Advances and Technical Standards in Neurosurgery

A. Advances.- Non-operative Management of Intracranial Hypertension.- I. Pathophysiology of Intracranial Hypertension.- 1. Cerebrospinal Fluid Dynamics and Intracranial Pressure.- 2. Interrelations between Intracranial Pressure and Intracranial Hemodynamics.- 3. Brain Edema.- 4. Transmission of Pressures in the Cranio-Spinal Cavity.- 5. Pressure/Volume Relationships.- 6. Rapid Variations of the Intracranial Pressure in Intracranial Hypertension (Plateau Waves).- 7. Extracranial Correlates of Intracranial Hypertension.- II. Monitoring of the Intracranial Pressure.- 1. Techniques.- 2. Measures against Infection.- 3. Complications.- 4. Interpretation of the Ventricular Fluid Pressure Curve.- a) Statistical Analysis.- 5. Clinical Application.- III. General Principles for the Care of Patients with Intracranial Hypertension.- IV. Special Treatments.- 1. Controlled Drainage of Cerebrospinal Fluid.- 2. Hypertonic Solutions and Diuretics.- a) Mode of Action of Hypertonic Solutions.- b) Clinical Experience with Intravenous Urea and Mannitol.- c) Side Effects.- d) Oral Treatment.- e) Diuretics.- f) Recommended Treatment.- 3. Hyperventilation.- a) Mode of Action and Effect on Intracranial Pressure.- b) Side Effects.- c) Recommended Treatment.- 4. Corticosteroids.- a) Corticosteroids and Intracranial Pressure.- b) Side Effects.- c) Recommended Treatment.- 5. Hypothermia.- 6. Hyperbaric Oxygen.- V. Concluding Remarks.- References.- Chronic Adult Hydrocephalus.- Clinical Signs.- Etiology.- 1. Idiopathic.- 2. Extraventricular Obstruction, Subarachnoid Haemorrhage, Post-Traumatic Hydrocephalus, Post- Meningitic Hydrocephalus.- 3. Focal Brain Lesions.- Pressure Studies.- 1. Intracranial Pressure Measurement.- 2. Resorption Studies.- Radiological Findings.- Isotopic Studies.- A. CSF Normal Scan.- B. CSF Scanning in Chronic Adult Hydrocephalus.- 1. Findings to Date.- 2. Quantitative Studies.- 3. Personal Series.- C. Result of CSF Scan Applied to Physiopathology of CSF Flow.- Treatment.- Pathophysiology.- References.- Surgery of Craniostenosis in Advanced Cases. A Method of Extensive Subperiosteal Resection of the Vault and Base of the Skull Followed Bone Regeneration by Bone Regeneration.- Anatomo-Clinical Considerations.- Operative Procedure.- Clinical Material.- Results and Evaluation.- 1. Surgical Risk.- 2. Decompression Effect, Protection of the Head, and Cosmetic Result.- 3. Regeneration of the Skull.- 4. Neurological Results.- Conclusion.- Illustrative Cases.- Addendum.- References.- Extra-Durai Hematoma.- History.- General Considerations.- Frequency.- Localization.- Sex and Age.- Clinical Signs.- Fractures of the Skull.- Free Interval.- Motor Disorders.- Eye Signs.- Pulse and Blood Pressure.- Other Signs.- a) Vomiting.- b) Anemia.- c) Cerebrospinal Fluid.- Angiography.- Echo-Encephalography.- Treatment.- Results and Conclusions.- References.- B. Technical Standards.- Supratentorial Craniotomy.- General Processes.- Preparation of the Patient’s Head.- Location of Skin Incisions.- Control of Scalp Haemorrhage.- Surgical Instruments.- Burr Holes.- Trephine Burr Holes.- Twist Drills.- Doyen Craniotomy.- Closure.- Traps.- The Bone.- The Dura.- Skull Flaps.- The Three Types of Skull Flaps.- Osteoplastic Skull Flap.- Free Skull Flap.- Pedicled Skull Flap.- General Procedure.- Skin Incision.- Procedure for Craniotomy.- Closure.- Modifications to the General Procedure.- Frontal Flaps.- Unilateral Frontal Flap.- Bilateral Frontal Flaps.- Traps.- Temporal Flaps.- Pure Temporal Flap.- Temporo-Frontal Flap.- Traps.- Parietal Flap.- Occipital Flap.- Special Craniotomies.- Occipito-Cerebellar Skull Flap.- Hemispheric Skull Flap.- Cushing Craniotomy (Subtemporal Decompression).- Skull Flap in Young Children.- Flap Reopening.- Conclusion.- References.- Removal of Extramedullar Benign Spinal Cord Tumours.- Laminectomy.- Benign Extradural Tumours.- Benign Intradural Tumours.- Meningiomas.- Neurinomas.- Subdural Lipomas.- Dermoids, Epidermoids, and Teratomas.- Tumours of the Cauda Equina.- Benign Tumours of Foramen Magnum.- Postoperative Treatment.- Results.- References.- Author Index.