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Practical points in neurosurgery

Practical points in neurosurgery

editor-in-chief: Dong Gyu Kim, editors: Hee-Jin Yang ... [et al.]

Ilchokak·2007-01-01

  • 기술과학
  • KDC 514.48

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Preface A neurosurgeon, even with extensive experience, cannot but have some concern or become nervous when preparing for major cranial or spinal surgery. In the case of young neurosurgeons who have just started their careers as practitioners, it is very typical for them to verify their surgical procedures several times in textbooks or surgical atlases to confirm their knowledge or mitigate their anxiety. As a beginner, I read textbooks and then performed the surgery many times in my imagination before the real procedure. In my dreams on the night before surgery, a smiling patient would sometimes appear after a successful operation, or alterna-tively, after an unsatisfactory operation, I presented a miserable figure, so ashamed that I felt like crawling into a mouse hole. Medical training is often referred to as an apprenticeship. Although there may be no problem understanding a disease or mastering a surgical procedure from a textbook or verbal explanation, the performance of even a very simple operation can be extremely daunting. For this reason, intern and resident education systems have been developed and everything involved in surgery must be learned the hard way, by experiencing it in person. Although many comprehensive books have been published and our thirst for knowledge or indirect experience has thus been assuaged in recent times, it is not easy to find textbooks that describe the critical scenes of an operation or pinpoint the most important surgical techniques that would be observed during training in an apprenticeship. This book has been written to facilitate the treatment of patients by providing residents, novice neurosurgeons, or neurosurgeons with little experience, who are preparing for an operation, an opportunity to directly experience an operation with their own eyes through animated video images, and thereby increase their self-confidence for the actual operation. We have collected about 100 typical cases in the areas frequently encountered in the field of neurosurgery, and have ex-plained them in easily understood terms. We have also tried to assist in the actual performance of these operations by itemizing the key points of each surgical procedure in each case. In this volume, the domain of all neurosurgical disorders has been divided into five parts: cerebrovascular diseases, brain tumors, spinal diseases, stereotactic and functional procedures, and pediatric neurosurgery. This division is based on the detailed major areas of neurosurgery and is intended to provide convenient access to the relevant cases for the reader. The introduction to each case describes the general information on the selected case, and the main text introduces the techniques used and experienced by the authors as the classi-cal method for treating the disease in question. Of these treatment modalities, cra-niotomy is usually selected, but minimally invasive treatment methods, including endoscopic surgery, endovascular surgery, or radiosurgery, have also been intro-duced in line with recent trends in neurosurgery. At the end of each section, the particular details that require attention during the operation are summarized as practical points to assist readers to build up treatment concepts. More surgical photos or images, rather than explanations, have been included so that the operat-ing procedures can be easily understood. Animations have been produced that enhance the important images, from pre-operational evaluations to the major scenes of an operation. Because the length of each animation is limited to a few minutes, owing to the capacity limitations of the storage material, the full processes of each operation cannot be shown; however, the essential elements are included. The authors of this book are neurosurgeons at the Seoul National University College of Medicine and have over 20 years of experience in neurosurgery. I believe that the living knowledge flowing from their long experience is enough to inspire many young ne…

