Neurosurgery greenberg m with a practical guide. How to comprehend neurosurgery (Recommendations). For those who know English

The Neurosurgery manual is again published in a single volume. Although the book has slightly increased in size, it is still suitable as a pocket guide. To achieve this goal, part of the material had to be reduced. The author has always believed that the main strength of this book is its clinical focus, and purely surgical material can be presented in a special manual. The 5th Edition is a strategic partnership with Thieme Publishing that will bring the book to greater distribution. In addition, the surgical material previously presented in its pages can now be found in a much larger volume in the companion manual published by Thieme, Fundamentals of Operative Neurosurgery, by Connolly, Chowdhry, and Huang. Interventions that are performed on an outpatient basis or with radiographic guidance continue to be included in this guideline.

Grinberg M.S. Neurosurgery download

General treatment
Anesthesiology

1. Assessment of the degree of anesthetic risk
2. Neuroanesthesia
3. Malignant hyperthermia

Help in critical conditions

1. Hypertension
2. Hypotension (shock)

Endocrinology

1. Steroids

Fluids and electrolytes

1. Need for fluids and electrolytes
2. Electrolyte disorders

Hematology

1. Treatment with blood components
2. Transfusion reactions and complications
3. Collapse
4. Extramedullary hematopoiesis

Immunology

1 Anaphylaxis

Pharmacology

1. Analgesics
2. Antiemetics
3. Anti-spasmodics/muscle relaxers
4. Benzodiazepines
5. Beta blockers
6. Sedatives and paralyzes
7. Hydrochloric acid inhibitors
8. Malignant neuroleptic syndrome

Lung problems

1. Neurogenic pulmonary edema

Neurology
Dementia
Headache

1. Migraine
2. Headache after lumbar puncture and myelography

parkinsonism

1. Treatment of parkinsonism

Multiple sclerosis
myasthenia gravis
amyotrophic lateral sclerosis
Guillain-Barré syndrome
Myelitis
Myelopathy
Neurosarcoidosis
Encephalopathy as a result of impaired vascular autoregulation
Vasculitis and vasculopathy

1. Temporal arteritis
2. Other vasculitis
3. Fibromuscular dysplasia
4. Other vasculopathies

Mixed syndromes

1. Stem and related syndromes
2. Jugular foramen syndromes
3. Syndromes of the parietal lobe
4. Paraneoplastic syndromes affecting the nervous system

Neuroanatomy and Physiology
Anatomy of external surfaces

1. Anatomy of the cortical surface of the brain
2. Anatomy of the outer surface of the skull

Cranial foramens and their contents

1. External landmarks for determining the cervical vertebrae

Spinal Cord Anatomy

1. Pathways of the spinal cord
2. Dermatomal and sensory innervation
3. Blood supply to the spinal cord

Cerebrovascular Anatomy

1. Vascular cerebral pools
2. Arterial blood supply to the brain
3. Anatomy of the venous system of the brain

Inner capsule (IC)
autonomic nervous system
Addition
Neurophysiology

1. Blood-brain barrier
2. Symptom Babinski
3. Neurophysiology of urination

Coma
General information
Approach to a patient in a coma
herniation syndromes

1. Central wedging
2. Temporal herniation

Hypoxic coma
brain death
Brain death in adults
brain death in children
Donation of organs and tissues

1. Criteria for eligibility for organ harvesting
2. Arrangements for organ harvesting after brain death

Anomalies of development
Arachnoid cysts
Neuroenteric cysts
Craniofacial development

1. Normal development
2. Craniosynostosis
3. Encephalocele

Chiari malformation
Dandy-walker malformation
Stenosis of the aqueduct
Neural tube defects

1. Agenesis of the corpus callosum
2. Spinal dysraphism (splitting of the arches of the vertebrae)

Klippel-Feil syndrome
Fixed spinal cord syndrome
Split spinal cord
Various developmental anomalies
Cerebrospinal fluid
general information
Composition of CSF
Artificial CSF
CSF fistula
Hydrocephalus
Treatment of hydrocephalus

Shunt Problems
Hydrocephalus of normal pressure.
Blindness due to hydrocephalus
hydrocephalus and pregnancy
infections
general information

1. Empiric antibiotics
2. Certain types of antibiotics
3. Antibiotics against specific organisms
4. Penetration of antibiotics into the CSF
5. Initial doses in neurosurgery

Prophylactic antibiotics
Meningitis

1. Post-traumatic meningitis

Infectious complications of shunts
Wound infections

1. Infections of the laminectomy wound

Osteomyelitis of the skull
brain abscess

1. Some Unusual Organisms That Cause Abscesses

subdural empyema
Viral encephalitis

1. Herpetic encephalitis
2. Multifocal leukoencephalitis caused by varicella-zoster virus and herpes zoster

1. Spinal epidural abscess
2. Osteomyelitis of the spine
3. Discitis

Seizures
Classification of seizures

1. Factors that reduce the seizure threshold

Certain types of seizures

1. First-time seizures
2. Post-traumatic seizures
3. Seizures during alcohol withdrawal
4. Non-epileptic seizures
5. Febrile seizures

Epileptic status

1. General therapeutic measures for status epilepticus
2. Medications for generalized status epilepticus
3. Certain types of status epilepticus

Anticonvulsants

1. Choice of antiepileptic drugs
2. Pharmacology of anticonvulsants

Surgical treatment of seizures
Spine and spinal cord
Low back pain and radiculopathy
Herniated discs

1. Herniated lumbar discs
2. Herniated cervical discs
3. Herniated discs

Spondylosis, spondylolysis, spondylolisthesis
Vertebral stenosis

1. Lumbar stenosis
2. Stenosis of the cervical spine
3. Combination of cervical and lumbar stenosis

Anomalies of the cranio-vertebral junction and upper cervical vertebrae
Rheumatoid arthritis

1. Damage to the upper cervical spine

Paget's disease

1. Paget's disease of the spine

Ossification of the posterior longitudinal ligament
Ossification of the anterior longitudinal ligament
Diffuse idiopathic skeletal hyperostosis
Spinal arteriovenous malformations
Spinal meningeal cysts
Syringomyelia

1. Communicating syringomyelia
2. Post-traumatic syringomyelia
3. Syringobulbia

Spinal epidural hematoma
coccydynia
Functional Neurosurgery
brain mapping
Surgical treatment of Parkinson's disease
spasticity
Torticollis
Neurovascular compression syndromes

1. Hemifacial spasm

Hyperhidrosis
Tremor
Sympathectomy
Pain
Types of pain interventions

1. Cordotomy
2. Commissural myelotomy
3. Introduction of narcotic drugs into the CNS
4. Spinal cord stimulation
5. Deep brain stimulation
6. Destruction in the region of the entrance zone of the posterior roots
7. Talamotomy

Complex Regional Pain Syndrome (CRPS)
Craniofacial pain syndromes

1. Trigeminal neuralgia
2. Glossopharyngeal neuralgia
3. Neuralgia of the geniculate ganglion

Postherpetic neuralgia
Tumors
General information

1. General clinical information

Primary brain tumors

1. Low grade gliomas
2. Astrocytoma
3. Oligodendroglioma
4. Meningiomas
5. Acoustic neuroma
6. Pituitary adenomas
7. Craniopharyngioma
8. Rathke's pouch cysts
9. Colloidal cysts
10. Hemangioblastoma
11. CNS lymphoma
12. Chordoma
13. Ganglioglioma
14. Paraganglioma
15. Ependymoma
16. Primitive neuroectodermal tumors
17. Epidermoid and dermoid tumors
18. Tumors of the pineal region
19. Tumors of the choroid plexus
20. Mixed primary brain tumors

