Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0007
S. Price, H. Bulstrode, R. Mair
The term high-grade glioma (HGG) encompasses a number of histological entities that are considered by the WHO Classification as WHO Grade III and IV tumours. They have traditionally been considered as having similar behaviour and had been treated in a similar manner but recent advances in our understanding of tumour biology have led to the identification of molecular markers that are now central to the classification of these tumours. Normal human cells develop into cancer cells through a stepwise accumulation of genomic and epigenomic alterations and this chapter considers the molecular markers of gliomas and explains their significance before going on to discuss the optimal management.
{"title":"High-grade gliomas and molecular biology of neurosurgical oncology","authors":"S. Price, H. Bulstrode, R. Mair","doi":"10.1093/med/9780198746706.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0007","url":null,"abstract":"The term high-grade glioma (HGG) encompasses a number of histological entities that are considered by the WHO Classification as WHO Grade III and IV tumours. They have traditionally been considered as having similar behaviour and had been treated in a similar manner but recent advances in our understanding of tumour biology have led to the identification of molecular markers that are now central to the classification of these tumours. Normal human cells develop into cancer cells through a stepwise accumulation of genomic and epigenomic alterations and this chapter considers the molecular markers of gliomas and explains their significance before going on to discuss the optimal management.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126130385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0061
K. Sweeney, C. Moran, C. Bolger
The thoracic spine occupies a unique position with respect to anatomical, biomechanical, pathological, and surgical considerations. The kyphosis of the thoracic spine is offset by the lordosis in the mobile cervical spine and the principal load bearing lumbar spine maintaining a sagittal balanced posture. Due to the biomechanical properties of the thoracic spine, the incidence of thoracic disc prolapse is low. However, the anatomical features of the thoracic spine make appropriate surgical planning imperative. This chapter will cover the management and operative approaches to thoracic disc disease, including open and minimally invasive techniques. Operative approaches can be broadly divided into two groups, anterior and posterior-lateral. Each approach is discussed with respect to technique, anatomy, closure, and common complications. It will also discuss pathogenesis, diagnosis, and management of osteoporotic fractures.
{"title":"Thoracic spinal disease","authors":"K. Sweeney, C. Moran, C. Bolger","doi":"10.1093/med/9780198746706.003.0061","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0061","url":null,"abstract":"The thoracic spine occupies a unique position with respect to anatomical, biomechanical, pathological, and surgical considerations. The kyphosis of the thoracic spine is offset by the lordosis in the mobile cervical spine and the principal load bearing lumbar spine maintaining a sagittal balanced posture. Due to the biomechanical properties of the thoracic spine, the incidence of thoracic disc prolapse is low. However, the anatomical features of the thoracic spine make appropriate surgical planning imperative. This chapter will cover the management and operative approaches to thoracic disc disease, including open and minimally invasive techniques. Operative approaches can be broadly divided into two groups, anterior and posterior-lateral. Each approach is discussed with respect to technique, anatomy, closure, and common complications. It will also discuss pathogenesis, diagnosis, and management of osteoporotic fractures.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121657307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-08DOI: 10.1093/med/9780198746706.003.0034
J. Roth, R. Dvir, S. Constantini
Choroid plexus tumours (CPT) are relatively rare and include three pathological subtypes: papilloma (CPP) (benign); carcinoma (CPC) (malignant); atypical papilloma (ACPP) (intermediate). Most cases of CPT occur during early childhood and infancy; however, occurrence at all paediatric ages as well as adulthood has been documented. The main treatment of CPT is surgical, aiming for complete resection in all subtypes of CPT. The location and vascularity of CPT present a special surgical challenge. Surgical excision of CPP can be curative. In the malignant CPC form, adjuvant chemotherapy is indicated. The role of radiotherapy is controversial. A subset of patients with CPT harbour germline or somatic TP53 mutations characterized by greater tumour aggressiveness and decreased survival.
{"title":"Choroid plexus tumours","authors":"J. Roth, R. Dvir, S. Constantini","doi":"10.1093/med/9780198746706.003.0034","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0034","url":null,"abstract":"Choroid plexus tumours (CPT) are relatively rare and include three pathological subtypes: papilloma (CPP) (benign); carcinoma (CPC) (malignant); atypical papilloma (ACPP) (intermediate). Most cases of CPT occur during early childhood and infancy; however, occurrence at all paediatric ages as well as adulthood has been documented.\u0000 The main treatment of CPT is surgical, aiming for complete resection in all subtypes of CPT. The location and vascularity of CPT present a special surgical challenge. Surgical excision of CPP can be curative. In the malignant CPC form, adjuvant chemotherapy is indicated. The role of radiotherapy is controversial. A subset of patients with CPT harbour germline or somatic TP53 mutations characterized by greater tumour aggressiveness and decreased survival.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"197 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124410483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-03DOI: 10.1093/med/9780198746706.003.0069
B. R. Chaudhary, S. Low
Trauma to the thoracic and lumbar spine may be classified using the Magerl’s or Thoracolumbar Injury Classification and Severity Score (TLICS) classifications. Older thoracolumbar trauma classification systems include those of Holdsworth, which emphasizes the mechanism of injury; Whitesides, which defines the two-column concept being analogous to a construction crane; Punjabi and White, who developed stability scoring systems; and Denis with a mechanistic classification based on instability pertaining to three columns of the spine. Management may be conservative with analgesia and bracing or surgical with posterior, transthoracic, or circumferential spinal fusion. In this chapter the classification of these injuries and their management will be discussed. The techniques to insert pedicle screws and the role of minimally invasive techniques will be explained.
