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Handbook of Neurosurgery

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The updated 8th edition of the Handbook of Neurosurgery in backpack format (20  12.5  5 cm) is an outstanding reference book for day-to-day neurosurgical practice. The book is divided in 24 parts and in 102 chapters in total. This classic handbook covers the full depth and breadth of the clinical neurosciences. The three introductory parts deal with anatomy and physiology, neurology and imaging/diagnostics. The book covers really all aspects of neurosurgery with parts on developmental anomalies, coma and brain death, infection, hydrocephalus, seizures, peripheral nerves, neurophthalmology and neurotology, tumors, head and spine trauma, spine and spinal cord, subarachnoid hemorrhage and aneurysms, vascular malformations, stroke and occlusive cerebrovascular disease, intracerebral hemorrhage, differential diagnosis and finally, on procedures, interventions and operations. Each chapter is clearly written and nicely illustrated. This handbook is an invaluable resource for anyone involved in the care of patients with disorders of the central nervous system- from nurses and medical students to neurological and (neuro) surgical residents, and allied healthcare practitioners. It is a good reference for a general practitioner as well 1).

The Handbook of Neurosurgery has enjoyed legendary status on the bookshelf of every neurosurgery department for over a quarter of a century. Renowned for its scope and accessibility, the portable, single-volume guide is an invaluable resource for anyone involved in the care of patients with disorders of the central nervous system – neurosurgical residents, nurses, neurologists, and allied healthcare practitioners.

This classic handbook covers the full depth and breadth of the complex field of neurosurgery – including inherited and acquired neurological disorders, developmental anomalies, and more esoteric topics such as toxins that impact the central nervous system. The text also covers conditions treated primarily by neurologists that may come to the attention of a neurosurgical care provider such as Parkinsonism, multiple sclerosis, motor neuron diseases, and dementia. The latest information is provided on anatomy and physiology, differential diagnosis, and current principles of nonsurgical and surgical management covering the full age continuum – from pediatric to geriatric conditions.

Expanded four-color graphics and illustrations

Packed with more than 1,600 pages of practical information, including thousands of literature citations, handy cross-references, and a comprehensive index

Fundamentals of Neurosurgical intensive care unit, with a comprehensive overview of conditions – from SAH to head and spine trauma – and complications such as rebleeding, vasospasm, cerebral salt wasting, and brain death

Comprehensive and conveniently compact, this is a must-have daily reference, a perfect study companion for board exams, as well as ideal for maintenance of certification preparation. It is certain to be a treasured tome for legions of new neurosurgery residents and an essential tool for anyone working in the clinical neurosciences.

Contents Anatomy and Physiology 1 GrossAnatomy,CranialandSpine ……………. 58 1.1 Corticalsurfaceanatomy………………………….. 58 1.2 Centralsulcusonaxialimaging…………………….. 60 1.3 Surfaceanatomyofthecranium……………………. 61 1.4 Surfacelandmarksofspinelevels…………………… 65 1.5 Cranialforaminaandtheircontents…………………. 65 1.6 Internalcapsule …………………………………. 67 1.7 Cerebellopontineangleanatomy…………………… 67 1.8 Occipitoatlantoaxial-complexanatomy ……………… 68 1.9 Spinalcordanatomy……………………………… 70 2 VascularAnatomy……………………………. 75 2.1 Cerebralvascularterritories……………………….. 75 2.2 Cerebralarterialanatomy…………………………. 75 2.3 Cerebralvenousanatomy…………………………. 85 2.4 Spinalcordvasculature …………………………… 87 3 Neurophysiology and Regional Brain Syndromes 90 3.1 Neurophysiology………………………………… 90 3.2 Regionalbrainsyndromes…………………………. 96 3.3 Jugularforamensyndromes……………………….. 100 General and Neurology 4 Neuroanesthesia……………………………… 104 4.1 Generalinformation……………………………… 104 4.2 Drugsusedinneuroanesthesia…………………….. 104 4.3 Anesthetic requirements for intra-operative evoked potentialmonitoring …………………………….. 107 4.4 Malignanthyperthermia………………………….. 108 29 Ebooksmedicine.net

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Contents 5 SodiumHomeostasisandOsmolality………… 110 5.1 Serum osmolalityand sodium concentration. . . . . . . . . . . . . 110 5.2 Hyponatremia ………………………………….. 110 5.3 Hypernatremia………………………………….. 119 6 GeneralNeurocriticalCare……………………. 126 6.1 Parenteralagentsforhypertension…………………. 126 6.2 Hypotension(shock) …………………………….. 127 6.3 Acidinhibitors………………………………….. 129 7 Sedatives,Paralytics,Analgesics……………… 132 7.1 Sedativesandparalytics ………………………….. 132 7.2 Paralytics (neuromuscular blocking agents). . . . . . . . . . . . . . 134 7.3 Analgesics……………………………………… 136 8 Endocrinology……………………………….. 144 8.1 Corticosteroids………………………………….. 144 8.2 Hypothyroidism…………………………………. 148 8.3 Pituitary embryology and neuroendocrinology. . . . . . . . . . . 149 9 Hematology………………………………….. 153 9.1 Generalinformation……………………………… 153 9.2 Bloodcomponenttherapy………………………… 153 9.3 Extramedullaryhematopoiesis…………………….. 171 10 NeurologyforNeurosurgeons ……………….. 174 10.1 Dementia………………………………………. 174 10.2 Headache………………………………………. 174 10.3 Parkinsonism …………………………………… 176 10.4 Multiplesclerosis………………………………… 179 10.5 Acutedisseminatedencephalomyelitis………………. 182 10.6 Motorneurondiseases…………………………… 182 10.7 Guillain-Barrésyndrome………………………….. 184 Ebooksmedicine.net

10.8 Myelitis................................................ 187

10.9 Neurosarcoidosis………………………………… 189 11 Neurovascular Disorders and Neurotoxicology . . 194 11.1 Posterior reversible encephalopathy syndrome (PRES) . . . . 194 11.2 Crossedcerebellardiaschisis ………………………. 194 11.3 Vasculitisandvasculopathy ……………………….. 195 11.4 Neurotoxicology…………………………………. 204 Imaging and Diagnostics 12 PlainRadiologyandContrastAgents…………. 212 12.1 C-Spinex-rays…………………………………… 212 12.2 Lumbosacral(LS)spinex-rays ……………………… 216 12.3 Skullx-rays……………………………………… 216 12.4 Contrastagentsinneuroradiology………………….. 219 12.5 Radiationsafetyforneurosurgeons…………………. 223 13 ImagingandAngiography……………………. 227 13.1 CATscan(AKACTscan)……………………………. 227 13.2 Magneticresonanceimaging(MRI)…………………. 228 13.3 Angiography……………………………………. 236 13.4 Myelography……………………………………. 236 13.5 Radionuclidescanning……………………………. 236 14 Electrodiagnostics……………………………. 238 14.1 Electroencephalogram(EEG)………………………. 238 14.2 Evokedpotentials………………………………… 238 14.3 NCS/EMG……………………………………….. 242 Developmental Anomalies 15 PrimaryIntracranialAnomalies………………. 248 15.1 Arachnoid cysts, intracranial . . . ……………………. 248 15.2 Craniofacial development . . . . . . ……………………. 251 Contents 31 Ebooksmedicine.net

