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Surgery of the Brainstem, 1ed

The ultimate guide to navigating and treating brainstem pathologies from master neurosurgeon Robert Spetzler

The brainstem is one of the last bastions of surgical prohibition because of its densely packed ascending and descending tracts and nuclei carrying information to and from the brain. Although 10% of all pediatric tumors and 5% of all vascular anomalies occur in the brainstem, neurosurgeons have traditionally resisted dissecting lesions in this area. Recent advances in imaging, microscopy, anesthesia, and operative techniques have expanded the treatment paradigm for this most eloquent region of the brain.

Surgery of the Brainstem, by internationally renowned neurosurgeons Robert F. Spetzler, M. Yashar S. Kalani, and Michael T. Lawton, along with an impressive cadre of global experts, is a comprehensive guide to managing disorders of the brainstem, thalamic region, and basal ganglia. Organized in seven sections with 33 chapters, the text opens with four sections covering a variety of topics. Section I presents the history of brainstem surgery; Section II examines anatomy, development, and pathology; Section III reviews patient examination, imaging, and monitoring; and Section IV provides a succinct overview of surgical approaches. Sections V-VII cover a wide range of adult and pediatric tumors, ischemia, stroke, aneurysms, arteriovenous malformations, and cerebral cavernous malformations. More than 300 high-quality clinical images and medical illustrations enhance the text.

Key Highlights

• A full spectrum of treatment modalities and outcomes, including open surgery, endoscopic approaches, stereotactic radiosurgery, radiotherapy, endovascular techniques, and revascularization
• An anatomy chapter featuring stunning Rhoton-style anatomical dissections delineates critical landmarks in the brainstem, thalamus, pineal region, and cranial nerves
• Detailed discussion of patient positioning and exposure of various brainstem domains
• Pearls on overcoming psychological, pathological, and anatomical barriers and managing complications

Understanding the basic anatomy, pathology, and clinical complexities of the brainstem and thalamic regions is essential for safe navigation and treatment. This remarkable book will provide neurosurgeons with additional insights on performing resections and achieving the best possible outcomes for patients with pathologic conditions in this delicate region.

Contents

۱ History of Brainstem Surgery
۲ Anatomy of the Brainstem, Thalamus, Pineal Region, and Cranial Nerves
۳ Development of the Human Brainstem and Its Vasculature
۴ Pathology of the Brainstem
۵ Imaging Anatomy and Pathology of the Brainstem, Thalamus, and Pineal Region
۶ Neuromonitoring for Brainstem Surgery
۷ Neurologic Examination of the Brainstem and Thalamus
۸ Surgical Approaches to the Ventral Brainstem and Thalamus
۹ Approaches to the Dorsal Brainstem, Thalamus, and Pineal Region
۱۰ Skull Base Approaches to the Lateral Brainstem and Cranial Nerves
۱۱ Endoscopic Approaches to the Brainstem
۱۲ Safe Entry Zones to the Brainstem
۱۳ Adult Brainstem Gliomas
۱۴ Pediatric Brainstem Tumors
۱۵ Tumors of the Thalamus
۱۶ Tumors of the Third Ventricle
۱۷ Tumors of the Fourth Ventricle
۱۸ Tumors of the Cerebellopontine Angle
۱۹ Pineal Region Tumors
۲۰ Stereotactic Radiosurgery for Tumors of the Brainstem, Thalamus, and Pineal Region
۲۱ Radiotherapy for Pineal, Thalamic, and Brainstem Tumors
۲۲ Neuro-Oncologic Considerations for Pineal, Thalamic, and Brainstem Tumors
۲۳ Brainstem Ischemia, Stroke, and Endovascular Revascularization of the Posterior Circulation
۲۴ Microsurgical Embolectomy for Emergency Revascularization of the Brainstem
۲۵ Brainstem and Thalamic Intraparenchymal Hemorrhage
۲۶ Surgical Management of Posterior Circulation Aneurysms
۲۷ Endovascular Management of Aneurysms of the Posterior Circulation
۲۸ Surgical Management of Thalamic and Brainstem Arteriovenous Malformations
۲۹ Endovascular Management of Brainstem and Thalamic Arteriovenous Malformations
۳۰ Surgery for Thalamic and Brainstem Cavernous Malformations
۳۱ Revascularization of the Brainstem
۳۲ Stereotactic Radiosurgery for Arteriovenous Malformations of the Basal Ganglia, Thalamus, and Brainstem
۳۳ Auditory Brainstem Implants