Deletis / Shils Neurophysiology in Neurosurgery

A Modern Intraoperative Approach
1. Auflage 2002
ISBN: 978-0-08-048945-2
Verlag: Elsevier Science & Techn.
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 512 Seiten, Web PDF

Through real-time assessments of how the patient's nervous system is functioning throughout a surgical procedure, Neurophysiology in Neurosurgery presents vital techniques to guide surgeons in their efforts to minimize the risks of unintentional damage to healthy nervous tissue. This book provides a comprehensive overview of the most up-to-date intraoperative neurophysiological techniques and guidelines for the managment of neuroanesthesia during MEP monitoring. Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example. - A valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example - Provides in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and guidelines for the management of neuroanesthesia during MEP monitoring

Autoren/Hrsg.

Deletis, Vedran

Shils, Jay

Inhaltsverzeichnis

1;Front Cover;1
2;Neurophysiology in Neurosurgery: A Modern Intraoperative Approach;4
3;Copyright Page;5
4;Contents;6
5;Contributors;12
6;Preface;14
7;Acknowledgments;16
8;Part I: Motor Evoked Potentials/Neurophysiological Base (Background);18
8.1;Chapter 1. Animal and Human Motor System Neurophysiology Related to Intraoperative Monitoring;20
8.1.1;1 Introduction;21
8.1.2;2 Corticospinal Responses;22
8.1.3;3 Muscle Responses;35
8.2;Chapter 2. Intraoperative Neurophysiology and Methodologies Used to Monitor the Functional Integrity of the Motor System;42
8.2.1;1 Intraoperative Monitoring of the Motor System: A Brief History;43
8.2.2;2 New Methodologies;46
8.2.3;3 Methodological Aspects of TES During General Anesthesia;48
8.2.4;4 Recording of MEPs over the Spinal Cord (Epidural and Subdural Space) Using Single Pulse Stimulation Technique;51
8.2.5;5 Recording of MEPs in Limb Muscles Elicited by a Multipulse Stimulating Technique;58
8.2.6;6 Conclusion;66
9;Part II: Intraoperative Neurophysiology of the Spinal Cord (Spinal Cord Monitoring);70
9.1;Chapter 3. Spinal Cord Surgery;72
9.1.1;1 Introduction;73
9.1.2;2 Epidemiology and Histology;73
9.1.3;3 Clinical Presentation;74
9.1.4;4 Diagnostic Studies;75
9.1.5;5 Surgical Management;77
9.1.6;6 Outcome Following Surgery;85
9.1.7;7 Surgical Complications;86
9.1.8;8 Conclusion;87
9.2;Chapter 4. Motor Evoked Potential Monitoring for Intramedullary Spinal Cord Tumor Surgery;90
9.2.1;1 Introduction;91
9.2.2;2 Neurophysiology;93
9.2.3;3 Anesthesia;96
9.2.4;4 Safety;97
9.2.5;5 Clinical Assessment and Correlation;97
9.2.6;6 Practical Surgical Application of Intraoperative Neurophysiological Information;98
9.2.7;7 Illustrative Cases;102
9.2.8;8 Summary;106
9.3;Chapter 5. Selective Spinal Cord Lesioning Procedures for Spasticity and Pain;110
9.3.1;Part I: Selective Lesioning Procedures in Spinal Roots and Spinal Cord for Treatment of Spasticity;111
9.3.2;Part II: Selective Spinal Cord Lesioning Procedures for Treatment of Pain: DREZ Lesions;121
9.4;Chapter 6. Neurophysiological Monitoring During Endovascular Procedures on the Spine and the Spinal Cord;136
9.4.1;1 Spinal Cord Vascularization and Ischemia;137
9.4.2;2 Neurophysiological Monitoring;141
9.4.3;3 Endovascular Treatment of Vascular Malformations and Tumors of the Spine and the Spinal Cord;150
9.4.4;4 Conclusions;164
9.5;Chapter 7. Intraoperative Neurophysiological Mapping of the Spinal Cord’s Dorsal Columns;170
9.5.1;1 Introduction;171
9.5.2;2 Methods of Intraoperative Recording of SEPs with Miniature Electrodes;173
9.5.3;3 Results;174
9.5.4;4 Discussion;177
9.5.5;5 Conclusion;181
