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Oxford Textbook of Neurological Surgery最新文献

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Carotid artery disease and cerebral ischaemia 颈动脉疾病和脑缺血
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0051
K. Sweeney, A. O'Hare, M. Javadpour
{"title":"Carotid artery disease and cerebral ischaemia","authors":"K. Sweeney, A. O'Hare, M. Javadpour","doi":"10.1093/med/9780198746706.003.0051","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0051","url":null,"abstract":"Due to the high incidence carotid artery disease and cerebral ischaemia, accurate and timely diagnosis and treatment is required to reduce the significant morbidity and mortality associated with these conditions. This chapter discusses the epidemiology, pathophysiology, clinical presentation, investigation, and treatment of these conditions. Cerebral ischaemia and stroke can occur due to a heterogeneous number of pathological processes. These pathological processes can affect either large or small vessels and can be broadly classified into thrombotic, embolic, or occlusive causes. The most common cause of thrombotic ischaemic is atherosclerosis. The most common cause of embolic ischaemia is cardiogenic due to atrial fibrillation followed by extracranial atherosclerosis of the aorta or carotids. Both of these causes can affect both the large and small vessels. This chapter explores the current evidence for medical, interventional, and surgical treatment options.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130547095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Movement disorders 运动障碍
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0076
K. Ashkan, I. Ughratdar
{"title":"Movement disorders","authors":"K. Ashkan, I. Ughratdar","doi":"10.1093/med/9780198746706.003.0076","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0076","url":null,"abstract":"Merely having the technical ability to perform functional neurosurgery is not sufficient. An understanding of key clinical concepts surrounding movement disorders lies at the heart of becoming a competent functional neurosurgeon in order to ensure correct patient selection and perioperative management. This chapter provides a thorough medical overview of the fundamental clinical aspects, including pathophysiology, diagnosis and medical therapy for the commonest movement disorders encountered in neurosurgical practice: Parkinson’s disease, essential tremor, and dystonia. A brief overview of the surgical management options and outcomes from surgery is discussed. Finally, some of the controversies related to the surgical aspects of movement disorders are examined.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130504084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cervical spine injuries 颈椎损伤
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0068
C. Mathieson, C. Barrett, L. Alakandy
{"title":"Cervical spine injuries","authors":"C. Mathieson, C. Barrett, L. Alakandy","doi":"10.1093/med/9780198746706.003.0068","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0068","url":null,"abstract":"The management of cervical spine fractures is a complex and fascinating topic. A multitude of descriptive terminologies and classification systems have been developed over the years in an attempt to better understand this heterogenous group of patients. Despite this however, there is often little consensus with regards to the best way to manage this population. This chapter will predominantly discuss the decision-making process involved in the management of cervical spine fractures. The goal of the spine surgeon in managing patients with acute cervical spine injury is to prevent secondary neurological injury, deformity, and pain by re-establishing stability if necessary. Assessing how to achieve this goal can be very challenging. The surgeon will be faced with many questions. Which patients should undergo surgical intervention? Which operation will best stabilize the spine? Which patients should be treated with a collar or a halo vest? Does the injury require reduction with traction initially? There are also questions of timing. When should the surgeon plan the proposed procedure?","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126209084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perioperative care of the neurosurgical patient 神经外科病人围手术期护理
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0005
K. Budohoski, A. Scudellari, S. Karcheva, D. Duane
{"title":"Perioperative care of the neurosurgical patient","authors":"K. Budohoski, A. Scudellari, S. Karcheva, D. Duane","doi":"10.1093/med/9780198746706.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0005","url":null,"abstract":"Perioperative care of the neurosurgical patient describes the processes required to facilitate safely and professionally neurological operative interventions and outcomes. An account is given of the systematic preoperative evaluation needed to optimize a patient’s medical conditions before surgery, the intraoperative anaesthetic management, the postoperative care, and the possible complications that may be encountered. Anaesthetic considerations for specific neurosurgical interventions are also described. Overall, emphasis is placed on the importance of requesting the appropriate investigations, adhering to strategies for the correction of coagulation disorders along with the prevention of venous thromboembolic complications, understanding the effect of anaesthesia on cerebrovascular haemodynamics and providing specialist postoperative facilities and expertise.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125018767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous intracranial haematoma 自发性颅内血肿
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0054
B. Orakcioglu, A. Unterberg
{"title":"Spontaneous intracranial haematoma","authors":"B. Orakcioglu, A. Unterberg","doi":"10.1093/med/9780198746706.003.0054","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0054","url":null,"abstract":"Spontaneous intracranial haematomas remain a challenging pathology with high morbidity and mortality (60–80% of long-term disability). Despite decades of the search for specific treatments no evidence has yet been found for neither conservative nor surgical treatment in randomized controlled studies. While patients with space occupying infratentorial haematomas are more likely to benefit from surgery treatment of supratentorial haemorrhages remains controversial. Recent studies suggest that minimally invasive surgery including endoscopy to evacuate intracranial haematoma may be more effective than conservative treatment or standard surgical craniotomy (MISTIE II). Future studies (i.e. MISTIE III, MISTICH, SWITCH) will hopefully demonstrate evidence for individualized treatments.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"333 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127576089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Principles of deep brain stimulation 深部脑刺激原理
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0075
E. Pereira, A. Green, T. Aziz
