Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0001
H. Marsh, E. Marts
The history of neurosurgery falls naturally into the premodern era, where it is essentially the history of surgery to the skull and of head injuries, and the modern era, where it is the history of surgery to the brain itself, made possible by cerebral localization theory, antisepsis, and anaesthesia, all of which developed in the nineteenth century. The first known neurosurgical procedures were skull trephines, seemingly carried out on both the living and the dead. It is unclear whether these were performed for therapeutic or ritualistic reasons. There are many trepanned skulls dating back thousands of years to the Neolithic era, and perhaps to even earlier, from sites all over the world.
{"title":"The history of neurosurgery","authors":"H. Marsh, E. Marts","doi":"10.1093/med/9780198746706.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0001","url":null,"abstract":"The history of neurosurgery falls naturally into the premodern era, where it is essentially the history of surgery to the skull and of head injuries, and the modern era, where it is the history of surgery to the brain itself, made possible by cerebral localization theory, antisepsis, and anaesthesia, all of which developed in the nineteenth century. The first known neurosurgical procedures were skull trephines, seemingly carried out on both the living and the dead. It is unclear whether these were performed for therapeutic or ritualistic reasons. There are many trepanned skulls dating back thousands of years to the Neolithic era, and perhaps to even earlier, from sites all over the world.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"15 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":"128935037","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/9780198746706.003.0022
T. Mathiesen, P. Förander, D. Pettersson
Sporadic vestibular schwannoma (VS) is the commonest tumour of the cerebellopontine angle and comprise 6–8% of all intracranial tumours. The incidence varies between 12 and 20 cases per million inhabitants and years in different reports; a large minority of these tumours grow during follow-up. Treatment options include wait and scan, microsurgery, radiosurgery, and radiotherapy. Micro- and radiosurgery are well validated to offer long-term tumour control, but patients may suffer from hearing deficit and facial nerve paresis. Unexpectedly, long-term life quality is more affected by vertigo and headaches. Other cranial nerve schwannomas cause symptoms depending on the affected nerves and respond to the same therapies when treatment is indicated.
{"title":"Schwannomas","authors":"T. Mathiesen, P. Förander, D. Pettersson","doi":"10.1093/med/9780198746706.003.0022","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0022","url":null,"abstract":"Sporadic vestibular schwannoma (VS) is the commonest tumour of the cerebellopontine angle and comprise 6–8% of all intracranial tumours. The incidence varies between 12 and 20 cases per million inhabitants and years in different reports; a large minority of these tumours grow during follow-up. Treatment options include wait and scan, microsurgery, radiosurgery, and radiotherapy. Micro- and radiosurgery are well validated to offer long-term tumour control, but patients may suffer from hearing deficit and facial nerve paresis. Unexpectedly, long-term life quality is more affected by vertigo and headaches. Other cranial nerve schwannomas cause symptoms depending on the affected nerves and respond to the same therapies when treatment is indicated.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"35 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":"127802397","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/9780198746706.003.0071
A. Forster, R. Morris
Clinical neurophysiology provides valuable information in neurosurgery, serving as: a diagnostic tool that can quantify type and severity of damage to the central and peripheral nervous system, a means of monitoring the safety of structures within and around the surgical site, and a method to map structures. As such it aides in identifying structures (e.g. finding sacral nerve roots within a spinal lipoma or nuclei within the thalamus), assessing functional integrity (e.g. motor pathways from cortex to any relevant accessible muscle), and monitoring their function while surgery occurs near to structures (e.g. VII while retraction during trigeminal microvascular decompression, and in scoliosis surgery) and provide guidance to technical operative steps (e.g. for selective dorsal rhizotomy). Intraoperative monitoring is not new, though the advances in equipment and technique of recent years have seen an explosion in the useful ways that neurophysiology can aid the neurosurgeon and protect the patient. The development of techniques to localize epileptic foci and map eloquent cerebral cortex in the 1950s produced major scientific advances as well as revolutionizing epilepsy surgery. Since the 1960s Tasker in Toronto, and Gillingham in Edinburgh, were recording from microelectrodes in the human thalamus to guide movement disorder surgery. Pioneers such as Møller have extended the applications of neurophysiological monitoring in skull base surgery. This chapter describes neurophysiological mapping and monitoring, and the different tools that are useful in different situations.
