Essentials of Neurosurgical Procedures and Operations

Foreword iii
Preface v
Contributing Authors vii

Basic procedures Part I



Chapter 1 Tracheostomy 3

Definition 3

Anatomy (muscles around trachea) 3

Indications 3

Operative techniques 3

Complications 8

References8



Chapter 2 Central venous catheterization 9

Definition and type 9

Anatomy9

Indications 10

Contraindications 10

Central venous catheterization by using seldinger techniques 11

Complications 15

References 15



Chapter 3 Principles of transfemoral catheter cerebral angiography 17

Introduction 17

Anatomy17

Common usage of transfemoral catheter cerebral angiography 18

Pre-procedural evaluation and medication 18

Preparation for the procedure 18

Operative techniques 19

Post-procedural remarks 20

Complications 21

Summary and conclusions 21

References 22



Cranial procedures & operations Part II



Chapter 4 Anesthesia and surgical position 25

Neuroanesthesia 25

Introduction 25

Anesthetic agents 25

Monitoring in neuroanesthesia 27

Positioning 27

Pediatric neuroanesthesia 27

Anesthesia for posterior fossa surgery 27

Anesthesia for aneurysm surgery 27

Anesthesia for cervical spine surgery 27

Anesthesia for awake craniotomy 28

Surgical position 28

References 31



Chapter 5 Ventriculostomy 33

External ventricular drain or extraventricular drain 33

Introduction 33

Indications 33

Surgical techniques 33

Puncture site 34

Management of the EVD 34

Complications 34

Ventriculoperitoneal shunt 35

Introduction 35

Indications 35

Contraindications 35

Surgical techniques 35

Complications 36

References 37



Chapter 6 Chronic subdural hematoma 39

Introduction 39

Treatments 39

Operative techniques 39

Complications 41

References 41



Chapter 7 Acute epidural hematoma 43

Introduction 43

Indications for surgery 43

Timing of surgery 43

Operative techniques: a standard frontotemporal craniotomy 43

Complications 46

References 46



Chapter 8 Acute subdural hematoma 47

Introduction 47

Indications for surgery 47

Operative techniques 47

Complications 49

References 49



Chapter 9 Navigation guided hematoma removal 51

Introduction 51

Indications of navigation assisted brain surgery51

Preoperative evaluation 51

Operative techniques 51

Post operative complications 54

References 54



Chapter 10 Pterional approach 55

Introduction 55

Anatomy55

Indications 55

Operative techniques 55

Complications 58

References 59



Chapter 11 Subfrontal approach 61

Introduction 61

Anatomy61

Indications 61

Preop evaluation 62

Operative techniques 62

Post operative complications 65

References 65



Chapter 12 Orbitozygomatic approach 67

Introduction 67

Indications 67

Operative techniques 67

Complications 70

References 70



Chapter 13 Anterior interhemispheric approach 71

Introduction 71

Anatomy71

Indications 71

Preop evaluation 71

Preparation for the operation 71

Operative techniques 71

Complications 74

References 75



Chapter 14 Transsphenoidal approach 77

Introduction 77

Indications and contraindications 77

Pre-operative evaluation 77

Preparation for the procedure 77

Operative techniques 78

Complications 80

References 81



Chapter 15 Transventricular approach 83

Introduction 83

Anatomy83

Approaches to the lateral ventricle 83

Approaches to the third ventricle 85

Approaches to the fourth ventricle 88

References 88



Chapter 16 Endoscopic third ventriculostomy 89

Indications 89

Preoperative risk factors 89

Preoperative management and evaluation 89

Operative techniques 89

Complications91

Postoperative remarks91

References91



Chapter 17 Anterior temporal lobectomy and amygdalohippocampectomy 93

Indication 93

Key anatomy of medial temporal lobe 93

Preoperative evaluation 94

Operative techniques 95

Complications 97

References 98



Chapter 18 Subtemporal approach 99

Introduction 99

Anatomy99

Indications 99

Preoperative evaluation and preparation 99

Operative techniques: Standard subtemporal approach100

Subtemporal transtentorial approach101

Complications102

References102

Chapter 19 Suboccipital retrosigmoid approach 105

Introduction105

Anatomy105

Indications107

Preparations for surgical procedure107

Operative techniques107

Complications110

