Spasticity is one of the most important and residual signs after pyramidal and para-pyramidal catastrophic lesions after diverse neurological insults, including stroke, brain and spine trauma and post-radiation; infection and immunological diseases affecting nervous system, between others. Spasticity is normally a compensatory motor mechanism that could ameliorate the patients´ disability. Nevertheless, disastrous spasticity is described when the extremities force is diminished in the affected limbs, or when is impossible to wake o to take objects, maximum when hand or foot deformity is exposed. The objective of this chapter is centered in the neurosurgical treatment of spasticity, including brain lesions with specific targets and the spine with its different modalities. This review shows not only the basic aspects in these techniques, but also the option of infusion pumps and deep brain stimulation. To close, a proposal is stablished to determinate the possible path to treat the spasticity in the future.
Part of the book: Frontiers in Clinical Neurosurgery
This chapter describes the epidemiology, clinical and neuroimaging features, histological characteristics, surgical approach, outcomes, and prognostic factors of different cases of very rare intracranial tumors, associated with complex clinical syndromes. Highlighting the important aspects in the diagnosis and management that were considered relevant through the experience of our center. Here we included an intracranial Rosai-Dorfman disease manifested as an apparent multiple meningiomatosis, a choroid plexus papilloma clinically manifested as a hemifacial spasm originated by a compression of the facial colliculus, and a neuroenteric cyst associated with Klippel-Feil syndrome. This type of tumor presents a challenge to the neurosurgeon, originating various questions about its management. In this chapter, we present the experience we had with these pathologies to establish the most appropriate management decisions.
Part of the book: Brain Tumors