{"title":"Electrodiagnostics","authors":"A. Forster, R. Morris","doi":"10.1093/med/9780198746706.003.0071","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0071","url":null,"abstract":"Clinical neurophysiology provides valuable information in neurosurgery, serving as: a diagnostic tool that can quantify type and severity of damage to the central and peripheral nervous system, a means of monitoring the safety of structures within and around the surgical site, and a method to map structures. As such it aides in identifying structures (e.g. finding sacral nerve roots within a spinal lipoma or nuclei within the thalamus), assessing functional integrity (e.g. motor pathways from cortex to any relevant accessible muscle), and monitoring their function while surgery occurs near to structures (e.g. VII while retraction during trigeminal microvascular decompression, and in scoliosis surgery) and provide guidance to technical operative steps (e.g. for selective dorsal rhizotomy). Intraoperative monitoring is not new, though the advances in equipment and technique of recent years have seen an explosion in the useful ways that neurophysiology can aid the neurosurgeon and protect the patient. The development of techniques to localize epileptic foci and map eloquent cerebral cortex in the 1950s produced major scientific advances as well as revolutionizing epilepsy surgery. Since the 1960s Tasker in Toronto, and Gillingham in Edinburgh, were recording from microelectrodes in the human thalamus to guide movement disorder surgery. Pioneers such as Møller have extended the applications of neurophysiological monitoring in skull base surgery. This chapter describes neurophysiological mapping and monitoring, and the different tools that are useful in different situations.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"36 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":"127937181","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/9780198746706.003.0064
D. Walsh
Vascular malformations of the spinal cord are uncommon and diverse conditions. Presentation is frequently with an indolent, radiculomyelopathy, the origins of which will be traced back many months or years. Fruitless investigation may be pursued for inflammatory or neoplastic processes. This is all the more regrettable as many such malformations are treatable. Haemorrhage from spinal malformations is still more rare and a considerable management challenge. In this chapter we will describe the pathophysiology of these conditions and summarize the current approach to management, while the adaptation of the Bicêtre system is covered towards the end. The pathophysiology of spinal ischaemia and primary spinal haemorrhage is also reviewed.
{"title":"Vascular lesions of the spinal cord","authors":"D. Walsh","doi":"10.1093/med/9780198746706.003.0064","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0064","url":null,"abstract":"Vascular malformations of the spinal cord are uncommon and diverse conditions. Presentation is frequently with an indolent, radiculomyelopathy, the origins of which will be traced back many months or years. Fruitless investigation may be pursued for inflammatory or neoplastic processes. This is all the more regrettable as many such malformations are treatable. Haemorrhage from spinal malformations is still more rare and a considerable management challenge. In this chapter we will describe the pathophysiology of these conditions and summarize the current approach to management, while the adaptation of the Bicêtre system is covered towards the end. The pathophysiology of spinal ischaemia and primary spinal haemorrhage is also reviewed.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"46 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":"132507997","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/9780198746706.003.0056
S. Thomson, C. Derham, S. Selvanathan
This chapter is an introduction to spinal surgery, specific surgical techniques will be covered in other chapters. Preoperative considerations include the need for effective preoperative patient selection and careful consent. The optimal management of antiplatelet drugs and low molecular weight heparins in patients having spinal surgery is discussed but remains unclear. Perioperative considerations include careful patient positioning to protect the eyes and other pressure areas as well as the accurate marking of levels using X-ray. The use of microscopes and neurophysiology in spinal surgery is also discussed. The importance of fusion and the techniques used to promote it are covered in this chapter. Screw, rod, and plate design is explained. The principles of minimal access surgery down tubes or with dedicated implant kits is also considered. Postoperative considerations include the place of physiotherapy and venous thromboembolism avoidance.
{"title":"Surgical principles in spinal surgery","authors":"S. Thomson, C. Derham, S. Selvanathan","doi":"10.1093/med/9780198746706.003.0056","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0056","url":null,"abstract":"This chapter is an introduction to spinal surgery, specific surgical techniques will be covered in other chapters. Preoperative considerations include the need for effective preoperative patient selection and careful consent. The optimal management of antiplatelet drugs and low molecular weight heparins in patients having spinal surgery is discussed but remains unclear. Perioperative considerations include careful patient positioning to protect the eyes and other pressure areas as well as the accurate marking of levels using X-ray. The use of microscopes and neurophysiology in spinal surgery is also discussed. The importance of fusion and the techniques used to promote it are covered in this chapter. Screw, rod, and plate design is explained. The principles of minimal access surgery down tubes or with dedicated implant kits is also considered. Postoperative considerations include the place of physiotherapy and venous thromboembolism avoidance.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"34 5 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":"132794985","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/9780198746706.003.0042
M. Kirkman, Martin Smith
This chapter provides an overview of the early and intensive care management of traumatic brain injury (TBI), with a focus on interventions designed to optimize cerebral and systemic physiological variables in order to minimize secondary brain injury and systemic complications. Importantly, it has become increasingly apparent that intracranial and cerebral perfusion pressure monitoring alone cannot detect all instances of cerebral compromise. There has thus been a shift towards the use of multimodality neuromonitoring to provide early warning of cerebral hypoxia/ischaemia and guide timely and targeted interventions that aim to improve outcomes after TBI. Further research is required to establish the role of many of the interventions that are currently considered routine aspects of the management of TBI.
