38.1 Introduction When chronic pain becomes refractory to medications and all available medical arsenal, one can have recourse to functional neurosurgery. Chronic pains are of many kinds. Main varieties include pain due to the alteration of the musculoskeletal apparatus, complex…
37.1 Introduction Spinal cord stimulation (SCS) is a common therapy used to treat medically refractory neuropathic back and other limb pain syndromes . Historically, placement of SCS leads required direct interaction with the patient to ascertain where the patient felt…
36.1 Introduction Persistent vegetative state (VS) (PVS) was first described as wakefulness without awareness . VS, a clinical entity known as a coma vigile , apallic syndrome , or PVS , includes complete unawareness of the self and environment, usually…
35.1 Introduction Spasticity should only be treated when excess of tone leads to functional impairment, discomfort, pain, and deformities. Functional neurosurgery can be a recourse when spasticity cannot be controlled by physical therapy, relaxant medications, and botulinum toxin injections. Spasticity…
34.1 Introduction The full potential of intraoperative neurophysiology is realized during the performance of so-called functional neurosurgical procedures. During these interventions, therapeutic lesions or stimulating electrodes are stereotactically placed within deep brain structures to treat movement disorders, such as Parkinson’s…
33.1 History Over the years, several neurological disorders have been identified as being caused by pulsatile vascular compression of centrally myelinated cranial nerves. Symptoms are thought to occur as the arteries of the base of the brain elongate and loop…
32.1 Introduction Epilepsy has been recognized as a serious medical condition for thousands of years . Estimates of its prevalence range from 0.5% to 1%; thus 30–80 million people suffer from epilepsy. Despite this, medical therapies fail in up to…
31.1 Introduction Peripheral nerve injury is a serious potential complication in hip procedures, which may result in postoperative permanent sensory and/or motor deficits. The incidence of sciatic nerve palsy after hip surgery ranges from 0.3% to 4% in primary total…
30.1 Background Over the course of the last four decades, there has been increasing interest in assessing segments of peripheral nerve during surgery. For example, the surgeon confronted by a neuroma in continuity has difficult decisions to make. He must…
29.1 Spinal cord vascularization and ischemia 29.1.1 Vascular anatomy of the human spinal cord Before describing the role of neurophysiological monitoring during endovascular procedures aimed to treat spinal hypervascular lesions, an overview on the vascular anatomy of the normal spinal…