Brain tumors in children
Skull tumors

1. Osteoma
2. Hemangioma
3. Epidermoid and dermoid tumors of the skull
4. Eosinophilic granuloma
5. Non-tumor lesions of the skull

Metastases to the brain
Carcinomatous meningitis
Tumors of the foramen magnum
Idiopathic intracranial hypertension
Empty Turkish saddle syndrome
Tumor markers
Neurocutaneous syndromes

1. Neurofibromatosis
2. Tuberous sclerosis
3. Sturge-Weber Syndrome

Tumors of the spine and spinal cord

1. Intramedullary spinal tumors
2. Bone tumors of the spine
3. Spinal epidural metastases

Radiation therapy
Ordinary external exposure

1. Irradiation of the head
2. Irradiation of the spine

Stereotactic radiosurgery
Interstitial irradiation
Stereotactic surgery
peripheral nerves
Brachial plexus
Peripheral neuropathies

1. Neuropathy due to compression

Thoracic outlet syndrome
Electrodiagnostics
Electroencephalogram
Evoked Potentials
Electromyography
Neuroradiology
Contrast agents in neuroradiology

1. Preparation of patients with allergies to iodine-containing contrast agents
2. Reactions to intravascular administration of contrast agents

CT scan
Cerebral angiography
Magnetic resonance imaging
Survey spondylograms

1. Cervical spondylograms
2. Lumbosacral spine
3. Overview craniograms

Myelography
Myelography
Neuro-ophthalmology
nystagmus
papilledema
pupil diameter

1. Changes in pupil diameter

External muscle system of the eye
Various neuro-ophthalmic features
neurootology
Dizziness
Meniere's disease
Paralysis of the facial nerve
hearing loss
Neurotoxicology
ethanol
Opiates
Cocaine
amphetamines
Operations and manipulations
Intraoperative dyes
Operating room equipment
Surgical hemostasis
Craniotomy

1. Craniectomy of the posterior cranial fossa (suboccipital)
2. Pterional craniotomy
3. Temporal craniotomy
4. Frontal craniotomy
5. Skull base surgery
6. Craniotomy of the petrous part of the pyramid
7. Access to the lateral ventricle
8. Access to the third ventricle
9. Interhemispheric access
10. Occipital craniotomy

Cranioplasty
Transoral access to the anterior surface of the craniovertebral junction
Puncture access to the central nervous system

1. Percutaneous ventricular puncture
2. Puncture of the subdural space
3. Lumbar puncture
4. Puncture of the large occipital cistern and in the interval C1-2

Procedures for the removal of cerebrospinal fluid

1. Ventricular catheterization
2. Ventriculostomy/monitoring of intracranial pressure
3. Ventricular shunting
4. Device providing access to the ventricles
5. Ventriculostomy of the third ventricle
6. Installation of a lumboperitoneal shunt

Biopsy of the sural nerve
Surgical fusion of the cervical spine

1. Upper cervical spine

Nerve blocks

1. Blockade of the stellate ganglion
2. Lumbar sympathetic blockade
3. Blockade of intercostal nerves

Traumatic brain injury
Transportation of victims with TBI
Providing assistance to a patient with TBI in the emergency department

1. Neurosurgical examination for trauma
2. X-ray diagnostics
3. Tactics of conducting the victim in the emergency department
4. Diagnostic burr holes

Intracranial pressure

1. General information about intracranial pressure
2. Monitoring of intracranial pressure
3. Correction of intracranial pressure
4. Therapy with high doses of barbiturates

Skull fractures

1. Depressed skull fractures
2. Fractures of the base of the skull
3. Craniofacial fractures
4. Skull fractures in children

Hemorrhagic brain injury
epidural hematoma
subdural hematoma

1. Acute subdural hematoma
2. Chronic subdural hematoma
3. Spontaneous subdural hematoma
4. Traumatic subdural hygroma
5. Extracerebral fluid accumulations in children

Feeding patients with TBI
Outcomes in traumatic brain injury

1. Age
2. Prognostic factors for outcomes
3. Late complications of TBI

Gunshot wounds to the head
Non-gunshot penetrating wounds of the head
Traumatic brain injury in children
Spine and spinal cord injury
Whiplash
Initial care for spinal cord injury
Neurological examination
spinal cord injury

1. Complete spinal cord injury
2. Incomplete spinal cord injury

Fractures of the cervical spine

1. Atlanto-occipital dislocation
2. Atlanto-axial dislocation
3. Fractures of the atlas (C1)
4. C2 fractures
5. Subaxial injuries/fractures (at the level of C3-C7)
6. Treatment of fractures of the cervical spine
7. Sports injury of the cervical spine

Fractures of the thoracic spine
Gunshot wounds of the spine
Penetrating neck injury
Treatment of the consequences of spinal cord injury
Cerebral circulation disorders
General information about strokes

1. Diagnostics
2. Management of reversible ischemic neurological deficit, transient ischemic attack and stroke
3. Cardiogenic cerebral embolism

Strokes in young people
Lacunar strokes
Additional forms of strokes
Subarachnoid hemorrhage (SAH) and aneurysms
Introduction
SAK classification
Treatment of the acute period of SAH
Vascular spasm

1. Definitions
2. Characteristics of cerebral vascular spasm
3. Pathogenesis
4. Diagnosis of vasospasm
5. Treatment of vasospasm

Brain aneurysms

1. Diseases associated with aneurysms

Treatment options for cerebral aneurysms
Choice of timing for surgical intervention on aneurysm
General issues of aneurysm surgery technique

1. Intraoperative aneurysm rupture

Aneurysms of various localization

1. Aneurysms of the anterior communicating artery
2. Distal aneurysms of the anterior communicating artery
3. Aneurysms of the posterior communicating artery
4. Aneurysms of the bifurcation of the internal carotid artery
5. Aneurysms of the middle cerebral artery (CMA)
6. Supraclinoid aneurysms
7. Aneurysms of the posterior circle of Willis
8. Aneurysms of the bifurcation of the basilar artery

Bursting aneurysms
Multiple aneurysms
Familial aneurysms
Traumatic aneurysms
Mycotic aneurysms
Giant aneurysms
Aneurysms of the vein of Galen
Subarachnoid hemorrhage of unknown etiology
Non-aneurysmal subarachnoid hemorrhages
Pregnancy and intracranial bleeding
Vascular malformations
Arteriovenous malformations
Venous angiomas
Angiographically hidden vascular malformations

1. Cavernous angiomas

Dural arteriovenous malformations
Carotid-cavernous fistula
intracerebral hemorrhage
Intracerebral hemorrhages in adults
Intracerebral hemorrhages in young people
IUD in newborns
Occlusive cerebrovascular disease
Atherosclerotic cerebrovascular diseases

1. Carotid arteries
2. Vertebrobasilar insufficiency

Dissection of the wall of the cerebral arteries

1. Carotid dissection
2. Dissection of the arteries of the vertebrobasilar system

Extra-intracranial anastomosis
Cerebrovascular venous thrombosis
My sickness is mine
Assessment of disease outcomes
Differential Diagnosis
Differential diagnosis based on symptoms

