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E-grāmata: Neurosurgical Emergencies

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  • Formāts: 392 pages
  • Sērija : AAN
  • Izdošanas datums: 25-Oct-2017
  • Izdevniecība: Thieme Medical Publishers Inc
  • Valoda: eng
  • ISBN-13: 9781638533979
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Neurosurgical EmergenciesPalielināt
  • Formāts: 392 pages
  • Sērija : AAN
  • Izdošanas datums: 25-Oct-2017
  • Izdevniecība: Thieme Medical Publishers Inc
  • Valoda: eng
  • ISBN-13: 9781638533979
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A state-of-the-art reference on the management and treatment of neurosurgical emergencies

The third edition of this acclaimed book covers frequently encountered neurosurgical emergencies, with contributions from renowned experts in their respective subspecialties. Clinical insights and easy-to-follow protocols are presented for emergencies associated with disease, infection, and trauma - and complications such as status epilepticus and acute shunt malfunction. Injury classification, evaluation, clinical presentation, imaging, surgical indications, approaches, and prognosis are presented for each condition. Concise, evidence-based descriptions enable readers to rapidly gain a solid understanding of the pathogenesis of each problem.

The authors retained the scope and content of previous editions and added six new chapters that reflect recent advances. These include novel invasive brain monitoring techniques and their relevance to clinical practice, emergency surgery for stroke, emergency endovascular stroke treatment, cerebral venous thrombosis, consideration of cervical stenosis as an emergency, and emergent presentation and management of spinal dural arteriovenous fistulas and vascular lesions.

Key Features





Updated from black and white to full-color illustrations Current guidelines for managing a full spectrum of intracranial, spinal, and peripheral nerve emergencies - from assessment of acute loss of consciousness - to pituitary apoplexy, cerebral herniation, and penetrating spine and peripheral nerve injuries Neurosurgical emergencies in pediatric patients including spinal cord injury and perinatal management of myelomeningocele Treatment and management of spontaneous intracerebral, subarachnoid, and intraspinal hemorrhages Recognition and management of intrathecal baclofen and narcotic withdrawal

This stellar resource is a must-have for practicing neurosurgeons and emergency medicine specialists. It will also greatly benefit residents and fellows in these fields of medicine.
Continuing Medical Education Credit Information and Objectives xv
Disclosure Information xvi
Foreword xviii
Preface xix
Contributors xx
1 Assessment of Acute Loss of Consciousness 1(8)
Michael P. Merchut
Jose Biller
1.1 Introduction
1(1)
1.2 Pathophysiology of Coma
1(1)
1.3 Clinical Evaluation of Comatose Patients
2(2)
1.4 Initial Management for Comatose Patients
4(1)
1.5 Specific Management of Comatose Patients
5(4)
2 Intracranial Pressure Monitoring and Management of Raised Intracranial Pressure 9(15)
Syed Omar Shah
Bong-Soo Kim
Bhuvanesh Govind
Jack Jallo
2.1 Introduction
9(1)
2.2 Intracranial Pressure Monitoring
9(1)
2.3 Management of Raised Intracranial Pressure
10(8)
2.4 Surgical Treatment of Raised Intracranial Pressure
18(1)
2.5 Conclusion
19(5)
3 Invasive Multimodality Brain Monitoring 24(11)
Margaret Pain
Charles Francoeur
Neha S. Dangayach
Errol Gordon
Stephan A. Mayer
