| List of Contributors | p. XIII |
| Advances | |
| Disorders of Consciousness: Anatomical and Physiological Mechanisms | |
| Abstract | p. 3 |
| Introduction | p. 4 |
| The Wake-Sleep Cycle | p. 4 |
| Phenomenology | p. 5 |
| Regulation | p. 6 |
| Wakefulness Network | p. 8 |
| The Posterior Hypothalamus | p. 11 |
| Histamine Network | p. 11 |
| Orexin/Hypocretin Network | p. 12 |
| Brainstem Acetylcholine and Amine Networks | p. 14 |
| The Serotonin System | p. 15 |
| Tentative Functions of the Wake System | p. 15 |
| Effect of Sleep Deprivation on Cognitive Performances | p. 17 |
| References | p. 18 |
| Advances in Craniosynostosis Research and Management | |
| Abstract | p. 24 |
| Introduction | p. 24 |
| Normal Craniofacial Embryology and Growth | p. 25 |
| Aetiology, Pathogenesis and Function | p. 27 |
| Classification and Diagnosis | p. 34 |
| Evolution of Surgical Treatment | p. 35 |
| Recent Advances | p. 39 |
| Molecular Studies | p. 39 |
| Imaging Techniques and Surgical Planning | p. 39 |
| Resorbable Fixation | p. 40 |
| Bone Substitutes and Tissue Engineering | p. 41 |
| Distraction Osteogenesis and the Spring-Mediated Cranioplasties | p. 43 |
| Resorbable Distractor Devices | p. 46 |
| Minimally Invasive Surgery | p. 47 |
| In Utero Surgery | p. 48 |
| Surgical Techniques | p. 48 |
| Sagittal Synostosis | p. 49 |
| Unicoronal Synostosis | p. 50 |
| Metopic Synostosis | p. 56 |
| Unilambdoid Synostosis | p. 58 |
| Bicoronal Synostosis | p. 60 |
| Saethre-Chotzen Syndrome | p. 62 |
| Crouzon and Pfeiffer Syndromes | p. 62 |
| Apert Syndrome | p. 63 |
| References | p. 66 |
| Technical Standards | |
| Preoperative Clinical Evaluation, Outline of Surgical Technique and Outcome in Temporal Lobe Epilepsy | |
| Abstract | p. 88 |
| Introduction | p. 89 |
| Epidemiology of Temporal Lobe Epilepsy (TLE) | p. 89 |
| Etiology and Pathology of TLE | p. 90 |
| Temporal Lobe Seizure Symptomatology | p. 91 |
| Mesial TLE | p. 92 |
| Neocortical TLE | p. 92 |
| Selection of Candidates for Preoperative Assessment | p. 92 |
| Neuropsychological Evaluation in TLE | p. 93 |
| WADA Test | p. 94 |
| Magnetic Resonance Imaging (MRI) in TLE | p. 95 |
| Volumetry | p. 96 |
| NMR-Spectroscopy | p. 97 |
| Lesions in MRI | p. 98 |
| Functional MRI | p. 98 |
| EEG-Videotelemetry in TLE | p. 101 |
| Interictal EEG | p. 101 |
| Diagnostic EEG-Videotelemetry | p. 101 |
| Intracranial EEG-Monitoring in TLE | p. 102 |
| Indications for Intracranial EEG | p. 102 |
| Intracranial EEG-Recording in Videotelemetry | p. 102 |
| Surgical Technique for Inserting the Electrodes | p. 103 |
| Complications of Invasive EEG-Monitoring | p. 104 |
| Functional Imaging in TLE | p. 106 |
| Positron Emission Tomography, PET | p. 107 |
| Single Photon Emission Computed Tomography, SPECT | p. 109 |
| Magnetoencephalography, MEG | p. 110 |
| Indications for Surgery in TLE | p. 111 |
| Surgery in Patients with Temporal Lobe Lesions | p. 112 |
| Technique of Tailored Temporal Lobe Resection with Amygdalo-Hippocampectomy | p. 113 |
| Peroperative Electrocorticography | p. 117 |
| Outcome of Surgery with Respect to Seizures | p. 119 |
| Complications | p. 121 |
| Conclusions | p. 123 |
| Acknowledgement | p. 124 |
| References | p. 124 |
| Motor Evoked Potential Monitoring for Spinal Cord and Brain Stem Surgery | |
| Abstract | p. 134 |
| Introduction | p. 134 |
| Intraoperative Neurophysiological Techniques | p. 135 |
| The Past | p. 135 |
| Historical Background on MEP Monitoring | p. 135 |
| Misconceptions about MEP Monitoring | p. 137 |
| The Present | p. 138 |
| MEP Monitoring Techniques for Spinal Cord and Brainstem Procedures | p. 138 |
| Transcranial Electrical Stimulation of the Motor Cortex and Muscle Recordings (Multipulse Technique) | p. 139 |
| Transcranial Electrical Stimulation of the Motor Cortex and Epidural Recordings (Single Pulse Technique) | p. 140 |
| Mapping of the Corticospinal Tract During Brainstem Procedures | p. 142 |
| The "Future" | p. 143 |
| Mapping of the Corticospinal Tract During Spinal Cord Procedures: The Collision Technique | p. 143 |
