Pediatric Neurosurgery Theoretical Principles — Art of Surgical Techniques

Both a theoretic text-book and a descriptive atlas, this standard reference in the field of pediatric neurosurgery presents basic clinical concepts and surgical techniques in a step-by-step fashion. The neuro-imaging essential both to clinical diagnosis and surgical planning are set into the text in a consequential manner, endeavoring to facilitate visual retention and spatial orientation. The illustrations present the visual perspectives of the surgeon, they are often integrated into imaging studies, and the sequence of their presentation is designed to permit time-frame comprehension. Great attention is given to the dynamics of decision making (offering alternatives) and where particular caution is the pass-word. The different perspectives and opinions of other leaders in the field are woven into the discussions, developing for the reader concepts upon which he may draw. The review of the world literature between 1980 and 1998 is complete, but the text is not laden with citations, quotes, supporting and opposing views. The author expresses these throughout the book as the synthesis of his readings, discussions, experiences, and reflections.

List of Contents.- 1 Positioning.- General Discussion.- Specific Positions.- Positioning of the Child Vis-à-vis the Surgeon’s Line of Sight.- Positions of Surgeon, Assistants, and Nurse Around the Patient.- Accommodating Anesthesia.- General Positions.- Supine Position.- Prone Position.- Lounging Position.- References.- 2 Incisions: Scalp, Muscle, Tissue, and Tumor Hemostasis.- Specific Incisions for Surgical Approaches.- Bifrontal Incision.- Frontal Incision.- Frontoparietal Skin Incision for Frontoparietal Bur Holes.- Frontoparietal Incision for Posterofrontal or Anteroparietal Lesions.- Parietal Incision.- Parasagittal Incision.- Temporal Incision.- Occipital Incision.- Suboccipital Incision.- Combined Supra-and Infratentorial Incision.- Hemispherical Incision.- Laminotomy.- Techniques for Scalp Hemostasis in Various Ages: Newborn, Infant, Toddler.- Specific Types of Bleeding.- Closure.- Laminotomy.- 3 Bur Holes and Flaps.- Bur Holes: Frontoparietal (So-Called “Diagnostic”).- Flaps.- Bifrontal Flap.- Frontal Flap.- Approaches to the Orbit.- Parietal Flap.- Parietotemporal Flap.- Biparietal Craniotomy.- Temporal Flaps.- Occipital Flaps.- Suboccipital Flaps.- Supra-and Infratentorial Craniotomy.- Hemispherical Craniotomy.- Laminotomy.- Bone Closure.- References.- 4 Suturotomy for Various Flaps in the Newborn and Infant.- 5 Dural Flaps.- General Comments.- Dural Openings.- Closure.- References.- 6 Cerebral Retraction.- Cistern Openings.- Use of Gravity.- Ambient Cistern Lesions.- Use of Cotton Fluffies and Telfa.- Self-Retaining Retractors.- References.- 7 Cerebrotomy.- Gyral Cerebrotomy.- Sulcal Cerebrotomy.- Small Vessels at the Depth of the Sulcus or Gyrus.- Cerebrotomy Through White Matter.- 8 Cerebral Resection.- Biopsy.- Lobectomy.- Hemispherectomy.- 9Epilepsy.- Results.- Definitions.- Epidemiology.- Classification of Epileptic Seizures.- Patient Selection.- Noninvasive Methodologies.- History and Physical.- EEG and Video- EEG.- Diagnosis by Imaging Studies.- Invasive Methodologies.- Operative Procedures.- References.- 10 Tumors.- Surgical Approach and Removal.- Bone Tumors.- Age and Brain Tumors.- Materials and Methods.- Hemispherical Tumors.- Ventricular Tumors.- Vermian Tumors.- Foramen Magnum Tumors.- Cerebellar Hemisphere Tumors.- Parasellar Tumors.- Corpus Callosum and Septum Pellucidum Tumors.- Spinal Tumors.- Intradural-Extramedullary Tumors.- Intramedullary Tumors.- References.- 11 Vascular Disorders: Surgical Approaches and Operative Technique.- Saccular Aneurysms.- Vascular Malformations.- Transcranial Venovenous Shunts.- Transcranial Arteriovenous Fistulae.- Dural Arteriovenous Fistulae.- Superior Sagittal Sinus Thrombosis.- Parenchymal Arteriovenous Malformations.- Venous Angiomas.- Cerebellar Hemisphere.- Arteriovenous Malformations.- Orbital Cavernoma.- Brainstem Arteriovenous Malformations.- Spontaneous Intraparenchymal Hemorrhage.- Intraventricular Arteriovenous Malformations.- Arteriovenous Fistulae Involving Galenic System and/or Perimesencephalic Leptomeninges.- Heart Failure, Arteriovenous Shunting, Thrombophlebitis, and Hydrocephalus.- Endovascular Occlusion or Open Surgery.- References.- 12 Infections.- Osteomyelitis.- Epidural Empyema.- Subdural Abscess and Subdural Empyema.- Acute Meningitis with Hydrocephalus.- Brain Abscess.- Bur Hole and Cannula Drainage.- Craniotomy and Resection of the Abscess.- Pyocephalus.- Ventriculitis.- Subdural Effusions.- Cerebritis and Cerebellitis.- Wound Infections.- References.- 13 Trauma.- Injuries of the Scalp.- Cerebral Contusion and Edema.- Epidural Hematoma.- Cerebrospinal Fluid Leaks.- Meningocele Spuria.- Child Abuse.- Post -traumatic Cerebrovascular Injuries.- False Aneurysms.- Cranioplasty.- Vertebral Fracture Dislocation.- References.- 14 Congenital Anomalies.- Congenital Anomalies Involving the Craniocerebrum and Craniocervical Junction.- Hypertelorism.- Arachnoidal Cysts.- Craniofacial Encephalomeningoceles.- Cranioschisis.- Cranial Meningoencephalocele.- Craniocerebral Disproportions: Chiari Malformations.- Separation of Craniopagus Twins.- Vertebrospinal Congenital Anomalies.- The Dysraphic State.- Nondysraphic Spinal Cord Anomalies and Congenital Tumors.- References.- 15 Hydrocephalus.- Definition and Classification.- Surgical Treatment and Prognosis.- Genesis of Parenchymal Destruction.- Diagnosis.- Treatment.- Intellectual Development and Quality of Survival.- Surgical Management.- Techniques for Cannulation of the Ventricles.- Shunts.- References.