10;Part III: Intraoperative Neurophysiology of Peripheral Nerves, Nerve Roots and Plexuses;184
10.1;Chapter 8. Intraoperative Neurophysiology of the Peripheral Nervous System;186
10.1.1;1 Background;187
10.1.2;2 Nerve Regeneration;191
10.1.3;3 Equipment for Intraoperative Recording;192
10.1.4;4 Electrodes for Intraoperative Recording and Stimulation;195
10.1.5;5 Anesthetic Considerations;199
10.1.6;6 Recording CNAPs Intraoperatively;199
10.1.7;7 Criteria for Appraising a CNAP;200
10.1.8;8 Operative Results;202
10.1.9;9 Troubleshooting;207
10.1.10;10 Conclusions;211
10.2;Chapter 9. Intraoperative Neurophysiological Monitoring of the Sacral Nervous System;214
10.2.1;1 Introduction;215
10.2.2;2 Functional Anatomy;216
10.2.3;3 Clinical Neurophysiological Tests in Diagnostics;219
10.2.4;4 Intraoperative Clinical Neurophysiology;220
10.2.5;5 Discussion and Conclusions;229
10.3;Chapter 10. Sensory Rhizotomy for the Treatment of Childhood Spasticity;236
10.3.1;1 Introduction;236
10.3.2;2 Modern Development of Selective Dorsal Rhizotomy;237
10.3.3;3 Physiologic Basis of Current Techniques;240
10.3.4;4 Outcome;242
10.3.5;5 Conclusion;245
10.4;Chapter 11. Neurophysiological Monitoring During Pedicle Screw Placement;248
10.4.1;1 Introduction;249
10.4.2;2 Techniques for Assessing Nerve Root Function and Pedicle Screw Placement;250
10.4.3;3 Personal Experience;272
10.4.4;4 Conclusions;276
11;Part IV: Intraoperative Neurophysiology of Cranial Nerves and Brainstem;282
11.1;Chapter 12. Surgery of Brainstem Lesions;284
11.1.1;1 Introduction;285
11.1.2;2 Patient Selection and Rationale for Surgery;286
11.1.3;3 General Principles of the Surgical Strategy;287
11.1.4;4 Postoperative Care;296
11.1.5;5 Neurophysiological Monitoring;302
11.1.6;6 Conclusion;303
11.2;Chapter 13. Monitoring and Mapping the Cranial Nerves and the Brainstem;308
11.2.1;1 Introduction;309
11.2.2;2 Monitoring Cranial Motor Nerves;309
11.2.3;3 Monitoring Sensory Cranial Nerves;318
11.2.4;4 Monitoring the Brainstem;326
11.2.5;5 Mapping the Floor of the Fourth Ventricle;327
11.2.6;6 Monitoring That Can Guide the Surgeon During an Operation;328
11.2.7;7 Conclusions;332
11.3;Chapter 14. Brainstem Mapping;336
11.3.1;1 Introduction;337
11.3.2;2 Methodology of BSM;339
11.3.3;3 Results of BSM;340
11.3.4;4 Surgical Implications of BSM;342
11.3.5;5 Clinical Limitations of BSM;344
11.3.6;6 Representative Case of BSM;345
11.3.7;7 Clinical Application of BSM;348
11.3.8;8 Summary;349
12;Part V: Intraoperative Neurophysiology of Supratentorial Procedures;354
12.1;Chapter 15. Intraoperative Neurophysiological Mapping and Monitoring for Supratentorial Procedures;356
12.1.1;1 Introduction;357
12.1.2;2 Somatosensory Evoked Potentials;359
12.1.3;3 Intraoperative and Perioperative Neurophysiological Functional Mapping;370
12.1.4;4 MEP Monitoring;384
12.1.5;5 Safety and Anesthesia;404
12.1.6;6 Value and Limitations from a Clinical Perspective;407
13;Part VI: Intraoperative Neurophysiology During Stereotactic Neurosurgery for Movement Disorders;420
13.1;Chapter 16. Neurophysiological Monitoring During Neurosurgery for Movement Disorders;422
13.1.1;1 Introduction;423
13.1.2;2 History and Theory;423
13.1.3;3 Operating Room Environment and Basic Equipment;434
13.1.4;4 Technique for Movement Disorder Surgery;441
13.1.5;5 Conclusion;456
14;Part VII: Intraoperative Neurophysiology and Anesthesia Management;466
14.1;Chapter 17. Anesthesia and Motor Evoked Potential Monitoring;468
14.1.1;1 Introduction;469
14.1.2;2 Overview;469
14.1.3;3 Effects of Specific Anesthetic Agents;472
14.1.4;4 Conclusion: Anesthetic Choice for Motor Tract Monitoring;485
15;Index;492