| Monitoring of the Corticobulbar Tracts | p. 144 |
| Clinical Application | p. 148 |
| Correlation Between Intraoperative MEP Recordings and Post-Operative Motor Outcome | p. 148 |
| How to Avoid Irreversible MEP Loss | p. 149 |
| Warning Signals | p. 150 |
| Corrective Measures for the Management of Deteriorating Signals | p. 152 |
| Dose MEP Monitoring Really Make a Difference? | p. 153 |
| Illustrative Cases | p. 153 |
| Conclusions | p. 161 |
| References | p. 165 |
| Acknowledgments | p. 165 |
| Motor Evoked Potential Monitoring for the Surgery of Brain Tumours and Vascular Malformations | |
| Abstract | p. 172 |
| Introduction | p. 173 |
| Direct Stimulation Mapping | p. 173 |
| Evoked Potentials | p. 174 |
| Motor Evoked Potentials | p. 175 |
| MEP Technique | p. 176 |
| Stimulation | p. 177 |
| Recording | p. 183 |
| Safety and Anesthesia | p. 184 |
| Equipment and Staffing | p. 186 |
| Neurophysiological Functional Mapping of the Pericentral Cortex | p. 188 |
| SEP Phase Reversal | p. 189 |
| Intraoperative Stimulation Mapping | p. 193 |
| Extraoperative Mapping with Grid Electrodes | p. 195 |
| Principles of Clinical Application | p. 196 |
| Indications for MEP Monitoring | p. 196 |
| Interpretation of MEP Changes | p. 197 |
| Correlation of Intraoperative MEP Changes and Motor Outcome | p. 198 |
| Surgical Reactions to MEP Changes | p. 200 |
| Influence of MEP Monitoring on Surgical Results and Outcome | p. 201 |
| Specific Applications | p. 202 |
| Supratentorial Tumors and Vascular Malformations | p. 202 |
| Central Tumors and AVMs | p. 203 |
| Insular Tumors and Sylvian AVMs | p. 204 |
| Infratentorial Surgery | p. 208 |
| Indications for MEP Monitoring | p. 208 |
| Impact on Surgical Strategy | p. 208 |
| Clinical Experience with MEP Monitoring for Infratentorial Surgery | p. 208 |
| Aneurysms | p. 211 |
| SEP Monitoring for Aneurysm Surgery | p. 211 |
| Conduction of MEP Monitoring for Aneurysm Surgery | p. 212 |
| Clinical Experience | p. 212 |
| Clinical Relevance of Aneurysm Monitoring | p. 213 |
| Summary and Conclusions | p. 213 |
| Why MEP Monitoring? | p. 213 |
| When to Perform MEP Monitoring? | p. 217 |
| How to Achieve Good MEP Monitoring? | p. 217 |
| How to Assess and Interpret MEPs? | p. 218 |
| Does MEP Monitoring Influence Surgical Strategy and Postoperative Outcome? | p. 218 |
| References | p. 219 |
| Functional Neuronavigation and Intraoperative MRI | |
| Abstract | p. 229 |
| Introduction | p. 230 |
| Functional Neuronavigation | p. 231 |
| Magnetoencephalography | p. 232 |
| Functional MRI | p. 233 |
| Clinical Impact of Functional Imaging | p. 234 |
| Comparing MEG/fMRI | p. 234 |
| Intraoperative Imaging | p. 237 |
| Low-Field MR Imaging | p. 237 |
| Clinical Experience | p. 238 |
| Pituitary Tumour Surgery | p. 239 |
| Glioma Surgery | p. 240 |
| Epilepsy Surgery | p. 242 |
| Limitations and Imaging Alternatives | p. 242 |
| High-Field MR Imaging | p. 244 |
| Integration of a High-Field Scanner into the Operating Room | p. 245 |
| First Clinical Results | p. 247 |
| Summary & Future Developments | p. 248 |
| Acknowledgments | p. 254 |
| References | p. 254 |
| Surgical Anatomy of the Insula | |
| Summary | p. 265 |
| Introduction | p. 266 |
| Descriptive Anatomy [33, 39] | p. 269 |
| The Borders of the Insula | p. 269 |
| The Insular Cortex (Fig. 7) | p. 270 |
| Relationships (Figs. 8-12) | p. 272 |
| The Association Fibers | p. 273 |
| Short Association Fibers | p. 273 |
| Long Ipsihemispheric Association Fascicles | p. 273 |
| Vascular Anatomy (Figs. 13-15) | p. 274 |
| Arterial Relationships | p. 277 |
| Veins | p. 278 |
| Functional Anatomy | p. 278 |
| Connections (Fig. 17) [1, 17, 18] | p. 278 |
| Physiological Roles of the Insula [1-3, 13, 14, 22, 23, 27] | p. 280 |
| Insula and Pain | p. 281 |
| The Insula and Epilepsy Surgery | p. 283 |
| Tumoral Surgery in the Insular Region | p. 283 |
| Conclusion | p. 285 |
| References | p. 285 |
| Table of Contents provided by Rittenhouse. All Rights Reserved. |