{"title":"Intensive care management of head injury","authors":"M. Kirkman, Martin Smith","doi":"10.1093/med/9780198746706.003.0042","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0042","url":null,"abstract":"This chapter provides an overview of the early and intensive care management of traumatic brain injury (TBI), with a focus on interventions designed to optimize cerebral and systemic physiological variables in order to minimize secondary brain injury and systemic complications. Importantly, it has become increasingly apparent that intracranial and cerebral perfusion pressure monitoring alone cannot detect all instances of cerebral compromise. There has thus been a shift towards the use of multimodality neuromonitoring to provide early warning of cerebral hypoxia/ischaemia and guide timely and targeted interventions that aim to improve outcomes after TBI. Further research is required to establish the role of many of the interventions that are currently considered routine aspects of the management of TBI.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"160 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":"121166763","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/9780198746706.003.0028
J. Rutka
Under the term embryonal tumours, we examine the malignant neoplasms medulloblastomas, CNS-PNETs, AT/RTs, and ETANTRs. The common histological link between them is the small, round, blue cells which appear on H&E stains. They are considered highly malignant tumours (WHO Grade IV), although significant variation of prognosis exists between the different subtypes. Current classification is based on their histopathological features. Advances on understanding of the molecular biology and behaviour of their cellular lines, has dramatically changed their stratification and scientific approach. Combination of surgical treatment with new schemes of adjuvant chemo- and radiotherapy offers improved survival rates but comes with a high cost on neurocognitive, endocrine, and overall functional status. New therapies with molecular targets will hopefully improve outcomes with minimal side effects and collateral damage.
{"title":"Medulloblastoma","authors":"J. Rutka","doi":"10.1093/med/9780198746706.003.0028","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0028","url":null,"abstract":"Under the term embryonal tumours, we examine the malignant neoplasms medulloblastomas, CNS-PNETs, AT/RTs, and ETANTRs. The common histological link between them is the small, round, blue cells which appear on H&E stains. They are considered highly malignant tumours (WHO Grade IV), although significant variation of prognosis exists between the different subtypes. Current classification is based on their histopathological features. Advances on understanding of the molecular biology and behaviour of their cellular lines, has dramatically changed their stratification and scientific approach. Combination of surgical treatment with new schemes of adjuvant chemo- and radiotherapy offers improved survival rates but comes with a high cost on neurocognitive, endocrine, and overall functional status. New therapies with molecular targets will hopefully improve outcomes with minimal side effects and collateral damage.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"262 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":"126052668","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/9780198746706.003.0015
R. Almefty, O. Al-Mefty
Chordomas and chondrosarcomas are rare tumours that occur at the skull base. Chordomas have a benign appearing histology but behave malignantly with a high tendency to invade locally, recur, demonstrate tumour progression by accumulating genetic mutations, metastasize, and surgically implant. Aggressive treatment is necessary and radical resection including of the invaded bone followed by adjuvant high-dose radiation therapy offers the best chance for long-term disease-free survival. This requires initiating treatment at the onset, since once the tumour recurs the outcome is poor. Multiple surgical approaches may need to be employed to achieve the sought-after radical resection in a given patient. Utilizing all of the advances in operative techniques including microscopic and endoscopic techniques, intraoperative imaging, and neuronavigation facilitates this goal. Particle-based radiation has a proven record in a large experience as an adjunct to radical surgical resection. Chondrosarcomas are rarer and carry a better prognosis. Complete surgical removal has excellent recurrence-free survival rates. Radiation therapy has also showed high control rates but may not be necessary given their benign course. Immunohistochemical analysis is essential for ensuring the proper diagnosis.