References110



Chapter 20 Midline suboccipital approach 111

Introduction111

Anatomy111

Indications112

Preparations for surgical procedure112

Operative techniques112

Complications113

References114



Chapter 21 Carotid arterectomy 115

Introduction115

Indications and contraindications115

Anatomy116

Operative techniques 116

Complications119

References119



Chapter 22

Superficial temporal artery (STA) - middle cerebral artery (MCA) bypass 121

Indications121

Pre- and post-operative medical management121

Intra-operative management121

Operative techniques121

Post-operative complications125

References125



Chapter 23 Balloon angioplasty and carotid artery stenting (CAS) 127

Introduction127

Indications127

Preparation128

Pre-procedure 129

Procedures130

Assessment of post-stenting131

Further dilation131

Medical therapy of complications131

Post-procedural care131

Follow up132

Retreatment 132

References132



Chapter 24 Basic ovascular techniques: Coil embolization of aneurysms 133

Introduction133

Preparation for procedure133

Set up136

Operative techniques136

Simple technique136

Balloon remodeling technique (wide-necked aneurysm)138

Stent-assisted technique140

References140

Spinal and peripheral procedures & operations Part III



Chapter 25 Facet block and medial branch block 145

Introduction145

Anatomy145

Indications146

Contraindications146

Preparation for the procedure 146

Operative techniques146

Complications148

Summary148

References148



Chapter 26 Spinal tapping and epidural block 151

Spinal tapping 151

Introduction151

Anatomy151

Indications151

Contraindications151

Preparation for the procedure 151

Operative techniques151

Normal cerebrospinal fluid152

Complications152

Summary152

Epidural Block 152

Introduction152

Anatomy152

Indications153

Contraindications153

Preparation for the procedure 153

Operative techniques154

Complications156

Summary and conclusion156

References156



Chapter 27 Root block 157

Cervical nerve root block 157

Definition157

Indications 157

Contraindications157

Preparation for the procedure157

Operative techniques157

Complications158

Lumbar and sacral nerve root block 158

Definition158

Anatomy 158

Indications159

Contraindications159

Preparation for the procedure159

Operative techniques159

Complications160

Postoperative remarks (cervical & lumbosacral root block) 160

References161



Chapter 28 Vertebroplasty and kyphoplasty 163

Introduction163

Anatomy163

Indications163

Contraindications163

Preparation for the procedure 163

Operative techniques164

Complications166

Summary166

References166



Chapter 29 Open carpal tunnel release 169

Introduction 169

Anatomy169

Indications 170

Preoperative evaluation 170

Preparation for the procedure170

Operative techniques171

Complications171

References171



Chapter 30 Cervical laminoplasty 173

Introduction173

Anatomy173

Indications173

Relative contraindications173

Preoperative evaluation174

Preparation for the procedures174

Operative techniques174

Postop remarks175

Complications176

Summary176

References176



Chapter 31

Anterior cervical discectomy and cervical corpectomy with reconstruction 179

Introduction179

Anatomy179

Indications180

Preparation for the procedure180

Operative techniques181

Complications185

Summary185

References186



Chapter 32 Posterior cervical fusion 187

Introduction187

Anatomy187

Indications188

Preoperative evaluation188

Operative techniques188

Postoperative remarks192

Complications192

References192



Chapter 33 Lumbar microdisectomy 193

Introduction193

Indications193

Operative techniques193

Postoperative remarks196

Complications196

References196

Chapter 34 Posterior lumbar interbody fusion 199

Introduction199

Indications199

Operative techniques199

Complications202

References202



Chapter 35 Minimally invasive transforaminal lumbar interbody fusion 203

Introduction203

Indications204

Operative techniques204

Complications206

References206



Chapter 36 Transpleural or extrepleural retroperitoneal approach 209

Introduction209

Anatomy209

Indications 210

Preparation for the procedure 211

Operative techniques211

Complications215

Summary215

References 216

Index 217