1240 INDEX

Numerics24 month rule (for peripheral nerve repair) 790

AA’s and B’s 1134abbreviations (list of) viabciximab 262abdominal cutaneous reflex 936, 946

in multiple sclerosis 63abdominal pseudocyst (see pseudocyst - abdomi-

nal)abducens nerve 106

palsy of 836as false localizing sign 836due to brainstem compression 1021due to clival fracture 888due to elevated ICP 836due to elevated ICP from tumor 586following lumbar puncture 203in Gradenigo’s syndrome 838in pseudotumor cerebri 714in trauma 856

abduction relief sign 461abductor sign 444Abelcet® (see amphotericin B)ablative surgery

for Parkinson’s disease 534abscess

cerebral 350DWI MRI appearance 1214from gunshot wound 913MR spectroscopy findings 133Nocardia 356toxoplasmosis 365treatment 353

spinal epidural 376absence seizure

absence status epilepticus 407definition 394, 395

acalculia 113ACAS (see either asymptomatic carotid stenosis,

or Asymptomatic Carotid Atherosclerosis Study)

ACDF (see anterior cervical discectomy)acetaminophen 46

and hepatic toxicity 46acetazolamide

challengewith CTP 128, 1011

for CSF fistula 304for hydrocephalus 314for Meniere’s disease 843for pseudotumor cerebri 717

acetazolamide (cont’d)for seizures 416IV 416side effects 416

acetazolamide challengewith SPECT for NPH 331

achondroplastic dwarf 477and macrocephaly 1207and myelopathy 1186, 1191

acid inhibitors 52ACNU 589acoustic neuroma (see vestibular schwannoma)acquired immunodeficiency syndrome (see

AIDS)acrocephaly 230acromegaly 639

and hyperostosis frontalis interna 700biochemical cure criteria 662evaluation 647growth hormone endocrinology 111management 652outcome following treatment 662reversibility of abnormalities 640treatment

medical treatment 653radiation therapy for 656

ACST (see Asymptomatic Carotid Surgery Trial)ACTH (see corticotropin)Activase® (see alteplase)activity modifications for low back problems 437Actonel® (see risedronate)acupuncture 439acute cerebellar ataxia 1201acute confusional state 56acute corticosteroid myopathy 937acute high-altitude sickness 916acute inflammatory demyelinating polyradiculo-

neuropathy 67acute intermittent porphyria 9, 68acute motor axonal neuropathy variant Guillain-

Barré 68acute mountain sickness 916acute subdural hematoma 896acyclovir

for herpes simplex encephalitis 360for herpes zoster 565

Adalat® (see nifedipine)Adamkiewicz’ artery 95, 96Addison’s disease 31Addisonian crisis (see adrenal crisis)adenocarcinoma

bronchogenic 704metastatic to brain 707

adenohypophysis 109adenoma (see pituitary gland - adenoma)ADH (see antidiuretic hormone)

36. Index

INDEX 1241

adhesive arachnoiditis (see arachnoiditis)ADI (see atlantodental interval)Adie’s pupil 832adjacent segment disease

after cervical fusion 493admission criteria

for alcohol withdrawal seizures 399head injury 856

admitting orders (see orders - admitting)adrenal crisis (adrenal insufficiency) 34

Addisonian crisis 34and macrocephaly 1206from meningitis (Waterhouse-Friderichsen)

343precipitated by ketoconazole 654precipitated by steroid withdrawal 31precipitated by stress 32precipitated by thyroid replacement 650

adrenal tissue transplantationfor parkinsonism 533

adrenalectomyand Nelson’s syndrome 654for Cushing’s disease 654

adrenocorticotropic hormone (ACTH) (see corti-cotropin)

adrenocorticotropic hormone (see corticotropin)adult Chiari malformation 234AED (see antiepileptic drugs)afferent pupillary defect 830, 831Affix™ interspinous fusion plate 482AFO (see ankle-foot-orthosis)afterloading catheters 779Agenerase® (see amprenavir)agenesis of the corpus callosum 239, 241, 246Aggrastat® (see tirofiban)Aggrenox® (dipyridamole/aspirin) 1147agraphesthesia 113agraphia without alexia 113agyria 243Ahumada-del Castillo syndrome 637AICA (see artery - AICA)Aicardi syndrome 246AIDS 364

AIDS related myelopathy 1188and CNS lymphoma 364, 366, 367, 673and infectious aneurysms 1082and neurosyphilis 365and varicella-zoster leukoencephalitis 360encephalopathy 365from cadaveric bone graft 464management of intracerebral lesions 366neurologic manifestations 364neuropathy 798neuroradiologic findings 365toxoplasmosis abscess treatment 367

AIN (see anterior interosseous nerve - neuropa-thy)

air embolism 153akinetic mutism 1209alar ligaments 91, 92ALARA 127

albendazolefor echinococcosis (hydatid cyst) 373for neurocysticercosis 372

albuminfor hyperdynamic therapy 1052transfusion 36

albuminocytologic dissociation 67alcohol (ethyl) (see ethanol)alcohol withdrawal seizures (see ethanol - with-

drawal seizures)alendronate

for osteoporosis 994alexia without agraphia 114alfentanil 3ALIF (see anterior lumbar interbody fusion)alkaline phosphatase

in Paget’s disease 499alkylating agents for gliomas 601Allcock test 134, 1072allergic reactions

to intravenous contrast media 125allergy prep

for gadolinium allergy 124for iodine allergy 124

allocheiria 113allodynia

in CRPS 576in postherpetic neuralgia 565

allograft 199alpha-2 adrenoceptor agonists 25alpha-adrenergic agonists

and intracerebral hemorrhage 1121alpha-fetoprotein

and neural tube defects 245as a tumor marker 693, 721

alprazolam 51, 52ALS (see amyotrophic lateral sclerosis)alteplase

for acute MI 1121for CVA 1016

alternating hemiplegia 1171Alzheimer’s disease

treatment with CSF shunt 334amaurosis fugax 1144

differential diagnosis 1204in giant cell arteritis 75

amaurotic pupil 831amebic infections of CNS 375amenorrhea-galactorrhea syndrome 634, 637

with empty sella syndrome 719American Academy of Otolaryngology hearing

classification 623American Spinal Injury Association (ASIA)

impairment scale 947motor scoring system 945sensory scoring system 946spinal cord injury completeness scale 947

Amicar® (see epsilon-aminocaproic acid)Amidate® (see etomidate)aminoglutethimide 654aminophylline - for contrast media reaction 126

1242 INDEX

amitriptylineas analgesic adjuvant 548for painful diabetic neuropathy 797for postherpetic neuralgia 566side effects 797

amniotic fluid embolism 1024amobarbital 421amphetamines

abuse and stroke 1024and the nervous system 277

Amphocin® (see amphotericin B)amphotericin B

for candidal meningitis 345for cryptococcal meningitis 374for fungal cerebral abscess 354

Amplatzer vascular plug 1114amprenavir 798amrinone 22amygdalo-hippocampectomy 162, 423amyloid

amyloid angiopathy 912, 1122amyloid neuropathy 800in chronic traumatic encephalopathy 912plaques

in Creutzfeldt-Jakob disease 362in kuru 362

amyotrophic lateral sclerosis 65differential diagnosis 1188, 1196differentiating from myelopathy 489with parkinsonism 60

Amytal® (see amobarbital)anal wink (see anal-cutaneous reflex)anal-cutaneous reflex 946analgesics 44

adjuvant medications 50for mild to moderate pain 47for moderate to severe pain 47for severe pain 48nonsteroidal anti-inflammatory drugs

(NSAIDs) 44opioid 46

anaphylaxisfrom chymopapain 447from IV contrast media 125

Anaprox® (see naproxen sodium)anatomy

cerebrovascular 96cortical surface 84internal capsule 107occiptoatlantoaxial complex 91parietal lobe 112spinal cord 92sural nerve 214surface anatomy of brain 84

Ancef® (see cefazolin)Andersson lesions 503Anectine® (see succinylcholine)anencephaly 243

and organ donation 293anesthesia dolorosa 558anesthesiology 1

aneurysm clipsand MRI 131

aneurysmal bone cyst 728sacral 1190skull

differential diagnosis 1221, 1223spine 728

differential diagnosis 737aneurysms 1055

AICA 1074and autosomal dominant polycystic kidney

disease 1057and fibromuscular dysplasia 79and pregnancy 1086and subarachnoid hemorrhage 1034angiogram for 1038angiographic findings 1039anterior cerebral artery 1068anterior communicating artery (ACoA) 1066associated systemic conditions 1057basilar bifurcation/tip 1074basilar trunk 1076berry 1055bleeding risk (see aneurysms - hemorrhage

risk)carotid cavernous 1079carotid terminus (bifurcation) 1069cavernous carotid artery 1079, 1081Charcot-Bouchard 1122coiling 1059DACA (see aneurysms - distal anterior cere-

bral artery)dissecting (see dissection, arterial)distal anterior cerebral artery 1068false aneurysms 1081

following carotid endarterectomy 1153familial 1057, 1080follow-up after treatment 1066fusiform 1055giant 1082hemorrhage risk

ruptured aneurysms (rebleeding) 1034, 1043

unruptured aneurysms 1077imminent rupture 1061in infancy and childhood 1055in moyamoya disease 1171incidental 1055, 1077

follow-up after diagnosis 1079infectious 1082intraoperative rupture

with coiling 1060with craniotomy 1064

prevention 1064location 1055mass effect 1056

clipping vs. coiling to treat 1058middle cerebral artery (MCA) 1069miliary 1122multiple 1080mycotic 1082

INDEX 1243

aneurysms (cont’d)operative techniques 1061ophthalmic artery 1070ophthalmic segment 1070PICA 1072posterior circulation 1071posterior communicating artery (P-comm)

1068posttraumatic (see aneurysms - traumatic)presentation 1055rebleeding 1043

intraoperative 1060, 1064prevention 1043

recurrence after treatment 1065rests 1061saccular 1055superior hypophyseal artery 1071supraclinoid 1070surgery for 1061

brain relaxation 1062cerebral protection 1062lumbar drainage 1062timing of surgery 1060

basilar bifurcation aneurysms 1074thrombosis

spontaneous 1058with detachable coils 1058

transmural pressure 1044traumatic 888, 1081treatment

trapping 1058treatment options 1057

surgery 1058, 1061thrombosis with detachable coils 1058,

1059dome-to-neck ratio 1059

thrombosis with Onyx 1058trifurcation 1069unruptured 1077vein of Galen (see vein of Galen malforma-

tion)vertebral artery 1072vertebral-basilar junction 1073with AVM 1100wrapping 1058

angina pectorissympathectomy for 545mimicked by cervical radiculopathy 461spinal cord stimulation for 574

angioblastic meningioma 616angioedema

following anterior cervical discectomy 466from contrast media reaction 125from propofol 1064

angioendothelomatosis (see intravascular lym-phomatosis)

angiogramangiogram-negative SAH 1083anterior cerebral artery 101computed tomography angiography (CTA)

for aneurysm detection 1038

angiogram (cont’d)for carotid stenosis 1146technical information 128

dynamic (for bow hunter’s stroke) 1160early draining vein 597emergency, in stroke 1013following aneurysm surgery 1064for aneurysms 1038for bow hunter’s stroke 1160for brain death 291for carotid stenosis 1145in gunshot wounds to the head 914in head trauma 860in hydranencephaly 244in intracerebral hemorrhage 1127in meningiomas 617in non-missile penetrating head trauma 916in penetrating neck trauma 999in pregnancy 1087in subarachnoid hemorrhage 1038intraoperative 135

ICG 135for spinal AVM 509

magnetic resonance angiography (MRA)for carotid stenosis 1145for cerebral aneurysms 1038, 1081

middle cerebral artery 101posterior fossa arterial 103posterior fossa venous 106radiation dose 127repeating after SAH 1084risks 134, 1086, 1145, 1149spinal

for angio negative SAH 1084supratentorial venous system 105tumor blush 597

angiographic findingswith aneurysms 1039

basilar bifurcation 1074angiographically occult vascular malformations

1105angiography

cerebral 134(see also angiogram)

AngioJet®for dural sinus thrombosis 1169

angiolipoma 729angioma (see venous angiomas)angiomatous meningioma 615angioplasty

for carotid stenosis 1151indications 1151

for vasospasm 1049angiotensin-converting enzyme 71angular artery 87angular gyrus

surface anatomy 87anisocoria 831

from third nerve compression 832from uncal herniation 286, 832physiologic 831

1244 INDEX

ankle to brachial BP ratio 480ankle-foot-orthosis for foot drop 821ankylosing spondylitis 431, 502, 1192, 1194

and lumbar spinal stenosis 479and upper cervical spine problems 494

annular (see anular)annulus of Zinn 836annulus tendineus 836anosmia

and postconcussive syndrome 910differential diagnosis 1202in Foster Kennedy syndrome 112, 614in Kallmann syndrome 635, 1202with basal skull fracture 888with CSF fistula 301

anosognosia 113anoxic encephalopathy 282, 287

use of EEG for 266ansa hypoglossi/cervicalis 1155Ansaid® (see flurbiprofen)anterior approaches to the spine

cervical 174for trauma 978upper cervical 174

lumbar 175thoracic 175, 471

anterior cerebral artery 100angiogram 101

anterior cervical discectomy 462Cloward technique 467complications 465fusion 464pseudarthrosis following 467redo 463Smith-Robinson technique 467

anterior cervical plating 492practice guideline 464

anterior choroidal artery 97, 100ligation for parkinsonism 532occlusion 1028

anterior cord syndrome 950anterior horn cell diseases 787anterior iliac crest bone graft 200anterior inferior cerebellar a. (see artery - AICA)anterior interosseous nerve 791, 791, 806

neuropathy of 807anterior knee of Wilbrand 643, 1071anterior lumbar interbody fusion (ALIF) 195anterior spinal artery 95anterior spinal artery syndrome 950anterior spine approaches 174

retroperitoneal 179sternal splitting 178trans-abdominal 179transoral 176transthoracic 178

anterior tibial compartment syndrome 450anterior tibialis

innervation 789weakness in peroneal nerve palsy 820weakness with lumbar disc herniation 443

anthropoid posture 478antibiotics

for CSF fistula 304intrathecal 347prophylactic 342

for external ventricular drains 869for gunshot wounds to the head 914with CSF shunt 323

in pregnancy 336anticoagulation 36

and acute subdural hematoma 897and intracerebral hemorrhage

anticoagulation after the hemorrhage 1127

anticoagulation before the hemorrhage 1020, 1123

and risk of chronic subdural hematoma 899anticoagulants 38considerations in neurosurgery 36following craniotomy 37for cardioembolic stroke 1023for stroke 1020in spinal cord injury 937reversal of 40

anticonvulsants (see antiepileptic drugs)antidepressants

for low back pain 438for pain 50, 548for painful diabetic neuropathy 797for postherpetic neuralgia 566

antidiuretic hormone 111antiepileptic drugs 407

and birth defects 419and bleeding complications 407and cerebral abscess 354and newly diagnosed brain tumors 588and oral contraceptives 419and pregnancy 419monotherapy vs. polytherapy 409prophylactic use after head trauma 399, 862prophylactic use with brain tumors 588withdrawal 418

following head trauma 399antifibrinolytic therapy

for aneurysms 1044, 1046, 1058anti-GQ1b antibodies 68antihistamines

for inadvertent intrathecal ionic contrast 122for pain 50

antiphospholipid-antibody syndrome 1025and cerebrovascular venous thrombosis 1166

antiplatelet drugsand safety with neurosurgical procedures 38for carotid stenosis 1146reversal of 38

antisiphon device 317for intracranial hypotension 327for slit ventricle syndrome 327for subdural hematoma following shunt 328

antispasmodics 50Antivert® (see meclizine HCl)

