Advances and Technical Standards in Neurosurgery Vol. 30 (eBook)

Nejat Akalan, Concezio Di Cuore Rocco, Vinko V. Dolenc, Rudolf Fahlbusch, J. Lobo Antunes, Marc Sindou, Nicolas de Tribolet, Cees A.F. Tulleken (Herausgeber)

eBook Download: PDF

2005 | 2005
XVI, 289 Seiten
Springer Wien (Verlag)
978-3-211-27208-4 (ISBN)

Infos

The latest in this already classic series presents recent progress and detailed descriptions of standard procedures, to assist young neurosurgeons in their post-graduate training. With contributions from experienced European and American clinicians.

Inhalt

Preface 6
Contents 7
List of Contributors 15
Advances 18
Depolarisation Phenomena in Traumatic and Ischaemic Brain Injury 19
Abbreviation List 20
History, Definitions and Introduction 21
Cortical Spreading Depression 23
Peri-Infarct Depolarisations ( PIDS) 35
The Role of Depolarisations in Pathophysiology of CNS Disorders in Humans 43
The Biological Signi.cance of CSD 53
Summary 54
Acknowledgements 55
Key Original Papers and Reviews 55
References 56
What is Magnetoencephalography and why it is Relevant to Neurosurgery? 67
Abstract 67
Introduction 68
Some Basic Notions: From Applied Physics to Biophysics 69
Clinical Applications of MEG in a Neurosurgical Setting 70
Magnetic Functional Source Imaging of the Sensorimotor Strip 71
MEG in Epilepsy: Identification of Epileptiform Inter-Ictal Foci 75
Functional Localization of Speech Relevant Brain Areas 77
Discussion and Future Developments 79
References 80
Basic and Clinical Aspects of Olfaction 85
Abstract 86
Anatomy 86
Olfactory Coding 89
Measurement of Olfactory Function 91
Causes and Symptoms of Smell Disorders 95
Surgical Risks to the Olfactory System 102
Recovery of Smell Disorders 104
Treatment of Olfactory Disorders 105
Acknowledgements 107
References 107
Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome 123
Abbreviations 124
Abstract 124
Introduction 125
Historical Perspective 125
Prevalence of Cranial Venous Outflow Obstruction in Pseudotumor Cerebri Syndrome 128
Interaction Between Venous Sinus Hypertension and CSF Pressure 130
Venous Sinus Obstruction in Pseudotumor Cerebri Syndrome: Cause or Effect? 144
Cerebrospinal Fluid Dynamics in Pseudotumor Cerebri Syndrome 156
Investigation of Venous Aetiology in Pseudotumor Cerebri Syndrome 158
Treatment of Venous Sinus Obstruction 162
Technical Considerations 172
Related Disorders 173
Conclusions 176
References 176
Technical Standards 192
Sacral Neuromodulation in Lower Urinary Tract Dysfunction 193
Abstract 195
Introduction 195
Anatomy and Physiology of the Lower Urinary Tract 196
Historical Evolution of Functional Surgery in Lower Urinary Tract Dysfunction 201
Methods and Techniques for Sacral Nerve Stimulation 204
Clinical Application of Sacral Neuromodulation 211
The Overactive Bladder 214
Results of Sacral Neuromodulation 217
Complications of Sacral Neuromodulation 221
Therapeutic Alternatives and Developping Treatments in Refractory Urge Incontinence and Idiopathic Bladder Overactivity 224
Cost of Sacral Neuromodulation 227
Conclusion 229
Acknowledgements 229
References 229
Prevention and Treatment of Postoperative Pain with Particular Reference to Children 241
Abstract 242
Introduction 242
Acute Pain Assessment in Paediatric Age 245
Specific Aspects of Post-Operative Pain 250
Post-Operative Pain Management 253
Non-Opioid Analgesics 259
Opioid Analgesics 262
Opioid Classification 264
Factors in Opioid Selection 267
Selecting the Appropriate Route of Systemic Opioid Administration 269
Scheduling of Opioid Administration 271
Patient-Controlled Analgesia 272
Management of Opioid Adverse E¤ects 275
Adjuvant Analgesics 278
Conclusions 281
References 282
Author Index Volume 1 – 30 289
Subject Index Vol. 1 – 30 301