3.1 Introduction
24(1)
3.2 Intracranial Pressure and Cerebral Techniques
25
3.3 Invasive Multimodal Brain Monitoring Autoregulation
24(9)
3.4 Conclusion
33(2)
4 Management of Acute Hydrocephalus 35(7)
John H. Honeycutt
David J. Donahue
4.1 Introduction
35(1)
4.2 Causes of Acute Hydrocephalus
35(1)
4.3 Treatment of Acute Hydrocephalus
36(3)
4.4 Conclusion
39(1)
4.5 Appendix
39(3)
5 The Recognition and Management of Cerebral Herniation Syndromes 42(12)
Daphne D. Li
Vikram C. Prabhu
5.1 Introduction
42(1)
5.2 Relevant Anatomy
42(2)
5.3 Biomechanics and Pathology of Transtentorial Herniation
44(1)
5.4 Clinical Signs of Transtentorial Herniation
45(1)
5.5 Other Types of Cerebral Herniation
46(3)
5.6 The Effect of Hypotension, Hypoxia, and Syndromes
49(2)
5.7 Management of Cerebral Herniation
5.8 Prognosis in Cerebral Herniation Other Factors on the Neurologic Syndromes
51
Examination
48(6)
6 Penetrating Cerebral Trauma 54(18)
Margaret Riordan
Griffith R. Harsh IV
6.1 Introduction
54(1)
6.2 Mechanism of Injury
54(1)
6.3 Pathology of Injury
54(1)
6.4 Physiology of Injury
55(1)
6.5 Overview of Management of Penetrating Cerebral Trauma
55(1)
6.6 Resuscitation and Initial Management
55(1)
6.7 Imaging
56(1)
6.8 Surgical Management
56(1)
6.9 Complications and Adjuvant Therapy
57(1)
6.10 Conclusion
58(2)
7 Extra-Axial Hematomas
60(1)
Shelly D. Timmons
7.1 Introduction
60(1)
7.2 Epidural Hematoma
60(3)
7.3 Acute Subdural Hematoma
63(3)
7.4 Subdural Hygroma
66(1)
7.5 Subacute and Chronic Subdural Hematoma
67(1)
7.6 Special Considerations
68(4)
8 Spontaneous Intracerebral Hemorrhage 72(9)
A. David Mendelow
Christopher M. Loftus
8.1 Introduction
72(1)
8.2 Classification of Intracerebral Hemorrhage
72(1)
8.3 Arteriovenous Malformations
73(1)
8.4 Aneurysms
74(1)
8.5 Cavernous Malformations
75(1)
8.6 Dural Fistulae
75(1)
8.7 Brain Tumors
75(2)
8.8 No Ictohemorrhagic Lesion
77(1)
8.9 Hematomas of the Cerebellum
78(1)
8.10 Conclusion
78(1)
8.11 AHA/ASA 2015 Guidelines42
79(2)
9 Pituitary Apoplexy 81(8)
Farid Hamzei-Sichani
Kalmon D. Post
9.1 Introduction
81(1)
9.2 Etiology
81(1)
9.3 Presentation
82(1)
9.4 Differential and Diagnosis
82(1)
9.5 Treatment
83(1)
9.6 Indications
84(1)
9.7 Preprocedure Considerations
84(1)
9.8 Operative Field Preparation
85(1)
9.9 Operative Procedure
85(1)
9.10 Postoperative Management
85(1)
9.11 Special Considerations
86(3)
10 Acute Management of Subarachnoid Hemorrhage 89(17)
Agnieszka Ardelt
Issam A. Awad
10.1 Introduction
89(5)
10.2 Clinical Presentation of Subarachnoid Subarachnoid Hemorrhage
94(7)
10.3 Establishing the Diagnosis of Underlying Subarachnoid Hemorrhage
101
10.4 Establishing the Etiology of Subarachnoid Hemorrhage
89(1)
10.5 Management of Patients with Subarachnoid Hemorrhage
90(12)
10.6 Definitive Treatment of Vascular Lesions
10.7 Conclusion
102(1)
10.8 Future Directions
103
Hemorrhage
91(15)
11 Chemical Thrombolysis and Mechanical Thrombectomy for Acute Ischemic Stroke 106(9)
Michael Jones
Michael J. Schneck
William W. Ashley Jr
Asterios Tsimpas
11.1 Introduction
106(1)
11.2 Evaluation
106(1)
11.3 Management
106(7)
11.4 Conclusion
113(2)
12 Surgical Interventions for Acute Ischemic Stroke 115(9)
Michael J. Schneck
Christopher M. Loftus
12.1 Introduction
115(1)
12.2 General Management Principles
115(1)
12.3 Revascularization Procedures
115(2)
12.4 "Salvage" Procedures for Brain Swelling Post Stroke
117(4)
12.5 Conclusion
121(3)
13 Cerebral Venous Thrombosis 124(11)
Jose M. Ferro
Diana Aguiar de Sousa
13.1 Introduction
124(1)