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Contents 15.3 DandyWalkermalformation………………………. 256 15.4 Aqueductalstenosis……………………………… 258 15.5 Agenesisofthecorpuscallosum……………………. 259 15.6 Absenceoftheseptumpellucidum…………………. 260 15.7 Intracraniallipomas……………………………… 260 15.8 Hypothalamichamartomas……………………….. 261 16 PrimarySpinalAnomalies……………………. 265 16.1 Spinalarachnoidcysts……………………………. 265 16.2 Spinaldysraphism(spinabifida)……………………. 265 16.3 Klippel-Feilsyndrome ……………………………. 271 16.4 Tetheredcordsyndrome………………………….. 272 16.5 Splitcordmalformation ………………………….. 274 16.6 Lumbosacralnerverootanomalies…………………. 275 17 PrimaryCraniospinalAnomalies……………… 277 17.1 Chiarimalformations…………………………….. 277 17.2 Neuraltubedefects ……………………………… 287 17.3 Neurenteric cysts. . ………………………………. 290 Coma and Brain Death 18 Coma……….. ………………………………. 296 18.1 Generalinformation……………………………… 296 18.2 Posturing………………………………………. 297 18.3 Etiologiesofcoma……………………………….. 297 18.4 Herniationsyndromes……………………………. 302 18.5 Hypoxiccoma…………………………………… 305 19 BrainDeathandOrganDonation…………….. 307 19.1 Braindeathinadults …………………………….. 307 19.2 Braindeathcriteria…………. …………………… 307 19.3 Braindeathinchildren………. …………………… 312 19.4 Organ and tissue donation . . . . . . …………………… 313 Ebooksmedicine.net

Infection

20 Bacterial Infections of the Parenchyma and MeningesandComplexInfections………. 20.1 Meningitis………………………………… 20.2 Cerebralabscess……………………………. 20.3 Subduralempyema…………………………. 20.4 NeurologicinvolvementinHIV/AIDS…………… 20.5 Lyme disease – neurologic manifestations. . . . . . . . . . 20.6 Nocardiabrainabscess………………………. 21 Skull, Spine, and Post-Surgical Infections . . 21.1 Shuntinfection…………………………….. 21.2 External ventricular drain (EVD)-related infection . . . 21.3 Woundinfections…………………………… 21.4 Osteomyelitisoftheskull……………………. 21.5 Spineinfections……………………………. 22 OtherNonbacterialInfections…………… …… 318 …… 318 …… 320 …… 327 …… 329 …… 334 …… 335 …… 339 …… 339 …… 342 …… 345 …… 348 …… 349 …… 364 22.1 Viralencephalitis…………………………… 22.2 Creutzfeldt-Jakobdisease …………………………. 367 22.3 ParasiticinfectionsoftheCNS……………………… 371 22.4 FungalinfectionsoftheCNS……………………….. 376 22.5 AmebicinfectionsoftheCNS………………………. 377 Hydrocephalus and Cerebrospinal Fluid (CSF) 23 CerebrospinalFluid…………………………… 382 23.1 Generalinformation……………………………… 382 23.2 Production……………………………………… 382 23.3 Absorption……………………………………… 382 23.4 CSFconstituents…………………………………. 382 23.5 CranialCSFfistula ……………………………….. 384 23.6 SpinalCSFfistula ………………………………… 386 23.7 MeningitisinCSFfistula…………………………… 386 …… 364 Contents 33 Ebooksmedicine.net

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Contents 23.8 EvaluationofthepatientwithCSFfistula……………. 387 23.9 TreatmentforCSFfistula………………………….. 388 23.10 Intracranialhypotension(spontaneous)……………… 389 24 Hydrocephalus–GeneralAspects……………. 394 24.1 Basicdefinition………………………………….. 394 24.2 Epidemiology…………………………………… 394 24.3 Etiologiesofhydrocephalus……………………….. 394 24.4 SignsandsymptomsofHCP……………………….. 395 24.5 CT/MRIcriteriaofhydrocephalus…………………… 398 24.6 Di erentialdiagnosisofhydrocephalus……………… 399 24.7 ChronicHCP……………………………………. 400 24.8 External hydrocephalus (AKA benign external hydrocepha- lus)……………………………………………. 400 24.9 X-linkedhydrocephalus…………………………… 401 24.10 “Arrestedhydrocephalus” ………………………… 402 24.11 Entrappedfourthventricle………………………… 402 24.12 Normalpressurehydrocephalus(NPH)………………. 403 24.13 Hydrocephalusandpregnancy…………………….. 410 25 TreatmentofHydrocephalus…………………. 414 25.1 Medicaltreatmentofhydrocephalus ……………….. 414 25.2 Spinaltaps……………………………………… 414 25.3 Surgical………………………………………… 414 25.4 Endoscopicthirdventriculostomy………………….. 415 25.5 Shunts…………………………………………. 416 25.6 Shuntproblems…………………………………. 419 25.7 Specificshuntsystems……………………………. 427 25.8 Surgicalinsertiontechniques ……………………… 435 25.9 Instructionstopatients…………………………… 435

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Seizures

26 Seizure Classification and Anti-Convulsant Pharmacology………………………………… 440 26.1 Seizureclassification……………………………… 440 26.2 Antiepilepticdrugs………………………………. 443 27 SpecialTypesofSeizures……………………… 461 27.1 Newonsetseizures………………………………. 461 27.2 Posttraumaticseizures……………………………. 462 27.3 Alcoholwithdrawalseizures……………………….. 464 27.4 Nonepilepticseizures…………………………….. 464 27.5 Febrileseizures………………………………….. 467 27.6 Statusepilepticus………………………………… 468 Pain 28 Pain…………………………………………… 476 28.1 Generalinformation……………………………… 476 28.2 Neuropathicpainsyndromes………………………. 476 28.3 Craniofacialpainsyndromes……………………….. 477 28.4 Postherpeticneuralgia……………………………. 493 28.5 Complexregionalpainsyndrome(CRPS)…………….. 497 Peripheral Nerves 29 PeripheralNerves…………………………….. 504 29.1 Generalinformation……………………………… 504 29.2 Muscleinnervation………………………………. 506 29.3 Peripheralnerveinjury/surgery…………………….. 509 30 EntrapmentNeuropathies……………………. 515 30.1 Generalinformation……………………………… 515 30.2 Mechanismofinjury……………………………… 515 30.3 Occipitalnerveentrapment ……………………….. 515 Contents 35 Ebooksmedicine.net

