Stereotactic Frame-based Methods.- Frameless Methods.- Curve and Surface Methods.- Other Methods.- The Surgical Planning Process.- Planning Applications.- Planning the Surgical Approach.- Planning Definition/Modification.- Planning Simulation.- Evaluation.- Issues Related to Surgical Planning.- Preplanning and Intraoperative Planning.- On-line Anatomical and Physiological Reference for Surgical Plan Optimization.- Human Interface Factors.- Surgical Planning and Simulation.- Wayne State University Surgical Planning System: Hardware and Software Configuration.- The NSPS Software.- Data Manipulation Modules from the NSPS Software.- Intraoperative Display and Guidance.- Surgeon-Computer Interface.- Intraoperative Digitization.- Passive and Active Digitizing Systems.- Passive Systems.- Modified Stereotactic Frame (Arc Digitizer).- Articulated Arms.- Sonic Digitizers.- Electromagnetic Digitizers.- Optical Digitizers.- Infrared-based Optical Digitizers: The Wayne State University System.- Machine Vision-based Methods.- Active Systems: Robotic Systems.- Robots and the Surgical Microscope.- MKM Robotic Microscope.- The Grenoble Robotized Microscope Support System (MSS) and Surgiscope.- Intraoperative Digitization: Clinical Applications.- Epilepsy Surgery.- Resection of Vascular Malformations.- Spinal Applications.- Discussion.- Conclusion.- References.- Editorial Comment.- B. Technical Standards.- The Endovascular Treatment of Brain Arteriovenous Malformations.- 1. Introduction and Historical Perspective.- 2. Epidemiology, Clinical Presentation and Natural History of Brain AVMs.- 3. Patients and Methods.- 4. Topographic Classification of Brain AVMs.- 5. Angioarchitecture of Brain AVM’s.- 5.1 Feedings Arteries.- 5.2 Arterial High-Flow Angiopathy in Brain AVMs.- 5.3 The Nidus of Brain AVMs and its Angioarchitecture.- 5.4 Draining Veins.- 5.5 Associated Venous Findings and Venous High-Flow Angiopathy.- 6. Indications for Endovascular Treatment.- 7. Technical Aspects.- 7.1 Patient Preparation.- 7.2 General Versus Local Anaesthesia.- 7.3 Neuroangiography Suite and Equipment.- 7.4 Neuroangiographic Investigation.- 7.5 Selection of Cervical Artery or Arteries for Intracranial Navigation.- 7.6 Endovascular Microinstrumentation for Catheterization of Brain AVMs.- 7.7 Superselective Exploration of Brain AVMs.- 7.8 Embolic Materials Used for Embolization of Brain AVMs.- 8. Applications and Goals of Endovascular Treatment of Brain AVMs.- 8.1 Preoperative Embolization.- 8.2 Preradiosurgical Embolization.- 8.3 Palliative Embolization.- 8.4 Postoperative and Postradiosurgical Embolization.- 8.5 Curative Embolization.- 9. Results of Endovascular Treatment of Brain AVMs.- 10. Complications of Endovascular Treatment of Brain AVMs.- 11. Summary and Conclusions.- 12. Acknowledgements.- 13. References.- The Interventional Neuroradiological Treatment of Intracranial Aneurysms.- Cerebral Arteries.- True Aneurysms.- Pseudo-Aneurysms.- Dissecting Aneurysms.- Dimensions and Measurements of Intracranial Aneurysms.- Location.- Clinical Presentation and Incidence.- Age and Sex.- Indications for Treatment.- Endovascular Treatment.- Endovascular Aneurysm Treatment with Sacrifice of the Arterial Axis.- Endovascular Aneurysm Treatment with Preservation of the Parent Artery.- Description of the GDC.- 1. Circular Memory.- 2. Diameter of the Coil.- 3. Diameter of the Platinum Wire.- 4. Length.- Polarity of the Vessel Wall.- Electrothrombosis.- Electrolysis.- Aneurysm Treatment with the GDC Technique: Patient Preparation.- Principles of Treatment.- Aneurysm Treatment.- Results of Treatment.- Complications.- 1. Aneurysm Rupture.- 2. Aneurysm Rebleeding.- 3. Aneurysm Bleeding.- 4. Thromboembolic Events.- Morbid-mortality Rates.- Clinical Follow-ups.- Further Development of the GDC System.- Conclusions.- References.- Benign Intracranial Hypertension. Pseudotumour cerebri: Idiopathic Intracranial Hypertension.- Life with Benign Intracranial Hypertension.- What’s in a name?.- 1. Definition and Historical Aspects.- 2. Incidence.- 3. Clinical Symptoms and Signs.- 3.1 Visual Symptoms of Papilloedema.- 3.2 Visual Field Studies.- 3.3 Miscellaneous Symptoms.- 3.4 Signs — Early Papilloedema.- - Associated Fundal Abnormalities.- - Chronic Papilloedema.- - Flourescein Angiography.- - The Prognosis of Papilloedema.- - Pathophysiology of Papilloedema.- 4. Investigations.- 4.1 Imaging.- 4.2 CSF Studies.- 4.3 Haematology.- 5. Aetiology.- 6. Pathophysiology of Raised CSF Pressure in BIH.- 6.1 Brain (Diffuse Cerebral Oedema).- 6.2 Cerebral Blood Volume.- 6.3 Increased CSF Volume.- 6.3.1 Hypersecretion.- 6.3.2 Reduced CSF absorption.- 7. Management.- 7.1 Initial Assessment.- 7.2 Pregnancy.- 7.3 The Evidence for Therapeutic Efficacy.- 7.4 No Treatment.- 7.5 Weight Reduction Including Bariatric Surgery.- 7.6 Serial Lumbar Puncture.- 7.7 Drug Therapy — Diuretics, Acetazolamide and Digoxin.- - Corticosteroids.- 7.8 Surgery — Indications.- - Subtemporal Decompression.- - CSF Shunts.- - Optic Nerve Sheath Fenestration.- - Techniques.- - Complications.- - Results Including Long Term Follow up.- - Mechanisms of Effect of Optic Nerve Sheath Fenestration.- 7.9 Management of Cerebral Venous Thrombosis.- Acknowledgements.- References.

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