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 Principles of
Neurological Surgery
This page intentionally left blank
Principles of
Neurological Surgery

Fourth Edition

Richard G. Ellenbogen, MD, FACS

Professor and Chairman
Theodore S. Roberts Endowed Chair
Department of Neurological Surgery
University of Washington
Seattle, Washington

Laligam N. Sekhar, MD, FACS, FAANS

Professor and Vice Chairman
Neurological Surgery
Harborview Medical Center
University of Washington
Seattle, Washington

Neil D. Kitchen, MD, FRCS (SN)

Consultant Neurosurgeon
National Hospital for Neurology and Neurosurgery
Queen Square
London, United Kingdom

Assistant Editor

Harley Brito da Silva, MD

Department of Neurological Surgery
Harborview Medical Center
University of Washington
Seattle, Washin~n

ELSEVIER
ELSEVIER
1600 John F. Kennedy Blvd.
Ste 1800
Philaddphia. PA 19103-2899

PRINCIPLES OF NEUROWGICAL SURGERY, 4th edition ISBN: 978-0-323-43140-8

Copyright@ lOlB by Elserier Inc. AU rights resenecl.
Copyright@ lOll by Saundc:rs, an imprint ofEiscfter Inc.
Copyright @ l005, F.lserier Ltd.
Copyright @ 1994, Mosby Year-Book 11mltcd

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material herein.

Ubrary of Congraa Cataloging-in-Publication Data

Names: Ellenbogen, Richard G., editor. I Sekhar, Laligarn N., editor. I Kitchen, Neil D., editor.
Title: Principles of neurological surgery I [edited by] Richard G. Ellenbogen, Laligarn N. Sckhar, Neil D. Kitchen.
Description: Fourth edition. I Philaddphia, PA: Elsevier, [2018] I Includes bibliographical references and index.
Identifiers: LCCN 2017025873 I ISBN 9780323431408 (hardcover: alk. paper)
Subjects: I MESH: Neurosurgical Procedures I Nervous System Diseases-surgery
Classification: LCC RD593 I NLM WL 3681 DDC 617.4/S--dc23 LC record available at
https://lccn.loc.gov/2017025873

Content Stwzugirt: Belioda Kuhn

Content Dwtlopmmt Specitdist: Joanie Miles
Publishing Smlices Manager: Patricia Tannian
Projm MaMgtr: Ted Rodgers
Design Dirmion: Amy Buxton

Working together
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Printed in China developing countries
Last digit is the print number: 9 8 7 6 5 4 3 2 1 www.elsevier.com • www.bookaid.org
 To Sandy, Rache4 Paul, and Zach: Thank you for your patience, humor and love!
Rich Ellenbogen

I dedicate the book to my loving wife, Gordana; to my children, Daniela. Kris, and Raja,
who constantly inspire me to greatness; and to my student Harley Brito da Silva, who toiled
for countless hours helping to get this book finished.
Sekhar Laligam

To Mandy, Jim, Harry, and Molly

NeU Kitchen
Isaac Josh Abecassis, MD Rocco A. Armonda, MD
Department ofNeurological Surgery Associate Professor and Director
University ofWashington Department of Neurosurgery
Seaucle, Washin~on Uniformed Services University of the Health Sciences
Chapter 42, Pineal Region Tumors Bethesda, Maryland;
Director, Neuroendovascular Surgery
Vijay Agarwal, MD MedStar Washington Hospital Center and Georgetown
Fellow in Neurosurgery University Hospital
Emory University School of Medicine Washin~on, D.C.
Atlanta, Georgia Chapter 27, Penetrating Brain Injury
Chapter 45, Endoscopic Approaches to Ventricular Tumors
and Colloid Cysts Lissa Baird, MD
Head of Pediatric Neurosurgery
Pankaj K. Agarwalla, MD Oregon Health and Science University
Department ofNeurosurgery Portland, Oregon
Massachusetts General Hospital Chapter 14, Nontraumatic Stroke in Children
Boston, Massachusetts
Chapter 50, Application ofCumnt Radiation Delivery James W. Bales, MD, PhD
Systems and Radiobiology Department of Neurological Surgery
University of Washington
Christopher S. Ahuja, MD Seaucle, Washin~on
Associate Professor of Neurosurgery Chapter 25, Closed Head Injury
University ofToronto
Toronto, Ontario, Canada Nicholas C. Bambakidis, MD
Chapter 33, Spinal Cord Injury Professor of Neurosurgery
Case Western Reserve University School of Medicine
Andrew Folusho Alalade, MBBS, MRCS, FRCS(SN), Director and Vice President of the Neurological Institute
FEBNS University Hospitals Cleveland Medical Center
Post-CCf Skull Base Fellow Clevdand, Ohio
Victor Horsley Department ofNeurosurgery Chapter 22, Spontaneous Intracerebral Hemorrhage
The National Hospital for Neurology and Neurosurgery
London, United Kingdom Daniel L. Barrow, MD
Chapter 41, Convexity and Parasagittal Vmu.r Skull Base Pamda R. Rollins Professor and Chairman
Meningiomas Department of Neurosurgery
Emory University School of Medicine
Saira Alii, MBBS, BSc (Hons) Atlanta, Georgia
Neurosurgery Chapter 17, Anterior Circulation Aneurysms
Leeds General Infirmary
Leeds, Great Britain David F. Bauer, MD, FAANS, FAAP
Chapter 11, Posterior Fossa and Brainrtem Tumors in Children Assistant Professor of Neurosurgery and Pediatrics
Children's Hospital at Dartmouth-Hitchcock Medical Center
Kristian Aquilina, MD, FRCS Lebanon, New Hampshire
Consultant Paediatric Neurosurgeon Chapter 13, All Other Brain Tumors in Pediatrics
Great Ormond Street Hospital;
Honorary Senior Lecturer Jeffrey S. Beecher, DO
Devdopmental Neurosciences Programme Neurovascular Chief Fellow
UCL Institute of Child Health University at Buffalo, State University of New York
London, United Kingdom Buffalo, New York
Chapter 12, Craniopharyngiomas Chapter 23, Endovascular Treatment ofAcute Stroke and
Occlusive Cerebrovascular Disease

VI
 Contributors vii

LCDR Randy S. Bell, MD David W. Cadotte, MD

Assistant Professor Neurosurgery and Pediatrics Neurosurgery
Uniformed Services University of Health Sciences University ofToronto
Attending Neurosurgeon Toronto, Ontario, Canada
National Capital Neurosurgery Service Chapter 33, Spinal Cord Injury
Walter Reed National Military Medical Center
Bethesda, Maryland Paolo Cappabianca, MD
Chapter 27. Pmetrating Brain Injury Professor and Chairman ofNeurological Surgery
Universita degli Studi di Napoli Federico II
Antonio Belli, MD Napoli, Italy
Professor ofTrauma Neurosurgery Chapter 48, Endoscopic Approaches to SkuU Base Lesions
University of Birmingham
Birmingham, United Kingdom Luigi Maria Cavallo
Chapter 26, Critical Care Managemmt ofNeurosurgical Neurosurgery
Patients Department ofNeurosciences, Reproductive and
Odontostomatological Sciences
Edward C. Benzel, MD Universit3. degli Studi di Napoli Federico II
Emeritus Chairman ofNeurosurgery Napoli, Italy
Cleveland Clinic Chapter 48, Endoscopic Approaches to SkuU Base Lesions
Cleveland, Ohio
Chapter 35, Degmerative Spinal Disease (Cervical) Alvin Y. Chan, MS
Chapter 36, Degmerative Spinal Disease (Lumbar) Medical College ofWisconsin
Milwaukee, W1Sconsin
Robert H. Bonow, MD Chapter 35, Degenerative Spinal Disease (Cervical)
Department of Neurological Surgery Chapter 36, Degmerative Spinal Disease (Lumbar)
University ofWashington
Seattle, Washington Roc Peng Chen, MD
Chapter 8, Hydrocephalus in Children Associate Professor ofNeurosurgery
Chapter 25, Closed Head Injury University ofTexas Health Science Center
Chapter 54. Spasticity: Classification, Diagnosis, and Houston (liTHealth) Medical School
Managemmt Houston, Texas
Chapter 21, Cavernous Malformations ofthe Brain and
Umberto Marcello Bracale Spina/Cord
Unit ofVascular and Endovascular Surgery
Department of Public Health Peter A. Chiarelli, MD
Universita degli Studi di Napoli "Federico II" Department ofNeurological Surgery
Naples, Italy University ofWashington
Chapter 48, Endoscopic Approaches to SkuU Base Lesions Seattle, Washington
Chapter 28, Traumatic Skull and Facial Fractures
Samuel R. Browd, MD, PhD Chapter 29, Injuries to the Cervical Spine
Professor ofNeurological Surgery
University ofWashington School of Medicine; Omar Choudhri, MD
Attending Neurosurgeon Department ofNeurosurgery
Seattle Children's Hospital Stanford University
Seattle, Washington Stanford, California
Chapter 8, Hydrocephalus in Children Chapter 21, Cavernous Malformations ofthe Brain and
Chapter 54, Spasticity: Classification, Diagnosis, and Spina/Cord
Managemmt
Michelle Chowdhary, MD
Ketan Bulsara, MD Assistant Professor in Neurological Surgery
Neurosurgery Division Chief University ofWashington
UConn Health Seattle, Washington
Farmington, Connecticut Chapter 46, Microsurgical Approaches to the Vmtricular
Chapter 21, Cavernous Malformations ofthe Brain and System
Spina/Cord
viii Contributors

