Neurovascular Surgical Diseases: A Case-Based Approach

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Renato Galzio, MD (Editor)
Sabino Luzzi, MD, PhD  (Editor)

Series: Surgery – Procedures, Complications, and Results

Nowadays, neurovascular diseases represent a field of enormous interest in clinical and surgical areas because of their complex management and recent advances about surgical and endovascular techniques. The difficult decision-making process at the base of these pathologies comprehends a wide series of treatment options which ought to be mastered by all the specialists facing the neurovascular pathology.

This book addresses every aspect of the most common neurovascular diseases, as intracranial aneurysms, brain and spinal cord AVMs and cavernous angiomas, cranial and spinal dural arteriovenous fistulas, as well as spontaneous cerebral hemorrhages. It also focuses on the newer technologies regarding the intraoperative imaging of the cerebral blood flow.

A large part is dedicated to the surgical approaches, but also tips and tricks of the management of these complex pathologies, presented by expert and world-renowned neurosurgeons, neuroradiologists and other specialists.

The first section reviews the anatomy of the skull base, cranial and spinal cord vasculature. The second analyzes in detail the diagnosis, decision-making process, preoperative evaluation and surgical planning of the most common surgical neurovascular diseases. The third reports the most common surgical approaches employed for cranial neurovascular diseases, whereas the fourth miscellaneous section is mainly dedicated to the peculiar aspects regarding the management of giant and complex aneurysms, endovascular techniques, and also the role of radiosurgery for specific intra-axial vascular lesions. A further chapter describes the technical aspects regarding the use of indocyanine green and fluorescein videoangiography during neurovascular surgery.

The main valuable strengths of this book lie in its case-based conception and wide number of colored figures, tables and treatment algorithms. In its structured organization, this book serves as a practical case-based guide for neurosurgeons, neurologists, neuroradiologists, residents, fellows, physicians and medical students involved in the field of neuroscience.

The book enables all these specialists to gain high-value insights into the preoperative evaluation, planning, surgical techniques, pitfalls, prevention and management of complications of the surgical neurovascular pathology.

Thanks to the contribution of different world-renowned neurosurgeons, neuroradiologists and experts, this book also promotes an updated overview of the most recent advances in neurovascular and neuroendovascular surgery, at the same time encouraging an interdisciplinary approach. (Imprint: Nova Medicine and Health)

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Table of Contents

Preface

Section I: Anatomical Overview of Skull Base and Cerebral Vasculature

Chapter 1. Microsurgical Anatomy of the Cranial Base
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, C. Gragnaniello, MD, PhD,
and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 2. Vascular Anatomy of the Cranial Anterior Circulation
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, M. Nuñez, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 3. Vascular Anatomy of the Cranial Posterior Circulation
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, M. Nuñez, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 4. Vascular Anatomy of the Spinal Cord
(B. Del Sette, A. Consoli, R. Russo and G. Rodesch, PhD, Ospedale Maggiore della Carità di Novara, Novara, Italy, and others)

Section II: Diagnosis, Preoperative Evaluation and Surgical Planning

Chapter 5. Intracranial Aneurysms
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, C. Gragnaniello, MD, PhD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 6. Brain Arteriovenous Malformations
(M. Cenzato, MD, PhD, and D. Boeris, MD, Department of Neurosurgery, Grande Ospedale Metropolitano Niguarda, Milan, Italy)

Chapter 7. Spinal Arteriovenous Malformations
(D. Boeris, MD, and M. Cenzato, PhD, Department of Neurosurgery, Grande Ospedale Metropolitano Niguarda, Milan, Italy)

Chapter 8. Brain and Spinal Cord Cavernous Malformations
(M. Fontanella, MD, L. Zanin, MD, A. Fiorindi, MD, G. Spena, MD, F. Nicolosi, MD, F. Belotti, MD, P. Panciani, MD, L. De Maria, MD, G. Saraceno, MD, C. Cornali, MD, and F. Doglietto, MD, PhD, Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy, and others)

Chapter 9. Cranial and Spinal Dural Arteriovenous Fistulas
(G. Baltsavias, Endovascular Neurosurgery, International Neuroscience Institute-INI,
Hannover, Germany)

Chapter 10. Cerebral Hemorrhages
(S. Luzzi, A. Giotta Lucifero, M. Del Maestro and R. Galzio, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 11. Principles of Neuroanesthesia
(M. Seveso, MD, and D. Caldiroli, MD, PhD, Neuroanesthesia and Neurointensive Care, C. Besta Neurological Institute, Milan, Italy)