1. Myelopathy
2. Sciatica (radiculopathy of the lower extremities)
3. Acute paraplegia and tetraplegia
4. Hemiparesis or hemiplegia
5. Lower back pain
6. Hanging foot
7. Weakness/atrophy of arm muscles
8. Radiculopathy of the upper limbs (cervical)
9. Neck pain
10. Symptom Lermitte
11. Syncope and apoplexy
12. Encephalopathies
13. Temporary neurological deficit
14. Diplopia
15. Paralysis of several cranial nerves (cranial neuropathy)
16. Exophthalmos
17. Pathological eyelid retraction
18. Macrocephaly
19. Tinnitus
20. Sensory disturbances on the face
21. Speech disorders

Differential diagnosis by location

1. Damage to the cerebellopontine angle
2. Damage to the posterior cranial fossa
3. Lesions of the foramen magnum
4. Atlanto-axial subluxation
5. Tumors of the second cervical vertebra
6. Multiple intracranial masses on CT or MRI
7. Ring-shaped accumulation of contrast on CT
8. Leukoencephalopathy
9. Lesions in the area of ​​the Turkish saddle
10. Intracranial cysts
11. Orbital lesions
12. Lesions of the cavernous sinus
13. Skull lesions
14. Combined intracranial/extracranial lesions
15. Intracranial calcifications
16. Intraventricular lesions
17. Periventricular formations
18. Intraventricular hemorrhage
19. Damage to the medial temporal lobe
20. Intranasal/intracranial lesions
21. Spinal epidural formations
22. Destructive lesions of the spine

ISBN: 978-5-98322-550-3
2010, 1008 p. : ill.

Book Mark S. Greenberg "Neurosurgery" is a comprehensive clinical guide to neurosurgery that has gone through a large number of editions in English and other languages. When translating the original 5th edition of the book according to the 4th edition, some practical aspects were restored that were removed from the book by the author due to the publication of a separate workshop.
The book will be useful to neurosurgeons, neurologists, students, residents, graduate students and teachers of medical universities and faculties.

From TRANSLATOR
The translation was made according to the 5th one-volume edition in 2001. The previous 4th edition in 1997 was a two-volume edition. The author returned to the one-volume version of the 1st-3rd editions due to the fact that the Thieme publishing house released in 2002 a new special guide on operative neurosurgery Fundamentals of Operative Techniques in Neurosurgery (authors E.S.Connolly, G.M.McKhann II, J.Huang, T.F. Choudhri), which became the second volume of the now collaborative manual. To this end, the author has made significant reductions related mainly to the technique of surgical interventions (but not only to them) (see the author's Preface to the 5th edition). However, these fragments seem to me essential, and besides, they, of course, were not included in the book written by other authors. Based on these considerations, in this translation, most of the denominations from the 4th edition have been restored.
In order to at least partially compensate for the increase in text, the translation uses abbreviations and symbols more widely than in the original, although this may make it somewhat difficult to understand. The use of abbreviations is not systematic. Some that occur regularly throughout the text are not covered in each section. Others relating to a particular section are disclosed at the beginning of the section on first use. In difficult cases, the reader should refer to the list of abbreviations.
International non-proprietary names (INN) of medicines are given in Russian, and trade (®) names in English. Also in English are the names of firms, organizations, randomized clinical trials.
The surnames of the authors are given mainly in Russian transcription.
When working on the translation, even in the 5th edition, I found a significant number of typos, some of which significantly affected the meaning of the text. They were, if possible, corrected, and they were reported to the author and publisher.
The translator will pay attention to comments and advice.
I dedicate my work to my teacher, the organizer of the Department of Emergency Neurosurgery of the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky, Professor V.V. Lebedev, the staff of the Institute, with whom I worked together for many years, my parents, wife and children.
In the United States, universal professional reference books designed for daily use and highly acclaimed are called bibles. The Guide to Neurosurgery by M. Grinberg rightfully belongs to this category, it is used by both novice doctors and practicing neurosurgeons with experience. This explains my choice.
In conclusion, a quote from the book that became the spiritual bible of a significant part of the Soviet intelligentsia of the 70s of the XX century, M. Bulgakov’s novel “The Master and Margarita”: “We speak with you in different languages, as always,” Woland replied, “but the things we talk about don't change. So..."

Preface to the 5th edition
The 5th edition of the Guide to Neurosurgeons is again published in a one-volume version. Although the book has grown somewhat in size, it is still suitable as a pocket aid. To achieve this goal, part of the material had to be reduced. The author has always believed that the main strength of this book is its clinical focus, and purely surgical material can be presented in a special manual. The book is being published in a strategic partnership with Thieme Publishing, through which it will gain more distribution. In addition, descriptions of surgical techniques previously presented on its pages can now be found in a much larger volume in the accompanying manual published by Thieme, Fundamentals of Operative Neurosurgery, by Connolly, Choudri and Huang. Interventions that are performed on an outpatient basis or with radiographic guidance continue to be included in this guideline.

Content
1. General treatment
1.1. Anesthesiology
1.1.1. Assessment of the degree of anesthetic risk in various conditions according to the classification of the American Society of Anesthesiologists
1.1.2. neuroanesthesia
1.1.3. Malignant hyperthermia
1.2. Help in critical conditions
1.2.1. Hypertension
1.2.2. Hypotension (shock)
1.3. Endocrinology
1.3.1. Steroids
1.3.2. Hypothyroidism
1.4. Fluids and electrolytes
1.4.1. Need for fluids and electrolytes
1.4.2. Electrolyte disorders
1.5. Hematology
1.5.1. Use of blood components
1.5.2. Transfusion reactions and complications
1.5.3. Clotting
1.5.4. Extramedullary hematopoiesis
1.6. Immunology
1.6.1. Anaphylaxis
1.7. Pharmacology
1.7.1. Analgesics
1.7.2. Antiemetics
1.7.3. Antispasmodics/muscle relaxants
1.7.4. Benzodiazepines
1.7.5. Beta blockers
1.7.6. Sedatives and muscle relaxants
1.7.7. Hydrochloric acid inhibitors
1.7.8. Malignant neuroleptic syndrome
1.8. Pathology of the respiratory system
1.8.1. Neurogenic pulmonary edema
1.9. Literature

2. Neurology
2.1. Dementia
2.2. Headache
2.2.1. Migraine
2.2.2. Headache after lumbar puncture and myelography
2.3. parkinsonism
2.3.1. Treatment of parkinsonism
2.4. Multiple sclerosis
2.5. myasthenia gravis
2.6. amyotrophic lateral sclerosis
2.7. Guillain-Barré syndrome
2.8. Myelitis
2.9. Myopathy
2.10. Neurosarcoidosis
2.11. Encephalopathy as a result of impaired vascular autoregulation
2.12. Vasculitis and vasculopathy
2.12.1. Temporal arteritis
2.12.2. Other vasculitis
2.12.3. Fibromuscular dysplasia
2.12.4. Other vasculopathies
2.13. Mixed syndromes
2.13.1. Stem and alternating syndromes
2.13.2. Jugular foramen syndromes
2.13.3. Syndromes of the parietal lobe
2.13.4. Paraneoplastic syndromes affecting the nervous system
2.14. Literature