Jason Chu, MD Michael C. Dewan, MD

Department ofNeurosurgery Department of Neurological Surgery
Emory University School of Medicine Vanderbilt University Medical Center,
Atlanta, Georgia Nashville, Tennessee
Chapter 44, Pituitary Tumors: Diagnosis and Management Chapter 7, Spinal Dysraphism and Tethered Spinal Cord

Lt. Michael J. Cirivello, MD Salvatore Di Maio, MCDM, FRCS(C)

Neurosurgery Assistant Professor of Neurosurgery
National Capital Neurosurgery Consortium Jewish General Hospital
Walter Reed National Military Medical Center McGill University
Bethesda, Maryland Montreal, Canada
Chapter 27, Penetrating Brain Injury Chapter 47, Skull Base Tumors: Evaluation and Microsurgery

Pablo Picasso de Araujo Coimbra, MD Dale Ding, MD

Hospital Geral de Fortaleza Neurosurgery
Hospital Institute Dr. Jose Frota University of Virginia
Fortaleza, Brazil Charlottesville, Virginia
Chapter 59, Surgical Management ofInfection ofthe Central Chapter 16, General Principles for the Management of
Nervous System, Skull, and Spine !Wptured and Unruptured Intracranial Aneurysms

Kelly L. Collins, MD Richard G. Ellenbogen, MD

Department ofNeurological Surgery Professor and Chairman
University ofWashington Department of Neurological Surgery
Seattle, Washington University of Washington
Chapter 54, Spasticity: Classification, Diagnosis, and Seattle, Washington
Management Chapter 3, Clinical Evaluation ofthe Nervous System
Chapter 25, Closed Head Injury
Juliane Daartz, PhD Chapter 42, Pineal Region Tumors
Radiation Oncology Chapter 46, Microsurgical Approaches to the Ventricular
Massachusetts General Hospital System
Boston, Massachusetts
Chapter 50, Application ofCurrent Radiation Delivery Chibawanye Ene, MD, PhD
Systems and Radiobiology Department of Neurological Surgery
University of Washington
Oreste de Divitiis, MD Seattle, Washington
Division of Neurosurgery Chapter 54, Spasticity: Classification, Diagnosis, and
Department ofNeurosciences, Reproductive and Management
Odontostomatological Sciences
Universita degli Studi di Napoli Federico II Michael Fehlings, MD, PhD
Napoli, Italy Professor of Neurosurgery
Chapter 48, Endoscopic Approaches to Skull Base Lesions University ofToronto
Halbert Chair in Neural Repair and Regeneration at the
Wolfgang Deinsberger, MD, PhD University Health Network
Professor and Chairman Toronto, Ontario, Canada
Neurochirurgische Klinik Chapter 33. Spinal Cord Injury
Klinikum Kassd
Kassd, Germany Flavio Leitao de Carvalho Filho, MD
Chapter 59. Surgical Management ofInfection ofthe Central Hospital Geral de Fortaleza
Nervous System, Skull, and Spine Hospital Institute Dr. Jose Frota
Fortaleza, Brazil
Simone E. Dekker, MD, PhD Chapter 59. Surgical Management ofInfection ofthe Central
Postdoctoral fellow Nervous System, Skull, and Spine
Department ofNeurological Surgery
Case Western Reserve University School of Medicine
University Hospitals Cleveland Medical Center
Clevdand, Ohio
Chapter 22, Spontaneous Intracerebral Hemorrhage
 Contributors

James R. Fink, MD Gerald A. Grant, MD, FACS

Associate Professor of Radiology Associate Professor ofNeurosurgery
University ofWashington Arline and Pete Harman Endowed Faculty Scholar
Seattle, Washington Division Chief, Pediatric Neurosurgery
Chapter 4, Principles ofModern Neuroimaging Stanford University School of Medicine
Stanford, California
Kathleen R. Tozer Fink, MD Chapter 3, Clinical Evaluation ofthe Nervous System
Department of Radiology
University ofWashington Bradley A. Gross, MD
Seattle, Washington Fdlow in Endovascular Neurosurgery
Chapter 4, Principles ofModern Neuroimaging Barrow Neurological Institute
St. Joseph's Hospital and Medical Center
Jared Fridley, MD Phoenix, Arizona
Assistant Professor of Neurological Surgery Chapter 20, Vascular Malformations (Arteriovenous
Warren Alpert Medical School of Brown University Malformations and Dura/Arteriovenous Fistulas)
Providence, Rhode Island
Chapter 32, Treatment ofSpinal Metastatic Tumors Joseph Gruss, MD
Marlys C. Larson Endowed Chair in Pediatric Craniofacial
George M. Ghobrial, MD Surgery
Neurosurgeon University ofWashington
Thomas Jefferson University Hospital Seattle, Washington
Philadelphia, Pennsylvania Chapter 28, Traumatic SkuO and Facial Fractures
Chapter 30, 1horacolumbar Spine Fractures
Lia Halasz, MD
Michael Gleeson, MD, FRCS, FRACS, FDS Assistant Professor of Radiation Oncology and Neurological
Professor ofNeurotology Surgery
National Hospital for Neurology and Neurosurgery University ofWashington
London, United Kingdom Seattle, Washington
Chapter 49, jugular Foramen Tumors Chapter 52, Description ofProton 1herapy

Atul Goel, MCh (Neurosurgery) Brian W. Hanak, MD

Professor and Head Department ofNeurological Surgery
Department of Neurosurgery University ofWashington
Seth G. S. Medical College and K.E.M. Hospital Seattle, Washington
Mumbai, India Chapter 8, Hydrocephalus in Children
Chapter 34, Craniovmebral junction Chapter 42, Pineal Region Tumors

Ziya L. Gokaslan, MD, FAANS, FACS Todd C. Hankinson, MD, MBA

Chief of Neurosurgery Associate Professor
Rhode Island Hospital Neurosurgery
Chairman of the Department of Neurosurgery Children's Hospital Colorado/University of Colorado
Warren Alpert Medical School of Brown University lulrora, Colorado
Providence, Rhode Island Chapter 10, Chiari Malformations and Syringohydromyelia
Chapter 32, Treatment ofSpinal Metastatic Tumors
James S. Harrop, MD
JamesTait Goodrich, MD, PhD, DSci (Hon) Professor of Neurological Surgery and Orthopedics
Professor of Clinical Neurosurgery, Pediatrics, Plastic and Sidney Kimmel Medical College at Thomas Jefferson
Reconstructive Surgery University
Leo Davidoff Department ofNeurosurgery Section Chief, Division of Spine and Peripheral Nerve
Director, Division of Pediatric Neurosurgery Disorders
Children's Hospital at Montefiore Thomas Jefferson University Hospital
Montefiore Medical Center Philadelphia, Pennsylvania
Albert Einstein College of Medicine Chapter 30, 1horacolumbar Spine Fractures
Bronx, New York
Chapter 1, Landmarks in the History ofNeurosurgery
 Contributors

Carl B. Heilman, MD R. Tushar Jha, MD

Professor and Chairman of Neurosurgery Neurosurgery
Tufts Medical Center MedStar Georgetown University Hospital
Boston, Massachusetts Washington, D.C.
Chapter 43, Cerebetlopontine Angle Tumors Chapter 9, Diagnosis and Surgical Options for
Craniosynostosis
Robert S. Heller, MD
Department ofNeurosurgery Kristen E. Jones, MD
Tufts Medical Center Assistant Professor of Neurosurgery
Boston, Massachusetts University of Minnesota
Chapter 43, Cerebetlopontine Angle Tumors Minneapolis, Minnesota
Chapter 37, Pediatric and Adult Scoliosis
S. Alan Hoffer, MD
Assistant Professor of Neurological Surgery and Neurocritical Patrick K. Jowdy, MD
Care Department of Neurosurgery
Case Western Reserve University School of Medicine School of Medicine and Biomedical Sciences
University Hospitals Cleveland Medical Center University at Buffalo, State University of New York
Cleveland, Ohio Buffalo, New York
Chapter 22, Spontaneous Intracerebral Hemorrhage Chapter 23, Endovascular Treatment ofAcute Stroke and
Occlusive Cerebrovascular Disease
Christoph P. Hofstetter, MD, PhD
Department ofNeurological Surgery Samuel Kalb, MD
University ofWashington Department of Neurosurgery
Seattle, Washington Barrow Neurological Institute
Chapter 29, Injuries to the Cervical Spine St. Joseph's Hospital and Medical Center
Phoenix, Arizona
Jonathan A. Hyam, BSc, FHEA, FRCS, PhD Chapter 20, Vascular Malformations (Arteriovenous
Consultant Neurosurgeon Malformations and Dural Arteriovenous Fistulas)
The National Hospital for Neurology and Neurosurgery
Honorary Senior Lecturer Robert F. Keating, MD
Institute ofNeurology Professor and Chair
University College London Department of Neurosurgery
London, United Kingdom Children's National Medical Center
Chapter 57, Deep Brain Stimulation for Movement Disorders George Washington University School of Medicine
Chapter 58, Stereotactic Functional Neurosurgery for Mental Washington, D.C.
Health Disorders, Pain, and Epilepsy Chapter 9, Diagnosis and Surgical Options for
Craniosynostosis
Kate Impastato, MD
Department of Surgery/Plastic Surgery Cory M. Kelly, BS
University ofWashington Cerebrovascular Neurosurgery Research Scientist
Seattle, Washington Department of Neurological Surgery
Chapter 28, Traumatic Skull and Facial Fractures University of Washington
Seattle, Washington
Semra lsik, MD Chapter 24, Endovascular Treatment ofIntracranial
Bahcesehir University Faculty of Medicine Aneurysms
Department ofNeurosurgery
Istanbul, Turkey Neil D. Kitchen, MD, FRCS
Chapter 11, Posterior Fossa and Brainstem Tumors in Children Neurosurgeon
Victor Horsley Department ofNeurosurgery
Greg James, PhD, FRCS The National Hospital for Neurology and Neurosurgery
Consultant Neurosurgeon and Honorary Senior Lecturer London, United Kingdom
Great Ormond Street Hospital Chapter 41, Convexity and Parasagittal Versus Skull Base
University College London Great Ormond Street Institute of Meningiomas
ChUd Health
London, United Kingdom
Chapter 12, Craniopharyngiomas
 Contributors