13.2 Cerebral Venous Thrombosis and the Risk Factor for Cerebral Venous Neurosurgeon
124(4)
13.3 Cerebral Venous Thrombosis Mimicking a Thrombosis
128(1)
13.4 Neurosurgical Diseases as a Risk Factor for Cerebral Venous Thrombosis
128(1)
13.5 Neurosurgical and Related Procedures as a Venous Thrombosis
129
13.6 Neurosurgical Treatments for Cerebral Neurosurgical Condition
125(6)
13.7 Conclusion
131(4)
14 Cerebral Infectious Processes 135(9)
Alexa Bodman
Walter A. Hall
14.1 Introduction
135(1)
14.2 Meningitis
135(2)
14.3 Encephalitis
137(1)
14.4 Extra-axial Abscesses
138(2)
14.5 Brain Abscess
140(1)
14.6 Conclusion
141(3)
15 Emergency Treatment of Brain Tumors 144(7)
Pierpaolo Peruzzi
E. Antonio Chiocca
15.1 Introduction
144(1)
15.2 Pathophysiology
144(2)
15.3 Tumor Location
146(1)
15.4 Patient Evaluation
146(1)
15.5 Intervention
147(2)
15.6 Summary
149(2)
16 Acute Bony Decompression of The Optic and Facial Nerves 151(13)
Stephen J. Johans
Zach Fridirici
Jason Heth
Christine C. Nelson
H. Alexander Arts
Matthew Kircher
Anand V. Germanwala
16.1 Traumatic Injury to the Optic Nerve
151(5)
16.2 Traumatic Injury to the Facial Nerve: Overview
156(1)
16.3 Pathology of Temporal Bone Fractures
156(1)
16.4 Anatomy of the Facial Nerve
156(4)
16.5 Conclusion
160(4)
17 Status Epilepticus 164(10)
Aradia X. Fu
Lawrence J. Hirsch
17.1 Introduction
164(1)
17.2 Definition and Classification
164(1)
17.3 Epidemiology, Etiology, and Outcome
165(2)
17.4 Clinical Features and Diagnosis
167(1)
17.5 Urgency to Treat Status Epilepticus
167(1)
17.6 Treatment
168(2)
17.7 Conclusion
170(4)
18 The Evaluation and Management of Combined Cranial, Spinal, and Multisystem Trauma 174(12)
Daphne D. Li
Hieu H. Ton-That
G. Alexander Jones
Paolo Nucifora
Vikram C. Prabhu
18.1 Introduction
174(1)
18.2 Epidemiology
174(1)
18.3 Mechanism of Injury
174(2)
18.4 Clinical Assessment
176(3)
18.5 Imaging Evaluation
179(2)
18.6 Management
181(3)
18.7 Conclusion
184(2)
19 Summary and Synopsis of The Brain Trauma Foundation Head Injury Guidelines 186(13)
Courtney Pendleton
Jack Jallo
19.1 Introduction
186(1)
19.2 Prehospital Guidelines
186(6)
19.3 General Adult Trauma Management Traumatic Lesions
192
19.4 Surgical Management of
19.5 General Pediatric Trauma Management Guidelines
187(8)
Guidelines
195(4)
20 Special Considerations of Antiplatelet Therapy, Anticoagulation, and The Need For Reversal In Neurosurgical Emergencies 199(4)
Drew A. Spencer
Paul D. Ackerman
Omer Q. Iqbal
Christopher M. Loftus
20.1 Introduction
199(1)
20.2 Antiplatelet
199(1)
20.3 Anticoagulation
199(1)
20.4 Reversal of Antiplatelet and Anticoagulant Medications for Neurosurgical Emergencies
200(1)
20.5 Resumption of Antiplatelet and Anticoagulant Medications after Definitive Treatment
201(1)
20.6 Conclusion
201(2)
21 Acute Intervention for Cervical, Thoracic, and Lumbar Spinal Disk Disease 203(9)
Mazda K. Turel
Vincent C. Traynelis
21.1 Introduction
203(1)
21.2 Clinical Evaluation
203(1)
21.3 Radiographic Evaluation
203(1)
21.4 Indications for Acute Surgical
21.5 Cervical Spine
204(1)
21.6 Thoracic Spine
205(3)
21.7 Lumbar Spine
208(1)
21.8 Conclusion
209
Intervention
203(9)
22 Is Cervical Stenosis An Emergency? 212(7)
Daipayan Guha
Allan R. Martin
Michael G. Fehlings
22.1 Introduction
212(1)
22.2 Initial Evaluation
212(1)
22.3 Radiographic Evaluation
212(1)
22.4 Indications for Acute Surgical Intervention
213(3)
22.5 Conclusion
216(3)
23 The Intensive Care Management of Spine-and Spinal Cord-Injured Patients 219(11)
Christopher D. Baggott
Joshua E. Medow
Daniel K. Resnick