3. Neuroanatomy and physiology
3.1. Anatomy of external surfaces
3.1.1. Anatomy of the cortical surface of the brain
3.1.2. Anatomy of the outer surface of the skull
3.2. Cranial foramens and their contents
3.2.1. External landmarks for determining the cervical vertebrae
3.3. Spinal Cord Anatomy
3.3.1. Pathways of the spinal cord
3.3.2. Dermatomal and sensory innervation
3.3.3. Blood supply to the spinal cord
3.4. Cerebrovascular anatomy
3.4.1. Vascular cerebral pools
3.4.2. Arterial blood supply to the brain
3.4.3. Anatomy of the venous system of the brain
3.5. Internal capsule
3.6. autonomic nervous system
3.7. Addition
3.8. Neurophysiology
3.8.1. Blood-brain barrier
3.8.2. Babinsky's symptom
3.8.3. Neurophysiology of urination
3.9. Literature

4. Coma
4.1. General information
4.2. Approach to the treatment of a patient in a coma
4.3. herniation syndromes
4.3.1. Central wedging
4.3.2. Temporal herniation
4.4. Hypoxic coma
4.5. Literature

5. Brain death
5.1. Brain death in adults
5.2. brain death in children
5.3. Donation of organs and tissues
5.3.1. Criteria for eligibility for organ harvesting
5.3.2. Arrangements for organ harvesting after brain death
5.4. Literature

6. Anomalies of development
6.1. Arachnoid cysts
6.2. Neuroenteric cysts
6.3. Regional Facial Development
6.3.1. normal development
6.3.2. Craniosynostosis
6.3.3. encephalocele
6.4. Chiari malformation
6.5. Dandy-walker malformation
6.6. Stenosis of the aqueduct
6.7. Neural tube defects
6.7.1. Agenesis of the corpus callosum
6.7.2. Spinal dysraphism (split vertebral arches)
6.8. Klippel-Feil syndrome
6.9. Fixed spinal cord syndrome
6.10. Split spinal cord
6.11. Various developmental anomalies
6.12. Literature

7. Cerebrospinal fluid
7.1. general information
7.2. Composition of CSF
7.3. Artificial CSF
7.4. CSF fistula
7.5. Literature

8. Hydrocephalus
8.1. Treatment of hydrocephalus
8.1.1. Shunts
8.2. Shunt Problems
8.3. Hyrocephaly of normal pressure
8.4. Blindness due to hydrocephalus
8.5. hydrocephalus and pregnancy
8.6. Literature

10. Seizures
10.1. Classification of seizures
10.1.1. Factors that lower the seizure threshold
10.2. Certain types of seizures
10.2.1. First time seizures
10.2.2. Post-traumatic seizures
10.2.3. Seizures during alcohol withdrawal
10.2.4. Non-epileptic seizures
10.2.5. Febrile seizures
10.3. Epileptic status
10.3.1. General therapeutic measures for status epilepticus
10.3.2. Medical treatment of generalized status epilepticus
10.3.3. Certain types of status epilepticus
10.4. Anticonvulsants
10.4.1. Choice of antiepileptic drugs
10.4.2. Pharmacology of anticonvulsants
10.5. Surgical treatment of seizures
10.6. Literature

11. Spine and spinal cord
11.1. Low back pain and radiculopathy
11.2. Herniated discs
11.2.1. Lumbar disc herniation
11.2.2. Herniated cervical discs
11.2.3. Herniated discs
11.3. Spondylosis, spondylolysis, spondylolisthesis
11.4. Spinal stenosis
11.4.1. Lumbar stenosis
11.4.2. Stenosis of the cervical spine
11.4.3. Combination of cervical and lumbar stenosis
11.5. Anomalies of the craniovertebral junction and upper cervical vertebrae
11.6. Rheumatoid arthritis
11.6.1. Damage to the upper cervical spine
11.7. Paget's disease
11.7.1. Paget's disease of the spine
11.8. Ossification of the posterior longitudinal ligament
11.9. Ossification of the anterior longitudinal ligament
11.10. Diffuse idiopathic skeletal hyperostosis
11.11. Spinal arteriovenous malformations
11.12. Spinal meningeal cysts
11.13. Syringomyelia
11.13.1. Communicating syringomyelia
11.13.2. Post-traumatic syringomyelia
11.13.3. Syringobulbia
11.14. Spinal epidural hematoma
11.15. coccydynia
11.16. Literature

12. Functional neurosurgery
12.1. brain mapping
12.2. Surgical treatment of Parkinson's disease
12.3. spasticity
12.4. Torticollis
12.5. Neurovascular compression syndromes
12.5.1. Hemifacial spasm
12.6. Hyperhidrosis
12.7. Tremor
12.8. Sympathectomy
12.9. Literature

13. Pain
13.1. Types of pain interventions
13.1.1. chordotomy
13.1.2. Commissural myelotomy
13.1.3. Introduction of drugs into the CNS
13.1.4. Spinal Cord Stimulation (SCM)
13.1.5. deep brain stimulation
13.1.6. Destruction in the region of the entrance zone of the posterior roots (VZZK)
13.1.7. thalamotomy
13.2. Complex Regional Pain Syndrome (CRPS)
13.3. Craniofacial pain syndromes
13.3.1. Trigeminal neuralgia
13.3.2. Glossopharyngeal neuralgia
13.3.3. Neuralgia of the geniculate ganglion
13.4. Postherpetic neuralgia
13.5. Literature

14. Tumors
14.1. General information
14.1.1. General clinical information
14.2. Primary brain tumors
14.2.1. Gliomas of low grade
14.2.2. Astrocytoma
14.2.3. Oligodendroglioma
14.2.4. Meningiomas
14.2.5. Acoustic neuroma
14.2.6. pituitary adenomas
14.2.7. Craniopharyngioma
14.2.8. Rathke's pouch cysts
14.2.9. Colloidal cysts
14.2.10. Hemangioblastoma
14.2.11. CNS lymphoma
14.2.12. Chordoma
14.2.13. Ganglioglioma
14.2.14. Paraganglioma
14.2.15. ependymoma
14.2.16. Primitive neuroectodermal tumors (PNETs)
14.2.17. Epidermoid and dermoid tumors
14.2.18. Tumors of the pineal region
14.2.19. Tumors of the choroid plexus
14.2.20. Mixed primary brain tumors
14.3. Brain tumors in children
14.4. Skull tumors
14.4.1. Osteoma
14.4.2. Hemangioma
14.4.3. Epidermoid and dermoid tumors of the skull
14.4.4. Eosinophilic granuloma
14.4.5. Non-tumor lesions of the skull
14.5. Metastatic tumors
14.6. Carcinomatous meningitis
14.7. Tumors of the foramen magnum (BSO)
14.8. Idiopathic intracranial hypertension
14.9. Empty Turkish saddle syndrome
14.10. Tumor markers
14.11. Neurocutaneous syndromes
14.11.1. Neurofibromatosis
14.11.2. tuberous sclerosis
14.11.3. Sturge-Weber Syndrome
14.12. Tumors of the spine and spinal cord
14.12.1. Intramedullary tumors of the spinal cord
14.12.2. Bone tumors of the spine
14.12.3. Spinal epidural metastases
14.13. Literature

15. Radiotherapy
15.1. Ordinary external exposure
15.1.1. Irradiation of the head
15.1.2. Irradiation of the spine
15.2. Stereotactic radiosurgery
15.3. Interstitial irradiation
15.4. Literature