Andrew L. Ko, MD Amy Lee, MD

Assistant Professor of Neurosurgery Associate Professor ofNeurological Surgery
University ofWashington University ofWashington;
Searcle, Washington Attending Neurosurgeon
Chapter 38, Low-Grade Gliomas Searcle Children's Hospital
Chapter 40, Brain Metastasis Searcle, Washington
Chapter 53, Trigeminal Neuralgia Chapter 28, Traumatic Skull and Facial Fractures
Chapter 55, Surgery for Temporal Lobe Epilepsy
Michael R. Levitt, MD
Matthew J. Koch, MD Assistant Professor of Neurological Surgery, Radiology, and
Department of Neurosurgery Mechanical Engineering
Massachusetts General Hospital University ofWashington
Boston, Massachusetts Searcle, Washington
Chapter 50, Application ofCurrent Radiation Delivery Chapter 15, Medical and Surgical Treatment of
Systems and Radiobiology Cerebrovascular Occlusive Disease
Chapter 24, Endovascular Treatment ofIntracranial
Douglas Kondziolka, MD Annlrysms
Professor ofNeurosurgery
Vice Chair, dinical Research (Neurosurgery} Elad I. Levy, MD, FACS, FAHA
Professor of Radiation Oncology Professor and Chairman ofNeurosurgery and Radiology
Director, Center for Advanced Radiosurgery School of Medicine and Biomedical Sciences
NYU Langone Medical Center University at Buffalo, State University of New York
New York, New York Buffalo, New York
Chapter 51, Radiosurgery ofCentral Nervous System Tumors Chapter 23, Endovascular Treatment ofAcute Stroke and
and Arteriovenous Malformations Occlusive Cerebrovascular Disease

Chao-Hung Kuo, MD Jay S. Loeffler, MD, FACR, FASTRO, FAAAS

Fellow in Neurological Surgery Herman and Joan Suit Professor of Radiation Oncology
University ofWashington Professor ofNeurosurgery
Searcle, Washington; Harvard Medical School
Fellow in Neurosurgery Chair, Department of Radiation Oncology
Taipei Veterans General Hospital Massachusetts General Hospital
Taipei, Taiwan Boston, Massachusetts
Chapter 55, Surgery for Temporal Lobe Epilepsy Chapter 50, Application ofCurrent Radiation Delivery
Chapter 56, Extratemporal Procedures and Hemispherectomy Systems and Radiobiology
for Epilepsy
Timothy H. Lucas II, MD, PhD
A. Noelle Larson, MD Assistant Professor
Associate Professor of Orthopedic Surgery Director, Surgical Epilepsy Center; Laser Neurosurgery
Mayo Clinic Center; Neurosurgery Gene Therapy
Rochester, Minnesota Assdate Director, Center for Neuroengineering
Chapter 37. Pediatric and Adult Scoliosis University of Pennsylvania
Philaddphia, Pennsylvania
Michael T. Lawton, MD Chapter 46, Microsurgical Approaches to the Ventricular
Professor and Chairman, Department of Neurological Surgery System
President and CEO, Barrow Neurological Institute
Chief, Vascular Neurosurgery Suresh N. Magge, MD
Robert F. Spetzler Endowed Chair in Neurosciences Associate Professor of Neurosurgery and Pediatrics
Barrow Neurological Institute Children's National Medical Center
Phoenix, Arizona George Washington University School of Medicine
Chapter 18, Surgery for Posterior Circulation Aneurysms Washington, D.C.
Chapter 9, Diagnosis and Surgical OptWns for
Craniosynostosis
 Contributors

Edward M. Marchan, MD Jeffrey P. Mullin, MD

Department ofNeurosurgery Department of Neurosurgery
Thomas Jefferson University Cleveland Clinic
Philadelphia, Pennsylvania Cleveland, Ohio
Chapter 30, Thoracolumbar Spine Fractures Chapter 35, Degenerative Spinal Disease (Cervical)
Chapter 36, Degenerative Spinal Disease (Lumbar)
Henry Marsh, MD, CBE, MA, FRCS
Consultant Neurosurgeon Mustafa Nadi, MD
St George's Hospital Division of Neurosurgery
London, United Kingdom Department of Clinical Neurosciences and Hotchkiss Brain
Chapter 2, Chalknges in Global Neurosurgery Institute
University of Calgary
Alexander M. Mason, MD Calgary, Alberta, Canada
Assistant Professor of Neurosurgery Chapter 61, Management ofPeripheral Nerve Injuries
Emory University School of Medicine Chapter 62, Entrapment Neuropathies and Peripheral Nerve
Atlanta, Georgia Tumors
Chapter 17, Anterior Circulation Aneurysms
Peter Nakaji, MD
Panagiotis Mastorakos, MD Professor of Neurosurgery
Department ofNeurosurgery Barrow Neurological Institute
University ofVirginia St. Joseph's Hospital and Medical Center
Charlottesville, Virginia Phoenix, Arizona
Chapter 16, General Principles for the Management of Chapter 20, Vascular Malformations (Arteriovenous
Ruptured and Unruptured Intracranial Aneurysms Malformations and Dural Arteriovenous Fistulas)

D. Jay McCracken, MD John D. Nerva, MD

Department ofNeurosurgery Department of Neurological Surgery
Emory University School of Medicine University of Washington
Atlanta, Georgia Seattle, Washington
Chapter 44, Pituitary Tumors: Diagnosis and Management Chapter 15, Medical and Surgical Treatment of
Cerebrovascular Occlusive Disease
Rajiv Midha, MD, MSc, FRCSC, FAANS
Professor and Head Toba N. Niazi, MD
Department of Clinical Neurosciences Calgary Zone Department of Pediatric Neurosurgery
Alberta Health Services Miami Children's Hospital
University of Calgary Cumming School of Medicine University of Miami Miller School of Medicine
Scientist, Hotchkiss Brain Institute Miami, Florida
Calgary, Alberta, Canada Chapter 31, Intradural Extramedullary and Intramedullary
Chapter 61, Management ofPeripheral Nerve Injuries Spinal Cord Tumors
Chapter 62, Entrapment Neuropathies and Peripheral N~
Tumors Jeffrey G. Ojemann, MD
Professor and Richard G. Ellenbogen Chair in Pediatric
Ryan P. Morton, MD Neurological Surgery
Endovascular Fellow Department of Neurological Surgery
Department ofNeurological Surgery University of Washington;
University ofWashington Division Chief of Neurological Surgery
Seattle, Washington Seattle Children's Hospital
Chapter 40, Brain Metastasis Seattle, Washington
Chapter 56, Extratemporal Procedures and Hemispherectomy
Kyle Mueller, MD for Epilepsy
Department ofNeurosurgery
MedStar Georgetown University Hospital Adetokunbo Oyelese, MD, PhD
Washington, D.C. Assistant Professor of Neurosurgery
Chapter 27, Penetrating Brain Injury Warren Alpert Medical School of Brown University;
Surgical Director for the Comprehensive Spine Center
Rhode Island Hospital
Providence, Rhode Island
Chapter 32, Treatment ofSpinal Metastatic Tumors
 Contributors xiii

Nelson M. Oyesiku, MD, PhD, FACS Ricardo Rocha, MD

Professor and Vice Chairman ofNeurosurgery Clinica Otoimagem and Clinica Radiogenese
Emory Univeristy Fortaleza, Brazil
Adanta, Georgia Chapter 59, Surgical Management ofInfection ofthe Central
Chapter 44, Pituitary Tumors: Diagnosis and Management Nervous System, Skull, and Spine