23.1 Introduction
219(1)
23.2 Prehospital Management
219(1)
23.3 Clearance of the Spine
219(1)
23.4 Immobilization and Reduction
220(1)
23.5 Acute Medical Management
221(5)
23.6 Conclusion
226(4)
24 Biomechanical Considerations for Operative Interventions in Vertebral Column Fractures and Dislocations 230(10)
Christopher E. Wolfla
24.1 Epidemiology
230(1)
24.2 General Consideration Regarding Timing of Surgical Treatment
230(1)
24.3 Occipitocervical Junction Injuries
230(3)
24.4 Atlantoaxial Ligamentous Injuries
233(1)
24.5 Isolated C1 Fractures
233(1)
24.6 C2 Fractures
233(1)
24.7 Odontoid Fractures
233(1)
24.8 Hangman's Fractures
234(1)
24.9 C2 Body Fractures
234(1)
24.10 Combined Atlas-Axis Fractures
234(1)
24.11 C1-C2 Rotatory Subluxation
235(1)
24.12 Subaxial (C3-C7) Cervical Column Injuries
235(1)
24.13 Thoracic and Thoracolumbar Column Injuries
235(2)
24.14 Lumbar Column Injuries
237(1)
24.15 Conclusion
238(2)
25 Athletic Injuries and Their Differential Diagnosis 240(11)
Julian E. Bailes
Vincent J. Miele
25.1 Head Injuries
240(4)
25.2 Spinal Injury
244(5)
25.3 Conclusion
249(2)
26 Penetrating Spine Trauma 251(6)
Michael D. Martin
Christopher E. Wolfla
26.1 Introduction
251(1)
26.2 Epidemiology
251(1)
26.3 Initial Evaluation and Imaging
251(2)
26.4 Treatment
253(1)
26.5 Neurologic Outcomes
254(1)
26.6 Conclusion
255(2)
27 Spinal Cord Compression Secondary to Neoplastic Disease: Epidural Metastasis and Pathologic Fracture 257(8)
James A. Smith
Roy A. Patchell
Phillip A. Tibbs
27.1 Introduction
257(1)
27.2 Epidemiology
257(1)
27.3 Evolution of the Standard of Care for Metastatic Epidural Spinal Cord Compression
258(1)
27.4 Clinical Evaluation
259(1)
27.5 Patient Selection for Surgery
260(1)
27.6 Preoperative Care
260(1)
27.7 Surgical Management
260(2)
27.8 Complications of Surgery
262(1)
27.9 Role of Stereotactic Radiotherapy
263(1)
27.10 Conclusion
263(2)
28 Intraspinal Hemorrhage 265(8)
Kenneth A. Follett
Linden E. Fornoff
28.1 Etiology
265(1)
28.2 Presentation
266(1)
28.3 Evaluation
266(1)
28.4 Treatment
267(2)
28.5 Outcome
269(1)
28.6 Conclusion
269(4)
29 Emergent Presentation and Management of Spinal Dural Arteriovenous Fistulas and Vascular Lesions 273(5)
Michael P. Wemhoff
Asterios Tsimpas
William W. Ashley Jr
29.1 Introduction
273(1)
29.2 Anatomy and Pathophysiology
273(1)
29.3 Classification Schemes
273(1)
29.4 Demographics
274(1)
29.5 Clinical Presentation
274(1)
29.6 Imaging Studies
275(1)
29.7 Management
275(1)
29.8 Conclusion
276(2)
30 Spinal Infections 278(16)
Edward K. Nomoto
Eli M. Baron
Joshua E. Heller
Alexander R. Vaccaro
30.1 Introduction
278(1)
30.2 Classification
278(1)
30.3 Organisms
278(1)
30.4 Risk Factors, Epidemiology, and Pathophysiology
278(3)
30.5 Diagnosis
281(4)
30.6 Treatment
285(5)
30.7 Conclusion
290(4)
31 Summary of Spine Injury Treatment Guidelines 294(5)
Kevin N. Swong
Russell P. Nockels
G. Alexander Jones
31.1 Overview
294(1)
31.2 Prehospital Cervical Spinal Immobilization after Trauma
294(1)
31.3 Transportation of Patients with Acute Traumatic Cervical Spine Injuries
294(1)
31.4 Clinical Assessment Following Acute Cervical Spinal Cord Injury
294(1)
31.5 Initial Closed Reduction of Cervical Spinal Fracture-Dislocation Injuries
295(1)
31.6 Acute Cardiopulmonary Management of Patients with Cervical Spinal Cord Injuries
295(1)
31.7 Pharmacologic Therapy for Acute Spinal Cord Injury
295(1)
31.8 Occipital Condyle Fractures
295(1)
31.9 Diagnosis and Management of Traumatic Atlanto-occipital Dislocation Injuries
296(1)