16. Stereotactic surgery
16.1. Literature

17. Peripheral nerves
17.1. Brachial plexus
17.2. Peripheral neuropathies
17.2.1. Neuropathy due to pressure
17.3. Thoracic outlet syndrome
17.4. Various peripheral nerves
17.5. Literature

18. Electrodiagnostics
18.1. Electroencephalogram (EEG)
18.2. Evoked Potentials (EP)
18.3. Electromyography (EMG)
18.4. Literature

19. Neuroradiology
19.1. Contrast agents in neuroradiology
19.1.1. Preparation of patients with allergy to iodine-containing contrast agents
19.1.2. Reactions to intravascular injection of contrast agents
19.2. CT scan
19.3. Cerebral angiography
19.4. Magnetic resonance imaging (MRI)
19.5. Survey spondylograms
19.5.1. Cervical spondylograms
19.5.2. Lumbosacral spine
19.5.3. Overview craniograms
19.6. Myelography
19.7. Isotope study of the skeleton
19.8. Literature

20. Neuroophthalmology
20.1. nystagmus
20.2. papilledema
20.3. pupil diameter
20.3.1. Pupil diameter changes
20.4. External muscle system of the eye
20.5. Various neuro-ophthalmic features
20.6. Literature

21. Neurotology
21.1. Dizziness
21.2. Meniere's disease
21.3. Paralysis of the facial nerve
21.4. hearing loss
21.5. Literature

22. Neurotoxicology
22.1. ethanol
22.2. Opioids
22.3. Cocaine
22.4. amphetamines
22.5. Literature

23. Operations and manipulations
23.1. Intraoperative dyes
23.2. Operating room equipment
23.3. Surgical hemostasis
23.4. Craniotomy
23.4.1. Posterior fossa craniectomy (suboccipital)
23.4.2. Pterional craniotomy
23.4.3. Temporal craniotomy
23.4.4. Frontal craniotomy
23.4.5. Skull Base Surgery
23.4.6. Craniotomy of the petrous part of the pyramid
23.4.7. Access to the lateral ventricle
23.4.8. Access to the third ventricle
23.4.9. Interhemispheric access
23.4.10. Occipital craniotomy
23.5. Cranioplasty
23.6. Transoral access to the anterior surface of the marginovertebral junction
23.7. Puncture access to the CNS
23.7.1. Percutaneous ventricular puncture
23.7.2. Puncture of the subdural space
23.7.3. Lumbar puncture
23.7.4. Puncture of the large occipital cistern and in the interval C1-C2
23.8. Procedures for the removal of cerebrospinal fluid
23.8.1. Ventricular catheterization
23.8.2. Ventriculostomy/ICP monitoring
23.8.3. Ventricular shunting
23.8.4. A device that provides access to the ventricles
23.8.5. Ventriculostomy of the third ventricle
23.8.6. Installation of a lumboperitoneal shunt
23.9. Biopsy of the sural nerve
23.10. Surgical elephant fusion of the cervical spine
23.10.1. Upper cervical spine
23.10.2. Bone graft and posterior iliac spine harvesting
23.11. Nerve blocks
23.11.1. Blockade of the stellate ganglion
23.11.2. Lumbar sympathetic block
23.11.3. Intercostal nerve block
23.12. Literature

24. Traumatic brain injury
24.1. Transportation of victims with TBI
24.2. Providing assistance to a patient with TBI in the emergency department
24.2.1. Neurosurgical examination in trauma
24.2.2. X-ray diagnostics
24.2.3. Tactics of conducting the victim upon admission to the emergency department
24.2.4. Diagnostic milling holes (DFO)
24.3. Intracranial pressure (ICP)
24.3.1. General information about intracranial pressure
24.3.2. ICP monitoring
24.3.3. ICP correction
24.3.4. Therapy with high doses of barbiturates
24.4. Skull fractures
24.4.1. Depressed skull fractures
24.4.2. Fractures of the base of the skull
24.4.3. Craniofacial fractures
24.4.4. Skull fractures in children
24.5. Hemorrhagic brain injury
24.6. Epidural hematoma (EDH)
24.7. subdural hematoma
24.7.1. Acute subdural hematoma
24.7.2. Chronic subdural hematoma (SDH)
24.7.3. Spontaneous subdural hematoma
24.7.4. Traumatic subdural hygroma
24.7.5. Extracerebral fluid accumulations in children
24.8. Feeding patients with TBI
24.9. Outcomes in traumatic brain injury
24.9.1. Age
24.9.2. Prognostic factors for outcomes
24.9.3. Late complications of TBI
24.10. Gunshot wounds to the head
24.11. Non-gunshot penetrating wounds of the head
24.12. high-altitude cerebral edema
24.13. Traumatic brain injury in children
24.13.1. cephalohematoma
24.13.2. Child abuse
24.14. Literature

25. Injury of the spine and spinal cord
25.1. Whiplash
25.2. Initial care for spinal cord injury
25.3. Neurological examination
25.4. spinal cord injury
25.4.1. Complete spinal cord injury
25.4.2. Incomplete spinal cord injury
25.5. Fractures of the cervical spine
25.5.1. Atlantococcipital dislocation
25.5.2. Atlantoaxial dislocation
25.5.3. Atlas fractures (C1)
25.5.4. C2 fractures
25.5.5. Subaxial injuries fractures (at the level of C3-C7)
25.5.6. Treatment of fractures of the cervical spine
25.5.7. Sports injury of the cervical spine
25.5.8. Delayed cervical instability
25.6. Fractures of the thoracic spine
25.7. Gunshot wounds of the spine
25.8. Penetrating neck injury
25.9. Treatment of the consequences of spinal cord injury
25.10. Literature

26. Disorders of cerebral circulation
26.1. General information about strokes
26.1.1. Diagnostics
26.1.2. Management of reversible ischemic neurological deficit, transient ischemic attack and stroke
26.1.3. Cardiogenic cerebral embolism
26.2. Strokes in young people
26.3. Lacunar strokes
26.4. Additional forms of strokes
26.5. Literature

27. Subarachnoid hemorrhage and aneurysms
27.1. Introduction
27.2. SAK classification
27.3. Treatment of the acute period of SAH
27.4. Vascular spasm (vasospasm)
27.4.1. Definitions
27.4.2. Characteristics of cerebral vasospasm
27.4.3. Pathogenesis
27.4.4. Diagnosis of vasospasm
27.4.5. Treatment of vasospasm
27.5. Brain aneurysms
27.5.1. Diseases associated with aneurysms
27.6. Treatment options for cerebral aneurysms
27.7. Choice of timing for surgical intervention on aneurysm
27.8. General issues of aneurysm surgery technique
27.8.1. Intraoperative aneurysm rupture
27.9. Aneurysms of various localization
27.9.1. Aneurysms of the anterior communicating artery
27.9.2. Distal aneurysms of the anterior communicating artery
27.9.3. Aneurysms of the posterior communicating artery
27.9.4. Aneurysms of the bifurcation of the internal carotid artery
27.9.5. Aneurysms of the middle cerebral artery (MCA)
27.9.6. Supraclinoid aneurysms
27.9.7. Aneurysms of the posterior circle of Willis
27.9.8. Aneurysms of the bifurcation of the basilar artery
27.10. Unruptured aneurysms
27.11. Multiple aneurysms
27.12. Familial aneurysms
27.13. Traumatic aneurysms
27.14. Mycotic aneurysms
27.15. Giant aneurysms
27.16. Aneurysms of the vein of Galen
27.17. Subarachnoid hemorrhage of unknown etiology
27.18. Non-aneurysmal subarachnoid hemorrhages
27.19. Pregnancy and intracranial bleeding
27.20. Literature