Anoop P. Patel, MD Trevor J. Royce, MD, MS, MPH

Assistant Professor of Neurological Surgery Harvard Radiation Oncology Program
University ofWashington Massachusetts General Hospital
Searcle, Washington Boston, Massachusetts
Chapter 39. High-Grade Gliomas Chapter 50, Application ofCurrent Radiation Delivery
Systems and Radiobiology
Eric C. Peterson, MD, MS
Assistant Professor of Neurological Surgery James T. Rutka, MD, PhD
University of Miami Professor and R.S. McLaughlin Chair
Miami, Florida Department of Surgery
Chapter 16, General Principles for the Management of University ofToronto Faculty of Medicine;
Ruptured and Unruptured Intracranial Aneurysms Director of the Arthur and Sonia Labatt Brain Tumour
Research Centre
David W. Polly, Jr., MD Division of Paediatric Neurosurgery
Professor and Chief of Spine Surgery The Hospital for Sick Children
Spine Division Toronto, Ontario, Canada
University of Minnesota Chapter 11, Posterior Fossa and Brainstem Tumors in
Minneapolis, Minnesota Children
Chapter 37. Pediatric and Adult Scoliosis
Laligam N. Sekhar, MD, FACS, FAANS
Helen Quach, BMed/MD Professor and Vice Chairman
Medical Officer Neurological Surgery
Concord Repatriation General Hospital Harborview Medical Center
Concord, Australia University ofWashington
Chapter 45, Endoscopic Approaches to Ventricular Tumors Searcle, Washington
and Colloid Cysts Chapter 6, Surgical Positioning, Navigation, Important
Surgical Tools, Craniotomy, and Closure ofCranial and
Shobana Rajan, MD Spinal WOundr
Staff Anesthesiologist Chapter 19, Complex Aneurysms and Cerebral Bypass
Cleveland Oinic Chapter 47. Skull Base Tumors: Evaluation and Microsurgery
Assistant Professor Chapter 53, Trigeminal Neuralgia
Departments of General Anesthesiology and Outcomes
Research Warren Selman, MD
Case Western Reserve Lerner College of Medicine Harvey Huntington Brown, Jr. Professor and Chairman
Cleveland, Ohio Department ofNeurological Surgery
Chapter 5. Neuroanesthesia and Monitoring for Cranial and Case Western Reserve University School of Medicine
Complex Spinal Surgery University Hospitals Cleveland Medical Center
Cleveland, Ohio
Ali Ravanpay, MD Chapter 22, Spontaneous Intracerebral Hemorrhage
Assistant Professor of Neurological Surgery
University ofWashington; Ashish H. Shah, MD
Searcle Veterans Affairs Hospital Department of Pediatric Neurosurgery
Searcle, Washington Miami Children's Hospital
Chapter 38, Low-Grade Gliomas University of Miami Miller School of Medicine
Miami, Florida
Leslie C. Robinson, MD, PharmD, MBA Chapter 31, Intradural Extramedullary and Intramedullary
Department of Neurosurgery Spinal Cord Tumors
University of Colorado
Aurora, Colorado
Chapter 10, Chiari Malformations and Syringohydromyelia
 Contributors

Hussain Shallwani, MD Edward Smith, MD

Research Associate Associate Professor of Neurosurgery
Neurosurgery Harvard Medical School
University at Buffalo, State University ofNew York Director, Pediatric Cerebrovascular Neurosurgery
Buffalo, New York Boston Children's Hospital
Chapter 23, Endovascular Treatmmt ofAcute Stroke and Boston, Massachusetts
Occlusive Cerebrovascular Disease Chapter 14, Nontraumatic Stroke in Children

Deepak Sharma, MD, DM Domenico Solari, MD

The Virginia and Prentice Bloedel Professor ofAnesthesiology Division of Neurosurgery
and Pain Medicine Department of Neurosciences, Reproductive and
Division Chief, Neuroanesthesiology and Perioperative Odontostomatological Sciences
Neurosciences Universita degli Studi di Napoli Federico II
University ofWashington Napoli, Italy
Seattle, Washington Chapter 48, Endoscopic Approaches to Skull Base Lesions
Chapter 5, Neuroanesthesia and Monitoring/or Cranial and
Compkx Spinal Surgery Hesham Soliman, MD
Assistant Professor of Neurosurgery
Mohan Raj Sharma, MD Medical College ofWisconsin
Professor of Neurosurgery Milwaukee, Wisconsin
Tribhuvan University Teaching Hospital Chapter 32, Treatment ofSpinal Metastatic Tumors
Kathmandu, Nepal
Chapter 2, Chalknges in Global Neurosurgery Teresa Somma
Division of Neurosurgery
Daniel L. Silbergeld, MD Department of Neurosciences, Reproductive and
Anhur A. Ward Jr. Professor of Neurological Surgery Odontostomatological Sciences
Adjunct Professor of Pathology Universita degli Studi di Napoli Federico II
University ofWashington Napoli, Italy
Seattle, Washington Chapter 48, Endoscopic Approaches to Skull Base Lesions
Chapter 38, Low~Grade Gliomas
Chapter 40, Brain Metastasis Robert M. Starke, MD, MSc
Department of Neurological Surgery
Dulanka Silva, MA, MBBChir, MPhil (Cantab), MRCS University of Miami
Department ofNeurosurgery Miami, Florida
Queen Elizabeth Hospital Chapter 16, General Principles for the Managemmt of
Birmingham, United Kingdom Ruptured and Unruptured Intracranial Aneurysms
Chapter 26, Critical GJre Managemmt ofNeurosurgical Patients
David C. Straus, MD
Harley Brito da Silva, MD Assistant Professor Neurosurgical Oncology and Skullbase
Department ofNeurological Surgery Surgery Palmetto Health~ University of South Carolina
Harborview Medical Center School of Medicine
University ofWashington Columbia, South Carolina
Seattle, Washington Chapter 19, Complex Aneurysms and Cerebral Bypass
Chapter 6, Surgical Positioning, Navigation, Important Chapter 53, Trigeminal Neuralgia
Surgical Tools, Craniotomy, and Closure of Cranial and
Spinal WOundr
Chapter 19, Complex Aneurysms and Cerebral Bypass
Chapter 59, Surgical Managemmt ofInfection ofthe Cmtral
Nervous System, Skull, and Spine

Luke Silveira
Boston University School of Medicine,
Boston, Massachusetts
Chapter 43, Cerebellopontine Angle Tumors
 Contributors

Charles Teo, MBBS, FRACS Scott D. Wait, MD

Conjoint Professor Director of Pediatric Neurosurgery
Department of Neurosurgery Levine Children's Hospital
University of New South Wales Charlotte, North Carolina
Sydney, Australia; Chapter 45, Endoscopic Approaches to Vmtricular Tumors
Consulting Professor and Colloid Cysts
Department of Neurosurgery
Duke University Brian P. Walcott, MD
Durham, North Carolina; Fellow in Endovascular Neurosurgery
Yeoh Ghim Seng Visiting Professor University of Southern California
Department of Neurosurgery Los Angeles, California
National University Hospital Chapter 18, Surgery for Posterior Circulation Aneurysms
Singapore
Chapter 45, Endoscopic Approaches to Vmtricular Tumors Connor Wathen, BS
and Colloid Cysts Cleveland Clinic Lerner College of Medicine
Cleveland, Ohio
Ahmed Toma, MB ChB, FRCS {Neuro.Surg.), MD {Res) Chapter 35. Degmerative Spinal Disease (Cervical)
Consultant Neurosurgeon Chapter 36, Degenerative Spinal Disease (Lumbar)
Victor Horsely Department of Neurosurgery
National Hospital for Neurology and Neurosurgery John C. Wellons, Ill, MD, MSPH
Honorary Senior Lecturer Chief, Division of Pediatric Neurosurgery
UCL Institute ofNeurology Professor of Neurosurgery and Pediatrics
London, United Kingdom Department ofNeurosurgery
Chapter 60, Hydrocephalus in Adults Vanderbilt University Medical Center
Chapter 7, Spinal Dysraphism and Tethered Spinal Cord
Yolanda D. Tseng, MD Chapter 10, Chiari Malformations and Syringohydromyelia
Assistant Professor of Radiation Oncology
University ofWashington Mark Wilson, PhD, MBBChir, FRCS{SN), MRCA, FIMC
Seatcle, Washington Professor of Brain Injury
Chapter 52, Description ofProton 1herapy Department ofNeurosurgery
Imperial College
R. Shane Tubbs, MS, PA-C, PhD London, United Kingdom;
Chief Scientific Officer Gibson Chair of Pre-Hospital Care
Seatcle Science Foundation Faculty of Pre-Hospital Care
Seatcle, Washington; Royal College of Surgeons
Adjunct Professor Edinburgh, Scodand
University of Dundee Chapter 63, Prehospital Neurotrauma
Dundee, United Kingdom
Chapter 10, Chiari Malformations and Syringohydromyelia Amparo Wolf, MD, PhD
Department ofNeurosurgery
Kunal Vakharia, MD NYU Langone Medical Center
Department of Neurosurgery New York, New York
School of Medicine and Biomedical Sciences Chapter 51, Radiosurgery ofCentral Nervous System Tumors
University at Buffalo, State University of New York and Arteriovenous Malformations
Buffalo, New York
Chapter 23, Endovascular Treatment ofAcute Stroke and Linda Xu, MD
Occlusive Cerebrovascular Disease Department ofNeurosurgery
Stanford University
Alessandro Villa Stanford, California
Unit ofNeurosurgery Chapter 3, Clinical Evaluation ofthe Nervous System
Azienda Ospedaliera Civico - Di Cristina - Benfratelli
Palermo, Italy
Chapter 48, Endoscopic Approaches to SkuU Base Lesions
 Contributors