INDEX 1245

Anton’s syndrome 335Anton-Babinski syndrome 113Antoni A & B tissue

in neurofibromas 722in spinal schwannomas 735in vestibular schwannoma 622

anular fissures (see anular tears)anular tears (lumbar disc pathology) 429

differential diagnosis 1193anulus fibrosus

definition 428AOD (see atlantooccipital dislocation)AOI (see atlantooccipital interval)aortic aneurysms

in giant cell arteritis 75aortic arch atherosclerosis 1011aortic bifurcation 449aortic dissection

causing low back pain 1192in giant cell arteritis 74

Apert’s syndrome 230, 232aphasia

differential diagnosis 1208parietal lobe origin 114

apical odontoid ligament 91, 92apical petrositis (see Gradenigo’s syndrome)aplanation principle 870aplastic anemia

with carbamazepine 412with felbamate 415

apneaand bradycardia (A’s and B’s) 1134and Chiari malformation 239sleep apnea

following C3-4 discectomy 465following cordotomy 568following surgery for Chiari malforma-

tion 237with acromegaly 640

with intracerebral hemorrhage in newborns 1134

apnea test (challenge) 289apneustic respiratory pattern 282apolipoprotein E (apoE) allele

and amyloid angiopathy 1123and chronic traumatic encephalopathy 910,

912and dementia 56and severe brain injury 910

apoplexydifferential diagnosis 1199pituitary apoplexy 635

apparent diffusion coefficient (on diffusion-weighted MRI) 132

appendicitis in patients with a VP shunt 348approaches

anterior spine 174, 178anterior thoracic spine 471lateral ventricle 168middle frontal gyrus 172middle temporal gyrus 423

approaches (cont’d)modified pterional 1075pineal region tumors 695pterional 159retroperitoneal 179superior temporal gyrus 423, 1069to third ventricle 168trans-abdominal 179transcallosal 169, 695transoral 176transthoracic 178

apraclonidine 833AquaMEPHYTON® (see vitamin K)aqueductal stenosis 241, 311arachnoid cysts

intracranial 222causing macrocephaly 1207follow-up 224intraventricular (differential diagnosis)

1225pineal region 691retrocerebellar 240suprasellar (differential diagnosis) 1216treatment 224

spinal 225arachnoid diverticula (spinal) 225arachnoid granulations 1220arachnoid villi (granulations) 297arachnoiditis 252, 458

following myelography 458MRI findings 458myelographic findings 458post operative 450

arachnoiditis ossificanslumbar 1189thoracic 1186

arcade of Frohse 817arcade of Lazorthes 96arcade of Struthers 813Archimedes’ screw for intracerebral hematoma

782arcuate lines 135arcuate sinus 1073ardeparin 40

reversal with protamine sulfate 41area postrema 586Aredia® (see pamidronate)Arenberg shunt 843arginine vasopressin (see antidiuretic hormone

(ADH))arginine vasopressin (see antidiuretic hormone)Argyll Robertson pupil 830arhinencephaly 244Arixtra® (see fondaparinux)arm claudication 75arm weakness (differential diagnosis) 1196armored endotracheal tube 154Arnold-Chiari malformation 238

(also see Chiari malformation)arrested hydrocephalus 309

1246 INDEX

arrow injuries 916arsenic

toxicology on the nervous system 798arteria radicularis anterior magna (see artery -

Adamkiewicz)arterial-venous oxygen content difference 874arteriogram (see angiogram)arteriosclerosis (see atherosclerosis)arteriosclerotic parkinsonism 60arteriovenous fistula 1098arteriovenous malformation 1098

and moyamoya disease 1170causing macrocephaly 1207cryptic 1105dural (intracranial) 1109embolization 1102grading 1101hemorrhage

lifetime risk 1100location of 1099morbidity and mortality 1099

normal perfusion pressure breakthrough 778, 1104

producing subarachnoid hemorrhage 1034rupture during pregnancy 1086spinal 507, 1187stereotactic radiosurgery for 774treatment 1102

arteritisTakayasu’s 74

arteryAdamkiewicz 95, 96AICA

anatomy 104as cause of hemifacial spasm 543

anterior cerebral 100anterior choroidal 100

(see also anterior choroidal artery)ascending pharyngeal 98basilar 104Bernasconi & Cassinari 99, 617external carotid 98Heubner’s 97, 100, 100

occlusion 1028inferior hypophyseal 99, 110internal carotid 99labyrinthine 104lenticulostriates 97, 100, 100

as source of hemorrhage 1119lateral 101

medial striate (see artery - Heubner’s)middle cerebral 101middle meningeal 98

as source of epidural hematomas 894on angiography 134

neuromeningeal trunk 98occipital 98, 1027ophthalmic 99, 1070Percheron, artery of 104

occlusion 1028persistent primitive trigeminal 107, 551

artery (cont’d)PICA 102, 103

anatomic variations 103as cause of hemifacial spasm 543

posterior cerebral 103, 104posterior communicating 99recurrent artery of Heubner 100SCA (superior cerebellar) 104

as cause of hemifacial spasm 543as cause of trigeminal neuralgia 551, 560

superficial temporal 98bypass 1165sparing frontal branch with craniotomy

160superior hypophyseal 97, 99, 110, 1070vertebral

anatomy 102management of trauma to 999segments 102

vidian 99, 1027arthroplasty - cervical disc 467arthrosis interspinosa 478artificial cerebrospinal fluid 300ascending paralysis 67ascending pharyngeal artery 98aseptic meningitis (see meningitis - aseptic)ash leaf macules 725Ashworth (spasticity) score 537ASIA (see American Spinal Injury Association)asomatagnosias 113Aspen® interspinous fusion plate 482aspergillosis

and multiple cranial neuropathies 1203aspirin

and DVT in glioma patients 42and elective surgery 38and intracerebral hemorrhage 1121as analgesic 45before carotid endarterectomy 1152following carotid endarterectomy 1152for atrial fibrillation 1024for DVT prophylaxis 42for ischemic neurologic deficit 1019, 1020for occlusive cerebrovascular disease 1146for stroke prevention 1146

astereognosis 113asterion 86, 86astrocytoma 593

cerebellar (pilocytic) 604chemotherapy for 601dedifferentiation 595diffuse 595giant cell 726grading 594low-grade 595malignant 595pilocytic 603pilomyxoid 606spinal cord 731treatment 598(see also glioma)

INDEX 1247

asymptomatic carotid artery stenosis 1147Asymptomatic Carotid Atherosclerosis Study

1149Asymptomatic Carotid Surgery Trial 1148asymptomatic meningiomas 615AT/RT or ATRT (see atypical teratoid/rhabdoid

tumors)Atarax® (see hydroxyzine)ataxia

differential diagnosis 1201ataxia telangiectasia 1106ataxic respiratory pattern 282atenolol

for ethanol withdrawal 274atherosclerosis 1144

and moyamoya disease 1171and stroke in young adults 1024aortic arch 1011intracranial 1023

athletics (see sports)Ativan® (see lorazepam)atlantoaxial fusion 183

C1 lateral mass screws 185C1-2 facet screws 184Dickman and Sonntag fusion 187

atlantoaxial impaction (see basilar impression)atlantoaxial subluxation

and increased atlantodental interval 957differential diagnosis/etiologies 1230from metastases 743in Down syndrome 498, 1230

surgical indications 183in Morquio syndrome 494in rheumatoid arthritis 495

indications for treatment 495rotatory subluxation/fixation 955surgical fusion 183traumatic 955

anterior dislocation 957“V” shaped pre-dens space 957with odontoid fractures 963

atlantodental interval 136, 136, 957abnormalities in rheumatoid arthritis 495increased (differential diagnosis) 1230posterior atlantodental interval (PADI) 136,

136, 495atlantooccipital dislocation 951

following cervical traction 943in pediatrics 951radiographic criteria 952

atlantooccipital interval 953atlantoocipital ligament 91atlas vertebra (C1)

fractures of 957lateral mass screws 185metastatic tumors of 743ossification centers 137pediatric 137

atonic seizures - Lennox-Gastaut syndrome 396atracurium 27

atrial fibrillationand stroke 1022, 1023

atrial myxoma 1022, 1024atrial natriuretic factor

following SAH 1043in volume overload 12

Atromid S® (see clofibrate)atrophy

first dorsal interosseous muscle 1197hand 1196in Charcot-Marie-Tooth 793in diabetic amyotrophy 796quadriceps 798with carpal tunnel syndrome 809with lower motor neuron paralysis 786with ulnar nerve palsy 813

atropineand pupillary dilatation 282, 292for bradycardia in spinal cord injury 935for bradycardia with Precedex™ 25for brain death evaluation 292for contrast media reaction 125for reversal of paralytics 27

atypical choroid plexus papilloma 695atypical facial pain 551

percutaneous trigeminal rhizotomy for 555atypical meningioma 616atypical teratoid/rhabdoid tumors 688audiometrics

with vestibular schwannoma 622auditory evoked potentials (see brainstem audito-

ry evoked responses)auras with seizures 394austenitic aneurysm clips 131autograft 198autoimmune hypophysitis 1217autonomic dysreflexia (see autonomic hyperre-

flexia)autonomic hyperreflexia 1000autoregulation (cerebral) 866, 1010

loss in trauma 867loss with inhalational anesthetics 1

autosomal dominant polycystic kidney diseaseand arterial dissections 1161and cerebral aneurysms 1057

Avandamet® (see metformin)avascular necrosis of bone from steroids 33Avastin® (see bevacizumab)Avinza® (extended releasea morphine) 49Avitene® (see microfibrillar collagen)AVM (see arteriovenous malformation)AVP (see antidiuretic hormone (ADH))avulsion

nerve root (see nerve root avulsion)avulsion fracture 971awake craniotomy 150axial lumbar interbody fusion (Ax-LIF) 195axial manual traction 462axillary nerve 791

injuries 817

1248 INDEX

axis vertebra (C2)anatomy 959fractures 959lesions

differential diagnosis 1231metastatic tumors of 743ossification centers 137pediatric 137pedicle screws 185, 187translaminar screws 187tumors

differential diagnosis 1231Ax-LIF or AxiaLIF™ (see axial lumbar inter-

body fusion)axonal shearing 853axonotmesis 802AZT® (see zidovudine)

BBaastrup’s syndrome 478Babinski sign 116

with cerebellar infarction 1021with cervical spondylotic myelopathy 488

back pain 428chances of return to work 440chronic 440conservative treatment 437differential diagnosis 1192failed back surgery syndrome 457in cancer patients 744, 745in spinal Paget’s disease 499physical examination 431psychological components 431psychosocial factors 436"red flags" 432with SAH 1035

back school 438baclofen

for ethanol withdrawal 274for spasticity

intrathecal 539mechanism of action 537oral 537

for trigeminal neuralgia 553in ALS 66overdose management 540withdrawal syndrome (intrathecal) 540

bacterial aneurysm 1082bacterial endocarditis

and cerebral abscess 350and infectious aneurysms 1082and spinal epidural abscess 377

BAER (see brainstem auditory evoked responses)BAI-BDI method of diagnosis atlanto-axial dislo-

cation 953Baker cyst and peroneal nerve palsy 821balance - sagittal (spine) 441balance problems - differential diagnosis 1201ballistics 912

balloonmicrocompression trigeminal rhizolysis 554occlusion test 1072

balloon disc (herniation) 455Balo (concentric sclerosis) 64bamboo spine 502, 1231banana sign 1210Bannwarth’s syndrome 368barbiturate

cerebral protectionduring aneurysm surgery 1063during carotid endarterectomy 1155

coma 883for anesthesia induction 2for seizures (see phenobarbital)high-dose therapy 883

barbotage 209basal angle 139basal cisterns 909

enhancement in carcinomatous meningitis 711

in cerebellar infarct 1021in classifying head injury 854in external hydrocephalus 307, 1206in prognosticating head injury 909obliteration in subdural empyema 357obliteration in trauma 909perimesencephalic cisterns 1085posterior and lateral limbs 909

basal energy expenditure 908basal ganglia

calcification 1224differential diagnosis of abnormalities 1228in Parkinson’s disease 59involvement in AIDS 365lacunar strokes

arteriosclerotic parkinsonism 60basal skull fractures 855, 887

and diabetes insipidus 16, 889and traumatic aneurysms 1081

basal vein of Rosenthal 105basilar artery 104

aneurysms (see aneurysms - basilar bifurca-tion/tip or vertebrobasilar)

basilar dolichoectasiacausing facial pain 550causing trigeminal neuralgia 551

basilar artery migraine 58basilar impression/invagination 138

congenital 511in rheumatoid arthritis 495, 497with Paget’s disease 499

basilar tip aneurysms (see aneurysms - basilar bi-furcation/tip)

basion-axial interval 953basion-dental interval 953Batson’s plexus

and cerebral abscess 350and cerebral metastases 703and spinal metastases 742and vertebral osteomyelitis 381

INDEX 1249

Battle’s sign 855, 888BCNU 589

for malignant gliomas 601Gliadel® wafers 601intra-arterial for gliomas 601systemic for gliomas 601wafers for gliomas (Gliadel®) 601

beaten copper cranium 312description 231with craniosynostosis 229with lambdoid synostosis 231

beaten silver cranium (see beaten copper crani-um)

beating aneurysm sign 1061bed rest

following lumbar puncture 304for low back problems 437for whiplash injuries 931

bedside confrontational test (visual fields) 829Beevor’s sign 946Behçet’s syndrome 74, 78

and cerebrovascular venous thrombosis 1166and pseudotumor cerebri 716

Bell’s cruciate paralysis (see cruciate paralysis)Bell’s palsy 845

in Lyme disease 368bellhop’s tip position 802Benadryl® (see diphenhydramine)Bence-Jones protein 741benediction hand

with median nerve dysfunction 807with ulnar nerve dysfunction 813

Benedikt’s syndrome 114benign (paroxysmal) positional vertigo 840, 842benign cerebral angiopathy or vasculitis 1035benign external hydrocephalus 307benign intracranial hypertension 713benign orgasmic cephalgia 1036benign postictal pleocytosis 404benign subdural collections of infancy 904benign thunderclap headache 1035benzodiazepines 51

for ethanol withdrawal 274in anesthesia 3reversal 52

Bernhardt-Roth syndrome 818berry aneurysms 1055Best disease (macular dystrophy) 833beta blockers

and IV contrast reactions 125for ethanol withdrawal 274

beta-transferrin (in CSF) 302bevacizumab 705

for vestibular schwannoma 624BiCNU® (see BCNU)bicycle test 480bilateral myoclonus (see juvenile myoclonic epi-

lepsy)Bill’s bar (of IAC) 89Biltricide® (see praziquantel)

bimastoid line 139Binswanger’s disease 1226biofeedback

for low back pain 439biomechanical stability 930biopsy

brain biopsyfor Creutzfeldt-Jakob disease 363for dementia 56for herpes simplex encephalitis 359for neurodegenerative disorders 56for neurosarcoidosis 72for possible cerebral mets 707in AIDS 367stereotactic (see stereotactic surgery)

sural nerve 214(superficial) temporal artery 76

Biot’s breathing 282bipuvicaine 824

following lumbar laminectomy 448for coccydynia 517

birth control pills (see oral contraceptives)birth injuries

acute subdural hematoma 904brachial plexus 802cephalhematoma 918ping-pong ball fractures 886subperiosteal hematoma 918