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Contents 30.4 Mediannerveentrapment………………………… 517 30.5 Ulnarnerveentrapment………………………….. 526 30.6 Radialnerveinjuries……………………………… 532 30.7 Axillarynerveinjuries ……………………………. 533 30.8 Suprascapularnerve……………………………… 533 30.9 Meralgiaparesthetica ……………………………. 534 30.10 Obturatornerveentrapment………………………. 535 30.11 Femoralnerveentrapment………………………… 535 30.12 Commonperonealnervepalsy…………………….. 535 30.13 Tarsaltunnel……………………………………. 538 31 Non-Entrapment Peripheral Neuropathies. . . . . . . 541 31.1 Definitions……………………………………… 541 31.2 Etiologiesofperipheralneuropathy ………………… 541 31.3 Classification……………………………………. 541 31.4 Clinical………………………………………… 542 31.5 Syndromesofperipheralneuropathy……………….. 542 31.6 Peripheralnerveinjuries………………………….. 550 31.7 Missileinjuriesofperipheralnerves ………………… 553 31.8 Thoracicoutletsyndrome………… ………………. 554 Neurophthalmology and Neurotology 32 Neurophthalmology…………. ………………. 558 32.1 Nystagmus…………………………………….. 558 32.2 Papilledema ……………………………………. 558 32.3 Visualfields…………………………………….. 559 32.4 Visualfielddeficits………………………………. 559 32.5 Pupillarydiameter ………………………………. 560 32.6 Extraocularmuscle(EOM)system ………………….. 565 32.7 Neurophthalmologicsyndromes …………………… 569 32.8 Miscellaneousneurophthalmologicsigns……………. 570 Ebooksmedicine.net

33 Neurotology......................................... 572

33.1 Dizzinessandvertigo…………………………….. 572 33.2 Meniere’sdisease………………………………… 573 33.3 Facialnervepalsy………………………………… 576 33.4 Hearingloss…………………………………….. 580 Primary Tumors of the Nervous and Related Systems: Tumors of Neuroepithelial Tissue 34 General Information, Classification and Tumor Markers………………………………………. 584 34.1 Classificationofnervoussystemtumors …………….. 584 34.2 Braintumors–generalclinicalaspects………………. 590 34.3 Pediatricbraintumors……………………………. 593 34.4 Medicationsforbraintumors………………………. 594 34.5 Chemotherapyforbraintumors……………………. 595 34.6 Intraoperative pathology consultations (“frozen section”). 596 34.7 Select commonly utilized stains in neuropathology . . . . . . . 598 35 SyndromesInvolvingTumors…………………. 603 35.1 Neurocutaneousdisorders ………………………… 603 35.2 Familialtumorsyndromes…………………………. 610 36 Astrocytomas………………………………… 612 36.1 Incidence,riskfactors…………………………….. 612 36.2 Classification and grading of astrocytic tumors . . . . . . . . . . . 612 36.3 Moleculargeneticsandepigenetics…………………. 616 36.4 Miscellaneouspathologicalfeatures ………………… 617 36.5 Neuroradiologicalgradingandfindings……………… 617 36.6 Spread…………………………………………. 618 36.7 Multiplegliomas ………………………………… 619 36.8 Treatment………… ……… ……………………. 619 36.9 Outcome…………. ……… ……………………. 624 Contents 37 Ebooksmedicine.net

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Contents 37 OtherAstrocyticTumors……………………… 629 37.1 Pilocyticastrocytomas……………………………. 629 37.2 Pleomorphicxanthoastrocytoma(PXA)……………… 635 38 Oligodendroglial Tumors and Tumors of the Ependyma, Choroid Plexus, and Other NeuroepithelialTumors…………….. 38.1 Oligodendroglialtumors………………… 38.2 Oligoastrocytictumors…………………. 38.3 Ependymaltumors…………………….. 38.4 Neuronalandmixedglialtumors…………. 38.5 Choroidplexustumors …………………………… 648 38.6 Otherneuroepithelialtumors……………………… 649 39 Neuronaland Mixed Neuronal-GlialTumors. . . . . 651 39.1 Ganglioglioma………………………………….. 651 39.2 Paraganglioma………………………………….. 652 39.3 Neuroblastomas ………………………………… 657 40 PinealRegion and EmbryonalTumors. . . . . . . . . . . . 658 40.1 Pinealregiontumors…………………………….. 658 40.2 Embryonaltumors………………………………. 663 41 Tumors of Cranial, Spinal and Peripheral Nerves 670 41.1 Vestibularschwannoma ………………………….. 670 41.2 Tumorsofperipheralnerves:Perineurioma………….. 687 42 Meningiomas…… 42.1 Generalinformation… 42.2 Epidemiology……… 42.3 Common locations . . . . 42.4 Pathology ………… 42.5 Presentation………. 42.6 Evaluation ………… ……… ……… ……… ……… ……… ……… ……… …………………… 690 …………………… 690 …………………… 690 …………………… 690 …………………… 693 …………………… 695 …………………… 695 ……….. 638 ……….. 638 ……….. 641 ……….. 642 ……….. 645 Ebooksmedicine.net

42.7 Treatment........................................ .

42.8 Outcome………………………………….. . 43 Other Tumors Related to the Meninges . . . . . 43.1 Mesenchymal, non-meningothelial tumors . . . . . . . . . . 43.2 Primarymelanocyticlesions………………….. . 43.3 Hemangioblastoma…………………………. . Tumors Involving Non-Neural Origin: Metastases, Lymphomas, Chordomas 44 LymphomasandHematopoieticNeoplasms 44.1 CNSlymphoma……………………………… 44.2 Multiplemyeloma…………………………… 44.3 Plasmacytoma………………………………. ….. 696 ….. 698 ….. 701 ….. 701 ….. 701 ….. 701 ….. 710 ….. 710 ….. 714 ….. 716 45 Pituitary Tumors – General Information and Classification…………………………….. ….. 718 45.1 Generalinformation……………………………… 718 45.2 Generaltumortypes……………………………… 718 45.3 Epidemiology…………………………………… 718 45.4 Di erentialdiagnosisofpituitarytumors ……………. 718 45.5 Clinicalpresentationofpituitarytumors…………….. 719 45.6 Specifictypesofpituitarytumors…………………… 721 46 Pituitary Adenomas – Evaluation and NonsurgicalManagement ……………………. 730 46.1 Evaluation………………………………………. 730 46.2 Management/treatment recommendations . . . . . . . . . . . . . . 737 46.3 Radiationtherapyforpituitaryadenomas……………. 744 47 Pituitary Adenomas – Surgical Management, Outcome, and Recurrence Management . . . . . . . . . 747 47.1 Surgicaltreatmentforpituitaryadenomas…………… 747 47.2 Outcome following transsphenoidal surgery . . . . . . . . . . . . . 753 47.3 Management of recurrent pituitary adenomas. . . . . . . . . . . . 755 Contents 39

