Advances and Technical Standards in Neurosurgery: Volume 34 by John D. Pickard, Nejat Akalan, Concezio Di Rocco, Vinko V.

By John D. Pickard, Nejat Akalan, Concezio Di Rocco, Vinko V. Dolenc, J. Lobo Antunes, J.J.A. Mooij, Johannes Schramm, Marc Sindou

Advances and Technical criteria in Neurosurgery used to be conceived in 1972byitsfoundingfathersJeanBrihaye, BernardPertuiset, FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst released in 1974 before everything via sponsorship through the ecu AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection, notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years, bothwithregardtoadvances, detaileddescriptions of ordinary operative systems and in- intensity stories of confirmed wisdom. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIII Advances current and capability destiny adjuvant matters in high-grade astrocytic glioma 1,2 1 1 2 1 remedy. F. LEFRANC, M. RYNKOWSKI, O. DEWITTE, andR. KISS, division ofNeurosurgery, ErasmeUniversityHospital, FreeUniversityofBrussels(U. L. B. ), 2 Brussels, Belgium, LaboratoryofToxicology, InstituteofPharmacy, FreeUniversity ofBrussels(U. L. B. ), Brussels, Belgium summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . four creation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . five Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Patternsofcelldeath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . eight Autophagy: apotentialTrojanhorseformalignantgliomas. . . . . . . . . . . . . . . . eleven Therapeuticbene?tsoftemozolomide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . thirteen Localtherapiesforglioblastomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Ongoingclinicaltrialsforglioblastomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixteen Growthfactorreceptorinhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 PI3K=Akt, mTORandNF- Binhibitors. . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Matrixmetalloproteinase(MMP)inhibitors(MMPI). . . . . . . . . . . . . . . . . . . 18 Angiogenesistargeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Cellularandvaccinationtherapies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Genetherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Thesodiumpump. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Cardiotonicsteroids: ligandsofthesodiumpump. . . . . . . . . . . . . . . . . . . . 24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas. . . . . . . 26 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Deepbrainstimulationforpsychiatricdisorders stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, mind Stimulation staff, division of Psychiatry and Psychotherapy, UniversityHospitalBonn, GermanyandDepartmentsofPsychiatry andMentalHealth, TheJohnsHopkinsUniversity, MD, united states summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 advent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Historyofdeepbrainstimulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 PrinciplesofDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty NeurobiologyofdepressionandOCD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty-one Neurobiologyofdepression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty-one NeurobiologyofOCD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty two StudiesofDBSandpsychiatricdisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . forty three Problemsintargetselection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty three Targetsindepression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty three TargetsinOCD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty six SafetyandadvantagesofDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . forty seven EthicalaspectsandstandardsinDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fifty one Ethicalconsiderations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fifty one ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders. . . . . . . . fifty two Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fifty three ThefutureofDBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fifty four References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fifty four criteria High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms: symptoms, surgicaltechnique, complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, division of educational Neurosurgery, Addenbrooke s medical institution, UniversityofCambridge, Cambridge, united kingdom summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixty one creation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixty two Surgicaltechnique. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixty seven Cranialexposure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixty nine Cervicalexposure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Saphenousveinexposure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy one Preauriculartunnel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy two Contents IX Anastamoses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy three Distalanastamosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy three Externalcarotidanastamosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy four Closureandpostoperativecare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy seven dialogue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy seven Comparisonofoutcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy seven Choosingthetypeofgraft. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy eight Longtermpatencyofgrafts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy nine Ischaemiccomplications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . seventy nine Anticoagulationrelatedmorbidity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . eighty one end. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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2. Circuit of mood in depression [11] in depression: Sartorius and Henn [50] suggested that overactivation of the lateral habenula leads to down regulation of serotonergic, noradrenergic and dopaminergic systems and stimulation of the hypothalamic-pituitary-adrenal axis in depression. Neurobiology of OCD OCD is characterized by anxiety-provoking thoughts (obsessions) and repeated, time-consuming behaviours (compulsions) [61]. As in most psychiatric disorders, a complex interplay of genetic factors, neurotransmitter changes and psychosocial characteristics contribute to the development of this disease.

Dean M, Fojo T, Bates S (2005) Tumor stem cells and drug resistance. Nat Rev Cancer 5: 275–84 19. Denker SP, Barber DL (2002) Ion transport proteins anchor and regulate the cytoskeleton. Curr Opin Cell Biol 14: 214–20 20. de Vleeschouwer S, Rapp M, Sorg RV, et al. (2006) Dendritic cell vaccination in patients with malignant gliomas: current status and future directions. Neurosurgery 59: 988–99 21. Eoli M, Menghi F, Bruzzone MG, et al. (2007) Methylation of O6-methylguanine DNA methyltransferase and loss of heterozygosity on 19q and=or 17p are overlapping features of secondary glioblastomas with prolonged survival.

The path towards mandatory standards for DBS in psychiatric disorders . . Conclusions . . . . . . . . . . . . . . . . . . . . . . . The future of DBS . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . 37 38 39 40 41 41 42 43 43 43 46 47 51 51 52 53 54 54 Abstract A substantial number of patients suffering from severe neuropsychiatric disorders do not respond to conventional therapeutic approaches.

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