Bischof’s myelotomy 538bisphosphonates

for multiple myeloma 741for osteoclastoma of spine 742for osteoporosis 993for Paget’s disease 500for vertebral metastases 747

bitemporal hemianopsia 635, 643with clival fractures 889with superior hypophyseal artery aneurysms

1071bivalirudin 40black disc 434bladder

dysfunctiondifferential diagnosis 117in cauda equina syndrome 446with lumbar disc herniation 443

hyperreflexia 117neurophysiology 116urinary retention 118

Blake's pouch cyst 240bleeding time

and NSAIDs 45blepharoptosis 1205blepharospasm 542blind spot 829blindness

cortical 335, 362following head injury 855

differential diagnosisbinocular 1204

1250

INDEX

blindness

(cont’d)

monocular 1204unilateral (amaurosis fugax) 1204

following lumbar spine surgery 450following optic nerve trauma 863following pallidotomy 534following trigeminal rhizotomy 559from cavernous carotid aneurysms 1080from giant cell arteritis 74, 75

acute onset 77from hydrocephalus 335from hypotension 335from pseudotumor cerebri 715

blistering of the skull 617block vertebrae 253blockogram 745blood component therapy 34blood ethanol concentrations 273blood patch

for intracranial hypotension 305for post LP headache 59

blood volumecerebral 867, 880

blood-brain barrier 109and chemotherapy 589and CNS metastases 702and the pituitary gland 109opened by mannitol 882

blown pupil 861blunt cerebrovascular injury 982blush (tumor) 597BMP (see bone morphogenic protein)bobble-head doll syndrome 223bolt (see subarachnoid screw)bone density (see bone mineral density)bone flap

infection 349options following craniectomy 165

bone grafts 197bone mineral density 992bone morphogenic protein 199

in anterior cervical fusion 464in lumbar fusion 197

bone scanfor ankylosing spondylitis 503for craniosynostosis 229for discitis 385for lambdoid craniosynostosis 231for low back problems 433for osteoid osteoma 737for spine fractures 940for vertebral osteomyelitis 382in coccydynia 517in hyperostosis frontalis interna 701in multiple myeloma 741in Paget’s disease 499in spinal metastases 746in spondylolysis 476three phase 140to assess lumbar fusion 198

bone tumorsmetastases to the spine 742of the skull 698primary tumors of the spine 736

Bonefos® (see clodronate)Booking the case v

anterior cervical discectomy (ACDF) 463axial lumbar interbody fusion (AxiaLIF™)

195C1-2 fusion using lateral mass screws 185cervical disc arthroplasty (artificial disc) 468cervical keyhole laminectomy 469cervical laminectomy 469costotransversectomy 472craniotomy

awake craniotomy 151for acute epidural/subdural hematoma

895for aneurysm 1062for arteriovenous malformations 1103for chronic subdural hematoma 900for depressed skull fracture 887for infratentorial tumor 587for intracerebral hemorrhage 1128for microvascular decompression 559for supratentorial tumor 586retrosigmoid for vestibular schwannoma

629transcallosal approach 169

defaults & general information vkyphoplasty 996lateral interbody fusion 194lumbar discectomy 447lumbar laminectomy ± fusion for stenosis 480odontoid screw fixation 182percutaneous trigeminal rhizotomy 556shunts 208transoral approach 177transpedicular approach 473transsphenoidal surgery 657transthoracic spine surgery 474ventricular access device (Ommaya reservoir)

212ventricular shunt 208

Borrelia burgdorferi

368bortezomib 741Boston brace 476, 988Botox® (see botulinum toxin)botulinum toxin

for hemifacial spasm 543for piriformis syndrome 1190for torticollis 541for trigeminal neuralgia 553

botulism 1191,

1202

Bourneville’s disease 725bovine circulation 98bovine spongiform encephalopathy (BSE) 361bow hunter’s sign 183bow hunter’s stroke 1159bowel perforation with axial interbody fusion 196bowel prep for axial interbody fusion 195

INDEX 1251

bowstring sign 444bow-tie sign 973brachial neuritis 794brachial plexus 790, 790

injuries 801birth injuries 802during 1st rib resection 823gunshot wounds 803perioperative 799

neuropathy 794in thoracic outlet syndrome 823

brachycephaly 230brachytherapy 779, 782bracing

cervical spine 979halo-vest 979

application 942lumbar spine

for lateral recess stenosis 485for low back pain 439for spondylolysis 476

thoracolumbar spine 988bradycardia

in Cushing’s triad 868in spinal shock 930

bradyphrenia 329brain biopsy (see biopsy)brain death 289

in children 292brain mapping 150brain natriuretic peptide 1043brain relaxation - for aneurysm surgery 1062brain swelling

intra-operative 147brain tissue oxygen tension monitoring 874

treatment thresholds 876brain tumors 582

(see also tumors - brain)brainstem auditory evoked responses (BAER)

267during pentobarbital coma 884with vestibular schwannoma 624

brainstem glioma 607dorsally exophytic 608tectal glioma 608

brainstem nodule (in hydranencephaly) 244brainstem syndromes 114breakthrough bleeding

following AVM radiosurgery 778following AVM surgery 1104following carotid endarterectomy 1153

bregma 86, 87Brevibloc® (see esmolol)brevicollis 254Brevital® (see methohexital)bright spot in pituitary gland 648broad-based disc herniation 429Broca’s (motor) aphasia 114Broca’s area 84, 172Brodmann’s areas 84, 84bromfenac 45

bromocriptinedosing forms 651for acromegaly 653for prolactinoma 651

with extremely high prolactin levels 651bronchogenic cancer

metastatic to brain 703non-small-cell 704small-cell 703

bronchospasmfrom contrast media reaction 126

brown tumor of hyperparathyroidism 1216Brown-Séquard syndrome 950

from cervical disc herniation 1192from spinal cord herniation 515, 1186in cervical spondylosis 489in radiation myelopathy 773with spinal cord tumor 733

Brudzinski sign 343, 1036bruit

carotidasymptomatic 1144with carotid dissection 1163

cranialwith AVM 1099with carotid-cavernous malformation

1113with dural AVM 1110

spinalwith spinal AVM 508

Brun syndrome 371Bruns-Garland syndrome 796BSAER (see brainstem auditory evoked respons-

es)buffalo hump (in Cushing’s syndrome) 638bulbar-cervical dissociation 948, 951bulbocavernosus reflex 946bulging lumbar disc 429bullet velocity (see ballistics)bundles of Probst 246Buprenex® (see buprenorphine)buprenorphine 49burner (football injury) 980burning hands syndrome 980

differential diagnosis 1198burr holes

for chronic subdurals 901for trauma (emergency) 864Frazier 156, 158, 207

burst fracturescervical 978

C1 958subaxial 970

thoracolumbar 987L5 990treatment 989

burst suppressionand pentobarbital levels 884definition 266during aneurysm surgery 1064with etomidate 1064

1252 INDEX

Butazolidin® (see phenylbutazone)butorphanol 49butterfly glioma 597, 601butterfly vertebra 138

in lipomyelomeningocele 251

CC1 (see atlas vertebra)C1-2 arthrodesis 183

C1 lateral mass screws 185Dickman and Sonntag fusion 187transarticular facet screws 184, 184

C1-2 puncture 205C1-dens distance (see atlantodental interval)C2 (see axis vertebra)C4 cape 946C5 palsy, post-op 493C7 lateral mass screw 190C7 transfacet screw 190cabergoline

dosing forms 652for prolactinoma 651

cachexiapituitary 635

cacosmia 395CADASIL 80café au lait spots

definition 723in McCune-Albright syndrome 701in neurofibromatosis 723

caffeineas pain medication adjuvant 50

Calan® (see verapamil)calcidiol 993calcifediol 993calcification

basal ganglia 1224choroid plexus 1223in stroke 1013intracranial (differential diagnosis) 1223of subperiosteal hematoma 918pineal 1223

Calcimar® (see calcitonin)calcitonin

for fibrous dysplasia 702for odontoid fracture 965for osteoporosis 993for Paget’s disease 500

calcitriol 993calcium

for osteoporosis 993calcium antagonist (see calcium channel block-

ers)calcium channel blockers

for hypertension 21for vasospasm 1042, 1053

Calderol® (see calcifediol)callosotomy 170calorics (see oculovestibular reflex)

Calve-Kummel-Verneuil disease 1232Campylobacter jejuni in Guillain-Barré 67Canavan’s disease 1207candelabra effect 292candidal meningitis

treatment 345candidiasis

infections in CNS 374shunt infections 346

candle gutteringon myelography in arachnoiditis 458with tuberous sclerosis 725

capillary telangiectasia 1106Capoten® (see captopril)capping (on myelography) 746capsaicin

for diabetic neuropathy 566for painful diabetic neuropathy 797for postherpetic neuralgia 566for trigeminal neuralgia 553

capsular arteries of McConnell 99capsule (disc space)

definition 428captopril 1020caput medusae 1105carbamazepine 411

as cause of myelomeningocele 245as cause of SIADH 9dosing forms 411for deafferentation pain 44for trigeminal neuralgia 552

Carbatrol® 411carbon dioxide

and cerebrovascular vasodilation 880and hyperventilation for ICP control 880and laparoscopic surgery 328

carbon monoxideand basal ganglion abnormalities 1229and leukoencephalopathy 1215and secondary parkinsonism 60encephalopathy 277toxicity 277

carbonic anhydrase inhibitors (see acetazola-mide)

carcinoembryonic antigen 721carcinoid syndrome 680carcinomatous meningitis 711Cardene® (see nicardipine)cardiac catheterization

neurologic complications 800cardiac effects from SAH 1054cardiac output

in hyperdynamic therapy 1052cardiac sympathectomy 545cardiogenic brain embolism 1022

risk on withholding anticoagulation 1128carisoprodol 51carmustine (see BCNU)carotid artery

(see also internal carotid artery)aneurysms (see aneurysms - carotid)

INDEX 1253

carotid artery (cont’d)bruit

with carotid dissection 1163with carotid stenosis 1144

injurygrading 983

plaque morphology 1145stenosis 1144

angiographic criteria 1145asymptomatic 1147

carotid body tumors 679carotid-cavernous fistula 1113

following percutaneous trigeminal rhizotomy 559

from ruptured cavernous carotid aneurysm 1080

carotid compressionAllcock test 1072during angiography

for a-comm a. 1039Huber maneuver 1113Mehringer-Hieshima maneuver 1113

to treat dural AVMs 1110carotid dissection (see internal carotid artery -

dissection)carotid endarterectomy 1150, 1152

and intracerebral hemorrhage 1120, 1156complications 1153emergency 1156indications 1150post op check 1152technique 1154

carotid ring 1070carotid sinus syncope 1199carotid siphon 100carotid stenosis (see internal carotid artery -

stenosis)carotid stenting (for stenosis) (see angioplasty -

for carotid stenosis)carotid tubercle 216carotid-cavernous fistula 1114carotid-vertebrobasilar anastomoses 107carotidynia 79, 1163carpal tunnel syndrome 808

acute 808electrodiagnostic findings 809surgery for 811

CASANOVA study 1149, 1150CAT scan

cisternography for CSF fistula 303definitions 128following myelogram 140following pituitary tumor removal 662following tumor removal 589for head trauma

findings 858follow-up 859indications 859

for stroke 1012in pregnancy 1087in seizures 420

CAT scan (cont’d)in subarachnoid hemorrhage 1037IV contrast enhanced 123lumbosacral 435radiation exposure 127

Cataflam® (see diclofenac)cataplexy (narcoleptic) 1200Catapres® (see clonidine)catch-up phase of brain growth 1136cauda equina syndrome 446, 744

and bladder dysfunction 446differential diagnosis 446following lumbar discectomy 449in ankylosing spondylitis 502with discitis 386

caudal loop of PICA 103caudal regression syndrome 1234causalgia 576causalgia minor 576cavernoma (see cavernous malformation)cavernous angioma (see cavernous malforma-

tion)cavernous carotid artery aneurysm 1079, 1081cavernous malformation 1105, 1106

chiasmal 1109cranial nerve 1109spinal cord 1107treatment 1108

cavernous or capillary hemangioma (see heman-gioma)

cavernous sinusACTH sampling for Cushing’s disease 646anatomy 105aneurysms (see cavernous carotid artery an-

eurysms)carotid-cavernous fistula (see carotid-cavern-

ous fistula)lesions (differential diagnosis) 1219meningiomas 774thrombosis 1167, 1205

cavernous sinus syndromedifferential diagnosis 1204

cavum septum pellucidum 1218and transcallosal surgery 171and traumatic brain injury 912

cavum velum interpositum 1218cavum vergae 1218CBF (see cerebral blood flow)CCF (see carotid-cavernous fistula)CCNU 589

for low grade gliomas 599for malignant gliomas 601for medulloblastomas 687for oligodendrogliomas 611

CeeNU® (see CCNU)cefamandole 342cefazolin

for prophylaxis 342ceftazidime for meningitis 343ceftriaxone for meningitis 343ceiling effect 45, 47

1254 INDEX

Celontin® (see methsuximide)central canal (see central spinal canal)central cord syndrome 948

in cervical spondylosis 488in Chiari malformation 235surgical treatment for 949

central herniation 285and PCA infarction 335CT criteria 285

central liponeurocytoma 612central neurocytoma 612central pontine myelinolysis 11central spinal canal 510central sulcus 84, 84

on axial imaging 85surface anatomy 87

central venous pressureand cerebral salt wasting 9

centripetal fat (in Cushing’s syndrome) 638cephalhematoma 918cephalocele 232cerebellar astrocytoma (pilocytic) 604cerebellar ataxia 1201cerebellar clamp 841cerebellar diaschisis 74cerebellar hemorrhage

etiologies 1122following supratentorial craniotomy 147,

1122presentation 1124relative frequency 1119treatment

guidelines 1130surgical technique 1130

cerebellar infarction 1021surgery for 1021

cerebellar lesionsdifferential diagnosis 1209

cerebellar liponeurocytoma 613cerebellar syndromes 586cerebellopontine angle (CPA) lesions 1210

cystic CPA lesions 1211meningioma

surgery 619meningioma vs. vestibular schwannoma 1211vestibular schwannoma 620vestibular schwannoma vs. meningioma 1211

cerebral abscess 350treatment 353

cerebral amyloid angiopathy (see amyloid - amy-loid angiopathy)

cerebral angiography (see angiography - cerebral)cerebral arterial anatomy 97cerebral arterial dissections 1160

from spinal manipulation 438cerebral autoregulation 1010Cerebral Autosomal Dominant Arteriopathy with