Chapter 12. Intraoperative Neurophysiological Monitoring in Neurovascular Surgery
(S. Luzzi, MD, PhD, G. Mezzini, MD, M. Del Maestro, MD, A. Giotta Lucifero, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 13. Intraoperative Evaluation of Cerebral Blood Flow
(A. Pasqualin, MD, P. Meneghelli, MD, F. Cozzi, MD, and A. Musumeci, MD, Section of Vascular Neurosurgery, Institute of Neurosurgery, University and City Hospital, Verona, Italy, and others)

Section III: Case-Based Surgical Approaches

Chapter 14. Pterional Approach
(S. Luzzi, MD, PhD, M. Del Maestro, MD, A. Giotta Lucifero, MD and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 15. Trans-Eyebrow Keyhole Approach
(G. Esposito, MD, PhD, and L. Regli, MD, Department of Neurosurgery, Clinical Neuroscience Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland)

Chapter 16. Cranio-Orbito-Zygomatic Approach
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 17. Interhemispheric Approach
(S. Anetsberger, MD, P. Gonzalez- Lopez, MD, PhD, Y. Elsawaf, BS, S. Luzzi, MD, PhD, and S. K. Elbabaa, MD, PhD, Department of Pediatric Neurosurgery, Arnold Palmer Hospital for Children, Orlando, Florida, US, and others)

Chapter 18. Subtemporal Approach
(L. Silveira, MD, J. Muse, MD, S. Luzzi, MD, PhD, R. Galzio, MD, and C. Gragnaniello, MD, Department of Neurosurgery, University of Vermont, Burlington, VT, US, and others)

Chapter 19. Retrosigmoid Approach
(F. Cofano, MD, F. Vincitorio, MD, F. Zenga, MD, and D. Garbossa, MD, PhD, Department of Neurosurgery, University of Turin, Turin, Italy)

Chapter 20. Far Lateral Approach
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, C. Gragnaniello, MD, and R. Galzio1,2, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 21. Combined Petrosal Approach
(D. T. Di Carlo, MD, T. Passeri, MD, P. Di Russo, MD, K. Watanabe, MD, A. L. Bernat, MD and S. Froelich, MD, PhD, Skull Base and Experimental Neurosurgery Laboratory, Hôpital Lariboisière, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France, and others)

Chapter 22. Approaches for Brain and Spinal Cord Arteriovenous Malformations
(R. Messina, MD, G. Cirrottola, MD, N. Bruno, MD, and F. Signorelli, MD, PhD, Chair of Neurosurgery, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy, and others)

Chapter 23. Approaches for Brain and Spinal Cord Cavernous Malformations
(M. Del Maestro, MD, S. Luzzi, MD, PhD, G. Mezzini, MD, A. Giotta Lucifero, MD, and R. Galzio, MD, PhD, School in Experimental Medicine, Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 24. Approaches for Brain and Spinal Cord Dural Arteriovenous Fistulas
(S. Paolini, MD, C. Mancarella, MD, R. Severino, MD, and V. Esposito, MD, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy, Neurosurgery Department, IRCCS Neuromed, Pozzilli, Italy, and others)

Section IV: Miscellaneous

Chapter 25. Endoscope-Assisted Microneurosurgery for Intracranial Aneurysms
(M. Del Maestro, MD, S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, A. Rampini, MD, and R. Galzio, MD, PhD, School in Experimental Medicine, Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 26. Surgical Management of Giant Intracranial Aneurysms
(S. Luzzi, MD, PhD, A. Giotta Lucifero, MD, M. Del Maestro, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 27. Revascularization Techniques for Complex Intracranial Aneurysms
(L. Berra, MD, and A. Santoro, MD, PhD, Department of Neurosurgery, Policlinico Umberto I – Sapienza Università, Roma, Italy)

Chapter 28. Endovascular Treatments for Intracranial Aneurysms and Dural Arteriovenous Fistulas
(S. Mangiafico, MD, PhD, F. Capasso, MD, S. Vidale, MD, F. Incandela, MD, and A. Laiso, MD, Neurovascular Interventional Unit, Careggi University Hospital, Florence, Italy, and others)

Chapter 29. Preoperative Embolization of Brain Arteriovenous Malformation
(S. Luzzi, MD, PhD, M. Del Maestro, MD, A. Giotta Lucifero, MD, and R. Galzio, MD, Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and others)

Chapter 30. Radiosurgery for Brain and Spinal Cord Arteriovenous and Cavernous Malformations
(B. C. Bono, MD, I. Zaed, MD, L. Attuati1, MD, and P. Picozzi, MD, Department of Neurosurgery, Functional Neurosurgery and Gamma Knife Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano [MI] – Italy)

Chapter 31. Intraoperative Indocyanine Green and Fluorescein Videoangiography of Brain and Spinal Cord Vascular Lesions
(F. Acerbi, MD, PhD, I. G. Vetrano, MD, G. Faragò, MD, and P. Ferroli, MD, Neurosurgical Unit II, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, and others)

Index

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