{"title":"Chordomas and chondrosarcomas of the skull base","authors":"R. Almefty, O. Al-Mefty","doi":"10.1093/med/9780198746706.003.0015","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0015","url":null,"abstract":"Chordomas and chondrosarcomas are rare tumours that occur at the skull base. Chordomas have a benign appearing histology but behave malignantly with a high tendency to invade locally, recur, demonstrate tumour progression by accumulating genetic mutations, metastasize, and surgically implant. Aggressive treatment is necessary and radical resection including of the invaded bone followed by adjuvant high-dose radiation therapy offers the best chance for long-term disease-free survival. This requires initiating treatment at the onset, since once the tumour recurs the outcome is poor. Multiple surgical approaches may need to be employed to achieve the sought-after radical resection in a given patient. Utilizing all of the advances in operative techniques including microscopic and endoscopic techniques, intraoperative imaging, and neuronavigation facilitates this goal. Particle-based radiation has a proven record in a large experience as an adjunct to radical surgical resection. Chondrosarcomas are rarer and carry a better prognosis. Complete surgical removal has excellent recurrence-free survival rates. Radiation therapy has also showed high control rates but may not be necessary given their benign course. Immunohistochemical analysis is essential for ensuring the proper diagnosis.","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":"126787682","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/9780198746706.003.0052
M. Guilfoyle, P. Kirkpatrick
Symptomatic stenosis or occlusion of the cervical (C1) internal carotid artery (ICA) is best addressed surgically with direct endarterectomy or thrombectomy procedures. This strategy is not usually possible for more distal lesions, and restoring brain perfusion requires diversion of blood from the extracranial to intracranial circulation with a variety of indirect and direct bypass techniques. However, despite five decades of experience and technical refinement, extracranial-intracranial (EC-IC) bypass for cerebral ischaemia remains contentious. This chapter looks at the conflicting bodies of evidence and opinion regarding how best to select patients for surgery, and asks whether there is meaningful clinical benefit with the surgical options available.
{"title":"Extracranial-intracranial bypass for cerebral ischaemia","authors":"M. Guilfoyle, P. Kirkpatrick","doi":"10.1093/med/9780198746706.003.0052","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0052","url":null,"abstract":"Symptomatic stenosis or occlusion of the cervical (C1) internal carotid artery (ICA) is best addressed surgically with direct endarterectomy or thrombectomy procedures. This strategy is not usually possible for more distal lesions, and restoring brain perfusion requires diversion of blood from the extracranial to intracranial circulation with a variety of indirect and direct bypass techniques. However, despite five decades of experience and technical refinement, extracranial-intracranial (EC-IC) bypass for cerebral ischaemia remains contentious. This chapter looks at the conflicting bodies of evidence and opinion regarding how best to select patients for surgery, and asks whether there is meaningful clinical benefit with the surgical options available.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"10 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":"125571158","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/9780198746706.003.0038
F. Greenway, F. Elmslie, Timothy Jones
The term phakomatosis, from the Greek root phakos, meaning lens or spot, was first used in 1920 to describe a group of multisystem disorders with common neuro-oculocutaneous findings. Each condition is caused by distinct genetic defects, with some overlap in terms of protein function. They share pathogenetic mechanisms in dysfunction of a tumour suppressor gene. This chapter details four of the phakomatoses seen in practice—neurofibromatosis types 1 and 2, tuberous sclerosis complex, and von Hippel-Lindau—paying attention to their neurological sequelae and impact on neurosurgical practice. For each condition, the epidemiology, genetics, diagnostic criteria, screening, clinical features, management, and controversy will be reviewed, with an accompanying illustrative case.
{"title":"Neurophakomatoses","authors":"F. Greenway, F. Elmslie, Timothy Jones","doi":"10.1093/med/9780198746706.003.0038","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0038","url":null,"abstract":"The term phakomatosis, from the Greek root phakos, meaning lens or spot, was first used in 1920 to describe a group of multisystem disorders with common neuro-oculocutaneous findings. Each condition is caused by distinct genetic defects, with some overlap in terms of protein function. They share pathogenetic mechanisms in dysfunction of a tumour suppressor gene. This chapter details four of the phakomatoses seen in practice—neurofibromatosis types 1 and 2, tuberous sclerosis complex, and von Hippel-Lindau—paying attention to their neurological sequelae and impact on neurosurgical practice. For each condition, the epidemiology, genetics, diagnostic criteria, screening, clinical features, management, and controversy will be reviewed, with an accompanying illustrative case.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"65 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":"125608771","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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