Subcortical Infarcts and Leukoencephal-opathy (CADASIL) 80

cerebral blood flow 1010in moyamoya disease 1172

cerebral blood flow (cont’d)in normal pressure hydrocephalus 333in trauma patients 881

regional monitoring 875in vasospasm 1047

cerebral blood volume 867, 880cerebral edema (see edema - cerebral)cerebral embolism (see embolism - cerebral)cerebral hemorrhage (see intracerebral hemor-

rhage)cerebral hyperperfusion syndrome 1153cerebral infarct (see stroke)cerebral ischemia 1062cerebral metabolic rate of oxygen consumption

(CMRO2)and cerebral protection 1062normal values 1010

cerebral metastases 702(also see metastases - cerebral)

cerebral microdialysis 875cerebral perfusion pressure 866

thresholds in trauma 876cerebral protection during surgery 1062cerebral radionuclide angiogram (CRAG) 291

hollow skull sign 292cerebral salt wasting 7, 13

with SAH 1043cerebral vasospasm (see vasospasm)cerebral venous anatomy 104, 105cerebrospinal fluid 297

absorption 297artificial 300conductance 332constituents 297differentiating from urine 316findings with parameningeal infection 379fistula 300

diagnostic tests 302following a procedure

anterior cervical discectomy 465lumbar puncture (LP) 58p-fossa crani 158transsphenoidal surgery 305unintended durotomy 449, 451vestibular schwannoma surgery 630

nontraumatic 301spinal 305

posttraumatic 301, 889pseudo-CSF rhinorrhea 302rhinorrhea (see cerebrospinal fluid - rhin-

orrhea below)spontaneous 300with pituitary adenoma 635, 637

bromocriptine-induced 637with spontaneous intracranial hypoten-

sion 305flow study (for Chiari malformation) 236impedance 332in Guillain-Barré 67in multiple sclerosis (MS) 64, 300in neurosarcoidosis 71in SAH 298, 1037

INDEX 1255

cerebrospinal fluid (cont’d)metastases of primary CNS tumors 702otorrhea 300pleocytosis following status epilepticus 404pressure 297production 297protein 299

and VP shunt 1137in pathologic conditions 299SAH vs. traumatic tap 298variation with age 299

rhinorrhea 300following bromocriptine therapy for pitu-

itary adenoma 651following vestibular schwannoma surgery

631nontraumatic 301with empty sella syndrome 719with pituitary tumors 635

shunts 315solutes 298specific gravity 297

cerebrovascular accident (see stroke)cerebrovascular anatomy 96cerebrovascular occlusion syndromes 1027cerebrovascular reserve/reactivity 1011cerebrovascular resistance 1010cerebrovascular venous thrombosis 1166Cerebyx® (see fosphenytoin)cervical bar 485cervical collar

after trauma 938for whiplash 931

cervical disc herniation 440, 461shoulder abduction test 462traumatic 461

cervical discectomywith arthroplasty 467

cervical lateral mass screwsC1 185C2 187C3-6 188C7 190

cervical myelopathy (see cervical spondylotic myelopathy)

cervical radiculopathy 461differential diagnosis 1197

cervical rib 823cervical spine

cervical sprain 931clearing after trauma 938compression injuries 970extension injuries 974facet fractures 976flexion injuries 970follow-up schedule 979fractures

surgical treatment 977herniated disc 440, 461lateral mass fractures 976ligamentous injuries

cervical spine (cont’d)MRI findings 941

spondylosis 485differential diagnosis 1196

stenosis 485radiologic criteria 136, 489

surface landmarks (levels) 89whiplash injuries 931x-rays 135

flexion-extension 940indications after trauma 938

cervical spondylotic myelopathy 486differential diagnosis 489evaluation 489treatment 490

cervical tractioncausing subdural empyema 357for hangman’s fracture 962for locked facets 973Gardner-Wells tong placement 942in basilar impression 497in rheumatoid arthritis 497

atlantoaxial subluxation 496with halo for trauma 942

cervical transarticular screw fixation 189cervical translaminar screw fixation 189cervicomedullary angle 497cervicothoracic orthoses 979chalk-stick fracture 503Chamber’s rule 706Chamberlain’s line 135, 139Chance fracture 987Charcot’s joints 512Charcot-Bouchard aneurysms 1122Charcot-Marie-Tooth syndrome 793

as cause of foot drop 1196use of sural nerve biopsy 214

Chassaignac’s tubercle 216chemical hemostasis 146chemodectoma 678chemonucleolysis 447

and myelitis 69chemotherapy 589

for cerebral metastases 708for chordoma 677for CNS lymphoma 675for low grade gliomas 599for malignant astrocytomas 601

alkylating agents 601for oligodendrogliomas 611intraarterial 589, 601methotrexate for CNS lymphoma 675"PCV" therapy 599, 611

Cheyne-Stokes respirations 282Chiari malformation 233

and C1-2 puncture 205Chiari zero malformation 236type 1 233

and hydrocephalus 234and spinal cord injury 975and syringomyelia 234

1256 INDEX

Chiari malformation - type 1 (cont’d)following lumbar puncture 203from LP shunt 317sports restrictions 851surgical treatment 236tonsillar herniation 236

type 2 238and hydrocephalus 238

chiasmal cavernous malformations 1109chiasmal syndrome 614chiasmopexy 719child abuse 918

and chronic extra-axial fluid collections 905and interhemispheric subdural hematoma 898

children’s coma scale 279chloramphenicol

for cerebral abscess 354chlordiazepoxide 52

for ethanol withdrawal 274for ethanol withdrawal seizures 399

chloroma 729, 1186chlorpromazine

for hiccups 34for nausea 50

chlorpropramideas a cause of SIADH 9for diabetes insipidus (DI) 18

chlorzoxazone 50cholesteatoma (see epidermoid tumor/cyst)cholesterol granuloma 689choline (Cho) on MRS 133chorda tympani 844chordoma 675

cranial 676foramen magnum

differential diagnosis 1212spinal

differential diagnosis 728, 1231sacral 676

choriocarcinoma 691, 721chorionic gonadotropin 721choristoma (see pituicytoma)choroid glioma of the 3rd ventricle 696choroid plexectomy 314choroid plexus

calcification of 1223coagulation of 314tumors 695, 1225

as cause of hydrocephalus 311, 696choroid plexus papilloma 695

atypical 695choroidal point of PICA 103chromogranin 721chronic brain injury scale 912chronic dysimmune neuropathy 1188chronic granuloma of the orbit 837chronic immune demyelinating polyradiculo-

neuropathy (CIDP) 68chronic low back pain 440chronic lymphocytic leukemia

and PML 364

chronic subdural hematoma (see subdural he-matoma - chronic)

chronic traumatic encephalopathy 60, 911Churg-Strauss syndrome 78Chymodiactin® (see chymopapain)chymopapain 447Cibacalcin® (see calcitonin)CIDP (see chronic immune demyelinating

polyradiculoneuropathy)ciliospinal center of Budge 830ciliospinal reflexes 284cimetidine

drug-drug interactioncarbamazepine 412

for contrast media reaction 125for iodine contrast prep 124

Cincinnati stroke scale (see NIH stroke scale)cingulate herniation 284cingulotomy 567CIP (see critical illness polyneuropathy)Circle of Willis 97, 97circular sinus 105cisatracurium 4, 27cisplatinum for astrocytomas 601cisternal tap 205cisternogram (see radionuclide cisternography)cisterns

basal (see basal cisterns)posterior fossa 1085

clasp thumbs 308clasp-knife resistance 786class I, II & III evidence ivclassic migraine 57Claude syndrome 1027claudication

arm 75neurogenic vs. vascular 477of jaw 75

claw deformity 802, 813clay shoveler’s fracture 969clazosentan 1049CLEAR-IVH trial 1130Cleocin® (see clindamicin)clindamicin

for toxoplasmosis 367clinic visit schedule

cervical spine 979post-op lumbar fusion 440

Clinoril® (see sulindac)clips, aneurysm (see aneurysm clips) 131clival fractures 889clodronate 501clofibrate 661

for diabetes insipidus (DI) 18clonazepam 415clonidine 21

clonidine suppression test 679for alcohol withdrawal syndrome 274

clopidogrel 38, 1147dosing forms 1147reversal of platelet inhibition 38

INDEX 1257

clorazepate 52close lipped schizencephaly 244closed head injury (see trauma - head)Cloward

anterior cervical discectomy 467club foot 255clubbing of the feet

in lipomyelomeningocele 251club-shaped conus medullaris 1234clumsy hand

dysarthria-clumsy hand syndrome 1026numb-clumsy hand syndrome 488

cluneal nerves 200cluster breathing 282cluster headache 58

treatment 58deep brain stimulation 575

CMV (see cytomegalovirus)CO2 (see carbon dioxide)coagulopathies 40

elevated PTT pre-op 41hypercoagulable states and strokes 1025reversal of anticoagulants 40use of ICP monitor in 869

Coats disease 1218Cobb angle 430

for kyphosis 430for scoliosis 430

cocaineand cerebral vasculitis 79and fetal microcephaly 245and fetal neural defects 245and intracerebral hemorrhage 1121, 1132and spontaneous subdural hematoma 902and status epilepticus 403and stroke 1025and subarachnoid hemorrhage 276and the nervous system 276in diagnosing Horner’s syndrome 833

coccidiomycosis 374coccydynia 516

coccygectomy for 517cock robin head position 956Cockcroft-Gault equation (creatinine clearance)

46codeine 47Codman Hakim programmable shunt valve 320Codman shunts 320Cognard grading of dural AVMs 1110coils, electrolytically detachable

for aneurysms 1059for carotid-cavernous fistula 1114for dural AVMs 1110stent assisted coiling 1060

colchicinefor low back pain 438

collagen (for bone grafting) 200collagen scar 352collateral circulation 1027

with internal carotid artery occlusion 1027with vertebrobasilar occlusion 1027

Collet-Sicard syndrome 115Collins’ law 605collision tumors 610collodion

for CSF leak 158colloid cyst 665

differential diagnosis 1224treatment 666

transcallosal approach 169coloboma 232coma 279

approach to patient 281barbiturate 883definition 279differential diagnosis 280from infratentorial mass 285from subarachnoid hemorrhage 1036from supratentorial mass 284hypoxic 287pseudocoma 281scales

children's 279Glasgow 279

combined system disease 1187, 1191commissural myelotomy 570common migraine 57common peroneal nerve

anatomy 820entrapment (see peroneal nerve - palsy)

communicating hydrocephalus 307Compazine® (see prochlorperazine)compensated hydrocephalus 309complete spinal cord injuries 948complex regional pain syndrome 576

following lumbar laminectomy and discecto-my 450, 1197

spinal cord stimulation for 574upper extremity 1197

following anterior cervical discectomy 466

following brachial plexus gunshot wound 803

following carpal tunnel surgery 812complex repetitive discharge on EMG 270complications

latefollowing cervical decompression 493following GSW to the brain 913following spinal cord injury 1000following traumatic brain injury 910

related toanterior cervical discectomy 465autograft procurement 199carotid endarterectomy 1153carpal tunnel surgery 812cervical decompression 493chronic subdural hematoma evacuation

902cingulate gyrus retraction 1068cranial-cervical traction for spine trauma

943

1258 INDEX

complications - related to (cont’d)craniotomy 148femoral arterial catheterization 800hyperdynamic therapy 1053ICP monitors 869lumbar drainage for suboccipital pseudo-

meningocele 158lumbar laminectomy 449lumbar puncture 203mannitol for ICP management 882posterior fossa craniectomy 157pregnancy and seizures 419sitting position 153stellate ganglion block 215suboccipital craniectomy for Chiari mal-

formation 237surgical treatment for cervical spine frac-

tures 978third ventriculostomy 315transcallosal approach 171transsphenoidal surgery 659ventricular CSF shunts 334vertebroplasty/kyphoplasty 995

compound skull fracture (see skull fractures - compound)

compression fracturecervical compression flexion fracture 970thoracolumbar 987

in osteoporosis 992treatment 988

compression of pituitary gland 634compression palsy 804

(also see entrapment neuropathies)(also see hereditary neuropathy with liability

to pressure palsies)computed tomography angiography (CTA)

for carotid stenosis 1146concentric sclerosis of Balo 64Concorde position 153concussion 850

admission criteria 857definition 850grading 851multiple 852postconcussive syndrome 910second impact syndrome 851sports related 850

return to play guidelines 851conduction aphasia 114conductive hearing loss 848condylar fracture (see fractures - occipital

condyle)condylar gap 953condyle screws (see occipital condyle screws)confusion

following concussion 850in delerium 56

congenital brain tumors 697congenital conditions (see developmental anoma-

lies)congenital hypermelanosis 1207

congestive heart failureand mannitol 862

congophilic angiopathy 1122conivaptan 13conjoined nerve root 256, 1189conjunctival injection

with SUNCT 549conservative treatment for back pain 437constitutional ventriculomegaly 1206contained (disc) herniation 429contour lines (on lateral C-spine x-ray) 135contralateral gaze 112contrast agents

and migraine H/A 57in neuroradiology 122inadvertent intrathecal injection of ionic

agents 122iodinated 124

allergy prep 124renal insufficiency prep 124

ionic agents 122reactions (allergies) 125

contrast-induced nephropathy 124contrecoup brain injury 852contusio cervicalis posterior 951contusion

cerebral 852, 857, 893spinal cord 975

conus medullarisclub-shaped 1234lesions 744normal location in adult 202, 945vascular malformations of 508

conversion factorsACTH (corticotropin) 638cortisol 638mm Hg to cm water 870

Cooley’s anemia 43copular point of PICA 103cord sign 1168cordectomy

for spasticity 539for syringomyelia 514

Cordis shunt 320cordotomy 568, 575

open (Schwartz technique) 569percutaneous 568sacral 568

corduroy pattern of hemangiomas 738core neuro exam (for coma) 282corneal mandibular reflex 838corneal reflex 289coronal suture

estimating position 208relative to lateral ventricles 88relative to motor strip 87synostosis of 230

coronal synostosis 230coronary angiography/angioplasty as cause of pe-

ripheral neuropathy 800corpectomy (see vertebral corpectomy)