28. Vascular malformations
28.1. Arteriovenous malformations
28.2. Venous angiomas
28.3. Angiographically hidden vascular malformations
28.3.1. Cavernous angiomas
28.4. Dural AVMs
28.5. Carotid-cavernous fistula
28.6. Literature

29. Intracerebral hemorrhages
29.1. Intracerebral hemorrhages in adults
29.2. Intracerebral hemorrhages in young people
29.3. Intracerebral hemorrhages in newborns
29.4. Literature

30. Occlusive cerebrovascular disease
30.1. Atherosclerotic cerebrovascular diseases
30.1.1. Carotid arteries
30.1.2. Vertebrobasilar dyscirculation
30.2. Dissection of the wall of the cerebral arteries
30.2.1. Carotid dissection
30.2.2. Dissection of the arteries of the vertebrobasilar system
30.3. Extra-intracranial microvascular anastomosis (EICMA)
30.4. Cerebrovascular venous thrombosis
30.5. moyamoya disease
30.6. Literature

31. Assessment of disease outcomes
31.1. Literature

32. Differential diagnosis
32.1. Differential diagnosis based on symptoms
32.1.1. Myelopathy
32.1.2. Sciatica
32.1.3. Acute paraplegia and tetraplegia
32.1.4. Hemiparesis, or hemiplegia
32.1.5. lower back pain
32.1.6. Paresis of the dorsiflexion of the foot ("hanging foot")
32.1.7. Weakness/atrophy of arm muscles
32.1.8. Upper limb radiculopathy (cervical)
32.1.9. Pain in the neck
32.1.10. Symptom of Lhermitte
32.1.11. Syncope and apoplexy
32.1.12. Encephalopathies
32.1.13. Temporary neurological deficit
32.1.14. Diplopia
32.1.15. Paralysis of several CNs (cranial neuropathy)
32.1.16. exophthalmos
32.1.17. Pathological eyelid retraction
32.1.18. Macrocephaly
32.1.19. Noise in ears
32.1.20. Sensory disturbances on the face
32.1.21. Speech disorders
32.2. Differential diagnosis by location
32.2.1. Cerebellar pontine fracture (MPF)
32.2.2. Posterior fossa lesion (PCF)
32.2.3. Foramen magnum lesions
32.2.4. Atlantoaxial subluxation
32.2.5. Tumors of the second cervical vertebra (C2)
32.2.6. Multiple intracranial masses on CT or MRI
32.2.7. Annular accumulation of contrast on CT
32.2.8. Leukoencephalopathy
32.2.9. Lesions in the area of ​​the Turkish saddle
32.2.10. intracranial cysts
32.2.11. Orbital lesions
32.2.12. Cavernous sinus lesions
32.2.13. Skull lesions
32.2.14. Combined intracranial/extracranial lesions
32.2.15. Intracranial calcifications
32.2.16. Intraventricular lesions
32.2.17. Periventricular formations
32.2.18. Intraventricular hemorrhage
32.2.19. Damage to the medial temporal lobe
32.2.20. Intranasal/intracranial lesions
32.2.21. Spinal epidural formations
32.2.22. Destructive lesions of the spine
32.3. Literature

Alphabetical index

” Ibragim Salamov, Tamerlan Koniev and Oleg Titov published instructions on how to properly study neurosurgery.

Theory

An important clarification: below will be given only the minimum that a person who is going to residency in neurosurgery should have. The deadline is the end of the first year of residency. During this time, you must read at least one book from each section. Otherwise, two whole years of residency can be spent on understanding basic things.

Books

We offer the following order of studying theory from books: neuroanatomy (simple and complex), neuroradiology (normal and pathology), neurology, operative neurosurgery (neuroanesthesiology, neurotraumatology, vascular neurosurgery, neurooncology, functional neurosurgery, spinal, pediatric neurosurgery, peripheral neurosurgery, endoscopic neurosurgery ), other books (microsurgery, neurophysiology, neurobiology).

For those who do not know English

“Learn English and go to the subchapter below” - we really wanted to leave only this sentence here. English is the global language spoken by physicians and scientists around the world. In medicine, without it, in any way, in neurosurgery - even more so. Neurosurgery in Russian is the tip of the iceberg, and only with knowledge of English can you dive to the right depth and see everything else. We hope you understand this. In the meantime, you are learning English, read these books in Russian.

Neuroanatomy. Start simple and gradually move on to something complex.

Simple neuroanatomy- books on normal anatomy and an introductory part of books on neurology and neurosurgery, which are issued by your university library as part of the curriculum. In normal anatomy, this can be, for example, a textbook by M. G. Prives or an atlas of the Sinelnikovs, but “Neurology and Neurosurgery”, for example, under the authorship of E. N. Gusev and A. N. Konovalov. In addition, you can see the "Workshop on the anatomy of the human brain" by S. V. Savelyev and M. A. Negashev, the drawn atlas "The human nervous system: structure and disorders" edited by V. M. Astapov and Yu. V. Mikadze and the photographic atlas " Anatomy of the brain "M. P. Bykov.

Complex neuroanatomy- this is, first of all, 2 volumes of "Neurosurgical Anatomy" edited by M. V. Pucillo and co-authors, and translated by M. Yu. Bobylov "Neuroanatomy: Atlas of Structures, Sections and Systems" by D. Haynes.

Neuroradiology. It is important to first deal with the norm and only then move on to pathology. "Diagnostic Neuroradiology" edited by V. N. Kornienko and I. N. Pronin in 5 volumes will satisfy all your needs. If you want only the norm and take it with you on duty, then you can take the book “Norm in CT and MRI Studies” by Torsten B. Meller and Emil Reif, translated by G.E. Trufanova and N.V. Marchenko. But it tells not only about the central nervous system. The normal and abnormal CNS alone is in the excellent recently translated book Imaging: The Brain, edited by Osborn, Saltzman, and Zaveri.

Neurology. From the Russian-language literature, we advise you to study "Topical Diagnosis in Neurology" by Peter Duus.

Neurosurgery(operative neurosurgery). In general, it will be enough if you read a book where there is a little bit of everything, for example, the manual “Neurosurgery” by M.S. Grinberg, the two-volume book of the same name by O.N. Guseva, A.N. Konovalov and V.I. Skvortsova.
But it would be ideal if you read one good book from each section below.

Neuroanesthesiology and neuroreanimatology : practical guide edited by V. V. Krylov "Neurosurgery and neuroreanimatology" and "Neuroreanimatology" S. V. Tsarenko.

Neurotraumatology : there is a detailed three-volume "Clinical Guide to TBI" edited by A. N. Konovalov, L. B. Likhterman, A. A. Potapov. On the back - "Injury of the spine and spinal cord" by V. V. Krylov and A. A. Grin.