{"title":"Thoracic and lumbar spine injuries","authors":"B. R. Chaudhary, S. Low","doi":"10.1093/med/9780198746706.003.0069","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0069","url":null,"abstract":"Trauma to the thoracic and lumbar spine may be classified using the Magerl’s or Thoracolumbar Injury Classification and Severity Score (TLICS) classifications. Older thoracolumbar trauma classification systems include those of Holdsworth, which emphasizes the mechanism of injury; Whitesides, which defines the two-column concept being analogous to a construction crane; Punjabi and White, who developed stability scoring systems; and Denis with a mechanistic classification based on instability pertaining to three columns of the spine. Management may be conservative with analgesia and bracing or surgical with posterior, transthoracic, or circumferential spinal fusion. In this chapter the classification of these injuries and their management will be discussed. The techniques to insert pedicle screws and the role of minimally invasive techniques will be explained.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132522307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/MED/9780198746706.003.0095
J. Pickard, N. Higgins, D. Rigamonti
Pseudotumour cerebri syndrome, previously known as benign intracranial hypertension and more recently termed idiopathic intracranial hypertension, is characterized by headaches, raised intracranial pressure, and the risk of sudden irreversible visual loss. The pathophysiology of the condition is not fully understood but reduced cerebrospinal fluid absorption secondary to venous outflow obstruction seems to be an important factor. Treatment of patients with this condition is generally with lumbar punctures, weight loss, and lumboperitoneal shunts but ventriculoperitoneal shunts, subtemporal decompression, venous sinus stenting, and acetazolamide may also be used. Prognosis in pseudotumour cerebri syndrome is variable—some patients stabilize after a single lumbar puncture, while others have persistent symptoms for many years. A patient’s symptoms may improve and then recur years later, especially if weight has been lost and then regained again.
{"title":"Pseudotumour cerebri syndrome","authors":"J. Pickard, N. Higgins, D. Rigamonti","doi":"10.1093/MED/9780198746706.003.0095","DOIUrl":"https://doi.org/10.1093/MED/9780198746706.003.0095","url":null,"abstract":"Pseudotumour cerebri syndrome, previously known as benign intracranial hypertension and more recently termed idiopathic intracranial hypertension, is characterized by headaches, raised intracranial pressure, and the risk of sudden irreversible visual loss. The pathophysiology of the condition is not fully understood but reduced cerebrospinal fluid absorption secondary to venous outflow obstruction seems to be an important factor. Treatment of patients with this condition is generally with lumbar punctures, weight loss, and lumboperitoneal shunts but ventriculoperitoneal shunts, subtemporal decompression, venous sinus stenting, and acetazolamide may also be used. Prognosis in pseudotumour cerebri syndrome is variable—some patients stabilize after a single lumbar puncture, while others have persistent symptoms for many years. A patient’s symptoms may improve and then recur years later, especially if weight has been lost and then regained again.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114520496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/med/9780198746706.003.0080
C. Bervoets, B. Nuttin, L. Gabriëls
Psychiatric disorders are among the most prevalent illnesses worldwide. Both medication and psychotherapy (alone or in combination) are evidence-based therapeutic steps in the treatment algorithm. In the past decades neurosurgical interventions for psychiatric disorders have attracted research interest and are sparsely introduced in the clinical field. The efficacy of these neurosurgical interventions (i.e. deep brain stimulation (DBS) and lesional neurosurgery) however remains under debate. We lack a full understanding of the pathophysiological basis of many psychiatric disorders. Researchers study multiple neuroanatomical targets within one psychiatric indication and multiple indications for electrical stimulation of one brain target. Stimulation parameter selection can still be improved.
{"title":"Neurosurgical interventions for psychiatric disorders","authors":"C. Bervoets, B. Nuttin, L. Gabriëls","doi":"10.1093/med/9780198746706.003.0080","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0080","url":null,"abstract":"Psychiatric disorders are among the most prevalent illnesses worldwide. Both medication and psychotherapy (alone or in combination) are evidence-based therapeutic steps in the treatment algorithm. In the past decades neurosurgical interventions for psychiatric disorders have attracted research interest and are sparsely introduced in the clinical field. The efficacy of these neurosurgical interventions (i.e. deep brain stimulation (DBS) and lesional neurosurgery) however remains under debate. We lack a full understanding of the pathophysiological basis of many psychiatric disorders. Researchers study multiple neuroanatomical targets within one psychiatric indication and multiple indications for electrical stimulation of one brain target. Stimulation parameter selection can still be improved.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"185 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116658168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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