Textauszug

Depolarisation Phenomena in Traumatic and Ischaemic Brain Injury (p. 3)

A. J. Strong and R. Dardis
History, Definitions and Introduction

In 1944 a young Brazilian physiologist, Aristides Lea˜o, was studying for his doctorate in Harvard University. According to Somjen [1], he was attempting to study propagation of epileptic activity in the cerebral cortex, and he approached the problem by applying electrical stimulation to the frontal convexity cortex of anaesthetised rabbits, and recording from an array of corticography electrodes posterior to this (Fig. 1).

Instead of seeing propagating epileptic activity, he observed a period of electrical silence, which was first seen adjacent to the stimulating electrodes, and did indeed propagate from the site of stimulation backwards along the cere- bral hemisphere – at a rate of some 3 millimetres per minute.

The phenomenon resolved after 5–15 minutes, with – apparently – full resumption of cortical electrical activity. He reported his .ndings in a landmark paper entitled ‘‘Spreading depression of activity in the cerebral cortex’’ [2].

The event which he described became known as ‘‘spreading depression’’ or ‘‘cortical spreading depression’’ [of Lea˜o] (CSD), and has remained a subject of intense interest to neurophysiologists. Although the electrophysiological and haemodynamic features have become very well characterised, with mass focal depolarisation of neurones and glia as the defining event, its most enigmatic challenges have remained its uncertain physiological role in grey matter, and its relevance – if any – to human disease states.

Since 1977–1978, stroke research laboratories have become aware of a feature of cerebral cortex in the ischaemic penumbra which shares certain characteristics with CSD, but also di¤ers from it in critical aspects. ‘‘Periinfarct depolarisations’’ (PIDs) arise spontaneously in cortex at the edge of the core ischaemic territory and propagate in the penumbra, but unlike CSD, they are harmful in that they cause progressive recruitment of the penumbra into the core territory, thus enlarging the infarct [3].

Somjen refers to such events as hypoxic spreading depression-like depolarisations (HSD) [1]. The evolution of this concept, and increasing awareness among some clinicians of its existence, has prompted increasing speculation as to whether CSD or PIDs occur in the injured human brain. Demonstrations of CSD-like events in models of traumatic brain injury, the imaging in the laboratory of propagation of PIDs across the cerebral cortex in models of focal cerebral ischaemia, the knowledge that not only cerebral cortex but also deep nuclei and the hippocampus may be subject to CSD, and particularly the recent confirmation that such events do indeed occur in patients with serious head injury [4], seem likely to open a fresh chapter in clinical brain injury research. This is an area of research to which neurosurgeons are uniquely placed to contribute.

The features of cortical spreading depression as it is observed in the experimental laboratory have been the subject of a number of authoritative reviews extending over many years, and the reader seeking the most detailed information is directed to them [1, 5–7]. We have relied extensively on these reviews as well as on the original sources.

Produkt-Details

• Erscheint lt. Verlag: 5.7.2005
• Reihe/Serie: Advances and Technical Standards in Neurosurgery
• Reihe/Serie: Advances and Technical Standards in Neurosurgery
• Mitarbeit: Chef-Herausgeber: J. D. Pickard
• Zusatzinfo: XVI, 289 p. 40 illus.
• Verlagsort: Vienna
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
• Schlagworte: Brain Injury • Consciousness • magnetoencephalography • neurosurgery • prophylactic and antibiotics • skin and bone flaps • spinal endoscopy • technical standards
• ISBN-10: 3-211-27208-9 / 3211272089
• ISBN-13: 978-3-211-27208-4 / 9783211272084