Vascular Neurosurgery : "Surgery of cerebral aneurysms" by V. V. Krylov et al., "Cerebral revascularization operations in vascular neurosurgery" by V. V. Krylov and V. L. Lemenev, and "Endovascular neurosurgery of the brain" by A. G. Lisachev.

Neuroncology: a short guide by B. M. Nikiforov and D. E. Matsko - “Brain Tumors” and the monograph “Tumors of the Spinal Cord and Spine” (Yu. A. Zozulya and co-authors) will help to understand. Mandatory reading "Intracranial meningiomas" by G. S. Tiglieva et al., as well as "Surgery of tumors of the base of the skull" by A. N. Konovalov et al.

Functional Neurosurgery : "Functional and stereotaxic neurosurgery" by E. I. Kandel or "Stereotactic neurology" by V. M. Smirnov. On epilepsy - "Epilepsy" by L. A. Dzyaka et al., as well as the classics - "Epilepsy and functional anatomy of the human brain" by Penfield and Jasper.

Spinal Neurosurgery : "The Spine: Surgical Anatomy and Operative Technique" by D. H. Kim, A. R. Vaccaro and others - the "bible" of the spinal column.

Pediatric Neurosurgery : read the clinical guidelines "Pediatric neurosurgery" edited by S. K. Gorelyshev.

Peripheral Neurosurgery : “Microsurgery of peripheral nerves” by I. N. Sheveleva, “Traumatic lesions of the brachial plexus (diagnosis, microsurgery)” by I. N. Sheveleva, “Surgery of peripheral nerve injuries” by F. S. Govenko.

Endoscopic Neurosurgery : "Endoscopic transsphenoidal surgery" - P. L. Kalinin, "Microsurgical and endoscopic anatomy of the ventricles of the brain" - A. A. Sufianov, and also as a sign of respect it is worth reading the dissertation of the pioneer of endoscopic operations in Russia - V. Yu. Cherebillo - " Transsphenoidal endoscopic surgery in the complex treatment of pituitary adenomas.

Other books

Microsurgery: "Fundamentals of Microsurgery" - A. R. Gevorkov; "Fundamentals of microvascular technology and reconstructive surgery" - N. G. Gubochkin, V. M. Shapovalov, A. V. Zhigalo; "Microneurosurgery Helsinki" - J. Hernesniemi; "Plastic, reconstructive and aesthetic surgery" - A. E. Belousov.

Neurophysiology: "Neurophysiology"- I. N. Prishchepa, I. I. Efremenko.

Neurobiology: "Fundamentals of neurobiology" - M. A. Kamenskaya, A. A. Kamensky.

For those who know English

neuroanatomy. For a painless entry, as usual, we start with simple neuroanatomy - "Atlas of neuroanatomy and neurophysiology" by Netter et al., or "Clinical Neuroanatomy made ridiculously simple" by Stephen Goldberg. Next, we move on to more difficult - "Clinical Neuroanatomy" by Stephen G. Waxman or Rhoton's books: "Atlas of Head, Neck and Brain" and, more neurosurgically, "Cranial Anatomy and Surgical Approaches".

Neuroradiology. Brain. Imaging, pathology and anatomy” (Osborn et al.); "Brain imaging with MRI and CT" (Rumboldt et al.); «Diagnostic imaging. Spine" (Ross, Moore et al.).

Neurology. Oxford Handbook of Neurology Hadi Manji et al.

Neurosurgery(operative neurosurgery). Here you need to fall in love with books from publishers such as Springer, Thieme, Elsevier. You can also read either one good book with all the top sections, or a book in each section. To cover all sections of neurosurgery, for example, the same Mark S. Greenberg tries in his "Handbook of Neurosurgery", or you can read Osborn's "Neurosurgery". Sectioned below.

Neuroanesthesiology and neuroreanimatology: "The NeuroICU book" by Kiwon Lee;

Neurotraumatology: "Neurotrauma and critical care of the brain" Jack Jallo, Christopher M. Loftus;

Vascular neurosurgery : Neurovascular Surgery, Robert F. Spetzler et al.;

Neurooncology : "Neuro-Oncology: The Essentials" Mark Bernstein, Mitchel S. Berger;

functional neurosurgery : "Textbook of Stereotactic and Functional Neurosurgery" Lozano Andres M. et al.;

Children's neurosurgery : "Pediatric NeuroSurgery" Alan R. Cohen;

peripheral neurosurgery : "Neurosurgical Operative Atlas: Spine and Peripheral Nerves" Christopher E. Wolfla, Daniel K. Resnick; "Nerves and nerve injuries" Tubbs et al.;

Endoscopic neurosurgery : Neuroendoscopic Surgery by Jaime Gerardo Torres-Corzo et al., and Endoscopic and Microsurgical Anatomy of the Cranial Base by Wolfgang Seeger

Other books

Microsurgery : Color Atlas of Microneurosurgery series by Wolfgang Th Koos, Robert F. Spetzler. And, of course, the classics - “Microneurosurgery” by Mahmut Gazi Yasargil in 4 volumes;

Neurophysiology : "Neurophysiology in Neurosurgery" Vedran Deletis Jay Shils;

Neurobiology: "Neurobiology" Gordon M. Shepherd

Where and how to find books?

Look on the sites:
Genesis Library
Neurosurgical Atlas

AT public and channels:
"Notes of a neurosurgeon"
"Nervous Surgeon"
"Vascular neurosurgeon"
"Neurosurgery"
NEURO BOOKS
"Neurosurgery and Neurology"
"Neurosurgery"

ask around in chat rooms:
Neurology-Neurosurgery Books Sharing Group
Neurosurgery Chat
Neurosurgery cocktail
Synapsus/STUD
Neurosurgery Journal Club

Articles

Clinical guidelines

Each country has its own clinical guidelines. For example, in Russia, clinical guidelines can be read on the website of the Association of Neurosurgeons of Russia.
Or in a thread "Notes of a neurosurgeon". Not only Russian recommendations are published there, but also foreign ones.

Magazines

We advise you to read the "Journal of Neurosurgery" - there is an appendix, but it is very convenient to flip through it even without appendices. If access is limited, then “break” the article you are interested in through Sci-hub and study it. Also read the domestic "Issues of Neurosurgery", "Neurosurgery", "Spine Surgery" and so on. Most of them also have applications.

Patents and dissertations

We have singled out patents and dissertations in a separate subchapter, because, unlike magazines - passive consumption of information, this is an active process. Go, for example, to Google Patents or Freepatent, drive in random words on a topic of interest, stumble upon delicious patents and enjoy. With regards to dissertations, you can search, for example, on the website of the RSL (Russian State Library).

Practice

Duty in the department

It does not matter if you have a top department that takes on the most complex operations, or a department that operates only emergency and uncomplicated ones - it will be useful for you to be on duty everywhere. Approach the teacher, directly to the neurosurgeons on duty, to the guys who are already walking - it doesn't matter. Your main task is to break into the department. Don't let rejection break you. Knock until they open. Find your mentor, learn from him, ask incomprehensible moments, assist in operations. Reinforce your theoretical knowledge with practice.

Attendance at autopsies

The ideal place to study the structures of the CNS is the mortuary. Ask for an autopsy, study both macro- and microstructure: normal and pathological morphology. Believe me, seeing the brain in photographs and seeing it live are completely different sensations.