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Contents 48 CystsandTumor-LikeLesions………. 48.1 Rathke’scleftcyst……………………… 48.2 Colloidcyst…………………………… 48.3 Epidermoidanddermoidtumors…………. 48.4 Craniopharyngioma……………………. 49 Pseudotumor Cerebri and Empty Sella Syndrome………………………….. 49.1 Pseudotumorcerebri…………………… 49.2 Emptysellasyndrome………………….. 50 Tumors and Tumor-Like Lesions of the 50.1 Skulltumors………………………….. 50.2 Non-neoplasticskulllesions……………… 51 Tumors of the Spine and Spinal Cord . . 51.1 Generalinformation……………………. 51.2 Compartmental locations of spinal tumors. . . . 51.3 Di erential diagnosis: spine and spinal cord tumors . . . . . . 783 51.4 Intradural extramedullary spinal cord tumors . . . . . . . . . . . . 785 51.5 Intramedullaryspinalcordtumors …………………. 787 51.6 Primarybonetumorsofthespine………………….. 792 52 CerebralMetastases………………………….. 800 52.1 Generalinformation……………………………… 800 52.2 Metastasestothebrain…………………………… 800 52.3 MetastasesofprimaryCNStumors…………………. 800 52.4 Locationofcerebralmets…………………………. 801 52.5 Primary cancers in patients with cerebral metastases. . . . . 801 52.6 Clinicalpresentation……………………………… 805 52.7 Evaluation……………………………………… 806 52.8 Management …………………………………… 806 52.9 Outcome …………………. …………………… 810 52.10 Carcinomatous meningitis . . . . . . …………………… 811 ……….. 756 ……….. 756 ……….. 756 ……….. 760 ……….. 763 ……….. 766 ……….. 766 ……….. 773 Skull….. 775 ……….. 775 ……….. 779 ……….. 783 ……….. 783 ……….. 783

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53 SpinalEpiduralMetastases........................ 814

53.1 Generalinformation……………………………… 814 53.2 Primarytumorsthatmetastasizetothespine………… 814 53.3 Presentation……………………………………. 814 53.4 Evaluation and management of epidural spinal metastases 815 Head Trauma 54 General Information, Grading, Initial Management…………………………………. 824 54.1 Generalinformation……………………………… 824 54.2 Grading………………………………………… 824 54.3 Transferoftraumapatients ……………………….. 825 54.4 ManagementinE/R………………………………. 826 54.5 Radiographicevaluation ………………………….. 832 54.6 Admitting orders for minor or moderate head injury. . . . . . 834 54.7 Patients with associated severe systemic injuries . . . . . . . . . 834 54.8 Exploratoryburrholes……………………………. 836 55 Concussion, High-Altitude Cerebral Edema, CerebrovascularInjuries……………………… 841 55.1 Concussion……………………………………… 841 55.2 OtherTBIdefinitions……………………………… 848 55.3 High-altitudecerebraledema ……………………… 848 55.4 Traumaticcervicalarterydissections………………… 849 56 Neuromonitoring…………………………….. 856 56.1 Generalinformation……………………………… 856 56.2 Intracranialpressure(ICP)…………………………. 856 56.3 AdjunctstoICPmonitoring………………………… 865 56.4 TreatmentmeasuresforelevatedICP……………….. 866 57 SkullFractures……………………………….. 882 57.1 Generalinformation……………………………… 882 57.2 Linearskullfracturesovertheconvexity…………….. 882 Contents 41 Ebooksmedicine.net

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Contents 57.3 Depressedskullfractures…………………………. 882 57.4 Basalskullfractures……………………………… 884 57.5 Craniofacialfractures…………………………….. 886 57.6 Pneumocephalus………………………………… 887 58 TraumaticHemorrhagicConditions………….. 891 58.1 Posttraumaticparenchymalinjuries………………… 891 58.2 Hemorrhagiccontusion…………………………… 891 58.3 Epiduralhematoma ……………………………… 892 58.4 Acutesubduralhematoma………………………… 895 58.5 Chronicsubduralhematoma………………………. 898 58.6 Spontaneoussubduralhematoma………………….. 901 58.7 Traumaticsubduralhygroma………………………. 902 58.8 Extraaxialfluidcollectionsinchildren……………….. 903 58.9 Traumaticposteriorfossamasslesions ……………… 905 59 Gunshot Wounds and Non-Missile Penetrating BrainInjuries…………………………………. 908 59.1 Gunshotwoundstothehead………………………. 908 59.2 Non-missilepenetratingtrauma……………………. 911 60 PediatricHeadInjury…………………………. 913 60.1 Generalinformation……………………………… 913 60.2 Management …………………………………… 913 60.3 Outcome………………………………………. 914 60.4 Cephalhematoma……………………………….. 914 60.5 Skullfracturesinpediatricpatients…………………. 914 60.6 Nonaccidentaltrauma(NAT)………………………. 916 61 Head Injury: Long-Term Management, Complications,Outcome …………………….. 918 61.1 Airwaymanagement…………………………….. 918 61.2 Deep-veinthrombosis(DVT)prophylaxis ……………. 918 61.3 Nutritioninthehead-injuredpatient ……………….. 918 Ebooksmedicine.net