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Contents 7 Preface Section 1 Cerebrovascular Disease 21 01 Carotid Stenosis Carotid endarterectomy Chang Wan Oh, Sukh Que Park, Dae Hee Han 29 02 Adult Moyamoya disease Superficial temporal artery-Middle cerebral artery (STA-MCA) anastomosis Chang Wan Oh, Jeong Eun Kim, Sukh Que Park, Dae Hee Han 39 03 Internal Carotid Artery Dorsal Aneurysm Pterional approach and aneurysm clipping Dae Hee Han, Jeong Eun Kim, Sang Hyung Lee 43 04 Internal Carotid Artery Dorsal Blister Aneurysm Pterional approach and ICA trapping Dae Hee Han, Chang Wan Oh 46 05 Posterior Communicating Artery Aneurysm Pterional approach and aneurysm clipping O-Ki Kwon, Sukh Que Park, Dae Hee Han 49 06 Anterior communicating Artery Aneurysm, Anterior Direction Pterional approach and aneurysm clipping Dae Hee Han, Sang Hyung Lee 53 07 Anterior communicating Artery Aneurysm, Superior Direction Pterional approach and aneurysm clipping Dae Hee Han, Jae Hyo Park 56 08 Anterior communicating Artery Aneurysm, Multidirection Pterional approach and aneurysm clipping Young-Je Son, Young-Seob Chung, Dae Hee Han 59 09 Large Anterior communicating Artery Aneurysm Pterional approach and aneurysm clipping Sukh Que Park, Young-Je Son, Dae Hee Han 62 10 Distal Anterior Cerebral Artery Aneurysm Interhemispheric approach and aneurysm clipping O-Ki Kwon, Sukh Que Park, Dae Hee Han 65 11 Middle Cerebral Artery Bifurcation Aneurysm Pterional approach and aneurysm clipping Dae Hee Han, O-Ki Kwon 68 12 Middle Cerebral Artery Bifurcation Aneurysm, Image Guided Minicraniotomy Image guided minicraniotomy and aneurysm clipping Dae Hee Han, Jeong Eun Kim 72 13 Middle Cerebral Artery Bifurcation Aneurysm with Broad Neck, Image Guided Minicraniotomy Image guided minicraniotomy and aneurysm clipping Dae Hee Han, Sang Hyung Lee 75 14 Ruptured Basilar Apex Aneurysm Pterional approach and aneurysm clipping Dae Hee Han, Chang Wan Oh 80 15 Unruptured Basilar Apex Aneurysm Pterional approach and aneurysm clipping Dae Hee Han, Chang Wan Oh 83 16 Giant Anterior Communicating Artery Aneurysm Pterional approach and aneurysm clipping Jae Hyo Park, O-Ki Kwon, Dae Hee Han 88 17 Giant Cavernous Internal Carotid Artery Aneurysm High flow bypass with the saphenous vein graft Chang Wan Oh, Jeong Eun Kim, Dae Hee Han 93 18 Cerebral Arteriovenous Malformation Bifrontal craniotomy and AVM removal Young-Seob Chung, Young-Je Son, Dae Hee Han 98 19 Dural Arteriovenous Fistula Craniotomy and removal of the dural arterioveous fistula Jeong Eun Kim, O-Ki Kwon, Dae Hee Han 101 20 Brain Stem Cavernous Malformation Translabyrinthine approach and removal of the malformation Jeong Eun Kim, Young-Seob Chung, Dae Hee Han Section 2 Brain Tumor 107 21 Diffuse glioma Resection of the diffuse glioma with the guidance of preoperative mapping (MR spectroscopic image, PET, and MEG) and image-guided surgical tools Chae-Yong Kim, Chul-Kee Park 112 22 Low-grade glioma (oligodendroglioma) of the eloquent area Awake surgery and intraoperative mapping Dong Gyu Kim, Jung Ho Han 117 23 High-grade glioma (glioblastoma) Transcortical approach Hee-Won Jung, Chae-Yong Kim 120 24 Central Neurocytoma Interhemispheric approach Dong Gyu Kim, Jung Ho Han 123 25 Hemangioblastoma of cerebellum Retrosigmoid approach for solid mass of cerebellopontine angle Chae-Yong Kim, Hee-Won Jung 127 26 Metastatic brain tumor Transcortical approach Chae-Yong Kim, Hee-Won Jung 130 27 Parasagittal meningioma Resection of tumor involving bone, dura and venous sinus Chul-Kee Park, Hee-Won Jung 134 28 Clinoid meningioma Orbitocraniozygomatic approach Hee-Won Jung, Seung-Yeob Yang 137 29 Tuberculum sellae meningioma Orbitopterional approach with anterior clinoidectomy Hee-Won Jung, Chae-Yong Kim 141 30 Petroclival meningioma Transtentorial combined pre-…

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