INDEX 1259

corpus callosumagenesis 246callosotomy 170, 422

for Lennox-Gastaut syndrome 396in hydrocephalus 310, 312lesions (differential diagnosis) 1215

corset brace 988cortical blindness 335

due to vascular encephalopathy 73following head injury 855in Creutzfeldt-Jakob disease 362

cortical stimulation 152cortical surface anatomy 84cortical vein sign 308cortical venous thrombosis 1166corticosteroids (see steroids)corticotropin 110, 634

ectopic secretion 639endocrinology of 111reserve post-op 661

corticotropin-releasing hormone (CRH) 110ectopic secretion 638stimulation test 646

cortisolreplacement therapy 31serum levels

after transsphenoidal surgery 661with cosyntropin stimulation test 647with dexamethasone suppression test 646with insulin tolerance test 647with pituitary tumors 643

urine free cortisol 643(see also hydrocortisone)

cortisone 31Cortone® (see cortisone)Cortrosyn® (see cosyntropin)costotransversectomy 175, 472

for spinal metastases 748cosyntropin stimulation test 647

following pituitary surgery 661for stress dose steroids 32

cough effect, with radiculopathy 443Coumadin® (see warfarin)counting levels in spine surgery 173coup de poignard of Michon 508coup-contrecoup brain injury 852coupling ratio 1010Cowden syndrome 593CPA (see cerebellopontine angle)crack cocaine (see cocaine)CRAG (see cerebral radionuclide angiogram)Cram test 444cramps (night) 51cranial arteritis (see giant cell arteritis)cranial foramina 89cranial nerves

palsies of (see cranial neuropathy)sensitivity to radiation 776

cranial neuropathydifferential diagnoses 1202due to unruptured aneurysm 1056

cranial settling 138cranialization of the frontal sinus 890craniectomy

decompressive 165for head trauma 880for MCA infarction 1022suboccipital

for cerebellar hemorrhage/infarction 1021for cerebellar infarction 1021

techniques 165timing after trauma 893

headache following 149suboccipital 152temporal 162, 163

craniocerebral disproportion 327, 904craniocervical junction

ligaments of 91craniocervical junction abnormalities 494

traumatic dislocation 951craniofacial development 228craniofacial dysmorphic syndromes 231craniofacial fractures 889craniofacial pain syndromes 549

differential diagnosis (etiologies) 549craniolacunia 239craniometric points 86craniopharyngioma 663

intraventricular 1225juxtasellar 1216

cranioplasty 173for hyperostosis frontalis interna 701to avoid post-craniotomy headache 149, 157

craniorachischisis 243craniostenosis 228craniosynostosis 228

and Chiari I malformation 234and microcephaly 245following CSF shunting 328from CSF shunt 325

craniotomyawake 150decompressive

suboccipital 152frontal 163headache following 149infection 349modified pterional 1075occipital 164posterior fossa 152post-op hematoma 147, 1121pterional 159temporal 162types 146

cranium bifidum 232crash migraine 1035CRASH syndrome 308CRD (see complex repetitive discharge)C-reactive protein

and cerebral abscess 352and giant cell arteritis 76and vertebral osteomyelitis 382

1260 INDEX

C-reactive protein (cont’d)in postoperative discitis 387normal values after craniotomy 349normal values after spine surgery 387

creatine (Cr) on MRS 133creatinine (serum) and iodine dye 124creatinine clearance - Cockcroft-Gault equation

46cremasteric reflex 946

in spinal cord injury 936crescendo TIA 1156crescent sign 1162Creutzfeldt-Jakob disease 361

differential diagnosis 363EEG findings 266

CRH (see corticotropin-releasing hormone)critical care 7critical illness myopathy 68critical illness polyneuropathy 794Crohn’s disease

and psoas abscess 378crossed adductors 444crossed cerebellar diaschisis 74crossed dominance 423crossed straight leg-raising test 444Crouzon’s syndrome 230, 232

and intracranial hypertension 326CRP (see C-reactive protein)cruciate ligament 91, 92cruciate paralysis 1196

from atlantooccipital dislocation 951cryoprecipitate 36cryptic cerebrovascular malformations 1105cryptococcal involvement of the CNS 374

cryptococcal meningitis 374associated intracranial hypertension 374in AIDS patients 366management 374

CSF (see cerebrospinal fluid)CSF leak (see cerebrospinal fluid - fistula)CT angiography (CTA)

following aneurysm treatment 1066for stroke 1013technical information 128

CT perfusiontechnical information 128

CT scan (see CAT scan)CTA (see CT angiography)cubital tunnel syndrome 813cultures

for discitis 388cuneus 86cupulolithiasis 840, 842Cushing’s disease 634

biochemical cure criteria 662inferior petrosal sinus sampling for ACTH

646management 654

Cushing’s syndrome 638and osteoporosis 993

Cushing’s syndrome (cont’d)and spinal epidural lipomatosis 516clinical findings 638iatrogenic 33medical therapy 654pseudo-Cushing’s state 646stereotactic radiosurgery for 654transsphenoidal surgery for 654

Cushing’s triad 868, 1122Cushing’s ulcers 878cutoff sign 1014CVA (see stroke)cyanide toxicity from nitroprusside 19cyanocobalamin (see vitamin B12)cyanotic heart disease

and cerebral abscess 350cyclobenzaprine 50cyclooxygenase 44cyclosporine

for neurosarcoidosis 72Cyklokapron® (see tranexamic acid)cyproheptadine 655cyproheptadine (for intrathecal baclofen with-

drawal) 541cyst

arachnoidintracranial 222, 224spinal 225

associated with gliomas 596cerebellopontine angle (CPA) 1211colloid 665dermoid and epidermoid

spine 252enterogenous (see neurenteric cyst)ependymal 1225neurenteric 227

cerebellopontine angle (CPA) 1210spinal 1185

pineal 691posttraumatic leptomeningeal 892spinal

ganglion 456juxtafacet 456meningeal 509pilonidal 252synovial 456

with cerebellar (pilocytic) astrocytoma 605cystic cerebellar astrocytoma 605cystic medial necrosis 1161cysticercosis (see neurocysticercosis)cystometrogram 119

in cauda equina syndrome 446cystourethrogram 119Cytadren® (see aminoglutethimide)cytokeratin stain 720cytomegalovirus

and nerve root enhancement 1234encephalitis 364

Cytotec® (see misoprostol)cytotoxic cerebral edema 109, 883

INDEX 1261

Ddabigatran 39dacarbazine

for metastatic malignant melanoma 705Dalmane® (see flurazepam)dalteparin 40

reversal with protamine sulfate 41danaparoid 40Dandy Walker malformation 240, 311Dandy’s point 207Dandy’s syndrome 841Dantrium® (see dantrolene)dantrolene 5

for spasticity 537dapsone

and peripheral neuropathy 68, 797Daraprim® (see pyrimethamine)Darvon®, Darvocet® (see propoxyphene)Dawson’s fingers on MRI in MS 64Daypro® (see oxaprozin)DBS (see deep brain stimulation)DDAVP® (see desmopressin)D-dimer 43de Morsier syndrome (see septo-optic dysplasia)de Quervain’s syndrome 809deafferentation pain

following lumbar laminectomy 457deafness 848

in Chiari malformation 235in Klippel-Feil syndrome 254in Paget’s disease 499(see also hearing loss)

Decadron® (see dexamethasone)decerebrate posturing 280, 284decompressive cervical laminectomy 492decompressive craniectomy (see craniectomy -

decompressive)decorticate posturing 279, 284dedifferentiation of astrocytomas 595deep brain stimulation 532

for pain 574for parkinsonism 534for seizures 422

deep tendon reflex (see muscle stretch reflex)deep-vein thrombosis

in neurosurgical patients 42in severe TBI 907in spinal cord injuries 937

degenerated lumbar disc 429degenerative disc disease 474

and smoking 475definition 429MRI findings 435

Dejerine-Roussy syndrome 1026delayed acute subdural hematoma 899delayed cervical instability 982delayed deterioration

after back surgery (discitis) 458after head injury 854

delayed deterioration (cont’d)after spinal cord injury 1000after transsphenoidal surgery 660with cryptococcal meningitis 374

delayed epidural hematoma 896delayed ischemic neurologic deficit (DIND) 1045delayed onset muscle soreness 478delerium 56

with meperidine 275delerium tremens 275delta sign 1168Deltasone® (see prednisone)demeclocycline

for SIADH 13dementia 56

due to vitamin B12 deficiency 1187following radiation therapy 708, 771in ALS 66in NPH 329parkinson-dementia complex of Guam 60posttraumatic 910

dementia pugilistica 911risk factors 912

Demerol® (see meperidine)demineralized bone matrix 199demyelination

in Charcot-Marie-Tooth 793in chronic immune demyelinating polyradicu-

loneuropathy (CIDP) 68in diabetic amyotrophy 796tumefactive demyelinating lesions 64

Denis’ 3 column model of the spine 986denosumab 994dens (see odontoid process)dentate ligament 108dentocentral synchondrosis 137

in pediatric trauma 932, 933Denver grading scale 983Depacon® 413Depakene® (see valproate)Depakote® 413

(see also valproate)Depo-Medrol® (see methylprednisolone)depressed skull fractures 885depression

in NPH 330depth electrodes

for seizure surgery 421dermal sinus 252

cranial 253spinal 252

dermatomesdiagram of 94table of 946

dermoid tumor/cystand dermal sinus 252intracranial 688intraventricular 1225skull 699spinal 729

following myelomeningocele closure 250

1262 INDEX

descending evoked potentials 267desflurane 2desipramine

as analgesic adjuvant 548for painful diabetic neuropathy 797side effects 797

desmoplastic infantile astrocytoma/ganglioglio-ma 612

desmopressinfollowing pituitary surgery 661for diabetes insipidus (DI) 17, 18for hemophilia A 41for thrombocytopenia 35for vasospasm 1051for von Willebrand’s disease 41preparations 17

destructive spondyloarthropathy in renal failure 1233

Desyrel® (see tranzodone)deterioration following craniotomy 148detrusor muscle

areflexia 117hyperreflexia 117

developmental anomalies 222Devic syndrome 1187dewlap tumor (in Cushing’s syndrome) 638DEXA scan 992

for interspinous process decompression 482dexamethasone 31

following seizure surgery 424for brain tumor 588for cerebral metastases 708for cysticercosis 372for gunshot wound to head 914for head trauma 883for headaches with intracranial hypotension

59for high altitude cerebral edema 917for intracerebral hemorrhage 1127for pseudotumor cerebri 717for SAH 1042for spinal metastases 745for stroke 1020post craniotomy 148suppression test

high-dose 646overnight 646

dexmedetomidine 25for awake craniotomy 151in neuroanesthesia 3

dextranand impaired coagulation 1042

dextroscoliosis 430DI (see diabetes insipidus)diabetes insipidus 15

following brain death 294following craniopharyngioma surgery 664following head injury 864following transsphenoidal surgery 661following transtentorial herniation 285from pituitary apoplexy 636

diabetes insipidus (cont’d)from suprasellar germ cell tumor 693, 1216in neurosarcoidosis 71in Wegener’s granulomatosis 78with ACoA aneurysm 1066with basal skull fractures 889with pituitary adenoma 635

diabetic amyotrophy 796diabetic autonomic neuropathy 117, 119, 796diabetic neuritis 478diabetic neuropathy 796diabetic plexus neuropathy 796Diabinese® (see chlorpropramide)Diamox® (see acetazolamide)Diastat® (see diazepam - rectal)diastatic fractures 885diastematomyelia 256diathermy

for low back pain 439diatrizoate meglumine 123diazepam 52

for autonomic hyperreflexia 1001for ethanol withdrawal 274for Meniere’s disease 843for muscle spasms 51for spasticity 537for status epilepticus 405rectal (for status epilepticus) 405

Dibenzyline® (see phenoxybenzamine)Dickman and Sonntag fusion technique 187diclofenac 45didanosine 798Didronel® (see etidronate)diencephalic syndrome 606differential diagnosis 1185

abducens palsy 836amaurosis fugax 1204anisocoria 831ankylosing spondylitis 502anosmia 1202anterior horn cell disease 787aphasia 1208apoplexy 1199arachnoid cysts 1217ataxia 1201atlantoaxial subluxation 1230atlantodental interval, increased 1230axis (C2) lesions 1231Babinski sign 116back pain 1192balance problems 1201basal ganglion abnormalities 1228bladder dysfunction 117blindness

binocular 1204monocular 1204

brachial plexopathy 794burning hands syndrome 1198by location 1209by signs and symptoms 1185calcifications (intracranial) 1223

INDEX 1263

differential diagnosis (cont’d)carpal tunnel syndrome 809cauda equina syndrome 446cavernous sinus lesions 1219cerebellar lesions 1209cerebellopontine angle (CPA) lesions 1210cerebral metastases 707cervical radiculopathy 1197chordomas

cranial 676foramen magnum 1212

comametabolic 280structural 280

corpus callosum lesions 1215cranial nerve palsies 1202craniofacial pain (etiologies) 549Creutzfeldt-Jakob disease 363cysts

CPA 1211intraspinal 1234supratentorial 1217

diabetes insipidus (DI) 15diffuse demineralization of the skull 1221diplopia 1201dizziness 840drop attacks (see apoplexy)dural enhancement 1227DWI-MRI bright signal 132encephalocele 1230encephalopathy 266, 1199enhancing nerve roots 1234enlarged cisterna magna 1217ependymal enhancement 1227exophthalmos 1205extra-axial fluid collections in children 904extraforaminal disc herniation 454facial diplegia 1204facial nerve palsy 844facial sensory changes 1208fasciculations 1196femoral neuropathy 798, 1190first dorsal interosseous atrophy/weakness

1197foot drop 1195foot drop (etiologies) 1195foramen magnum lesions 1212foramen magnum tumors 711giant cell arteritis 75Guillain-Barré syndrome 68gyral enhancement 1013hand atrophy/weakness 1196headache 57headache of sudden onset 1035hemiparesis/hemiplegia 1191hydrocephalus 311hyperdensities on brain CT 128hyperpigmentation 639increased CSF signal on FLAIR MRI 130infratentorial masses causing coma 285

differential diagnosis (cont’d)internuclear ophthalmoplegia (INO) - etiolo-

gies 834intracranial cysts 1217intracranial/extracranial lesions 1223intramedullary spinal cord tumor 731intraspinal cysts 1234intraventricular lesions 1224ivory bone 1233L4 radiculopathy 1190L5 radiculopathy 1195language disturbance 1208lateral disc herniation 454leukoencephalopathy 1214Lhermitte’s sign 1198lipomas (intracranial) 225localized increased density of calvaria 1222low back pain 1192low density lesion in AIDS 366low density on CT 1214lumbar spinal stenosis 478lumbosacral plexus neuropathy 795lytic skull lesions 1220macrocephaly 1206macrocrania 1206medial temporal lobe lesions 1228Meniere’s disease 842meningeal thickening/enhancement 1227meningioma 616meralgia paresthetica 819metastases (cerebral) 707midline intracranial cavities 1218multiple cranial neuropathies 1202multiple intracranial lesions 1212multiple sclerosis 62multiple strokes 1023, 1213myelopathy 1185nasal/intracranial lesions 1229neck pain 1197nerve root enhancement 1234neurosarcoidosis 72new onset of focal deficit 1011nodular enhancing intraspinal lesions 1234normal pressure hydrocephalus 330occipital neuralgia 805oculomotor palsy 834ophthalmoplegia 834

painful 836orbital lesions 1218osteoid osteoma 736osteolytic skull lesions 1220painless ophthalmoplegia 837papilledema (unilateral) 829paraplegia 1190parasellar lesions 1215Parinaud’s syndrome 115Parkinson’s disease 60paroxysmal headache 1035pathologic lid retraction 1206perioral numbness 1208