Self-training

With a strong desire, you can build a whole training neuro-platform at home. One has only to buy a used microscope, microinstruments, chicken wing or drumstick in the store, get a suture at 9/0 and higher (monofilament, atraumatic, stabbing) and train microsurgical skills (microvascular anastomoses, nerve plasty). Ideally, if all this is done on a live rat. If it is not possible to purchase a microscope, then you can ask for the department of topographic anatomy of the alma mater and do it all there. How to learn to do a craniotomy at home? Go to the Leroy Merlin store, buy a Dremel 3000, buy pork / lamb heads on the market - and go! If you live in a private house with a garage, then weld yourself a Mayfield fixator, fix a ram's head there and train translabyrinthic accesses under a previously purchased microscope using a previously purchased diamond jewelry bur.

Offline and online development

Offline

These are various kinds of conferences, lectures, master classes. Lucky for those who study in cities such as Moscow, St. Petersburg, Tyumen, Novosibirsk, Rostov - there is a lot of different movement. Wein and Diamond readings, conferences on strokes, Parkinson's disease (NPs), epilepsy, neurocritical care, and so on. There are so many of them, you can't count them all. Install the Neurogid application for yourself, visit the websites of associations and federal centers of neurosurgery, subscribe to specialized publics and channels - and it will be almost impossible to miss the news about the upcoming conference. Attending conferences is not always free, especially if 3D live surgery is planned there. Master classes, of course, are mostly paid.

Online

There are more opportunities for those who know English. Below is a list of YouTube channels worth subscribing to. There you will from time to time stumble upon lectures, broadcasts of conferences and master classes. Among all the channels, we highlight the channel of Dr. John Bennet "Neurosurgical TV", where many large international neuro-conferences are broadcast. In addition, there are weekly lectures from neurosurgeons from around the world. The most famous neurosurgeons of the planet often become guests of the broadcast. So this option is ideal for guys who live in small towns and do not have the opportunity to attend conferences.

Networking

Everything is simple here: the more you get to know, communicate with people from this area, the more and faster you grow. Attend student scientific circles in neurology and neurosurgery, participate in competitions, join profile chats and groups. In a word, look for like-minded people not only at your university, but also in other cities and even countries. Unfortunately, there is no association of young neurosurgeons in our country yet, but it will appear very soon. You must be involved in such associations, and after residency - in the Association of Neurosurgeons of Russia and other international associations, such as WFNS or EANS. Before such a specialist, many roads and opportunities open up. The main message: in our business it is impossible to be clamped, closed introvert. You need to be open to the exchange of experience and acquire connections.

As for chats, here are the most famous of them:

Scientific activity

In parallel, do not forget to do science. Ideally, if you work on some project of your own, patent your invention, participate in international scientific conferences and publish in respected journals. But it's okay if it's some kind of retrospective work or small prospective studies that you do with departments. The main thing is to do science, get used to searching for information, scientific slang, and get your hands on it. And, all the more so, these same scientific works, oh, how useful to you when applying for residency.

Microenvironment

Here we will talk about the desirable actions that you can perform in your free time. The main message: to create a versatile developing environment with a neurosurgical focus. Cozy, useful, comfortable and culturally enriching.

cultural baggage

It is important to know the history of the development of neurosurgery, to know the forefathers, both domestic and foreign. This is a tribute. Well, as N. N. Burdenko said: “There are times when, in order to illuminate and understand the present, it is useful to turn over a few forgotten pages in the history of medicine, and maybe not so much forgotten as for many unknown.” It can be articles on the Internet, fiction and biographical books, films, series. Also - any art that concerns neurosurgery and neurology and what goes beyond them. A neurosurgeon, like any doctor, must be a culturally enriched person.

Social networks and the Internet

Try to set up your feeds to be 70% neurosurgery and 30% neuroscience with general medicine and science. Hahashek and memes should be kept to a minimum.
You may not know what to sign up for. We will help you from neurosurgery. Below are the main sources that we advise the future and current neurosurgeon to subscribe to (pay special attention to YouTube channels - you will learn a lot there).

In contact with

"Notes of a neurosurgeon"
"NERVOUS SURGEON"
"Vascular neurosurgeon"

a) Hardware and software. Necessary equipment:
1. Planning block.
2. Neuronavigation system:
a) high-end computer systems.
b) infrared LED camera systems and detection.
c) a system of reflective markers.
d) touch screen monitor.
3. A sensor that registers skin marks, or
4. Laser based registration without coordinate sensors.

Required Software:
1. VectorVision (current version).
2. Image fusion software for multimodal neuronavigation.

You can use the following items:
1. Microscope integration (semi-robotic function).
a) instrument tracking (the microscope follows the instrument).
b) transition to the target (the microscope finds the position of a predetermined target).
c) return to the target (the focus of the microscope returns to the target from each new position)
2. Heads-Up Display (HUD) - "monitor above the head" (the contour of the tumor is displayed in the field of view of the microscope).
3. Video integration.

b) Navigation planning. Before starting the procedure, the following questions should be answered:
1. The position of the patient (on the stomach, on the back, with a turn of the head).
2. Type of surgical access.
3. The position of the head fixators.
4. Type of visualization.
a) three-dimensional MRI or 2- and 3-mm CT.
b) Can different image data such as MPT, DT1 or PET be connected to a navigation dataset?

in) Token based registration. Token-based registration includes the following steps:
1. Depending on the position of the patient's head during the operation, the sensors should be glued to the head around the target area.
2. Visualization.
3. Data transmission to the planning station.
4. Definition of the target area (tumor).
5. Combining images.
6. Planning of surgical access.
7. Registration of markers.

G) Patient Registration. The following steps are included in patient registration:
1. Data transfer to the neuronavigation system.
2. Display in three planes and 3D-reconstruction.
3. Positioning the patient and fixing the head in a rigid fixation system (for example, Mayfield) in accordance with the planned access.
4. Fixing the adapter of the transmitting "star" and the "star" itself.
5. The patient is registered with a pointer, touching points on the skin (when moving the head and registering, try not to move the sensors, otherwise inaccuracies are possible).
6. Determination of tumor boundaries and planning of craniotomy.

e) Navigation Accuracy. The accuracy of neuronavigation is determined by:
1. Image slice thickness.
2. Position of the patient.
3. Offset during head fixation and/or patient registration.
4. Displacement of the brain due to:
a) loss of cerebrospinal fluid.
b) the use of mannitol.
c) tumor reduction.

The average accuracy of patient registration is 0.7 mm. Intraoperative brain displacement varies between 1.5 and 6.0 mm, with an average of 3.9 mm. Surgical planning using neuronavigation cannot replace anatomical knowledge.

The localization of the lesion in the three-dimensional space of the brain and the best access should be known before the use of computer technology. Then neuronavigation can be used as a useful tool to improve the surgical procedure.

e) Indications for neuronavigation. In general, neuronavigation can be used in all neurosurgical procedures. The additional time required to set up navigation in our department ranges from 15 to 30 minutes and is justified.

Sometimes navigation is used only at the beginning of the operation to perform a perfectly placed small craniotomy, but sometimes it is used throughout the entire procedure. Even during endoscopic surgeries, such as transsphenoidal pituitary surgery, navigational assistance can be useful, especially in complex cases or reoperations.

Standard readings:
1. Deep tumors.
2. Small tumors.
3. Endoscopic surgery.
4. Tumors of functional areas.
5. Tumors of the base of the skull.
6. Frameless biopsy.