61.4 Posttraumatichydrocephalus ........................... 920

61.5 Outcomefromheadtrauma……………………….. 920 61.6 Late complications from traumatic brain injury . . . . . . . . . . . 923 Spine Trauma 62 General Information, Neurologic Assessment, Whiplash and Sports-Related Injuries, Pediatric SpineInjuries…………………………………. 930 62.1 Introduction…………………………………….. 930 62.2 Terminology……………………………………. 930 62.3 Whiplash-associateddisorders …………………….. 931 62.4 Pediatricspineinjuries……………………………. 933 62.5 Cervicalbracing…………………………………. 935 62.6 Follow-upschedule………………………………. 935 62.7 Sports-relatedcervicalspineinjuries………………… 935 62.8 Neurologicalassessment………………………….. 939 62.9 Spinalcordinjuries………………………………. 943 63 ManagementofSpinalCordInjury……………. 949 63.1 Generalinformation……………………………… 949 63.2 Managementinthefield………………………….. 949 63.3 Managementinthehospital……………………….. 950 63.4 Radiographic evaluation and initial C-spine immobilization 952 63.5 Traction/reduction of cervical spine injuries . . . . . . . . . . . . . . 957 63.6 Indications for emergency decompressive surgery . . . . . . . . 960 64 Occiptoatlantoaxial Injuries (Occiput to C2) . . . . . 963 64.1 Atlanto-occipitaldislocation……………………….. 963 64.2 Occipitalcondylefractures………………………… 966 64.3 Atlantoaxialsubluxation/dislocation………………… 968 64.4 Atlas(C1)fractures………… ……………………. 971 64.5 Axis(C2)fractures…………. ……………………. 972 64.6 Combination C1–2 injuries . . . . . ……………………. 982 Contents 43 Ebooksmedicine.net

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Contents 65 Subaxial (C3 through C7) Injuries / Fractures . . . . 986 65.1 Classificationsystems ……………………………. 986 65.2 Clayshoveler’sfracture…………………………… 988 65.3 Verticalcompressioninjuries………………………. 989 65.4 Flexioninjuriesofthesubaxialcervicalspine…………. 989 65.5 Distractionflexioninjuries………………………… 991 65.6 Extension injuries of the subaxial cervical spine . . . . . . . . . . 994 65.7 Treatment of subaxial cervical spine fractures . . . . . . . . . . . . 996 65.8 Spinal cord injury without radiographic abnormality (SCIWORA)…………………………………….. 999 66 Thoracic, Lumbar and Sacral Spine Fractures . . . . 1002 66.1 Assessment and management of thoracolumbar fractures 1002 66.2 Surgicaltreatment ………………………………. 1007 66.3 Osteoporoticspinefractures………………………. 1008 66.4 Sacralfractures…………………………………. 1014 67 Penetrating Spine Injuries and Long Term Management/Complications………………… 1017 67.1 Gunshotwoundstothespine……………………… 1017 67.2 Penetratingtraumatotheneck……………………. 1017 67.3 Delayedcervicalinstability………………………… 1019 67.4 Delayed deterioration following spinal cord injuries . . . . . . 1019 67.5 Chronic management issues with spinal cord injuries . . . . . 1020 Spine and Spinal Cord 68 LowBackPainandRadiculopathy……………. 1024 68.1 Generalinformation……………………………… 1024 68.2 Intervertebraldisc……………………………….. 1024 68.3 Nomenclaturefordiscpathology…………………… 1024 68.4 Vertebralbodymarrowchanges …………………… 1025 68.5 Clinicalterms…………………………………… 1025 68.6 Disability, pain and outcome determinations. . . . . . . . . . . . . 1026 Ebooksmedicine.net

68.7 Di erentialdiagnosisoflowbackpain................... 1026

68.8 Initialassessmentofthepatientwithbackpain ………. 1026 68.9 Radiographicevaluation ………………………….. 1029 68.10 Electrodiagnosticsforlowbackproblems……………. 1032 68.11 Bonescanforlowbackproblems…………………… 1032 68.12 Thermographyforlowbackproblems ………………. 1033 68.13 Psychosocialfactors……………………………… 1033 68.14 Treatment………………………………………. 1033 68.15 Chroniclowbackpain ……………………………. 1037 68.16 Coccydynia……………………………………… 1038 68.17 Failedbacksurgerysyndrome……………………… 1039 69 Lumbar and Thoracic Intervertebral Disk Herniation/Radiculopathy…………………… 1046 69.1 Lumbar disc herniation and lumbar radiculopathy . . . . . . . . 1046 69.2 Thoracicdischerniation…………………………… 1061 70 CervicalDiscHerniation………………………. 1069 70.1 Generalinformation……………………………… 1069 70.2 Cervical nerve root syndromes (cervical radiculopathy) . . . 1069 70.3 Cervical myelopathy and SCI due to cervical disc herniation………………………………………. 1069 70.4 Di erentialdiagnosis…………………………….. 1070 70.5 Physicalexamforcervicaldischerniation ……………. 1070 70.6 Radiologicevaluation…………………………….. 1070 70.7 Treatment………………………………………. 1071 71 Degenerative Cervical Disc Disease and Cervical Myelopathy…………………………………… 1083 71.1 Generalinformation……………………………… 1083 71.2 Pathophysiology…………………………………. 1083 71.3 Clinical…………………………………………. 1084 71.4 Di erentialdiagnosis…………………………….. 1086 71.5 Evaluation………………………………………. 1088 71.6 Treatment………………………………………. 1090 71.7 Coincident cervical and lumbar spinal stenosis. . . . . . . . . . . . 1093 Contents 45

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Contents 72 Thoracic and Lumbar Degenerative Disc Disease 1096 72.1 General information about degenerative disc disease (DDD)…………………………………………. 1096 72.2 Anatomicsubstrate ……………………………… 1096 72.3 Riskfactors…………………………………….. 1099 72.4 Associatedconditions ……………………………. 1099 72.5 Clinicalpresentation……………………………… 1099 72.6 Di erentialdiagnosis…………………………….. 1101 72.7 Diagnosticevaluation ……………………………. 1101 72.8 Treatment……………………………………… 1103 72.9 Outcome………………………………………. 1108 73 Adult Spinal Deformity and Degenerative Scoliosis……………………………………… 1111 73.1 Generalinformation……………………………… 1111 73.2 Epidemiology…………………………………… 1111 73.3 Clinicalevaluation……………………………….. 1111 73.4 Diagnostictesting……………………………….. 1111 73.5 Pertinentspinemeasurements…………………….. 1112 73.6 SRS-Schwab classification of adult spinal deformity. . . . . . . 1112 73.7 Treatment/management………………………….. 1113 74 SpecialConditionsA ectingtheSpine……….. 1120 74.1 Paget’sdiseaseofthespine……………………….. 1120 74.2 Ankylosingspondylitis……………………………. 1123 74.3 Ossification of the posterior longitudinal ligament (OPLL). 1127 74.4 Ossification of the anterior longitudinal ligament (OALL). . 1129 74.5 Di use idiopathic skeletal hyperostosis (DISH) . . . . . . . . . . . 1129 74.6 Scheuermann’s kyphosis. . . . . . . . …………………… 1130 74.7 Spinal epidural hematoma . . . . . . …………………… 1131 74.8 Spinal subdural hematoma. . . . . . …………………… 1131

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75 Other Non-Spine Conditions with Spine Implications......................................... 1134

