Tumor Neurosurgery provides information on the basic knowledge and clinical management required for optimal care of neurooncology patients. Providing an up-to-date synopsis of the field of tumor neurosurgery, the book covers the most common sites and tumor pathologies encountered by neurosurgeons. The chapters are organized under broad topics, including investigative studies, perioperative care and the role of newer techniques. The clinical management of CNS tumors in adults and children is described, including spinal tumors, both intradural and extradural. This book provides coverage of relevant topics in the field of tumor neurosurgery, for residents and registrars in training, and for recent graduates of training programs.
Author(s): Anne J. Moore, David W. Newell
Series: Springer Specialist Surgery Series
Edition: 1st Edition.
Publisher: Springer
Year: 2006
Language: English
Pages: 352
Tumor Neurosurgery......Page 1
Front-matter......Page 2
Title Page
......Page 4
Copyright Page
......Page 5
Preface......Page 6
Table of Contents (with page links)......Page 7
Contributors......Page 9
I.
Investigations......Page 12
Introduction......Page 13
Electroencephalography......Page 14
Electrocorticography......Page 16
Somatosensory Evoked PotentiaIs......Page 17
Spinal Stimulation......Page 21
Motor Evoked PotentiaIs......Page 22
Microelectrode Recording/Stimulation......Page 23
Brainstem Auditory Evoked PotentiaIs......Page 24
Cranial Nerve Monitoring......Page 26
Measurement of Cerebral Blood Flow......Page 27
Peripheral Nerve Monitoring......Page 28
Conclusions......Page 29
References......Page 30
Introduction......Page 32
Computed Tomography......Page 33
Magnetic Resonance Imaging......Page 35
MRI of Intracranial Hemorrhage......Page 36
Extra-axial Hemorrhage......Page 37
Safety Issues ofMRI......Page 38
Magnetic Resonance Angiography......Page 40
Complications......Page 41
Myelography......Page 43
Transcranial Ultrasound in the Neonate......Page 44
Carotid Ultrasound......Page 45
References......Page 46
3 Neuropathology......Page 48
1.How is a Histopathological Diagnosis Made?......Page 50
Gliosis vs Glioma......Page 51
Inflammatory Lesions......Page 52
Vascular Diseases......Page 54
Trauma......Page 57
Neoplasms......Page 58
2. How Can One Understand the Changing Diagnostic Terminologies?......Page 74
3. What are the Limitations of the Histopathological Diagnosis of Surgical Specimens?......Page 76
References......Page 77
II. Perioperative Care......Page 78
Introduction......Page 79
Neuromuscular Blocking Drugs......Page 80
Opioids......Page 82
Induction of Anesthesia......Page 83
Positioning......Page 84
Perioperative Brain Protection......Page 85
Pediatric Neuroanesthesia......Page 86
Anesthesia for Neuroradiology and Magnetic Resonance Imaging (MRI)......Page 87
Anesthesia for Posterior Fossa Surgery......Page 88
Anesthesia and the Cervical Spine......Page 89
Anesthesia for Awake Craniotomy......Page 90
References......Page 91
Intracranial Pressure......Page 93
Cushing's Response......Page 94
Head Elevation......Page 95
Hyperventilation......Page 96
Sedation andParalysis......Page 97
Dexmedetomidine......Page 98
Use of Positive End-expiratory Pressure in Patients with Elevated ICP......Page 99
Head Injury......Page 100
Neurological Examination......Page 101
Monitoring of Intracranial Pressure......Page 102
ICP Tracings......Page 103
Monitoring of Cerebral Oxygenation/Metabolism......Page 104
Monitoring of Cerebral Blood Flow......Page 105
Electrocardiographic and Cardiac Monitoring......Page 107
Fluid and Electrolytes......Page 108
Pneumonia, Antibiotics and Mechanical Ventilation......Page 110
Temperature Control......Page 111
References......Page 112
III.
Techniques......Page 113
Historical Landmarks......Page 114
Instrumentation [3]......Page 115
Neuroimaging......Page 116
Neuroendoscopic Procedures and Applications......Page 117
Neuroendoscopic Third Ventriculostomy (NTV)......Page 118
Results of NTV......Page 119
Neuroendoscopy in the Management of Shunt Complications and Complex Hydrocephalus......Page 120
Neuroendoscopy in the Management of Non-tumorous Cysts......Page 121
Management of Intracranial Tumors......Page 122
Complications......Page 123
Strategies for Reducing Complications......Page 124
Training......Page 125
Research Questions in Neuroendoscopy......Page 126
References......Page 127
Introduction......Page 129
Defining the Patient Coordinates......Page 130
Patient Immobilization and Tracking......Page 131
Brain Biopsy......Page 132
Skull Base and Pituitary Surgery......Page 133
Intrinsic Brain Tumors and Functional Mapping......Page 135
Intraoperative MRI......Page 136
Arteriovenous Malformations......Page 138
Endoscopic Surgery......Page 139
Spinal Surgery......Page 140
Current Developments......Page 141
References......Page 143
Historic Notes......Page 145
Stereotactic Imaging......Page 146
The Gamma Knife......Page 147
Suitable Targets......Page 148
Pathologies......Page 149
Arteriovenous Malformations......Page 150
Other Vascular Malformations......Page 152
Vestibular Schwannomas (Acoustic Neurinoma)......Page 153
Functional Indications......Page 155
Future Trends......Page 156
References......Page 157
IV.