Tong Yang, MD Ludvic Zrinzo, MD, PhD

Pediatric Neurosurgeon Associate Professor
Sanford Medical Center Unit of Functional Neurosurgery
Fargo, North Dakota Sobdl Department of Motor Neuroscience and Movement
Chapter 6, Surgical Positioning, Navigation, Important Disorders
Surgical Tools, Craniotomy, and Closure of Cranial and UCL Institute of Neurology, University College London;
Spinal WOunds Consultant Neurosurgeon
Victor Horsley Department of Neurosurgery
Christopher C. Young, MBChB, DPhil National Hospital for Neurology and Neurosurgery
Department ofNeurological Surgery London, United Kingdom
University ofWashington Medical Center Chapter 57, Deep Brain Stimulation for Movement Disorders
Seattle, Washington Chapter 58, Stereotactic Functional Neurosurgery for Mental
Chapter 29, Injuries to the Cervical Spine Health Disorders, Pain, and Epilepsy
 Concern for man and his fate must alwaysform the chiefinter- spectrum of neurological surgery more comprehensible. The
est ofall technical endeavors .. . Never forget this in the midst text was then combined with the beautiful renderings of highly
ofyour diagrams and equations. skilled artists, organized tables, and pertinent photographs to
ALBERT EINSTEIN ddineate both concepts and techniques. The authors added
"Clinical Pearls" that sum up the critical bullet points of the
chapters. The chapters are further supplemented with a section
Principles ofNeurological Surgery is in its fourth edition because of "Sdected Key References" from the bibliography, which
of the popular demand of our students. We are thrilled to see the authors bdieve are worthy of in-depth investigation. Fur-
the previous editions being read by medical students, house thermore, we have listened to our students' desire for visual
officers, nurses, and practicing neurosurgeons. It is for these reinforcement and simulation to master psychomotor skills
treasured students, young and old, novice and experienced, in the operating room. For that reason, we have included
that this book is intended. It is to be used to guide both those video clips for key operations. They can be downloaded from
learning and those teaching. We are most indebted to our the Elsevier website and reviewed at any time from any loca-
patients for inspiring us to perform at our best every day and tion by those who desire to augment their understanding of
pass on this experience to the next generation. We hope this the material.
edition contributes to the modest goal of shaping more I am fortunate to be joined by two exceptional neurological
informed clinicians, ultimatdy for the benefit and safety of our surgery talents: Professors Sekhar (USA) and Kitchen (Great
patients. Britain). These two professors possess a keen eye for the critical
The world of medical education has evolved rapidly, and dements of our field. They are internationally recognized as
our students do not necessarily learn in the same manner we master educators, as well as technical virtuosos. Of course, the
once learned. We have listened carefully to their constructive success of this book truly rests upon a team of world class
comments and presented a book that addresses their individual contributing scholars, known for their specific expertise, with
approach to learning basic neurological surgery principles. Sci- this edition drawing from them new contributions. The entire
entific information is growing at an exponential rate. Thus, project was then overseen by a patient and experienced Elsevier
mastering the wide spectrum of neurological surgery is argu- editing team.
ably even more challenging for the current generation of stu- I am deeply grateful to the authors, artists, and editors for
dents than it was for our generation. A host of excellent the precious time and hard work invested in this third edition.
encyclopedic neurological surgery reference texts currendy are They created a book with extraordinary visual appeal, contain-
available. Our work is intended to be a simpler, coherent, ing accurate, evidence-based explanations, beautiful color
practical education tool. illustrations, simple tables, illustrative photographs, and video
We hope it could be the sort of tool that students can use highlights. It is our hope that this approach will be substantive,
every day. We recognize that the internet and easily searchable long lived, and enjoyable for our readers and beneficial to our
peer-reviewed literature have often supplanted multivolume patients.
collections, so we took a different approach with this single
volume text. It is our goal to make the complex and broad Richard G. Ellenbogen

XVII
Part 1: General Overview 13 All Other Brain Tumors in Pediatrics,219
David F. Bauer
1 Landmarks in the History of Neurosurgery, 1
James Tait Goodrich 14 Nontraumatic Stroke in Children, 229
Lissa Baird, Edward Smith
2 Challenges in Global Neurosurgery, 38
Mohan Raj Sharma, Henry Marsh
Part 3: Vascular Neurosurgery
3 Clinical Evaluation of the Nervous System, 44
Gerald A. Grant, Linda Xu, Richard G. Ellenbogen 15 Medical and Surgical Treatment of
Cerebrovascular Occlusive Disease, 241
4 Principles of Modern Neuroimaging, 62 John D. Nerva, Michael R. Levitt
Kathleen R. Tozer Fink, James R. Fink
16 General Principles for the Management
5 Neuroanesthesia and Monitoring for Cranial and of Ruptured and Unruptured Intracranial
Complex Spinal Surgery, 87 Aneurysms, 254
Shobana Rajan, Deepak Sharma Panagiotis Mastorakos, Dale Ding, Eric C. Peterson,
Robert M. Starke
6 Surgical Positioning, Navigation, Important
Surgical Tools, Craniotomy, and Closure of 17 Anterior Circulation Aneurysms, 264
Cranial and Spinal Wounds, 103 Alexander M. Mason, Daniel Louis Baffow
Tong Yang, Harley Brito da Silva, Laligam N. Sekhar
18 Surgery for Posterior Circulation
Part 2: Pediatric Neurosurgery Aneurysms, 282
Brian P. Walcott, Michael T. Lawton
7 Spinal Dysraphism and Tethered Spinal Cord, 116
Michael C. Dewan, John C. Wellons, Ill 19 Complex Aneurysms and Cerebral Bypass, 295
David C. Straus, Harley Brito do Silva, Laligam N. Sekhar
8 Hydrocephalus in Children, 133
Robert H. Bonow, Brian W. Hanak, Samuel R. Browd 20 Vascular Malformations (Arteriovenous
Malformations and Dural Arteriovenous
9 Diagnosis and Surgical Options for Fistulas), 313
Craniosynostosis, 148 Samuel Kalb, Bradley A. Gross, Peter Nakaji
R. Tushar Jha, Suresh N. Magge, Robert F. Keating
21 Cavernous Malformations of the Brain and
10 Chiari Malformations and Spinal Cord, 325
Syrlngohydromyella, 170 Omar Choudhri, Roc Peng Chen, Ketan Bulsara
Leslie C. Robinson, R. Shane Tubbs, John C. Wellons, Ill
Todd C. Hankinson 22 Spontaneous Intracerebral Hemorrhage, 334
Simone E. Dekker, S. Alan Hoffer, Waffen Selman,
11 Posterior Fossa and Brainstem Tumors in Nicholas C. Bambakidis
Children, 183
Saira Alii, Semra lsik. James T. Rutka 23 Endovascular Treatment of Acute Stroke and
Occlusive Cerebrovascular Disease, 343
12 Craniopharyngiomas, 204 Kunal Vakharia, Hussain Shallwani, JeffreyS. Beecher,
Greg James, Kristian Aquilina Patrick K. Jowdy, Elad I. Levy

XVIII
 Content xix

24 Endovascular Treatment of Intracranial Part 6: Tumors

Aneurysms, 355
Ryan P. Morton, Cory M. Kelly, Michael R. Levitt 38 Low-Grade Gliomas, 573
Ali Ravanpay, Andrew L Ko, DanielL Silbergeld

Part 4: Trauma 39 High-Grade Gliomas, 580

Anoop P. Patel
25 Closed Head Injury, 366
James W. Bales, Robert H. Bonow, Richard G. Ellenbogen
40 Brain Metastasis, 586
Ryan Morton, Andrew L Ko, DanielL. Silbergeld
26 Critical Care Management of Neurosurgical
Patients, 390 41 Convexity and Parasagittal Versus Skull Base
Dulanka Silva, Antonio Belli
Meningiomas, 593
Andrew Folusho Alalade, Neil D. Kitchen
27 Penetrating Brain Injury, 420
Kyle Mueller, Michael J. Cirivello, Randy S. Bell,
42 Pineal Region Tumors, 602
Rocco A. Armonda Isaac Josh Abecassis, Brian W. Hanak. Richard G. Ellenbogen

28 Traumatic Skull and Facial Fradures, 445 43 Cerebellopontine Angle Tumors, 622
Peter A. Chiarelli, Kate Impastato, Joseph Gruss, Amy Lee
RobertS. Heller, Luke Silveira, Car/B. Heilman