75.1 Rheumatoidarthritis……………………………… 1134 75.2 Downsyndrome…………………………………. 1138 75.3 Morbidobesity………………………………….. 1139 76 Special Conditions A ecting the Spinal Cord . . . . 1140 76.1 Spinalvascularmalformations……………………… 1140 76.2 Spinalmeningealcysts……………………………. 1142 76.3 Juxtafacetcystsofthelumbarspine ………………… 1143 76.4 Syringomyelia………………………….. ………. 1144 76.5 Posttraumaticsyringomyelia……………… ………. 1148 76.6 Spinalcord herniation (idiopathic). . . . . . . . . . . . . ………. 1150 76.7 Spinalepidurallipomatosis(SEL)…………… ………. 1150 76.8 Craniocervical junction and upper cervical spine abnormalities…………………………………… 1151 SAH and Aneurysms 77 Introduction and General Information, Grading, Medical Management, Special Conditions . . . . . . . 1156 77.1 Introductionandoverview………………………… 1156 77.2 EtiologiesofSAH………………………………… 1156 77.3 Incidence ………………………………………. 1157 77.4 RiskfactorsforSAH………………………………. 1157 77.5 Clinicalfeatures…………………………………. 1157 77.6 Work-upofsuspectedSAH………………………… 1159 77.7 GradingSAH……………………………………. 1162 77.8 InitialmanagementofSAH………………………… 1163 77.9 Rebleeding……………………………………… 1167 77.10 Pregnancyandintracranialhemorrhage……………… 1169 77.11 HydrocephalusafterSAH………………………….. 1170 Contents 47

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Contents 78 CriticalCareofAneurysmPatients…………… 1177 78.1 Neurogenicstresscardiomyopathy(NSC)……………. 1177 78.2 Neurogenicpulmonaryedema…………………….. 1178 78.3 Vasospasm……………………………………… 1178 78.4 Post-opordersforaneurysmclipping……………….. 1186 79 SAHfrom CerebralAneurysm Rupture. . . . . . . . . . . 1191 79.1 Epidemiologyofcerebralaneurysms ……………….. 1191 79.2 Etiologyofcerebralaneuysms……………………… 1191 79.3 Locationofcerebralaneurysms ……………………. 1191 79.4 Presentationofcerebralaneurysms………………… 1191 79.5 Conditionsassociatedwithaneurysms………………. 1193 79.6 Treatmentoptionsforaneurysms………………….. 1194 79.7 Timingofaneurysmsurgery………………………. 1199 79.8 General technical considerations of aneurysm surgery . . . . 1200 80 AneurysmTypebyLocation………………….. 1210 80.1 Anterior communicating arteryaneurysms . . . . . . . . . . . . . . 1210 80.2 Distalanteriorcerebralarteryaneurysms……………. 1211 80.3 Posterior communicating artery aneurysms. . . . . . . . . . . . . . 1212 80.4 Carotidterminus(bifurcation)aneurysms……………. 1213 80.5 Middlecerebralartery(MCA)aneurysms ……………. 1213 80.6 Supraclinoidaneurysms ………………………….. 1214 80.7 Posteriorcirculationaneurysms……………………. 1215 81 Special Aneurysms and Non-Aneurysmal SAH. . . 1222 81.1 Unrupturedaneurysms…………………………… 1222 81.2 Multipleaneurysms……………………………… 1226 81.3 Familialaneurysms………………………………. 1226 81.4 Traumaticaneurysms…………………………….. 1227 81.5 Mycoticaneurysms………………………………. 1228 81.6 Giantaneurysms………………………………… 1229 81.7 Corticalsubarachnoidhemorrhage…………………. 1230 81.8 SAHofunknownetiology…………………………. 1230 81.9 PretruncalnonaneurysmalSAH(PNSAH). . . . . . . . . . . . . . . . . 1231 Ebooksmedicine.net

Vascular Malformations

82 VascularMalformations………………………. 1238 82.1 Generalinformationandclassification ………………. 1238 82.2 Arteriovenousmalformation(AVM)…………………. 1238 82.3 Venousangiomas………………………………… 1245 82.4 Angiographically occult vascular malformations . . . . . . . . . . 1246 82.5 Osler-Weber-Rendusyndrome……………………… 1246 82.6 Cavernousmalformation………………………….. 1247 82.7 Duralarteriovenousfistulae(DAVF)…………………. 1251 82.8 VeinofGalenmalformation ……………………….. 1255 82.9 Carotid-cavernousfistula………………………….. 1256 82.10 Sigmoidsinusdiverticulum………………………… 1258 Stroke and Occlusive Cerebrovascular Disease 83 General Information and Stroke Physiology . . . . . 1264 83.1 Definitions……………………………………… 1264 83.2 Cerebrovascularhemodynamics……………………. 1264 83.3 Collateralcirculation……………………………… 1265 83.4 “Occlusion”syndromes…………………………… 1265 83.5 Strokeinyoungadults……………………………. 1269 83.6 Atheroscleroticcarotidarterydisease……………….. 1271 84 EvaluationandTreatmentforStroke…………. 1280 84.1 Rationaleforacutestroketreatment………………… 1280 84.2 Evaluation………………………………………. 1280 84.3 ManagementofTIAorstroke………………………. 1282 84.4 Carotidendarterectomy ………………………….. 1290 84.5 Carotidangioplasty/stenting………………………. 1297 85 SpecialConditions……………………………. 1301 85.1 Totallyoccludedinternalcarotidartery ……………… 1301 85.2 Cerebellarinfarction……………………………… 1302 85.3 Malignant middle cerebral artery territory infarction . . . . . 1303 Contents 49 Ebooksmedicine.net

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Contents 85.4 Cardiogenicbrainembolism ………………………. 1304 85.5 Vertebrobasilarinsu ciency………………………. 1305 85.6 Bowhunter’sstroke……………………………… 1307 85.7 Cerebrovascularvenousthrombosis………………… 1308 85.8 Moyamoyadisease………………………………. 1313 85.9 Extracranial-intracranial(EC/IC)bypass . . . . . . . . . . . . . . . . . . 1317 86 CerebralArterialDissections…………………. 1322 86.1 Generalinformation……………………………… 1322 86.2 Nomenclature…………………………………… 1322 86.3 Pathophysiology………………………………… 1322 86.4 Epidemiology…………………………………… 1323 86.5 Sitesofdissection……………………………….. 1323 86.6 Clinical………………………………………… 1323 86.7 Evaluation……………………………………… 1324 86.8 Overalloutcome………………………………… 1324 86.9 Vesselspecificinformation………………………… 1324 Intracerebral Hemorrhage 87 IntracerebralHemorrhage……………………. 1330 87.1 GeneralInformation……………………………… 1330 87.2 Intracerebralhemorrhageinadults…………………. 1330 87.3 Epidemiology…………………………………… 1330 87.4 Locationsofhemorrhagewithinthebrain …………… 1331 87.5 Etiologies………………………………………. 1332 87.6 Clinical………………………………………… 1336 87.7 Evaluation……………………………………… 1338 87.8 InitialmanagementofICH………………………… 1339 87.9 Surgicaltreatment ………………………………. 1342 87.10 Outcome………………………………………. 1345 87.11 ICHinyoungadults………………………………. 1345 87.12 Intracerebralhemorrhageinthenewborn …………… 1346 87.13 Other causes of intracerebral hemorrhage in the newborn 1352

