Neurosurgery
From Psy3242
Contents |
Definition
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the spinal column, spinal cord, brain and peripheral nerves. Some of the general categories of neurosurgery include: treating tumors of the CNS, treating seizure and movement disorders, treating the affects of injury to the CNS, treating strokes, and treating chronic pain.SOURCE: The American Association of Neurological Surgeons (AANS).
While all of this is very interesting, the aspects of neurosurgery that bear particular relevence course material include: biopsy, functional neurosurgery, commisurotomy, and lobotomy.
Surgical Management of Seizures
temporal lobectomy
Commissurotomies
A commisurotomy is a neurosurgical procedure in which the corpus callosum, the large fiber tract connecting the right and left hemispheres, is split. Millions of axons run from one side of the brain to the other via the corpus collusium. These axons allow the two hemispheres to communicate. After the coomisuratomy the hemispheres can no longer send messages to one another. The procedure did not have a profound effect on evryday psychological functioning, although hemisphere rivalry (for example one hand trying to open a door while the other is trying to close it) occasionally occurs. The commisurotomy was first performed in humans in the 1940s in an attempt to control epilepsy and yielded mixed results; however it is important to note that the corpus callosum was probably not divided completely in most of these first patients. By separating the two hemispheres the hope was that seizures could no longer spread from one hemisphere to the other. Bogden and Vogel were the first neurosurgeons to perform complete commisurotomies, which incuded the dividing of smaller commisures as well as the corpus callosum. Their most prominent patients were: LB, NG, and AA. The collosotomy is a staged commissurotmy in which only the corpus callosum is split and gradually, over two separate surgeries. Michael Gazzaniga was a proponent of the collosotomy.
hemispherectomy'
Pschosurgery
lobotomy
Tumors
Craniotomy
In removing a brain tumor the surgeon performs a craniotomy (removing part of the patients skull), to insure that he or she can fully access the tumor and remove as much of it as possible. The goal is to remove the tumor, while harming as little brain matter as possible, and not harming the patients speech, movement, and memory capabilities.
Biopsy
Often times before a craniotomy a sterotactic biopsy is done. This is so the neurosurgeon can make sure that the tumor is malignant. A small hole is drilled so a small sample of tissue can be removed.
Intraoperative language mapping
Intraoperative language mapping is a technique used for patients with tumors affecting language function. This procedure involves operating on an awake patient and mapping the anatomy of their language function during the operation, prior to deciding which portions of the tumor are safe to resect.