31.10 Management of Isolated Fractures of the Atlas in Adults
296(1)
31.11 Management of Acute Combination Fractures of the Atlas and Axis in Adults
296(1)
31.12 Os Odontoideum
296(1)
31.13 Subaxial Cervical Spine Injury Classification Systems
296(1)
31.14 Treatment of Subaxial Cervical Spinal Injuries
297(1)
31.15 Management of Acute Traumatic Central Cord Syndrome
297(1)
31.16 Management of Pediatric Cervical Spine and Spinal Cord Injuries
297(1)
31.17 Spinal Cord Injury without Radiographic Abnormality
297(1)
31.18 Management of Vertebral Artery Injuries Following Nonpenetrating Cervical Trauma
297(1)
31.19 Deep Venous Thrombosis and Thromboembolism in Patients with Cervical Spinal Cord Injuries
298(1)
31.20 Nutritional Support after Spinal Cord Injury
298(1)
31.21 Conclusion
298(1)
32 Penetrating Injuries of Peripheral Nerves 299(13)
James Tait Goodrich
32.1 Introduction
299(1)
32.2 Anatomical Considerations and Their Clinical Implications
299(1)
32.3 Basic Considerations of Peripheral Nerve Repair
299(3)
32.4 Repair Techniques
302(5)
32.5 Surgical Management of Problematic Injuries
307(4)
32.6 A Final Comment
311(1)
33 Acute Management of Compressive Peripheral Neuropathies 312(8)
Kashif A. Shaikh
Nicholas M. Barbaro
Richard B. Rodgers
33.1 Introduction
312(1)
33.2 Anatomy and Physiology
312(1)
33.3 Pathophysiology of Nerve Injury
312(1)
33.4 Classification of Peripheral Nerve Injuries
313(1)
33.5 Evaluation of Compressive Peripheral Nerve Injuries
314(1)
33.6 Acute Management
315(1)
33.7 Surgery
316(1)
33.8 Conclusion
317(3)
34 Spinal Cord Injury and Spinal Cord Injury Without Radiographic Abnormality in Children 320(10)
Jamal McClendon Jr
P. David Adelson
34.1 Introduction
320(1)
34.2 Spinal Cord Injury
320(1)
34.3 Incidence and Prevalence
320(1)
34.4 Mechanism of Injury
321(1)
34.5 Extent of Injury
321(1)
34.6 Pathobiology
321(1)
34.7 Location of Injury
322(1)
34.8 Biomechanics for Regional Prevalence
322(1)
34.9 Imaging Findings
323(1)
34.10 SCIWORA
323(1)
34.11 Early Resuscitation after SCI
324(1)
34.12 Neurologic Evaluation
324(1)
34.13 Associated Cranial Injury
325(1)
34.14 Initial Management of Pediatric Spinal Cord Injury
325(1)
34.15 Treatment for Acute Spinal Cord Injury
325(1)
34.16 Treatment of SCIWORA
325(1)
34.17 Complications
326(1)
34.18 Outcome
326(1)
34.19 New Therapies for Acute Spinal Cord Injury
326(1)
34.20 Conclusion
327(3)
35 Acute Shunt Malfunction 330(7)
Ahmed J. Awad
Rajiv R. Iyer
George I. Jallo
35.1 Introduction
330(1)
35.2 Clinical Presentation and Diagnosis
330(1)
35.3 Radiographic Studies
330(1)
35.4 Shunt Tap
331(1)
35.5 Causes of Acute Malfunction
332(2)
35.6 Management of the Unstable Patient
334(1)
35.7 Special Situations
335(2)
36 The Perinatal Management of a Child Born with a Myelomeningocele 337(10)
Kimberly A. Foster
Frederick A. Boop
36.1 Introduction
337(1)
36.2 Prenatal Diagnosis
338(1)
36.3 Postnatal Diagnosis and Evaluation
338(1)
36.4 Neuroimaging
339(1)
36.5 Counseling and Timing of Surgery
339(2)
36.6 Immediate Treatment
341(1)
36.7 Operative Technique
341(3)
36.8 Postoperative Care
344(1)
36.9 Conclusion
344(3)
37 Recognition and Management of Intrathecal Baclofen and Narcotic Withdrawal Syndromes 347(4)
Douglas E. Anderson
Drew A. Spencer
37.1 Introduction
347(1)
37.2 Pharmacology and Indications
347(2)
37.3 Complications Leading to Baclofen Withdrawal Syndromes
349
37.4 Recognition and Treatment of Clinical and Morphine Withdrawal
348(1)
37.5 Conclusion
349(2)
Index 351
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