1264 INDEX

differential diagnosis (cont’d)periventricular enhancement 1227periventricular lesions 1226peroneal nerve palsy 1195petrous apex lesions 1211pineal region tumors 691pituitary tumors 1215posterior fossa CSF collections 240posterior fossa lesions 1209proptosis 1205pseudocoma 281pseudotumor cerebri 716pseudotumor of the orbit 1205, 1219ptosis 1205quadriplegia 1190radiculopathy

lower extremity 1188upper extremity 1197

retinal hemorrhage 919ring enhancing lesions 1214S1 radiculopathy 1190sacral lesions 1233sarcoidosis 72sarcoidosis of the orbit 1219schizencephaly 243sciatica 1188seizures (new onset) 396sellar/parasellar lesions 1215septum pellucidum, absence of 247shoulder pain 1197skull

calvarial thickening 1221diffuse demineralization 1221diffuse increased density 1221"hair-on-end" 1222hyperostosis 1221increased density of calvaria 1222increased density of skull base 1222lesions of 1219lucencies (approach) 1220lytic lesions 1220

slit ventricles 326spinal cord tumors 728spinal epidural abscess 377spinal epidural masses 1185spinal tumors

primary 1186SSPE 266status epilepticus 403subarachnoid hemorrhage (SAH) on CT 1037subependymal enhancement 1227supraorbital neuralgia 563suprascapular nerve entrapment 818suprasellar/parasellar lesions 1215supratentorial masses causing coma 285swallowing difficulties 1209syncope 1199synovial cyst (spinal) 456syringomyelia

etiologies 510other conditions 510

differential diagnosis (cont’d)thalamic lesions 1229thoracic outlet syndrome 823tinnitus 1207torticollis 541transient neurologic deficit 1200trigeminal neuralgia 552upgaze palsy 115upper extremity weakness 1196urinary retention 118ventricular lesions 1224vertebral body abnormalities 1231vertebral hyperostosis 1233vertebral osteomyelitis 1233vertigo 840Wegener’s granulomatosis 78white matter lesions 1214

diffuse astrocytoma (Grade II) 595diffuse axonal shearing/injury

definition 853diffuse idiopathic skeletal hyperostosis (DISH)

506diffusion tensor tractography MRI 134diffusion-perfusion mismatch 133diffusion-weighted imaging (DWI-MRI) 132

diffusion-perfusion mismatch 133trace image 132

Diflucan® (see fluconazole)diflunisol 45DIG (see desmoplastic infantile astrocytoma/gan-

glioglioma)digastric line 139, 139digit agnosia 113digital subtraction angiography (see angiogram)Dilantin® (see phenytoin)dilated pupil (see pupillary dilatation)Dilaudid® (see hydromorphone)dimple in wall of lateral ventricle (in schizen-

cephaly) 244dimple of Venus 200diphenhydramine

for contrast media reaction 125for inadvertent intrathecal ionic contrast 122for iodine contrast allergy prep 124

diplomyelia 256diplopia 1201

from abducens palsy 586, 836Diprivan® (see propofol)dipyridamole

for strokes 1146dipyridamole in Aggrenox® 1147direct carotid-cavernous fistula 1113direct fistula 1098disability index

cervical spineNeck Disability Index 487Nurick 505

low back pain 430disabling positional vertigo 840, 842Disalcid® (see salsalate)disc, intervertebral (see intervertebral disc)

INDEX 1265

discitis 383and spinal epidural abscess 376avascular 387postoperative 386spontaneous 386

discogenic pain 436, 475discography 436

as an indicator for lumbar fusion 434for extreme lateral disc herniation 454

disco-ligamentous complex 968disconnection syndrome 423

following transcallosal surgery 170DISH (see diffuse idiopathic skeletal hyperosto-

sis)dissecting aneurysms (see dissection, arterial)dissection, arterial 1160

aortic 1192with cocaine abuse 276

internal carotid 1162vertebral 1163

disseminated intravascular coagulationand malignant hyperthermia 5from intrathecal baclofen withdrawal 540in trauma 863

dissociated sensory loss 235, 511in amyloid neuropathy 800with anterior cord syndrome 950with Brown-Séquard syndrome 950with intramedullary spinal cord tumors 732

distal dural ring 99distraction flexion fracture

cervical 971thoracolumbar 987, 988

dizziness 840DLIF (see extreme lateral lumbar interbody fu-

sion)DNT or DNET (see dysembryoplastic neuroepi-

thelial tumors)dobutamine 22

for cerebral vasospasm 1052for neurogenic pulmonary edema 28for neurogenic stunned myocardium 1054for vasospasm 1051

Dobutrex® (see dobutamine)dolichobasilar ectasia (see basilar artery - basilar

dolichoectasia)dolichocephaly 229

following CSF shunting 328doll’s eyes (see oculocephalic reflex)Dolobid® (see diflunisol)Dolophine® (see methadone)dome-to-neck ratio (for aneurysm coiling) 1059domino connector 191DOMS (see delayed onset muscle soreness)dopamine

for hypotension (shock) 22for vasospasm 1051

dopamine agonistsfor acromegaly 653for prolactinoma 651

duration of treatment 652

dopplertranscranial

for brain death 292for vasospasm 1048, 1050

ultrasound for carotid stenosis 1145Dorello’s canal 838dorsal column stimulation 572dorsal rhizotomy 538dorsal root entry zone (DREZ) lesions 575

for postherpetic neuralgia 567dorsal scapular nerve 792dorsiflexion-eversion test (for tarsal tunnel) 822dorsolateral fasciculus (of Lissauer) 93Dostinex® (see cabergoline)double lumen sign 1162double-crush syndrome 809Down syndrome

and amyloid angiopathy 1123and atlantoaxial subluxation 183, 498, 1230and basilar impression 139and moyamoya disease 1171

downbeat nystagmus 235, 828doxacurium 25doxepin

as analgesic adjuvant 548dressing apraxia 113DREZ (see dorsal root entry zone lesions)drop attacks

atonic seizures 394differential diagnosis (see apoplexy)in Lennox-Gastaut syndrome 396in Meniere’s disease 842with colloid cysts 665with vertebrobasilar insufficiency 1158

drop metastases 702with ependymomas 682with medulloblastoma 686with pineal region tumors 692(see also metastases - spinal seeding)

drop mets/metastases (see metastases - spinal seeding)

droperidol 571drug-eluting stents

cardiac 38drug-induced neuropathy 797drusen 716, 1219dry eye 844DSA (digital subtraction angiography) (see an-

giogram)DTs (see delerium tremens)DTT (see diffusion tensor tractography MRI)dual energy x-ray absorptiometry 992Duane syndrome 838Dublin measure

for atlantooccipital dislocation 953dumbbell tumors 735Duract® (see bromfenac)Duragesic® (see fentanyl)dural AVM

intracranial 1109spinal 507

1266 INDEX

dural enhancementdifferential diagnosis 1227

dural ringdistal 99proximal 99

dural sinus thrombosis 1166and idiopathic intracranial hypertension

(pseudotumor cerebri) 716in transcallosal surgery 172

dural tailwith meningioma 617with pleomorphic xanthoastrocytoma 592

dural tear (see durotomy - unintended)Duramorph® 571Duret hemorrhages 285durotomy

to remove herniated disc 447unintended 449, 450

with surgery for lumbar stenosis 484DVT (see deep-vein thrombosis)DWI (see diffusion-weighted imaging (MRI)Dyazide® (see hydrochlorothiazide)dyes

contrast agents in neuroradiology 122intraoperative 144

dynamic cerebral angiographyfor bow hunter’s stroke 1160

dynamic Hoffman’s sign 488dysarthria

following pallidotomy 536following thalamotomy 532in ALS 66

dysembryoplastic neuroepithelial tumors 591dysgeusia (with hyponatremia) 9dysphagia

due to DISH 506following ACDF 466from ossification of the anterior longitudinal

ligament 506from radiation therapy 773in ALS 66in Chiari type 2 malformation 239

dysphasiafollowing stereotactic biopsy 600with brain tumors 586

dysplastic gangliocytoma of cerebellum 593dystonia

torticollis 541treatment - surgical 536

EEagle’s syndrome 1198ε-aminocaproic acid (see epsilon-aminocaproic

acid)early draining vein 134, 597early surgery for aneurysms 1060Eastern Association for the Surgery of Trauma

cervical spine guidelines 939EC/IC bypass (see extracranial-intracranial

(EC/IC) bypass)ECASS-3 study 1017echinococcosis 373echocardiography for cerebral embolism 1023eclampsia

and intracerebral hemorrhage 1086, 1121ecstasy (street drug) (see methylene-

dioxymethamphetamine)ectodermal inclusion cyst (see epidermoid cyst)ectopic bone 1000EDAS (see encephaloduroarteriosynangiosis)edema

cerebral 109cytotoxic 109, 883following head injury 853following radiation therapy 771from metastases 706high altitude 916ischemic 109vasogenic 109, 883

exacerbated by mannitol 882with acute subdural hematoma 896

pulmonaryfrom contrast media 126high altitude 916in spinal cord injury 935neurogenic 28

spinal cordfollowing injury 948, 949, 980, 981following radiation therapy 748, 772

Edinger-Westphal nucleus 104, 830, 834EEG (see electroencephalogram)effective serum osmolality 8Effendi grade (hangman’s fracture) 960Ehlers-Danlos syndrome

and cerebral aneurysms 1057EKG changes after SAH 1054EKOS® ultrasound catheter 1018

(also see mechanical clot disruption)Elavil® (see amitriptyline)electrocerebral silence on EEG 291electrocorticography 422electrodiagnostics 266

for carpal tunnel syndrome 809for low back problems 432for ulnar neuropathy 814

electroencephalogram 266electrocerebral silence 291for brain death 291for hydranencephaly vs. hydrocephalus 244for withdrawal of anticonvulsants 419monitoring for vasospasm 1047rebuildup in moyamoya disease 1172

electrolytically detachable coils (see coils, elec-trolytically detachable)

electromyography 269for low back problems 432for radiculopathy 270H-reflex 432in ALS 66in cervical spondylotic myelopathy 490

INDEX 1267

electromyography (cont’d)in diabetic amyotrophy 796in facial palsy 846in lumbosacral plexus neuropathy 796in peroneal nerve palsy 821to differentiate root from plexus lesion 1195to localize S1 involvement 1190

electroneuronography 889electronystagmography 624elevating head of bed

following chronic subdural drainage 900to lower ICP 880

Elgiloy (aneurysm clip alloy) 131Elliott’s solution 300ellipsoid method of volume estimation on CT

1125embolectomy

for stroke 1018embolism (cerebral)

air 153amniotic fluid 1024and atrial fibrillation 1022, 1023and myocardial infarction 1022and patent foramen ovale 1023and prosthetic heart valves 1023and stroke in young adults 1024cardiogenic 1022echocardiography, use of 1023fat 1024paradoxical 1023, 1024septic 350top o’the basilar 1026

embolizationof AVM 1102of dural AVMs 1110of meningiomas 617

olfactory groove meningiomas 614of spine tumors

giant cell tumors 742hemangiomas 739metastatic 748

embryonal tumors 685primary spinal 685

emergency burr holes 864EMG (see electromyography)emotional incontinence 1030

with pseudobulbar palsy 61emotional lability (see emotional incontinence)empty can test 1197empty delta sign 1168empty sella syndrome 719

from chronic hydrocephalus 312primary 719secondary 659, 719

empyemafollowing thoracic vertebral osteomyelitis

380subdural (intracranial) 356

en bloc turning 331enalapril 21enalaprilat 20

encephalitisherpes simplex 358multifocal necrotizing (see encephalitis - her-

pes simplex)post-encephalitic parkinsonism 60varicella-zoster 360with CNS lymphoma 673

encephalocele 232, 1230encephaloduroarteriosynangiosis 1173encephalomyosynangiosis 1173encephalopathy

AIDS 365anoxic (see anoxic encephalopathy)bovine spongiform (BSE) 361chronic traumatic 911differential diagnosis 266, 1199due to carbon monoxide 277due to vascular autoregulatory dysfunction 73epileptic (with hypothalamic hamartomas)

226hypertensive 73uremic 73Wernicke’s 275, 404

encephalotrigeminal angiomatosis 726enchondroma 728end tidal pCO2

and air embolism 154and malignant hyperthermia 5

endocarditisin cerebral embolism 1023

endocarditis (see bacterial endocarditis)endocrine evaluation

for pheochromocytoma/glomus jugulare 679for pituitary adenoma 643

(table) 642endocrinology 31

pituitary 109endodermal sinus cyst (see neurenteric cyst)endolymphatic hydrops 842endolymphatic sac tumors 668endoneurium 801endoscopic discectomy 448endoscopic third ventriculostomy (see third ven-

triculostomy)endothelial cell proliferation

and glioblastoma 595, 596and radiation myelopathy 773following stereotactic radiosurgery 774

endothelin 1047endothelin receptor antagonists 1048endovascular intervention 262endovascular therapy

for ischemic stroke 1018endovascular therapy

for carotid-cavernous fistula 1114enlarged cisterna magna

differential diagnosis 1217enoxaparin 40, 43

after craniotomy 37reversal with protamine sulfate 41

enterogenous cyst (see neurenteric cyst)

