Advances and Technical Standards in Neurosurgery

A. Advances.- Biological Markers for Tumours of the Brain.- Classification of Brain Tumours.- General Features of Brain Tumours.- Investigative and Diagnostic Neuro-Oncology Techniques.- 1. Tumours of Neuroepithelial Tissue.- 1.1. Astrocytic Tumours.- Astrocytomas.- Anaplastic (Malignant) Astrocytomas.- Glioblastoma Multiforme.- Pilocytic Astrocytomas.- Pleomorphic Xanthoastrocytomas.- Subependymal Giant Cell Astrocytomas.- 1.2. Oligodendroglial Tumours.- 1.3. Ependymal Tumours.- 1.4. Choroid Plexus Tumours.- 1.5. Neuronal and Mixed Neuronal-Glial Tumours.- Dysembryoplastic Neuroepithelial Tumour (DNT).- Ganglioglioma.- Desmoplastic Infantile Ganglioglioma.- Central Neurocytoma.- 1.6. Pineal Tumours.- 1.7. Embryonal Tumours.- Primitive Neuroectodermal Tumours (PNETs).- Neuroblastomas.- 2. Tumours of Cranial and Spinal Nerves.- 2.1. Schwannomas.- 2.2. Neurofibroma.- 3. Tumours of the Meninges.- 3.1. Meningiomas.- 3.2. Mesenchymal, Non-Meningothelial Tumours.- Haemangiopericytomas.- 3.3. Tumours of Uncertain Histogenesis.- Capillary Haemangioblastomas.- 4. Haemopoietic Neoplasms.- Primary Malignant Lymphomas.- 5. Germ Cell Tumours.- 6. Pituitary Adenomas.- 7. Local Extension from Regional Tumour.- 8. Metastatic Tumours.- References.- Histoprognosis of Gliomas.- Historical Considerations.- Intra-tumoral Heterogeneity of Gliomas.- Intra-tumoral Heterogeneity and Structure Type of Gliomas.- Structure Type of Gliomas and Imaging.- Structure Type of Gliomas and Treatment Planning.- Structure Type and Spatial Kinetics of Gliomas.- Intra-tumoral Heterogeneity and Tumor Progression: Recent Molecular Biology Data.- Intra-tumoral Morphological Heterogeneity of Gliomas: Issue of Sampling.- Current Problems in Histological Typing of Glial Neoplasms.- Histological Typing of Astrocytomas.- Pilocytic Astrocytomas versus Ordinary Astrocytoma Cell Types.- Microcystic Cerebellar Astrocytomas versus Pilocytic Astrocytomas.- Histological Typing of Oligodendrogliomas.- Histological Grading System of Astrocytomas.- Histological Grading of Oligodendrogliomas.- Histological Typing and Grading in Childhood Gliomas.- References.- Brain Protection.- I. Introduction: Historical Perspective.- II Pathophysiology of Brain Insults.- 1. Aspects of Brain Ischemia.- Energy Production in the Normal Brain.- Thresholds and Duration of Ischemia.- Global Ischemia and Delayed Neuronal Death.- Focal Ischemia and the “Penumbra” Zone.- 2. Secondary Brain Damage.- Evolution of Primary Insult.- Secondary Insults.- 3. Ischemic and Traumatic Insults: Common Mechanism.- III. Mechanisms of Damage and Related Protections.- 1. Energy Failure and Metabolic Protection.- Barbiturates and Similar Drugs.- Hypothermia.- 2. Ca++ Damage, Excitotoxic Mechanisms and Related Therapies.- Mechanism of Ca++ Increased Cytosolic Concentrations.- Consequences of Increased Cytosolic Ca++ Concentration.- Evidence of Ca++ Damage in CNS Injuries.- Pharmacologic Protection Against Ca++ Overload.- 3. Peroxidative Damage and Antioxidant Therapy.- Free Radical Reactions.- Origin of Free Radicals in CNS Injury.- Evidence of Free Radicals Injury in CNS Insult.