Advances and Technical Standards in Neurosurgery

A. Advances.- The Classification and Molecular Biology of Pituitary Adenomas..- The Functional Classification of Pituitary Adenomas (Kovacs and Horvath 1986).- Prolactin Producing Adenomas "Prolactinomas".- Growth Hormone Producing Adenomas.- Pituitary Adenomas Producing GH and PRL.- ACTH Producing Adenomas.- Functioning Corticotroph Adenomas.- "Silent" Corticotroph Adenomas.- Glycoprotein Hormone Producing Pituitary Adenomas.- Gonadotroph Adenomas.- Thyrotroph Adenomas.- Null Cell Adenomas and Oncocytomas.- Plurihormonal Pituitary Adenomas.- Invasive Adenomas.- Carcinoma of the Pituitary Gland.- Proliferation Markers and Laboratory Evaluation of Pituitary Tumor Aggressiveness.- Pathogenesis and Molecular Biology of Pituitary Adenomas.- Clonal Origins of Pituitary Adenomas.- Pituitary Tumorigenesis: Endocrine Factors.- Pituitary Adenomas: Cytogenetic Aberrations.- Structural Genomic Alterations: Oncogene Activation (v-fos, H-ras, gsp).- Structural Genomic Alterations: Tumor Suppressor Gene Inactivation.- The Retinoblastoma Tumor Suppressor Gene (Rb).- The p53 Tumor Suppressor Gene.- The MEN 1 Tumor Suppressor Gene.- Growth Factors and Pituitary Tumorigenesis.- Growth Factors and Pituitary Neoplasm: Conclusion.- The Pituitary Specific Transcription Activator: Pit-1.- Acknowledgements.- References.- Biomechanics and Classification of Traumatic Lesions of the Spine..- 1. Introduction.- 2. Experimental Biomechanics.- 2.1. The Spinal Column: a Composite Material.- 2.1.1. The Vertebrae.- 2.1.2. The Intervertebral Discs.- 2.1.3. The Vertebral Ligaments.- 2.2. Stability.- 2.2.1. Vertical Stability: the Supporting Elements and Their Resistance to Compression.- 2.2.2. Transverse Stability: the Elements of Cohesion and Their Resistance to Tearing.- 2.2.3. Global Stability: Elements of Mechanical Strain and Their Controlling Factors.- 2.3. Spinomedullary Dynamics.- 2.3.1. Behaviour of the Spinal Canal During Movement.- 2.3.2. Mechanical Behaviour of the Neural Tissue.- 2.3.3. Reciprocal Behaviour.- 3. Anatomo-Radiologic Classification.- 3.1. The Thoraco-Lumbar Spine.- 3.1.1. Group of Disco-Ligamentous Lesions.- 3.1.2. Group of Disco-Corporeal Lesions.- 3.1.3. Group of Mixed Lesions.- 3.2. The Inferior Cervical Spine (C3-C7).- 3.2.1. Group of Disco-Ligamentous Lesions.- 3.2.2. Group of Disco-Corporeal Lesions.- 3.2.3. Group of Mixed Lesions.- 3.4. The Sub-Occipital Spine.- 4. Conclusions.- 5. References.- Space-Occupying Lesions of the Sensori-Motor Region..- Summary.- 1. Introduction.- 2. Surgical Anatomy of the Sensori-Motor Region.- 2.1. Definition of the Sensori-Motor Region.- 2.2. Craniocerebral Topography of the Sensori-Motor Region.- 2.3. Anatomy of the Medial Sensori-Motor Region.- 2.4. Anatomy of the Lateral Sensori-Motor Region (Including Broca's Area).- 2.5. Anatomy and Proportions of the Pyramidal Tract.- 2.5.1. Anatomy.- 2.5.2. Proportions.- 3. Clinical Syndrome and Neuroradiology of Central Lesions.- 3.1. Clinical Syndrome.- 3.2. Neuroradiology.- 4. Displacement of Anatomical Structures.- 5. The Role of Intraoperative Mapping of the Sensori-Motor Cortex.- 5.1. Technique of Cortical Electrophysiological Mapping.- 5.1.1. Cortical Electrical Stimulation (MCS).- 5.1.2. Results of Cortical Motor Stimulation.- 5.1.3. Recording of Somato-Sensory Evoked Potentials.- 5.2. Examples.- 5.2.1. Central Falx Meningioma (General Anaesthesia).- 5.2.2. Anaplastic Glioma of the Precentral Gyrus (General Anaesthesia).- 5.2.3. Low-Grade Glioma of the Superior Frontal Gyrus (Local Anaesthesia).- 5.2.4. Low-Grade Glioma of the Operculum (General Anaesthesia).- 5.2.5. Subcortical Central Metastasis (General Anaesthesia).- 5.3. Anaesthetic Regimen.- 5.3.1. General Anaesthesia.- 5.3.2. Local Anaesthesia.- 6. Surgery of Central Lesions.- 6.1. General Considerations on Localization.- 6.2. Positioning of the Patient and Drug Regimen.- 6.3. Placement of Craniotomy.- 6.4. General Considerations on Surgical Strategy.- 6.5. Lesion-Specifi