1268 INDEX

entheses/enthesopathy (in ankylosing spondyli-tis) 502

entrapment neuropathy 804entrapped fourth ventricle 309entry points

AxiaLIF™ 196C1 lateral mass 186C1-2 puncture 206C1-2 transarticular facet screws 185C2 pedicle screws 187C7 lateral mass screws 190C7 transfacet screws 190cervical lateral mass screws 188lumbar puncture 202occipital condyle screws 180occipital-C1 transarticular screws 181thoracic pedicle screws 190

enuresis (in radiculopathy) 443eosinophilic granuloma

of the skull 699differential diagnosis 1221

of the spine 729ependymal cyst 1225ependymal enhancement 1227ependymitis 1227ependymoblastoma 683, 688ependymoma 682

intracranial 683differential diagnosis 1225subependymoma 683

myxopapillary (see ependymoma - spinal cord)

papillary 683pathology 683spinal cord 731

myxopapillary 683, 731tanycytic 683World Health Organization grading 683

ephedra alkaloids 1121epidermoid tumor/cyst 689, 690

and dermal sinus 252CPA (differential diagnosis) 1210intracranial 688, 689intraventricular (differential diagnosis) 1225skull 699spinal 731

following lumbar puncture 203epidural abscess

spinal 376epidural blood patch

for intracranial hypotension 305for post LP headache 59

epidural free fat graft 448epidural hematoma 894

CT scan 894delayed 896posterior fossa 896presentation 894spinal 515

differential diagnosis 1186postoperative 449, 452

epidural hematoma (cont’d)treatment 895

indications for surgery 895epidural steroids

following lumbar discectomy 448for chronic low-back pain 437for radiculopathy 438

epilepsy 395epilepsy partialis continuans 403epilepsy surgery (see seizure surgery)epileptic encephalopathy 226epinephrine 23

for contrast media reaction 125epineurium 801epistaxis

from cavernous carotid aneurysms 1080, 1081

from esthesioneuroblastoma 1230from traumatic aneurysm 1081with Osler-Weber-Rendu syndrome 1106

epistrophic ligament 805epsilon-aminocaproic acid

for subarachnoid hemorrhage 1044Epstein-Barr virus (and CNS lymphoma) 673

in AIDS 367eptifibatide 262Erb’s palsy 802Erb’s point 823ertapenem 195erythema chronicum migrans 368erythermalgia 1198erythrocyte sedimentation rate

and anemia 387following uncomplicated discectomy 387in cerebral abscess 352in discitis 385in giant cell arteritis 76in isolated angiitis of the CNS 79in postoperative discitis 387in spinal epidural abscess 378in vertebral osteomyelitis 382

erythromelalgia (see erythermalgia)esmolol 20

in neuroanesthesia 3esophageal injury with ACDF 465ESR (see erythrocyte sedimentation rate)essential hyperhidrosis 544esthesioneuroblastoma 1230estrogen

for osteoporosis 993ethamsylate

to prevent subependymal hemorrhage 1133ethanol

and intracerebral hemorrhage 1118, 1121and subarachnoid hemorrhage 1035and the nervous system 273neuropathy 794withdrawal seizures 273, 399

ethanol drip treatment 274withdrawal syndromes 273

prophylaxis 274

INDEX 1269

ethosuximide 414dosing forms 414

etidronatefor osteoporosis 993for Paget’s disease 500to reverse steroid-induced osteoporosis 33

etodolac 45etomidate 3

for anesthesia induction 2Evans ratio

criteria for NPH 331definition 310

EVD (see ventricular catheterization)evidence based medicine ivEvista® (see raloxifene)evoked potentials 266

in cervical spondylotic myelopathy 490intraoperative 267

anesthesia requirements 4for mapping sensory/motor cortex 150transcranial motor evoked potentials 267

Ewing’s sarcoma of the spine 729executive function 331exercise

for low back problems 437exophthalmos 1205

due to oculomotor palsy 835with multiple myeloma 740

experimental treatmentstissue transplantation for parkinsonism 533

exploratory burr holes 864extension TLSO 988extensor hallicus longus (EHL)

innervation 789weakness in common peroneal nerve palsy

820weakness with lumbar disc herniation 443

external carotid artery 98external hydrocephalus 307external ventricular drainage (see ventricular

catheterization)extinction (in asomatagnosia) 113extra-axial fluid collections in children 904extracorporeal membrane oxygenation 1132extracranial-intracranial (EC/IC) bypass

for cerebrovascular disease 1165for moyamoya disease 1173for vasospasm 1049

extraforaminal lumbar disc herniation 453extramedullary hematopoiesis 43

causing visual deficit 1216extraocular muscles 834extraventricular neurocytomas 612extreme lateral lumbar disc herniation 453extreme lateral lumbar interbody fusion (XLIF)

(see lateral lumbar interbody fusion)extruded intervertebral disc 429extubation

timing of 907

FFABER test 444facet (pedicle) screws (lumbar) 196facet fractures 976facet fusion 197facet joint injections

for low back pain 439for low-back pain 437for synovial cysts 457

facet syndrome 439facial colliculus 844facial diplegia

differential diagnosis 1204etiologies 844in Lyme disease 368

facial myokymia 542facial nerve

anastomosis for facial palsy 846palsy 844

Bell’s palsy 845bilateral 1202central vs. peripheral 844differential diagnosis 844in Guillain-Barré 67in Lyme disease 368posttraumatic 889treatment 846with cerebellar infarct 1021with facial nerve neuroma 845with vestibular schwannoma 621

following treatment 632grading 622

facial nerve neuroma 845, 1210facial pain (see pain - craniofacial)facial sensory changes 1208

following vestibular schwannoma treatment 632

facial veinfor ventriculo-atrial shunt 210in carotid endarterectomy 1155

factor VIIfor intracerebral hemorrhage 1127, 1127prior to subarachnoid bolt insertion 869side effects/complications 1127to reverse antiplatelet drugs 38

factor VIIIelevation and dural sinus thrombosis 1167

factor Xaeffect of LMWH on 39inhibitors 40levels to check anticoagulation on LMWH 38

factor XIIIand spontaneous subdural hematoma 902

Fahr’s disease 1224failed back surgery syndrome 452, 457

spinal cord stimulator for 573faint 1199Fajersztajn’s sign 444falciform ligament 1071

1270 INDEX

false aneurysms 1081carotid 1153

falx syndrome 898famciclovir

for herpes zoster 565familial aneurysms 1080familial intracranial aneurysm syndrome 1057familial syndromes with CNS tumors 588Famvir® (see famciclovir)fanning of cervical spines 137far lateral disc herniation (see extreme lateral

lumbar disc herniation)fascicles 801fasciculations

differential diagnosis 1196tongue 489

fast spin echo (on MRI) 130FAST study (factor VII) 1127fastigium 88, 686fat on MRI 129fat embolism syndrome 1024fat suppression MRI 130fatty infiltrate in vertebral bodies 1231febrile seizures 397, 402

and mesial temporal sclerosis 395definition 402preceding status epilepticus 403

fecal incontinencein cauda equina syndrome 446

felbamate 414dosing forms 415

Felbatol® (see felbamate)Feldene® (see piroxicam)femoral neuropathy 798

perioperative 800vs. L4 radiculopathy 1190vs. plexus neuropathy 796vs.lumbosacral plexus neuropathy 795

femoral stretch test 444fenoldopam 20fenoprofen 45fentanyl 3, 24

for severe pain 48patch 48to control ICP 877, 879

festinating gait 59fetal circulation 104, 1068fetal hydantoin syndrome 420fetal tissue transplantation

for parkinsonism 533FFP (see fresh frozen plasma)FGFR genes (see fibroblast growth factor recep-

tor genes)fibrillary astrocytoma 593fibrillation potentials

in ALS 66vs. fasciculations 786

fibrillation potentials (on EMG) 270fibrin glue 305fibrinoid necrosis 1120fibroblast growth factor receptor genes 231

fibromuscular dysplasia 79and arterial dissection 1161and intracranial aneurysms 1057and moyamoya disease 1171and stroke in young adults 1024

fibromyalgia 1198fibrous (fibroblastic) meningioma 615fibrous dysplasia 701

differential diagnosis 1220fibular bone graft (autogenous) 201FIESTA MRI 624fifth ventricle 1218filum terminale

distinguishing features 255myxopapillary ependymoma of 731tethering 254thickened filum

definition 255in tethered cord 254

finger drop 817Finkelstein’s test 809first dorsal interosseous muscle

atrophy/weakness 1197Fischgold’s lines 139, 139Fisher SAH grade 1046Fishman’s formula 298fistula

arteriovenous (direct) 1098CSF (see cerebrospinal fluid - fistula)

fixed and dilated pupil (see pupillary dilatation)Flagyl® (see metronidazole)flail foot 1194FLAIR images (on MRI) 129

for SAH 1038flame hemorrhages 1168flaring of cervical spinous processes 137, 939flat back syndrome 442Flexeril® (see cyclobenzaprine)flexion compression fracture - cervical (see com-

pression flexion fracture)flexion-extension cervical spine x-rays 940flexor synergy 116floating lateral mass 976floppy infant syndrome 420, 1191Florinef® (see fludrocortisone)flow study

cerebrospinal fluid 236for arachnoid cyst 224

fluconazolefor cryptococcal meningitis 374

fludrocortisonefor Addisonian crisis 34for cerebral salt wasting 14for vasospasm 1053

fluids and electrolytesand elevated ICP 878

flumazenil 52for benzodiazepine overdose 281precipitating seizures 397

fluoresceinintrathecal 144

INDEX 1271

fluoride 993fluorodeoxyglucose PET scan (see PET scan)fluoxetine

interaction with phenytoin 411fluphenazine

for diabetic neuropathy 797flurazepam 52flurbiprofen 45focal disc herniation 429focal seizure 394fogging

on CT 1012on MRI 1013

Foix-Alajouanine disease 508, 1187folic acid

and pernicious anemia 1188to reduce neural tube defects 245

fondaparinux 40fontanelles 228foot drop 1194

ankle-foot-orthosis for 821differential diagnosis 1195emergency (disc) surgery for 445EMG findings 821from parasagittal meningiomas 614from peroneal nerve palsy 820in Charcot-Marie-Tooth 793recovery after discectomy 452

footballand cervical spine injury 980helmet removal guidelines 934

foramen magnum 89compression syndrome 235lesions

differential diagnosis 1212tumors 711

meningiomas 614foraminal disc herniation 453foraminal stenosis 477Forane® (see isoflurane)Forbes-Albright syndrome 637forced duction test 836Forestier’s disease 506Fortaz® (see ceftazidime)Fosamax® (see alendronate)fosphenytoin 411

dosing forms 411Foster Kennedy syndrome 112, 614four “R’s” of radiobiology 770four hour rule for subdural hematoma 898fractionated stereotactic radiosurgery (see stereo-

tactic radiotherapy)fractionation

hyperfractionated radiation therapy 608of radiation therapy 770

fracturesatlas (C1) (see below under spine)axis (C2) (see below under spine)craniofacial 889facial 858

fractures (cont’d)frontal sinus 889Le Fort 890, 890occipital condyle 954skull 885

basal 855, 887clivus 889depressed 885differentiating from suture 885growing 892in epidural hematoma 894linear non-displaced 857, 885occipital 858temporal bone 888

spineatlas (C1) 957

Jefferson 958lateral mass 958

axis (C2) 959hangman’s 959

treatment 961miscellaneous 967odontoid (dens) 963

cervical 951cervical (subaxial) 968

burst 970classification systems 968compression flexion 970determining stability 969distraction flexion 971facet 976lateral mass 976management 977quadrangular 971teardrop 970treatment 977

coccyx, and coccydynia 516hangman’s (see fractures - spine - axis)limbus 442lumbar 986

L5 burst 990sacral 997spinous process

cervical (clay shoveler’s) 969thoracolumbar 986

thoracic 986thoracolumbar 986

burst 987, 989Chance 987compression 987fracture-dislocation 988lamina 986seat-belt 987TLICS classification 990transverse process 986, 988treatment 988

Fragmin® (see dalteparin)Francis grade (hangman’s fracture) 962Frankel neurological performance scale 947Frankfurt plane 87Frazier burr hole 156, 207

emergency use of 158free fat graft (epidural) 448free fragment of disc material 429

1272 INDEX

free radical scavengersfor intra-operative cerebral protection 1063for vasospasm 1049

FREE study 995Freedox® (see tirilazad)Freiberg test 1190fresh frozen plasma 35fried egg cells 610Froin’s syndrome 733Froment’s prehensile thumb sign 813frontal craniotomy 163frontal eye field 84, 834frontal eye fields 112frontal nerve 562frontal sinus

cranialization of 890fractures 889infection and subdural empyema 357

frontal suture 230frontal-occipital horn ratio 326Functional Independence Measure 1184fungal infections

CNS 374vertebral osteomyelitis 380

furosemidefor hydrocephalus 314for ICP management 879, 882for pseudotumor cerebri 717for pulmonary edema 126prior to mannitol 862

Furstenberg sign 1230furuncle

in spinal epidural abscess 377fusiform aneurysms 1055fusion

cervical spine 179posterior fusion 179

lumbar spine 440bone graft extenders/substitutes 197brace therapy 483choice of technique 439correlation with outcome 198following discectomy 440for (chronic) low back pain 439pedicle screw fixation

angulation 192for low back pain 440technique 191

posterior fusion 191post-op clinic visits 440radiographic assessment 198with stenosis and spondylolisthesis 483with stenosis without spondylolisthesis

483risk factors for nonunion 484thoracic spine

posterior fusion 190F-wave response (on EMG) 270, 433

Ggabapentin

dosing forms 416, 566for neuropathic pain 549for painful diabetic neuropathy 797for postherpetic neuralgia 566for seizures 416for trigeminal neuralgia 553

Gabitril® (see tiagabine)gadolinium

allergy prep 124contrast for MRI 130in pregnancy 1087nephrogenic systemic fibrosis with 130

gallium scancomparison to bone scan for osteomyelitis

382in sarcoidosis 72in vertebral osteomyelitis 141, 382

gammopathy 799gangliogliomas 590, 677

brainstem 607ganglion cyst (spinal) 456ganglion impar (ganglion of Walther) 517ganglioneuromas 678, 749Garamycin® (see gentamicin)t’s syndrome 698Gardner-Robertson hearing classification 623Gardner-Wells tong placement 942Gasserian ganglion (see trigeminal ganglion)gastric emptying

in head injury 908Geipel hernia 455gelastic seizures 226gelatin sponge 146Gelfoam® (see gelatin sponge)gemistocytes 594gemistocytic astrocytomas 594, 596generalized tonic-clonic seizure 394genetic markers

for astrocytoma dedifferentiation 595geniculate neuralgia 563genitofemoral nerve

injury following LLIF 194gentamicin

intrathecal 345germ cell tumors 692

differential diagnosis 1216synchronous 692

germinal matrix hemorrhage 1131germinoma 692Gerstmann’s syndrome 113GFAP (see glial fibrillary acidic protein)GH (see growth hormone)"ghost-cell tumor" 674ghrelin 111giant aneurysms 1082giant cell arteritis 74giant cell astrocytoma 726