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Outcome Assessment

88 OutcomeAssessment………………………… 1358 88.1 Cancer…………………………………………. 1358 88.2 Headinjury…………………………………….. 1358 88.3 Cerebrovascularevents…………………………… 1358 88.4 Spinalcordinjury………………………………… 1362 Di erential Diagnosis 89 Di erential Diagnosis by Location or RadiographicFinding–Intracranial…………… 1364 Contents 51 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 Skulllesions…………………………………….. 1376 89.11 Combined intracranial/extracranial lesions . . . . . . . . . . . . . . . 1380 89.12 Intracranialhyperdensities………………………… 1380 89.13 Intracranialcalcifications………………………….. 1380 89.14 Intraventricularlesions …………………………… 1381 89.15 Periventricularlesions ……………………………. 1384 89.16 Meningealthickening/enhancement………………… 1385 89.17 Ependymaland subependymalenhancement. . . . . . . . . . . . . 1385 89.18 Intraventricularhemorrhage ………………………. 1386 89.19 Medialtemporallobelesions………………………. 1386 89.20 Basalganglionabnormalities………………………. 1386 89.21 Thalamiclesions…………………………………. 1386 89.22 Intranasal/intracraniallesions……………………… 1387 Diagnosescoveredoutsidethischapter……………… 1364 Posteriorfossalesions……………………………. 1364 MultipleintracraniallesionsonCTorMRI……………. 1368 Ring-enhancinglesionsonCT/MRI………………….. 1369 Whitematterlesions…………………………….. 1371 Sellar,suprasellarandparasellarlesions……………… 1371 Intracranialcysts………………………………… 1374 Orbitallesions…………………………………… 1375 Cavernoussinuslesions…………………………… 1376 Ebooksmedicine.net

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Contents 90 Di erentialDiagnosisbyLocationor RadiographicFinding–Spine ………………… 1390 90.1 Diagnosescoveredoutsidethischapter……………… 1390 90.2 Atlantoaxialsubluxation………………………….. 1390 90.3 Abnormalitiesinvertebralbodies ………………….. 1390 90.4 Axis(C2)vertebralesions…………………………. 1391 90.5 Pathologicfracturesofthespine…………………… 1391 90.6 Spinalepiduralmasses……………………………. 1392 90.7 Destructivelesionsofthespine ……………………. 1392 90.8 Vertebralhyperostosis……………………………. 1393 90.9 Sacrallesions…………………………………… 1393 90.10 Enhancingnerveroots……………………………. 1394 90.11 Nodularenhancinglesionsinthespinalcanal………… 1394 90.12 Intraspinalcysts…………………………………. 1394 90.13 Di use enhancement of nerve roots/cauda equina. . . . . . . . 1394 91 Di erential Diagnosis (DDx) by Signs and Symptoms–PrimarilyIntracranial…………… 1395 91.1 Diagnosescoveredoutsidethischapter……………… 1395 91.2 Encephalopathy…………………………………. 1396 91.3 Syncopeandapoplexy……………………………. 1396 91.4 Transientneurologicdeficit……………………….. 1398 91.5 Ataxia/balancedi culties…………………………. 1398 91.6 Diplopia……………………………………….. 1399 91.7 Anosmia……………………………………….. 1399 91.8 Multiple cranial nerve palsies (cranial neuropathies) . . . . . . 1399 91.9 Binocularblindness………………………………. 1401 91.10 Monocularblindness…………………………….. 1401 91.11 Exophthalmos…………………………………… 1402 91.12 Ptosis…………………………………………. 1403 91.13 Pathologiclidretraction………………………….. 1403 91.14 Macrocephaly…………………………………… 1403 91.15 Tinnitus……………………………………….. 1404 91.16 Facial sensory changes. ……… …………………… 1405 91.17 Language disturbance . ……… …………………… 1406

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92 Di   erential Diagnosis (DDx) by Signs and Symptoms–PrimarilySpineandOther.......... 1407

92.1 Diagnosescoveredoutsidethischapter……………… 1407 92.2 Myelopathy…………………………………….. 1407 92.3 Sciatica………………………………………… 1410 92.4 Acuteparaplegiaorquadriplegia …………………… 1413 92.5 Hemiparesisorhemiplegia………………………… 1414 92.6 Lowbackpain…………………………………… 1414 92.7 Footdrop………………………………………. 1416 92.8 Weakness/atrophyofthehands/UEs………………… 1419 92.9 Radiculopathy,upperextremity(cervical)……………. 1420 92.10 Neckpain(cervicalpain)………………………….. 1420 92.11 Burninghands/feet………………………………. 1421 92.12 Musclepain/tenderness…………………………… 1421 92.13 Lhermitte’ssign…………………………………. 1421 92.14 Swallowingdi culties……………………………. 1421 Procedures, Interventions, Operations 93 GeneralInformation…………. ………………. 1426 93.1 Introduction……………………. 93.2 Intraoperativedyes……………… 93.3 Operatingroomequipment………. 93.4 Surgicalhemostasis……………… 93.5 Craniotomy general information. . . . . . 93.6 Intraoperative cortical mapping (brain 93.7 Cranioplasty……………………. 93.8 Bonegraft ……………………………………… 1437 93.9 Stereotacticsurgery……………………………… 1441 94 SpecificCraniotomies………………………… 1445 94.1 Posterior fossa (suboccipital)craniectomy . . . . . . . . . . . . . . . 1445 94.2 Pterional craniotomy . ……… ……………………. 1453 94.3 Temporalcraniotomy. ……… ……………………. 1456 ………………. 1426 ………………. 1426 ………………. 1426 ………………. 1428 ………………. 1428 mapping)……… 1432 ………………. 1436 Contents 53

