By Robin Bhatia, Ian Sabin
A part of the difficult thoughts in sequence, this e-book is a case-based consultant to tough scientific situations in neurosurgery protecting the key sub-speciality components of oncology, vascular neurosurgery, mind and backbone trauma, paediatrics, spinal degenerative affliction, peripheral and cranial nerves, practical neurosurgery and an infection. particular instances are tested with attention of medical presentation, diagnostics, and surgical ideas, with a precis of proof from the neurosurgical literature highlighting parts of curiosity and controversy.
This e-book serves as an invaluable and interesting source for experts and trainees in neurosurgery in addition to within the disciplines of neurology, maxillofacial surgical procedure, spinal surgical procedure and neuro-oncology.
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Additional info for Challenging Concepts in Neurosurgery: Cases with Expert Commentary
Glioblastomas are distinguished from WHO grade III astrocytomas by the presence of necrosis and endothelial hyperplasia. Both usually form in the cerebral white matter. In adults, this is usually in the cerebral hemispheres supratentorially, but in children it is not unusual for the primary location to be the brainstem. Approximately, half of the supratentorial tumours occupy more than one lobe or are bilateral. 7) develops as a result of growth across the corpus callosum. Grade III and IV tumours most commonly can develop de novo or can be the result of a transformation from a lower grade astrocytoma (less than 10%).
The SF-36 has been validated for use in measuring morbidity and surgical outcomes in common spinal disorders . 1). Flexion and extension plain radiographs of the lumbar spine were also performed. These demonstrated dynamic instability at L5/S1. 1 Sagittal T2-weighted MRI of the lumbar spine demonstrates Grade 1 anterolisthesis of L5 on S1 with resultant disc uncovering. Associated Modic end-plate changes, disc desiccation, and disc height loss are also noted. Case 3 Spondylolisthesis Given the symptoms, findings on imaging, and the fact that the patient had completed an exhaustive trial of non-operative management, it was felt that she was a candidate for lumbosacral fusion surgery.
It is important to note that conservative treatment refers to active nonoperative management of the patient with the aim of reducing pain and increasing quality of life. Pain specialists and physiotherapists should be involved. Pain specialists may prescribe various analgesics and/or perform nerve root, joint, or epidural injections. Physiotherapy involves exercises, education on ergonomics, transcutaneous electrical nerve stimulation (TENS), and/or acupuncture. Cognitive intervention should be sought if available.