Part 5: The Spine 44 Pituitary Tumors: Diagnosis and

Management, 632
29 Injuries to the Cervical Spine, 475 D. Jay McCracken, Joson Chu, Nelson M. Oyesiku
Christopher C. Young, Peter A. Chiarelli,
Christoph P. Hofstetter 45 Endoscopic Approaches to Ventricular Tumors
and Colloid Cysts, 658
30 Thoracolumbar Spine Fractures, 493 Helen Quach, Scott D. Wait Vijay Agarwal, Charles Teo
Edward M. Morchon, George M. Ghobrial, James S. Harrop
46 Microsurgical Approaches to the Ventricular
31 Intradural Extramedullary and Intramedullary System,666
Spinal Cord Tumors, 500 Timothy H. Lucas II, Michelle Chowdhary, Richard G. Ellenbogen
Ashish H. Shah, Toba N. Niozi
47 Skull Base Tumors: Evaluation and
32 Management of Spinal Metastatic Tumors, 51 0 Microsurgery, 682
Hesham Soliman, Jared Fridley, Adetokunbo Oyelese, Salvatore DiMaio, Laligom N. Sekhor
Ziya L Gokas/an
48 Endoscopic Approaches to Skull Base
33 Spinal Cord Injury, 518 Lesions, 695
Christopher S. Ahuja, David W. Cadotte, Michael Fehlings Paolo Cappabianca, Alessandro Villa, Luigi Maria Cavallo,
Teresa Somma, Umberto Marcello Bracole, Oreste de Divitiis,
34 Craniovertebral Jundion, 532 Domenico Solari
Atu/Goe/
49 Jugular Foramen Tumors, 706
35 Degenerative Spinal Disease (Cervical), 549 Michael Gleeson
Alvin Y. Chan, Jeffrey P. Mullin, Connor Wathen,
Edward C. Benzel Part 7: Radiosurgery and Radiotherapy
36 Degenerative Spinal Disease (Lumbar), 554 SO Application of Current Radiation Delivery
Connor Wathen, Jeffrey P. Mullin, Alvin Y. Chon, Systems and Radiobiology, 714
Edward C. Benzel Pankoj K. Agarwalla, Trevor J. Royce, Matthew J. Koch,
Julione Doartz,. JoyS. Loeffler
37 Pediatric and Adult Scoliosis, 561
Part I. Scoliosis in the Pediatric Patient David W. Polly, Jr., 51 Radiosurgery of Central Nervous
Kristen E. Jones, A. Noelle Larson System Tumors and Arteriovenous
Port II. Adult Scoliosis and Spinal Deformity: David W. Polly, Jr., Malformations, 727
Kristen E. Jones Amparo Wolf, Douglas Kondziolko
 Content

52 Description of Proton Therapy, 736 Part 9: Miscellaneous

Yolanda D. Tseng, Lia Halasz
59 Surgical Management of Infection of the Central
Part 8: Functional Pain Nervous System, Skull, and Spine, 806
Harley Brito da Silva, Pablo Picasso de Araujo Coimbra,
53 Trigeminal Neuralgia, 745 Ricardo Rocha, Flavia Leitao de Carvalho Filho,
David C. Straus, Andrew L. Ko, Laligam N. Sekhar Wolfgang Deinsberger

54 Spasticity: Classification, Diagnosis, and 60 Hydrocephalus in Adults, 822

Management, 753 AhmedToma
Robert H. Bonow, Kelly L Collins, Chibawanye Ene_
Samuel R. Browd 61 Management of Peripheral Nerve Injuries, 832
Mustafa Nadi, Rajiv Midha
55 SurgeryforTemporal Lobe Epilepsy, 761
Andrew L. Ko, Chao-Hung Kuo 62 Entrapment Neuropathies and Peripheral Nerve
Tumors,842
56 Extratemporal Procedures and Mustafa Nodi, Rajiv Midha
Hemispheredomy for Epilepsy, 771
Chao-Hung Kuo, Jeffrey G. Ojemann 63 Prehospital Neurotrauma, 861
Mark Wilson
57 Deep Brain Stimulation for Movement
Disorders, 781 lndex,868
Ludvic Zrinzo, Jonathan A. Hyam

58 Stereotactic Functional Neurosurgery for Mental

Health Disorders, Pain, and Epilepsy, 799
Jonathan A. Hyam, Ludvic Zrinzo
The Chiari Malformations and • Video 8B. Transposterior communicating artery stenting
Syringohydromyelia (Courtesy of Codman Neurovascular, Raynham, MA)
• Video 9: PED deployment (Courtesy of ev3, Irvine,
R Shane Tubbs, Todd C Hankinson, john C Wellons, III California)
See Chapter 10
• Video 1: Posterior fossa decompression 1 Intradural Extra- and Intramedullary Spinal
• Video 2: Posterior fossa decompression 2
Cord Tumors
Posterior Fossa and Brainstem Tumors Michael Bruneau, Florence Lifi"anc, Danielle Baleriau:x:, jacques
in Children Brotchi
See Chapter 31
Adrienne Weeks, Aria Fallah, james T. &tka • Video 1: Intradural extra- and intramedullary spinal cord
See Chapter 71 tumors (Copyright: H6pital Erasme, Universite Libre de
• Video 1: Suboccipital approach to a fourth ventricular Bruxelles)
choroid plexus tumor
Cerebellopontine Angle Tumors
Spontaneous Intracerebral Hemorrhage
Madjid Samii, Venelin M. Gerganov
S. Alan Hoffir, justin Singer, Nicholas C Bambakidis, \%rren See Chapter 43
Selman • Video 1: Vestibular schwannoma Grade T2: retrosig-
See Chapters 22 moid tumor removal
• Video 1: Microsurgical resection of ruptured Grade III • Video 2: Vestibular schwannoma Grade T4b: retrosig-
arteriovenous malformation moid tumor removal
• Video 3: Management of high located jugular bulb
Endovascular Neurosurgery
Aneurysm Surgeries
Sabareesh K Natarajan, Adnan H. Siddiqui, L. Nelson Hopkins,
Elad L Levy Saleem L Abdulrauf
See Chapters 23 • Video 1: Clipping of multiple interior circulation aneu-
• Video 1. Animation ofMerci device dot retrieval (Cour- rysms to a right transylvian approach
tesy of Concentric Medical, Mountain View, CA) • Video 2: High flow bypass for a giant ICA aneurysm;
• Video 2. Animation of Penumbra dot aspiration (Cour- anastomosis to the supradinoidal ICA
tesy of Penumbra Inc., Alameda, CA) • Video 3: Clipping of a right SCA aneurysm through a
• Video 3. Animation showing an intracranial atheroscle- right interior petrosal approach
rotic stenosis that is crossed with a microwire-microcath- • Video 4: Dissection of a complex MCA ruptured
eter system. (Courtesy of Boston Scientific, Natick, MA) aneurysm
• Video 4. Carotid stenting with the Xact and EmboShield • Video 5: Demonstration of a technique of dissection
devices (Courtesy of Abbott Vascular, Santa Clara, perforators off the dome of an aneurysm prior to
CA) dipping
• Video 5. Animation showing coiling of an aneurysm • Video 6: Demonstration of intracranial dip occlusion of
(Courtesy of ev3, Irvine, California) the ICA following high flow bypass for a giant/calcified
• Video 6: Stent-assisted coiling with an Enterprise stent aneurysm (left transylvian approach)
(Courtesy of Codman Neurovascular, Raynham, MA) • Video 7: Demonstration of sharp dissection of perfora-
• Video 7. Balloon anchor technique tors adherent to the dome of the aneurysm
• Video 8A. Transanterior communicating artery stenting • Video 8: Multiple dip reconstruction technique for a
(Courtesy of Codman Neurovascular, Raynham, MA) giant ICA aneurysm

XXI
 Online Video Contents

• Video 9: Clipping of an ophthalmic artery aneurysm • Video 2: Resection of a retro-chiasmatic craniopharyn-