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Contents 94.4 Frontalcraniotomy………………………………. 1459 94.5 Petrosalcraniotomy……………………………… 1460 94.6 Approachestothelateralventricle …………………. 1461 94.7 Approachestothethirdventricle…………………… 1461 94.8 Interhemisphericapproach ……………………….. 1466 94.9 Occipitalcraniotomy…………………………….. 1466 94.10 Decompressivecraniectomy………………………. 1467 95 Spine,Cervical……………………………….. 1472 95.1 Anteriorapproachestothecervicalspine……………. 1472 95.2 Transoral approach to anterior craniocervical junction . . . . 1472 95.3 Occipitocervicalfusion……………………………. 1474 95.4 Anteriorodontoidscrewfixation…………………… 1476 95.5 Atlantoaxialfusion(C1–2arthrodesis)………………. 1479 95.6 C2screws………………………………………. 1483 95.7 Anterior vertebral body screw-plate fixation . . . . . . . . . . . . . 1486 95.8 Zeroprofileinterbodydevices……………………… 1487 96 Spine,ThoracicandLumbar………………….. 1489 96.1 Anterior access to the cervico-thoracic junction/upper thoracicspine……………………………….. …. 1489 96.2 Anterior access to mid and lower thoracic spine . . . . . . …. 1489 96.3 Thoracicpediclescrews……………………….. …. 1489 96.4 Anterior access to thoracolumbar junction . . . . . . . . . . . …. 1493 96.5 Anterioraccesstothelumbarspine ………………… 1493 96.6 Instrumentation/fusion pearls for the lumbar and lumbosacralspine…………………………… ….. 1494 96.7 Lumbosacralpediclescrews…………………… ….. 1494 96.8 Minimally invasive lateral retroperitoneal transpsoas interbodyfusion ………………………………… 1498 96.9 Transfacetpediclescrews…………………………. 1501 96.10 Facetfusion…………………………………….. 1502 96.11 S2screws………………………………………. 1502 96.12 Iliacscrews…………………………………….. 1502 96.13 Post-op clinic visits – lumbar and/or thoracic spine fusion . 1502 Ebooksmedicine.net

97 MiscellaneousSurgicalProcedures............... 1504

97.1 Percutaneousventricularpuncture …………………. 1504 97.2 Percutaneoussubduraltap………………………… 1504 97.3 Lumbarpuncture………………………………… 1504 97.4 LumbarcatheterCSFdrainage……………………… 1510 97.5 C1–2punctureandcisternaltap……………………. 1511 97.6 CSFdiversionaryprocedures ………………………. 1512 97.7 Ventricularaccessdevice………………………….. 1518 97.8 Suralnervebiopsy……………………………….. 1520 97.9 Nerveblocks……………………………………. 1521 98 FunctionalNeurosurgery……………………… 1524 98.1 Deepbrainstimulation……………………………. 1524 98.2 Typical targets used in functional brain surgery. . . . . . . . . . . 1524 98.3 SurgicaltreatmentofParkinson’sdisease……………. 1524 98.4 Dystonia……………………………………….. 1528 98.5 Spasticity………………………………………. 1528 98.6 Torticollis………………………………………. 1533 98.7 Neurovascularcompressionsyndromes……………… 1534 98.8 Hyperhidrosis…………………………………… 1537 98.9 Tremor…………………………………………. 1537 98.10 Sympathectomy…………………………………. 1537 99 PainProcedures………………………………. 1541 99.1 Generalinformation……………………………… 1541 99.2 Choiceofpainprocedure………………………….. 1541 99.3 Typesofpainprocedures………………………….. 1541 99.4 Cordotomy……………………………………… 1542 99.5 Commissuralmyelotomy………………………….. 1544 99.6 Punctatemidlinemyelotomy………………………. 1545 99.7 CNSnarcoticadministration……………………….. 1545 99.8 Spinalcordstimulation(SCS)………………………. 1547 99.9 Deepbrainstimulation(DBS)………………………. 1550 99.10 Dorsalrootentryzone(DREZ)lesions……………….. 1550 Contents 55 Ebooksmedicine.net

56 Contents 100 SeizureSurgery………………………………. 1553 100.1 Generalinformation,indications …………………… 1553 100.2 Pre-surgicalevaluation …………………………… 1553 100.3 Surgicaltechniques………………………………. 1554 100.4 Surgicalprocedures……………………………… 1555 100.5 Risksofseizuresurgery………………………….. . 1557 100.6 MRI guided laser interstitial thermal therapy (MRGLITT) . . 1557 100.7 Postoperative management for seizure surgery (epilepsy surgery)………………………………………. . 1557 100.8 Outcome………………………………………. 1557 101 RadiationTherapy(XRT)……………………… 1560 101.1 Introduction……………………………………. 1560 101.2 Conventionalexternalbeamradiation………………. 1560 101.3 Stereotactic radiosurgery and radiotherapy . . . . . . . . . . . . . . 1564 101.4 Interstitialbrachytherapy…………………………. 1571 102 EndovascularNeurosurgery………………….. 1575 102.1 Generalinformation……………………………… 1575 102.2 Pharmacologicagents……………………………. 1576 102.3 NeuroendovascularProcedureBasics……………….. 1582 102.4 Diagnostic angiography for cerebral subarachnoid hemorrhage……………………………………. 1583 102.5 Disease-specificintervention………………………. 1584

Seventh Edition

For two decades, Handbook of Neurosurgery –seventh edition – has been an invaluable companion for every neurosurgery resident and nurse, as well as neurologists and others involved in the care of patients with brain and spine disorders. Dr. Greenberg's classic text covers the breadth of neurosurgery and its allied specialties and provides the latest information on anatomy and physiology, differential diagnosis, and currently accepted principles of clinical management. Renowned for its scope and accessibility, this portable, single-volume guide is packed with more than 1,300 pages of practical information, including thousands of literature citations, handy cross-references, and a thorough index.

Features:

New to the seventh edition: detailed coverage of blunt cervical arterial injuries; awake craniotomies; brain mapping; new grading systems for cervical and thoracolumbar fractures; radiation safety for neurosurgeons; organ donation after cardiac death; and expanded discussion of endovascular techniques Numerous updates, including information on dural arteriovenous malformations; tumors and molecular biology; and new neuromonitoring modalities such as brain oxygen tension, cerebral microdialysis, and regional cerebral blood flow The return of basic surgical material to acquaint readers with the operating room A practical new feature called Booking the Case supplies helpful information about scheduling surgery and obtaining informed consent Highly valuable section on hot topics in neurocritical care Color highlights and full-color inserts to enhance readability Comprehensive and conveniently compact, this book is a must-have reference for neurosurgery residents and a useful tool for anyone working in the clinical neurosciences.

1)
De Backer A. Handbook of neurosurgery, 8th edition. Acta Chir Belg. 2016 Aug;116(4):269. Epub 2016 Sep 20. PubMed PMID: 27648484.
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