Description
Book SynopsisSince Harvey Cushing's extensive study on brain meningiomas no similar study has been conducted on spinal cord meningiomas. The high scientific value of this book is based on the careful elaboration of data from patients affected by spinal meningiomas who have been examined and operated on over the last 33 years (1962-1995) at the Neurosurgical School of the University of Florence, Italy. The main focus of this study was on the anatomic and clinical relationship that enabled early diagnosis of spinal meningiomas. More over this book emphasizes the interaction between neurology and neuroradiology in the form of "dynamic neurology". Myeloradiculographic findings are described together with those using more recent techniques such as CT and MRI.
Table of Contents1 General Considerations.- 2 Historical Origins of Embryology.- 3 Genetics.- 4 Vascularization of the Spinal Cord and Variations in Myelitic Blood Flow.- 5 Case Reports.- 6 Clinical Symptoms.- 6.1 Regionally Localized Pain.- 6.2 Sensory Radicular Symptoms.- 6.3 Cervical Root Syndrome.- 6.4 Dorsal Root Syndrome.- 6.5 Lumbar Root Syndrome.- 6.6 Sensory Cord Syndrome.- 6.7 Motor Cord Syndrome.- 6.8 Brown-Sequard Syndrome.- 6.9 Clinical Signs in the Development of Meningiomas.- 6.9.1 Cervical Tract.- 6.9.2 Dorsal Tract.- 6.9.3 Lumbar Tract.- 6.10 Differential Diagnosis.- 6.11 Causes of Diagnostic Error and Delay.- 6.12 Supra- and Sublesional Symptoms.- 6.13 Von Recklinghausen’s Disease.- 6.14 Rare Cases.- 6.15 Conclusions.- 7 Neurophysiopathology.- 7.1 Evoked Potentials.- 7.2 Somatosensory and Motor Evoked Potentials.- 7.3 Intraoperative Neurophysiological Monitoring.- 7.4 Materials, Methods, Case Reports.- 7.5 Results, Discussion, Conclusions.- 8 Neuroradiology.- 8.1 Bone Alterations from Compression of the Meningioma on the Vertebral Sac.- 8.1.1 Modification of a Single Pedicle.- 8.1.2 Bilateral Peduncular Alterations.- 8.1.3 Morphological Alterations in the Vertebral Body.- 8.2 Calcifying Features of a Meningioma.- 8.3 Neuroradiological Diagnostic Examinations.- 8.3.1 Myelography.- 8.3.2 Computed Tomography.- 8.3.3 Myelo-Computed Tomography.- 8.3.4 Magnetic Resonance Imaging.- 8.3.5 Angiography.- 8.4 Conclusions.- 9 Surgical Techniques.- 9.1 Microscopic Features and Variations in the Relationship with the Spinal Dura and Leptomeningeal and Myeloradicular Structures.- 9.2 Neighbouring Relationships with the Leptomeninges.- 9.3 Position of the Patient.- 9.4 Laminectomy, Lamina-arthrectomy with Foraminotomy.- 9.5 Deformations of the Spinal Dura as Seen in the Operative Microscope.- 9.6 Microsurgical Splitting of the Dura and Variations in Dural Incisions.- 9.7 Opening the Arachnoid.- 9.8 Radicotomy.- 9.9 Modes of Excision.- 9.10 Complications and Follow-Up.- 9.11 Conclusions.- 10 Other Anatomical-Clinical Observations.- References.