through a left transylvian approach gioma going through the optical-carotid and oculomo-
• Video 10: Clipping of a previously coiled ICA aneurysm tor-carotid triangles
(right transylvian approach) • Video 3: Resection of a craniopharyngioma through a
• Video 11: Endoscopic assisted clipping of a basilar tip right transylvian approach; demonstration of how to
aneurysm dissect the capsule of the tumor off the ICA
• Video 12: Demonstration of a giant MCA aneurysm that • Video 4: Demonstration of the resection of a cranio-
is not clipable, leading to halting of the procedure pharyngioma away from the basilar artery
• Video 13: Clipping ofa large right ophthalmic aneurysm • Video 5: Resection of a colloid cyst using the inter-
through a right transylvian approach hemipsheric transcallosal approach
• Video 14: Clipping of a basilar tip aneurysm 1 • Video 6: Tuberculum sellae meningioma resection
• Video 15: Clipping of a basilar tip aneurysm 2 through a left cranial orbital approach
• Video 16: Clipping of a giant carotid wall aneurysm • Video 7: Resection of a hypothalamic tumor
• Video 8: Demonstration of hypothalamic-chiasmatic
glioma
AVM Surgeries
Saleem 1 Abdulrauf EC/ IC Bypass Surgeries
• Video 1: Resection of a previously ruptured temporal-
frontal AVM; stepwise approach Saleem 1 Abdulrauf
• Video 2: Obliteration of tentorial dural AVM • Video 1: Demonstration of the proximal anastomosis for
• Video 3: A stepwise technique on how to resect an arte- a high flow bypass
rial-venous malformation (AVM) and resection of an • Video 2: Demonstration of STA-MCA bypass
AVM • Video 3: Preparation for a high flow radial artery ECIC
• Video 4: Demonstration of the interior petrosal trans- bypass
tentorial approach for an AVM of the tentorial surface • Video 4: Demonstration of an intracranial anastomosis
of the cerebellum of the radial artery graft to M2
• Video 5: Intercranial anastomosis of radial artery to the
Approaches for Brainstem and middle cerebral artery
• Video 6: Preparation of the radial artery graft for
Thalamic Legions
anastomosis
Saleem 1 Abdulrauf • Video 7: Demonstration of the intracranial anastomosis
• Video 1: Interior hemispheric petrosal approach for a (M2) using a radial artery graft
midbrain cavernoma
• Video 2: Resection of a midbrain cavernoma through a Special Technical Nuances
right interior petrosal approach
• Video 3: Resection of a pulvinar cavernoma through a Saleem 1 Abdulrauf
right-sided posterior inter-hemispheric transcingulate • Video 1: Resection of a posterior fossa epidermoid using
approach the far lateral approach
• Video 4: Resection of a midbrain cavernoma through a • Video 2: A dissection of an adherent meningioma away
right-sided interior petrosal approach from optic nerve (left cranial-orbital approach)
• Video 5: Tdo-velar approach to the floor of the fourth • Video 3: Resection of an upper clival meningioma
ventricle for a pontine cavernoma through a right-sided cranial-orbital-zygomatic approach
• Video 4: Demonstration on how to split the sylvian
Operative Approaches to the Supra-Sellar and fissure
• Video 5: Demonstration of the reconstruction of the
Third Ventricular Regions
orbital roof following cranial-orbital approach using
Saleem 1 Abdulrauf Porex implant
• Video 1: Resection of an interior third ventricular cra-
niopharyngioma through a right-sided transylvian trans-
lamina-terminalis approach
 • Unruptured Basilar Tip Aneurysm: Clipping and Rathke's
1. Cerebrovascular Cases Cleft Cyst Resection
Aneurysm Clipping Cases Surgeon: Laligam N . Sekhar
Edited by: Ramon LOpez LOpez
• Ruptured ACOM Artery Aneurysm: Clipping by Fronto-
temporal Approach • Unruptured Basilar Tip Aneurysm: Clipping by Right Fron-
Surgeon: Laligam N. Sekhar totemporal Craniotomy and Orbitozygomatic Osteotomy
Edited by: Victor Correa-Correa Surgeon: Laligam N. Sekhar
Edited by: Rabindranath Garcia, Farzana Tariq
• Ruptured Large ACOM Artery Aneurysm Pointing Inferi-
orly: Clipping by Frontotemporal Approach with Contra- • Unruptured Basilar Tip Aneurysm: Clipping by Subtempo-
lateral Craniectomy and Evacuation of Blood Clot ral Transzygomatic Approach
Surgeon: Laligam N. Sekhar Surgeon: Laligam N. Sekhar
Edited by: Victor Correa-Correa Edited by: Rabindranath Garcia, Farzana Tariq

• Ruptured Small ACOM Aneurysm: Clipping by Bifron- • Ruptured Basilar Tip Aneurysm: Clipping by Frontotem-
tal Transbasal Interhemispheric Approach, Aneurysm poral-Orbitozygomatic Approach
Repair Surgeon: Louis ] . Kim
Surgeon: Laligam N. Sekhar Edited by: Farzana Tariq
Edited by: Victor Correa-Correa
Aneurysm Bypass Cases
• Unruptured Giant Anterior Communicating Artery Aneu-
rysm: Interhemispheric Approach, Aneurysm Repair • Giant Basilar Artery Bifurcation Aneurysm: Treated by
Surgeon: Laligam N. Sekhar Proximal BA Occlusion and Radial Artery Graft Bypass
Edited by: Ramon LOpez LOpez Surgeon: Laligam N. Sekhar
Edited by: Farzana Tariq
• Ruptured Giant ACOM Aneurysm: Clipping and Aneurys-
morrhaphy by Bifrontal and Temporal Craniotomies, Inter- • Large Paraclinoid Aneurysm: Trapping by Frontotemporal-
hemispheric approach (Part 1) Orbital Approach with Bypass ECA-MCA
Surgeon: Laligam N. Sekhar Surgeon: Laligam N. Sekhar
Edited by: Alessandra Mantovani Edited by: Victor Correa-Correa

• Unruptured Basilar Tip Aneurysm: Clipping by Frontotem- • Cavernous Right Internal Carotid Artery Aneurysm: Radial
poral Orbitozygomatic Approach Artery Graft from ECA to MCA, Trapping of Aneurysm
Surgeon: Laligam N. Sekhar Surgeon: Laligam N. Sekhar
Edited by: Victor Correa-Correa Edited by: Ramon LOpez LOpez

• Unruptured Basilar Tip Aneurysm: Clipping by Orbito- • Recurrent Distal Middle Cerebral Artery Aneurysm: Resec-
Frontotemporal Approach tion with Reimplantation and Radial Artery Graft Interpo-
Surgeon: Laligam N. Sekhar sition Graft
Edited by: Victor Correa-Correa Surgeon: Laligam N. Sekhar
Edited by: Ramon LOpez LOpez
• Ruptured Complex Basilar Tip and SCA Aneurysms:
Clipping by Left Temporal Craniotomy and Zygomatic • Pericallosal Aneurysm: Clipping and A4-A4 Side-to-Side
Osteotomy Anastomosis
Surgeon: Laligam N. Sekhar Surgeon: Laligam N. Sekhar
Edited by: Sabareesh K Natarajan, Farzana Tariq Edited by: Victor Correa-Correa