{"title":"Principles of deep brain stimulation","authors":"E. Pereira, A. Green, T. Aziz","doi":"10.1093/med/9780198746706.003.0075","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0075","url":null,"abstract":"Deep brain stimulation (DBS) is a minimally invasive targeted neurosurgical intervention that enables structures deep in the brain to be stimulated electrically by an implanted pacemaker. It has become the treatment of choice in Parkinson’s disease patients with either disabling medication side effects, on-off fluctuations, or tremor. Its efficacy in Parkinson’s disease has been demonstrated robustly by randomized controlled clinical trials, with numerous brain areas having been targeted in the last two decades for indications including dystonia and tremor in movement disorders; depression, obsessive-compulsive disorder, and Tourette’s syndrome in psychiatry; epilepsy, cluster headache, and chronic pain. The principles of framed stereotactic surgery enabling DBS electrode placement are reviewed here, before describing the putative mechanisms underlying DBS and its action upon individual neurons. Recent and future developments in DBS technology such as segmented, directional leads, and smart, adaptive stimulation are then discussed alongside related technological advances such as diffusion tensor imaging, robotic surgery, and molecular and cellular therapies. The role of stereotactic lesions in the era of DBS and the different modalities of lesioning are then summarized.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"233 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131869466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Intraventricular tumours 脑室肿瘤
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0032
P. Grundy, V. Apostolopoulos
{"title":"Intraventricular tumours","authors":"P. Grundy, V. Apostolopoulos","doi":"10.1093/med/9780198746706.003.0032","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0032","url":null,"abstract":"Intraventricular tumours are relatively rare, histologically diverse, and commonly low grade. The location of the tumour, MRI features, associated conditions, and the age of the patient help to narrow the radiological differential diagnosis. The management of intraventricular tumours needs to be tailored to the presumed nature of the tumour, its location, size, and the general state of the patient. The management of hydrocephalus is often the first priority. Radical excision of intraventricular tumours is usually favoured for younger patients, whereas subtotal excisions or even just cerebrospinal fluid (CSF) diversion is favoured for older patients with tumours which are less accessible. Excision of tumours, usually ependymomas originating from the floor of the fourth ventricle may be associated with significantly disabling postoperative deficit with can frequently but not always improve over a period of time. As always in brain tumour surgery, balancing radical excision and overall well-being of patients requires careful consideration.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"24 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114047719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Glioneuronal and other epilepsy-associated tumours 神经胶质和其他癫痫相关肿瘤
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0010
M. Simon, A. Grote
{"title":"Glioneuronal and other epilepsy-associated tumours","authors":"M. Simon, A. Grote","doi":"10.1093/med/9780198746706.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0010","url":null,"abstract":"Patients with (glio)neuronal brain tumours are rare. The most common variants, hat is, gangliogliomas and dysembryoplastic neuroepithelial tumours (DNTs), frequently present with pharmacoresistant epilepsy. Together with certain other tumour types associated with chronic epilepsy (including selected cases with diffuse gliomas WHO grade II/III) these entities have historically been referred to as LEATs (long-term epilepsy-associated tumours). LEATs share a very benign clinical course and rarely recur following a gross total resection. More than 80% of patients can expect to become seizure-free following epilepsy surgery (i.e. resection of the epileptogenic zone rather than tumour removal only). Hippocampal resections may improve the seizure outcome in cases with mesial temporal lobe epilepsy, but may also carry a concurrent risk of neuropsychological deficits. In contrast, oncological issues dominate the clinical course of LEATs and glioneuronal tumour variants if encountered outside the setting of refractory epilepsy. The dysplastic cerebellar gangliocytoma (L’Hermitte-Duclos disease, LDD) is the major central nervous system manifestation of Cowden disease. Its neoplastic nature is questionable.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115162091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Microbiology 微生物学
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0097
W. Hall
{"title":"Microbiology","authors":"W. Hall","doi":"10.1093/med/9780198746706.003.0097","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0097","url":null,"abstract":"Infection of the central nervous system can be due to a variety of pathogenic agents that include bacteria, viruses, fungi, and parasites. Several sensitive and specific diagnostic tests are now available that allow for the rapid and accurate identification of the offending organism. The widespread indiscriminate use of some antibiotics has resulted in the emergence of organisms that are resistant to those agents at an alarming rate. The prevention of a neurosurgical site infection is usually possible with the use of prophylactic antibiotics and through careful attention to surgical technique. Controversy surrounds several issues in neurosurgical practice such as preoperative surgical site preparation, antimicrobial prophylaxis, and the surgical and medical management of postoperative infections. Only after the causative microbe is determined and the appropriate surgical and medical management is initiated can you hope to achieve the optimal clinical outcome leading to a reduction in neurological morbidity and mortality.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124220490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colloid cysts 胶体囊肿
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0033
A. Sheikh, P. Chumas
{"title":"Colloid cysts","authors":"A. Sheikh, P. Chumas","doi":"10.1093/med/9780198746706.003.0033","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0033","url":null,"abstract":"Colloid cysts are benign, mostly intraventricular tumours accounting for 0.5 to 2% of all intracranial mass lesions. They are most commonly found in the anterior portion of the third ventricle at the level of foramina of Monro and, if symptomatic, usually present with obstructive hydrocephalus of the lateral ventricles. The original description historically linked them with sudden death in the pre-CT era. They are also known as neuroepithelial cysts. Management options include treatment of hydrocephalus alone, aspiration of the cyst contents, and removal of the cyst endoscopically or via a microsurgical approach. However, the most important factor in the choice of any of these approaches is operator experience.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126302488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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