Tumors......Page 159
Introduction......Page 160
Diagnostic Imaging......Page 161
Pathological Anatomy......Page 162
Management......Page 163
1. Tumors that are Too Large for Complete Resection to be Possible Without Unacceptable Risk......Page 164
2. Tumours where, on the Basis of the Pre-operative Scan, Complete Resection is Anticipated......Page 165
3. Tumors where it is Uncertain Whether Complete Resection can be Achieved......Page 166
4. Tumours that Recur......Page 167
Management of Gangliogliomas, Neurocytomas and Pleomorphic Xanthoastrocytomas......Page 169
References......Page 170
Introduction......Page 172
Molecular Pathogenesis......Page 173
HGG Growth Patterns......Page 174
Tumor Cell Invasiveness and Migration......Page 175
Recursive Partition Analysis......Page 176
Radiation......Page 177
Surgical Resection......Page 178
Biopsy vs Resection......Page 180
Anesthesia for Biopsy or Resection......Page 181
Intracranial Pressure Management......Page 182
Positioning and Flap Strategies......Page 183
Intraoperative Navigation......Page 184
Cortical Stimulation Motor and Sensory Mapping......Page 185
Mapping of language Cortex......Page 186
Intratumoral Therapies......Page 188
Future Directions......Page 189
References......Page 190
Embryology of the Sellar Region......Page 192
Pathophysiology......Page 193
Growth-hormone-producing Adenomas......Page 196
Presentation......Page 194
Visual Manifestations......Page 195
Prolactin-secreting Tumors......Page 197
ACTH-producing Turnors......Page 198
Glycoprotein-secreting Tumors (TSH, FSH and LH)......Page 199
Surgical Aims......Page 200
Early Postoperative Management......Page 201
Radiotherapy......Page 202
Treatment......Page 203
Diagnosis......Page 204
Recurrence......Page 205
Pathophysiology......Page 206
Surgical Approach......Page 207
Other Treatments......Page 208
References......Page 209
Introduction......Page 210
Incidence......Page 211
Understanding the Natural History......Page 213
Growth Estimates......Page 214
Recurrence......Page 215
Pre-operative Evaluation......Page 216
Observation......Page 217
Surgical Technique......Page 218
Positioning, Incision and Exposure......Page 219
Internal Decompression and Extracapsular Dissection......Page 221
Early localization and Preservation of Adjacent Neurovasculature......Page 222
Removal of the Involved Bone and Dura......Page 223
Post-operative Management......Page 227
Role of Radiation Therapy: an Overview......Page 228
Intensity-modulated Radiation Therapy......Page 229
Stereotactic Radiosurgery......Page 230
Mechanisms of Tumorigenesis......Page 231
NF-2 Turnor Suppressor......Page 232
Other Turnor Suppressor Genes......Page 233
Sex Hormones......Page 234
Future Therapy......Page 235
References......Page 236
Intraventricular Tumors......Page 239
Relevant Anatomy......Page 241
Pineal Region Tumors......Page 242
Epidemiology......Page 243
Pathological Appearance......Page 244
Relevant Anatomy......Page 246
Management and Outcome......Page 247
References......Page 249
Cranial Nerves......Page 251
Clinicopathological Correlates......Page 252
Epidermoid Tumor (Cholesteatomas)......Page 253
Otoneurological Findings......Page 254
Intraoperative Monitoring......Page 256
Translabyrinthine Approach......Page 257
Retrosigmoid Approach......Page 258
Results of Acoustic Neuroma Surgery......Page 259
Facial Nerve Outcome......Page 260
Nervus Intermedius Function......Page 261
Stereotactic Radiosurgery in the Treatment of Acoustic Neuromas......Page 262
Other Schwannomas......Page 263
Glomus Tumors......Page 264
References......Page 265
15 Skull Base Tumors......Page 267
Imaging of the Skull Base......Page 268
General Principles of Skull Base Surgery......Page 269
Benign Primary Skull Base Lesions......Page 270
Malignant Primary Skull Base lesions......Page 271
Benign Intracranial Skull Base Tumors......Page 272
Malignant Intracranial Skull Base Turnors......Page 274
Benign Extracranial Skull Base Tumors......Page 275
Malignant Extracranial Skull Base Turnors......Page 276
Anterior Craniofacial Resection......Page 278
Infratemporal-Middle Cranial Fossa Approach......Page 280
Temporal Bone Resection......Page 281
Extended Presigmoid Translabyrinthine Approach......Page 282
Conclusion......Page 283
References......Page 284
Epidemiology......Page 285
Imaging......Page 287
Medical Therapy......Page 288
Radiation......Page 289
Surgery......Page 290
Summary......Page 291
Epidemiology......Page 292
Pathology......Page 293
Imaging......Page 294
Radiotherapy......Page 296
Chemotherapy......Page 298
Conclusion......Page 299
References......Page 300
Epidemiology......Page 302
MeduIloblastoma/Primitive Neuroectodermal Tumor......Page 303
Radiation Therapy and Chemotherapy......Page 304
Low-grade Astrocytomas......Page 306
Management......Page 307
Management......Page 308
Surgery......Page 309
Other CNS Tumors of Childhood Craniopharyngioma......Page 310
Surgery......Page 311
Summary......Page 312
Choroid Plexus Tumors......Page 313
References......Page 314
Introduction......Page 316
Intramedullary Tumors......Page 317
Clinical Presentation......Page 319
Angiography......Page 323
Surgical Technique......Page 324
Intraoperative Neurophysiological Monitoring......Page 326
Post-operative Spinal Deformity......Page 328
Adjuvant Therapy......Page 329
References......Page 330
Introduction......Page 331
Benign Tumors of theSpinal Column......Page 332
Malignant Tumors of the Axial Skeleton......Page 334
Metastatic Spinal Disease......Page 336
Breast Carcinoma......Page 337
Prostate Carcinoma......Page 338
Renal Carcinoma......Page 339
Treatment......Page 340
References......Page 341
Index......Page 343