XXIII
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MP25014.
MP25015.
MP25017.
MP25109.
MP25110.
MP25203 - MP25205.
MP25388 - MP25396.
MP25457 - MP25458.
MP25461.
Esquire, Inc. Perspective Films.
MP25108.
Essentia, the Evergreen State College. SEE Evergreen State College,
Olympia, WA. Essentia.
Establishing observer reliability with the teacher self appraisal
observation system.
MP25048.
Esty (William) Company, Inc.
MP24842 - MP24843.
MP24910.
MP24977 - MP24981.
MP25041.
ETA Productions.
MP25273.
Ethnographics, Inc.
MP25360 - MP25361.
MP25364 - MP25377.
Eugene O’Neill’s The Iceman cometh.
 LP42935.
Euro International Films, S. P. A.
LP42961.
Evergreen State College, Olympia, Wa. Essentia.
MP25429.
Evil men do.
LP43016.
Ewing, Wayne H.
MP25359.
Executioners.
LP43278.
Exits and entrances: show biz in a lively era.
LP43309.
Exorcist.
LP42969.
Explorer Post 2001.
MP24885.
Exploring inner space.
MP24886.
Extravagant Film Productions, Ltd.
LP42985.
 F
Fabulous Suzanne.
R568603.
Face.
MP25254.
MP25255.
Factory Mutual Engineering Corporation.
MP24900.
F. A. C. T. S.
MP25340.
Fairbanks, Douglas, Jr.
LP43608.
Fairchild Industries, Inc.
LP43226.
Falcon, prince of birds.
MP25202.
Falcon’s adventure.
R570317.
Fallen.
LP43487.
Fallen image.
LP43303.
Fall of the House of Usher.
LP43353.
Fall of Troy.
LP43361.
Fame is the spur.
LF154.
Fannie Mae guide to buying, financing and selling your home.
 MP25415.
Fantasy of Siam.
R572006.
Farmer in a changing America.
MP24840.
Farmer’s daughter.
R578233.
Far world.
R572331.
Fatal decision.
LP43321.
Fatal memory.
LP43478.
Feather in his hare.
R569649.
Fedderson, Don.
LP43202.
Federal National Mortgage Association.
MP25415.
Feeding.
MP25115.
Feed Service Corporation.
MP25479.
Feelings.
MP25076.
Feiner (Richard) and Company, Inc.
R576618.
Felipa: north of the border.
LP43080.
Ferrell (J. W.) Company, Inc.
MP25171.
Ferris, Bill.
 MP25277.
Fiesta.
R578944.
Fiesta Films.
MP25063.
50 happy years.
MP25387.
Fifty years of thorns and roses.
LP43122.
Fighting frontiersman.
R567582.
Film Archives Company.
LP43259.
LP43353.
R577971.
R577972.
FilmFair Communications.
MP24934.
MP24935.
MP24936.
FilmFair, Inc.
MP24934.
MP24935.
MP24936.
Film making techniques.
MP25420.
Film Production Unit, Iowa State University, Ames. SEE Iowa State
University of Science and Technology, Ames. Film Production
Unit.
Films, Inc.
MP24863 - MP24867.
MP24912.
MP25473 - MP25474.
MP25476.
Films of Scotland.
LP43189.
MP24876.
Filmways Television Productions, Inc.
LP43607.
Final semester.
LP43144.
Fine arts and humanities.
LP42945.
Fire in the laboratory.
MP25234.
Fire Service Extension and Film Production Unit, Iowa State
University. SEE Iowa State University of Science and Technology,
Ames. Fire Service Extension and Film Production Unit.
First aid action.
MP24847.
First day of your life.
LP43152.
First encounter.
MU8943.
First hurrah.
LP43215.
Fitch, John T.
MP25228 - MP25234.
Fitch, Robert M.
MP25228 - MP25234.
Fitzgerald, F. Scott.
LP43372.
Five days in the death of Sergeant Brown.
LP43106.
Five Hand Company.
LP43138.
Five on the black hand side.
LP43138.
Five will get you six.
LP43151.
Fixation and dehydration in haemanthus.
MP25306.
Flammability and flame retardants in plastic.
MP25276.
Flint Laboratories, division of Travenol Laboratories, Inc. SEE
Travenol Laboratories, Inc. Flint Laboratories.
Flood tide.
LF132.
Flossie and religion.
LP43607.
Flowering and fruiting of papaya.
MP24969.
Flying sportsman in Jamaica.
R578349.
FNMA. SEE Federal National Mortgage Association.
Foibles.
LP43071.
Food chains in a lake environment.
MP24762.
Food labeling: Understanding what you eat.
MP24988.
Food: the story of a peanut butter sandwich.
LP43078.
Fool and his money.
LP43417.
Fool’s gold.
R573667.
Fools rush in.
 LF134.
Football fanfare.
R568015.
Ford Foundation.
MP24902.
Ford Motor Company.
LP43469.
Forest animals and their young.
MP24795.
For richer, for poorer.
LP43219.
For the love of pizza.
LP43105.
For the love of Rusty.
R578897.
For the rest of your life.
MP25227.
Fortune hunters.
R567077.
Foul hunting.
R578550.
Fowl brawl.
R570075.
Fowler, Bruce.
MP25303.
MP25304.
Fox, J. Lawrence.
MP25312 - MP25315.
Fragile possession.
LP43455.
Framed.
R572335.
Franciscan Communications Center.
MP24901.
MP24916.
Franck, Edward A.
MP24886.
Frangakis, Nicholas.
MP25066.
Franklin, Robert J.
MP25421.
Freedom trap.
LP42953.
Freeman, Everett.
LP43575.
Freeman, Leonard.
LP42947.
LP42948.
LP42949.
Freeman (Leonard) Productions, Inc.
LP43048.
LP43049.
Free men triumph.
R570071.
Freleng.
LP43130 - LP43133.
LP43137.
LP43630 - LP43631.
LP43634 - LP43636.
French Revolution: the Bastille.
LP43085.
French Revolution: the terror.
LP43096.
Friend of the family.
LP43216.
Fright and flight.
LP43284.
Fright night.
R577569.
From Homo Erectus to Neanderthal.
MP24742.
From the source.
MP25226.
Frozen war, America intervenes in Russia, 1918–1920.
MP25181.
Frugal Films, Ltd. Kotch Company.
LP43606.
Fruit fly: a look at behavior biology.
MP25430.
Fruiting of cacao (Theobroma cacao)
MP24971.
Fruiting of coffee (Coffea arabica)
MP24974.
Fugitive.
LP42987 - LP43046.
Fulkerson, Ann Tavi.
MU8902.
Fuller, Samuel.
LP43118.
Fun and fancy free.
R577489.
Functions.
MP24732.
Fundamental theorem.
MP25051.
Fun on a weekend.
R577972.
Fun with speech sounds.
MP25015.
Fury / Impala / Galaxie 500 comparison.
MP25034.
Fussy baby.
MP25123.
Future action computerized training system.
MP25340.
Fuzz brothers.
LP42968.
Fuzz lady.
LP43165.
 G
Gainsborough Pictures, Ltd.
LF137.
LF138.
LF142.
LF149.
LF150.
LF152.
R578286.
R578604.
Gait and musculoskeletal disorders.
MP25261.
Galapagos: Darwin’s clues.
MP24892.
Gallant, Denise P.
MU8997.
Game for one player.
LP43493.
Game of showdown.
LP43430.
Games.
MP25078.
Gandy Goose in Fortune hunters.
R567077.
Gandy Goose in It’s all in the stars.
R570610.
Gandy Goose in Mexican baseball.
R579969.
Gandy Goose in Peace time football.
R572099.
Gandy Goose in The Golden hen.
R572101.
Gardner, B. T.
MP25170.
Gardner (James) Child Development Centers.
MP25358.
Gardner, R. A.
MP25170.
Garner Ted Armstrong.
MP24724 - MP24731.
MP24797 - MP24798.
MP24809 - MP24827.
MP24887.
MP24992 - MP25012.
MP25147 - MP25153.
MP25206 - MP25213.
MP25248 - MP25253.
MP25283.
MP25285 - MP25289.
MP25495 - MP25500.
Gashouse kids.
R569740.
Gassner, Mordi.
MU8910.
Gathering information for weather forecasting.
MP24774.
Gaucho.
LP43352.
Gaumont British Distributors, Ltd.
LF128.
Gay anties.
R567284.
Gearing.
MP24923.
Gears and machines.
MP24749.
Gellerman effective supervision series.
MP25013.
MP25135.
MP23136.
Gemini descending.
LP43420.
General Film Distributors, Ltd.
LF128.
LF137 - LF140.
LF151.
R574818.
R578285.
R578287.
R578288.
General Foods Corporation. Beverage and Breakfast Foods Division.
MP24828.
General Motors.
MU8973.
General Motors Corporation. Chevrolet Motor Division.
MU8944 - MU8949.
MU8987.
MU8989 - MU8990.
MU9006 - MU9007.
General Motors Corporation. Oldsmobile Division.
MP25477.
General Motors Institute, Flint, MI.
MP25275 - MP25276.
MP25423.
Generation 70, Inc.
LP43623.
Gentleman Joe Palooka.
R577414.
Geothermal power.
MP25039.
Gettysburg - 1863.
MP25065.
Ghetto clinic.
LP43592.
Ghost of the dancing doll.
LP43425.
Giddy up woe.
LP43132.
Giffith, James F.
MP24829.
Gifts and long letters.
LP43442.
Gilbert Film Associates.
MP25429.
Gillette Company.
MP25049.
MP25050.
Gillette Company. Safety Razor Division.
MU8971.
Ginn and Company.
MP25137.
MP25138.
MP25139.
Ginn instructional film series on political roles.
MP25137.
MP25138.
MP25139.
Girl named Tham.
LP43142.
Girls and gags.
R568021.
Girl who ran out of night.
LP43614.
Gladiator.
LP43491.
Glen/Kaye Films.
MP25487.
Gloriously clean/campus.
MP24843.
Go Cub Scouting.
MP24982.
Godwin Bevers Company, Inc.
MU8986.
Go faster.
LP43098.
Golan, Menahem.
LP42940.
Goldberg Werrenrath Productions.
MP25269.
MP25270.
Golden Door Productions.
MP24908.
Golden hen.
R572101.
Golden Salamander.
LF133.
Goldsmith, Isadore.
LF124.
R575036.
Gold struck.
LP43133.
Goldwhite, Harold.
MP25299 - MP25300.
 MP25316 - MP25320.
MP25398 - MP25399.
Goldwyn (Samuel) Productions, Inc.
R574865.
R574866.
Good bad egg.
R577565.
Goodbye my love.
LP42987.
Good guys and the bad guys.
LP43013.
Goodman, Dolores M.
MU9011.
Good sense about your stomach.
LP43307.
Good thing.
MP24910.
Goofy golf.
R578420.
Goofy gophers.
R567287.
Gordon’s war.
LP43208.
Grappling groaners.
R578908.
Grass story.
LP43611.
Gravity.
MP25221.
Great expectations.
R578288.
Great Gatsby.
 LP43372.
Great land.
MU8937.
Great moments from “Birth of a nation.”
LP43201.
Great Outdoor Productions.
MU8950.
Great piggy bank robbery.
R567283.
Greeks: in search of meaning.
LP43095.
Green corner.
MP25273.
Greene Valley grandparents.
MP25277.
Greenfield, Amy.
MP24736.
Greenwich Film Productions.
LP42971.
Greenwood Press, Inc.
MP24896.
Gregory, John R.
MP24844.
Grid approach to conflict solving.
MP25292.
Griffin, Patrick.
MP25181.
Griffith (Andy) Enterprises.
LP43320.
Grotto of greed.
R578424.
Group 7A elements: Chemical properties.
 MP25229.
Group 7A elements: Physical properties.
MP25228.
MP25231.
Group 7B elements: Manganese.
MP25230.
Groverton Productions, Ltd.
LP43140 - LP43158.
LP43409 - LP43412.
Growth and development, toilet training.
MP25116.
Growth and fruiting of African oil.
MP24972.
Growth and fruiting of banana.
MP24970.
Growth and fruiting of pineapple.
MP24973.
Guess who owes Lucy $23.50.
LP43560.
Guided by the nene.
MP24913.
Guilt of Janet Ames.
R572336.
Gutman (Leo A.) Inc.
R570569.
Gyroscope.
MP25224.
 H
Haley, Gail E.
LP42979.
Half wits holiday.
R570073.
Hall, Richard.
MU8904.
Hall, Richard S.
MU8903.
Hammer, Jerry.
LP43350.
Handi Wipes, Betsy Cullen, golf ’74 ABC.
MP25443.
Handi Wipes, Betsy Cullen, golf ’74 CBS / NBC.
MP25493.
Handling reagents.
MP25295.
Handling walk ins.
MP25144.
Hangman’s wages.
LP43389.
Hang up.
LP43186.
Hanick, Jack M.
MP25134.
Happy go lucky.
R579970.
Harbor Productions, Inc.
LF157.