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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
Radiotherapy and radiosurgery for brain tumours 脑肿瘤的放射治疗和放射外科治疗
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0011
S. Short
{"title":"Radiotherapy and radiosurgery for brain tumours","authors":"S. Short","doi":"10.1093/med/9780198746706.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0011","url":null,"abstract":"Following surgery fractionated radiotherapy is standard treatment for high-grade gliomas. The place for radiotherapy in low-grade gliomas is more open to debate.\u0000 Radiotherapy works by causing double stranded DNA breaks, there are two DNA repair pathways in mammalian cells, tumour cells are less able to repair DNA damage caused by radiotherapy than normal cells, thus radiotherapy is usually delivered in fractions. Conformal beam and intensity-modulated radiotherapy techniques can be used to optimize the distribution of the radiation and protect organs at risk. Brachytherapy, gamma knife, boron neutron capture, and proton beam therapy are other techniques in development or with indications for use in certain situations. The side effects of radiotherapy include fatigue, hair loss, pseudoprogression, which can be difficult to distinguish from tumour recurrence and induced secondary tumours.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"10 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":"125293350","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
Paediatric epilepsy 小儿癫痫
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0091
S. Varadkar, M. Tisdall
{"title":"Paediatric epilepsy","authors":"S. Varadkar, M. Tisdall","doi":"10.1093/med/9780198746706.003.0091","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0091","url":null,"abstract":"All children, young people, and indeed adults with a recent onset suspected seizure should be seen promptly by a physician with expertise in epilepsy, to avoid misdiagnosis as well as to ensure precise and early diagnosis, and to recognize serious non-neurological diagnoses, especially cardiological ones. Paediatric epilepsy offers particular challenges in terms of diagnosis, evaluation, and management. Surgical treatment is a safe and effective management strategy in selected patients. In order to optimize seizure and cognitive outcome, surgery should be offered at an early stage in suitable, drug-resistant cases. This chapter summarizes the key steps in diagnosis, presurgical evaluation, and operative techniques required to treat this patient group and highlights the special considerations required in the paediatric population.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"21 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":"134368417","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
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
Peripheral nerve tumours 周围神经肿瘤
Oxford Textbook of Neurological Surgery Pub Date : 2019-09-01 DOI: 10.1093/med/9780198746706.003.0074
R. Trivedi, V. Nga
{"title":"Peripheral nerve tumours","authors":"R. Trivedi, V. Nga","doi":"10.1093/med/9780198746706.003.0074","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0074","url":null,"abstract":"This chapter on peripheral nerve sheath tumours (PNSTs) explores the pathology, clinical presentation, investigation, management, and outcomes of both benign and malignant peripheral nerve sheath tumours (MPNSTs). The focus is centred upon the more commonly encountered tumours: schwannoma, neurofibroma, and perineurioma. Significant emphasis is also given to the rarer but life-threatening MPNSTs. It aims to equip the reader with the latest information available in the literature with regards to PNSTs occurring sporadically or in association with inherited conditions. Up to date investigation and management options available are also presented. With the detailed insights provided, the aim is to ensure that the reader would be confident in managing patients presenting with peripheral nerve tumours.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"183 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":"121189378","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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