- Therapies Against Free Radicals.- 4. Acidotic Damage and Antiacidotic Therapies.- 5. Miscellaneous Mediators of Brain Damage and Neuroprotective Agents.- IV. Acute Brain Insults and Attempts at Protection.- 1. Intraoperative Brain Protection.- Cardiovascular Surgery.- Carotid Surgery.- Aneurysm Surgery.- 2. Subarachnoid Haemorrhage.- 3. Stroke.- 4. Brain Trauma.- 5. Spinal Trauma.- V. Concluding Remarks.- 1. Relevance of Experimental Research.- 2. Methodology of Clinical Trials.- 3. Overall Philosophy of Brain Protection.- References.- B. Technical Standards.- AIDS and the Neurosurgeon — an Update.- Summary.- Incidence and Epidemiology.- Neurologic Manifestations.- Intracranial Mass Lesions.- Nonviral Infections.- Cryptococcal Infection.- Toxoplasmosis.- Other Fungal Infections.- Neoplasms.- Primary CNS Lymphoma.- Metastatic Neoplasms.- Cerebrovascular Diseases.- Viral Infections.- Progressive Multifocal Leukoencephalopathy.- Multiple CNS Diseases.- Peripheral Neuropathic Syndromes.- Evaluation of the Symptomatic Patient.- Algorithms to Evaluate the AIDS Patient with Neurologic Symptoms.- Impact of AIDS on Neurosurgical Practice.- References.- The Surgery of Occult Spinal Dysraphism.- Embryology and Foetal Development of the Spinal Cord. Pathogenesis of Malformations.- I A. Neurulation.- I B. Deranged Neurulation.- II A. Canalization and Retrogressive Differentiation.- II B. Deranged Canalization and Retrogressive Differentiation.- Classification.- Age and Sex Distribution.- Clinical Presentation.- Indications for Investigations.- The Lesions.- I. Spinal Lipomas.- II. Anomalies of the Spinal Cord and Roots.- A. Adhesions and Bands.- B. Tight Filum terminale.- C. Diastematomyelia and Diplomyelia.- III. Anterior Meningoceles.- IV. Dermal Sinus.- V. Neurenteric Cysts.- VI. Sacral Agenesis.- Conclusion.- References.- Functional Stereotactic Neurosurgery for Psychiatric Disorders: an Experience in Belgium and The Netherlands.- Preface.- 1. Principles of Psychosurgery.- 1.1. Introduction.- 1.2. Historical Overview.- 1.3. Patient Data.- 1.4. Ethical and Legal Issues.- 1.5. Committee on Psychosurgery.- 1.6. Committee on Psychosurgery: Patient Material.- 2. Stereotactic Techniques.- 2.1. Psychosurgery in Obsessive Compulsive Disorder.- 2.1.1. Introduction.- 2.1.2. Anterior Capsulotomy (AC): the Operative Technique Followed by Caemaert.- 2.1.3. Subcaudate Tractotomy (SCT).- 2.1.4. Surgical Complications of Subcaudate Tractotomy.- 2.1.5. Technique of Progressive Leucocoagulation Followed by van Veelen and Haaijman.- 2.2. Psychosurgery in Aggressive Conduct Disorder.- 2.2.1. Intralaminar (i.La.) and Dorsomedial (MD) Thalamotomy.- 2.2.2. Amygdalotomy.- 3. Patients with Obsessive Compulsive Disorder (OCD).- 3.1. Patient Data.- 3.2. Post-Operative Psychiatric Evaluation.- 3.3. Comparison of the Results of the Two Stereotactic Techniques (SCT and PL).- 3.4. Post-Operative Psychiatric Evaluation: Particular Clinical Observations.- 4. Aggressive Conduct Disorder in Patients with Mental Retardation (IQ50).- 4.1. Patient Data.- 4.2. Post-Operative Psychiatric Follow-up.- References.- Subject Index Listed in Index Medicus.