INDEX 1273

giant cell reparative granulomaof spine 728

giant cell tumor (of bone) 742of the sacrum 1190of the spine

differential diagnosis 728gigantism (from excess growth hormone) 640Gill procedure 476, 476Ginkgo biloba

and subdural hematoma 902glabella 86, 87Glasgow coma scale 279

for children 279Glasgow outcome scale 1183Gleevec® (see imatinib)Gliadel® wafer (see BCNU)glial fibrillary acidic protein 596, 720

and oligodendrogliomas 610glial tumors of uncertain origin 696glioblastoma 596

in adult posterior fossa 1209multiple 597outcome 602primary 596secondary 596treatment 600

extent of resection 600WHO grading criteria 594with oligodendroglioma component 612

glioblastoma multiforme (see glioblastoma)glioependymal cysts 1217glioma 593

brainstem 607butterfly 597, 601definition 585grading

pathologic 594radiographic 596

hypothalamic 606low grade 590

grading scale 597mixed 610, 612multiple 597multiple primary 598nasal 1230optic 606outcome

for malignant astrocytomas 602pilocytic astrocytoma 603recurrent 602spread 597tectal 608treatment 598

chemotherapy 601for high grade astrocytomas

in the elderly 600for low-grade astrocytomas 598for malignant astrocytomas 600

wounded glioma syndrome 600gliomatosis cerebri 598glioneural elements (with DNTs) 591

glioneuronal tumors 612global aphasia 114globus

definition 506following ACDF 466

globus pallidussurgical lesioning 534

glomus AVM (spinal) 507glomus jugulare tumors 678, 680glomus tympanicum tumors 680glossopharyngeal neuralgia 563glove-distribution sensory loss 488glucagon

for hypotension 125glucocorticoids 31Glucophage® (see metformin)glucose

in coma 281in status epilepticus 403, 404in stroke 1019

glucose suppression test (for growth hormone se-cretion) 648

gluteus maximusinnervation 789

gluteus medius 789examination in foot drop 1194

glycopyrrolate 27for bradycardia with Precedex™ 25

GnRH (see gonadotropin-releasing hormone)goggle neuralgia 562gonadotroph hyperplasia 1215gonadotropin

chorionic 721secreting adenoma 634

medical treatment 649serum 645

gonadotropin-releasing hormone (GnRH) 111in gonadotroph adenomas 649in hypothalamic hamartomas 226

Gore-Tex - for sinus reconstruction 618Gorlin’s syndrome 1224Gradenigo’s syndrome 838gradient echo MRI 130

for AVM 1101grading scales

American Academy of Otolaryngology hear-ing classification 623

arteriovenous malformation (AVM)cerebral 1101spinal 507

Ashworth (spasticity) 537ASIA

impairment (spinal cord injury) 947motor (spinal cord injury) 945sensory (spinal cord injury) 946

astrocytoma 594pathologic 594radiographic 596

Brice and MacKissock (spinal metastases) 744

1274 INDEX

grading scales (cont’d)cerebrovascular injuries 983cervical myelopathy 487CHADS2 (stroke risk in a-fib) 1022chronic brain injury 912coma 279concussion 851Denver (vertebral artery injury) 983disability from low back pain 430facial nerve 622Fisher grade (vasospasm) 1046Francis (hangman’s fracture) 962Frankel (spinal cord injury) 947Functional Independence Measure (spinal

cord injury outcome) 1184Gardener and Robertson (hearing) 623Glasgow (coma) 279Glasgow (outcome) 1183glioma

pathologic 594radiographic 596

glioma - low grade 597hangman’s fracture 960, 962hearing 623House and Brackmann (facial nerve) 622Hunt and Hess 1040intracerebral hemorrhage 1126Karnofsky (outcome) 1182Kernohan (astrocytoma) 594Levine/Effendi (hangman’s fracture) 960Medical Research Council (strength) 786meningioma removal 619Meyerding (spondylolisthesis) 475modified Japanese Orthopedic Association

scale (cervical myelopathy) 487muscle strength 786muscle stretch reflexes 786myelopathy 494NIH stroke scale 1014Nurick (cervical spondylosis) 505Oswestry disability index (low back pain) 430outcome 1182pain 430Papille (subependymal hemorrhage) 1133Ranawat (myelopathy) 494Ranchos Los Amigos cognitive scale 1182(modified) Rankin scale (outcome) 1183Richmond agitation-sedation scale 23sedation/agitation 23Simpson (meningioma removal) 619spasticity 537Spetzler et al. (AVM - spinal) 507Spetzler-Martin (AVM - cerebral) 1101spinal cord injury 945, 946, 947spinal metastases 744spondylolisthesis 475St. Anne/Mayo (astrocytoma) 594stroke 1014subarachnoid hemorrhage 1040subependymal hemorrhage 1133

grading scales (cont’d)vasospasm 1046vertebral artery injury 983visual analogue scale (pain) 430WHO 594World Federation of Neurosurgical Societies

(SAH) 1040grand-mal seizure (see generalized tonic-clonic

seizure)granular cell tumor/myoblastoma (see pituicyto-

ma)granular cell tumors 641granulomatous angiitis 72GRASS MRI image 130

flow enhancement in AVMs 1106Graves’ disease 645, 1219

and exophthalmos 1205and moyamoya disease 1171

Gray (radiation dose) 126great cerebral vein of Galen 105greater occipital nerve 804

dermatome 551greater superficial petrosal nerve 844Grinker’s myelinopathy 277Grisel syndrome 956

and increased atlantodental interval 1230ground glass appearance in fibrous dysplasia 701growing skull fractures 892

pseudogrowing skull fracture 892growth hormone 110, 111

acromegaly 639biochemical cure criteria 662management of 652medical treatment for 653

ectopic secretion 640evaluation of 648

in acromegaly 648transmitting Creutzfeldt-Jakob disease 362use in myelomeningocele 251

guanethedine block 577Guglielmi detachable coils (see coils, electrolyti-

cally detachable)Guidelines for the Management of Severe Trau-

matic Brain Injury 876Guilford brace 979Guillain-Barré syndrome 66

differential diagnosis 68, 1188variants 67

gunshot woundsto peripheral nerves 804to the brachial plexus 803to the head 912

antibiotics for 914entrance/exit wound 913indications for angiography 914

to the spine 998Guyon's canal 816gyral enhancement

differential diagnosis 1013on CT 1013on MRI 1013

INDEX 1275

gyri of Heschl 84gyrus rectus cortisectomy

for a-comm aneurysm 1067

HHACE (see high altitude cerebral edema)hair-on-end skull 44, 1222hair-pin turn of artery of Adamkiewicz 96Hakim shunt 320Hakim-Adams syndrome (see normal pressure

hydrocephalus)Haldol® (see haloperidol)half-lives to steady state 409Halifax clamps 184hallucinosis 274halo sign 302haloperidol 24

and parkinsonism 60for DTs 275

halo-vest brace 979and cerebral abscess 351halo application 942pin care 943vest application 943

hamartomasdefinition 226hypothalamic 226with tuberous sclerosis 726

hamstrings 789handcuff injury to radial nerve 817hanging drop technique 59hangman’s fracture 959

Francis grade 962Levine/Effendi grade 960treatment 961

hard disc 485harlequin eye sign 230Harris line (for atlantooccipital dislocation) 953Harris-Benedict equation 908head circumference (see occipital-frontal circum-

ference)head fixation in surgery 145

skull block for 145head injury (see trauma - head)headache 57

following craniotomy 149from cranial defect 149in subarachnoid hemorrhage 1035migraine 57paroxysmal 1035post myelogram/LP 58spinal (see headache - post myelogram/LP)thunderclap 1035warning (in subarachnoid hemorrhage) 1035with brain tumors 587with giant cell arteritis 75with orgasm 1036with unruptured aneurysms 1035, 1056

head-holder, Mayfield 145

hearing classification 623hearing loss 848

American Academy of Otolaryngology hear-ing classification 623

following loss of CSF 203following lumbar puncture 203following MVD for hemifacial spasm 544Gardener and Robertson classification 623with glomus jugulare tumor 680with Meniere’s disease 842with vestibular schwannoma 621, 622

following treatment 632sudden/spontaneous 621

heart valves (prosthetic) (see prosthetic heart valves)

Heiss-Oldfield theory 511helmets

football, removal after injury 934motorcycle 898

hemangioblasomatosis 667hemangioblastoma

intracranial 667differential diagnosis 1209

retinal 669spinal cord 732

hemangiomacapillary

orbital 1218skull 699vertebral 738

cavernous 1209intracranial (see cavernous malformation)

1106orbital 1218vertebral 738

facial 1210in Sturge-Weber 726, 1218of the skull 699, 1221

radiographic appearance 1219vertebral 515, 738, 1186

and spinal epidural hematoma 1186treatment 739

hemangiopericytomas 620meningeal 616

hematocritin hyperdynamic therapy 1052in vasospasm 1049

hematology 34hematoma

epiduralcerebral 894spinal 1186

intracerebral 1118posterior fossa 905post-op 147subdural 896

Hemedex® monitor 875hemianopsia

bitemporal 635, 643homonymous

1276 INDEX

hemianopsia (cont’d)from occipital lobe lesions 112with parietal lobe tumors 587with pituitary tumors 643

junctional scotoma 643, 1071hemiballism 1027hemicrania continua 563hemicraniectomy (for increased ICP) (see

craniectomy - decompressive)hemifacial spasm 542

treatment 543hemiparesis

differential diagnosis 1191following pallidotomy 536infantile

and seizure surgery 420from arterial dissection 1163

pure motor 1026hemiplegia cruciata 1197hemiplegic migraine 58hemispherectomy 422hemodialysis

following intracerebral hemorrhage 1128hemogenic meningitis (see meningitis - he-

mogenic)hemorrhagic brain tumors 1123hemorrhagic contusion 852, 857, 893

excision to control ICP 880hemorrhagic conversion of ischemic infarct 1023hemostasis (surgical) 146hemotympanum 855, 888heparin 39

and intracerebral hemorrhage 1020and thrombocytopenia 39considerations in neurosurgery 36contraindications 36discontinuation prior to neurosurgical proce-

dures 38for cardioembolic stroke 1023for cerebrovascular dissection 984for cerebrovascular venous thrombosis 1169for DVT prophylaxis 42for DVT treatment 43for spinal cord injury 938for stroke 1020for VA shunt 211low molecular weight 39, 42

reversal with protamine 41low-dose 39, 42, 938

discontinuation prior to neurosurgical procedures 38

reversal 41hepatic toxicity

from acetaminophen 46from labetalol 21

hepatolenticular degeneration 1228hereditary spastic paraplegia 1185hereditary hemorrhagic telangiectasia (see Osler-

Weber-Rendu syndrome)hereditary motor and sensory neuropathy (see

Charcot-Marie-Tooth syndrome)

hereditary neuropathy with liability to pressure palsies (HNPP) 793

hereditary spastic paraplegia 489herniated disc (see intervertebral disc - hernia-

tion)herniation

braincentral 285during craniotomy 147following LP 203, 204herniation syndromes 284tonsillar 285uncal 286upward (cerebellar) 285, 590

intervertebral disc (see intervertebral disc - herniation)

intra-operative 147spinal cord 514, 1186

herpes simplex encephalitis 266, 358herpes simplex eruption following trigeminal

rhizotomy 558herpes zoster 564

and facial paralysis 846leukoencephalitis 360myelopathy 1188ophthalmicus 564

and stroke in young adults 1024radiculopathy 1189

herpetic ganglionitis 564Heschl’s gyri 84Hespan® (see hetastarch)hetastarch 22

and impaired coagulation 1042, 1052for contrast media reaction 125

heterotopia 243Heubner’s artery 97, 100, 100

occlusion 1028Heyer-Schulte shunt 320hiccups

from steroids 34treatment

chlorpromazine (Thorazine®) 34with lateral medullary syndrome 1029

high altitude cerebral edema (HACE) 916hippus 838histamine

release with morphine 3release with paralytics 25, 27

histamine2 (H2) antagonistsfor head trauma 878

histaminic migraine 58histiocytosis X 699

differential diagnosis 1221Hivid® (see zalcitabine)HNPP (see hereditary neuropathy with liability to

pressure palsies)hockey-stick incision 155Hoffman’s sign 116

dynamic 488in cervical spondylotic myelopathy 488

Hollenhorst plaques 1144

INDEX

1277

hollow skull phenomenon (sign) on CRAG 292Holmes-Adie’s pupil 832holoprosencephaly 244Holter valve 321Homans’ sign 43homocystinuria

and arterial dissections 1161and cerebrovascular venous thrombosis 1166and strokes 1024

homonymous hemianopsia (see hemianopsia - homonymous)

honeycomb appearance of hemangiomas 738honeycomb pattern (on skull x-ray) 1220honeymoon paralysis 807honeymoon seizures 424hook effect (on prolactin level) 644Hoover sign 444horizontalization of the facet joint 976horizontal-vertical lumbar valve 317,

321

Horner’s syndrome 833due to pituitary apoplexy 636following cervical discectomy 465from cervical cordotomy 569from stellate ganglion block 216in brachial plexus injury 801in carotid dissection 1163in fibromuscular dysplasia 80in Raeder’s paratrigeminal neuralgia 838with cervical disc herniation 461with cluster headaches 58with foramen magnum tumors 712

hot bath test (Uhthoff sign) in MS 63Hounsfield units 128hourglass deformity on myelogram 746House and Brackmann grading scale 622H-reflex (on EMG)

270

, 432Huber maneuver 1113Hunt and Hess grade 1040Hunt’s neuralgia 563hunterian ligation

for aneurysms 1058for giant aneurysms 1083for VA-PICA aneurysms 1072

huntingtin 1228Huntington’s chorea

1228

and parkinsonism 60Hurler syndrome 138, 222, 1185hydatid cyst 373hydranencephaly

244

, 307hydrocephalus 307

and contact sports - return to play 851and pregnancy 336and type 2 Chiari malformation 238arrested 309benign external 307catch-up phase of brain growth 1136chronic (differentiated from acute) 312communicating 307compensated 309differential diagnosis 311etiologies 311

hydrocephalus

(cont’d)

ex vacuo 307, 332following TBI 906

external 307following excision of cerebellar pilocytic as-

trocytoma 605following myelomeningocele closure 248following p-fossa SAH 1072following pituitary surgery 659following SAH 1037, 1040, 1041,

1044

traumatic SAH 906with a-comm aneurysms 1066

following subependymal hemorrhage 1134following traumatic brain injury 906, 910following vestibular schwannoma surgery

632from bullet fragment 913from neurocysticercosis 371from pituitary apoplexy 636from pituitary macroadenoma 637frontal-occipital horn ratio 326in Chiari type 1 malformation

234

in myelomeningocele 248instructions to patients 323medical treatment 314normal pressure 329normal volume 326obstructive 307otitic 1166posttraumatic

906

, 910pseudohydrocephalus 307shunt problems 321surgical treatment 314triventricular 241, 307ventricular measurements 310vs. hydranencephaly 244with neurosarcoidosis 71with posterior fossa tumors 590with vein of Galen malformations 1112with vestibular schwannoma 621, 627X-linked 308

hydrochlorothiazidecausing SIADH 9for diabetes insipidus (DI) 18

hydrocodone 47hydrocortisone 31

as a measure of adrenal sufficiency 32for Addisonian crisis 34

hydromorphone 48extended release (Palladone®)

hydromyelia (see syringomyelia)hydrosyringomyelia (see syringomyelia)hydroxyamphetamine

and neurotoxicology 277in diagnosing Horner’s syndrome 834

hydroxyapatite 198,

200

hydroxyapatite bone graft 464hydroxyproline 499hydroxyzine 50hygroma, subdural 903hyperacusis 844

1278 INDEX

hyperbilirubinemiawith cephalhematoma 918

hypercalcemiafrom bone metastases 743from multiple myeloma 740

hypercoagulable statesduring Coumadin initiation 1020

hypercoagulable states and strokes 1025hyperdense artery sign 1013, 1022hyperdensities on brain CT 128hyperdynamic therapy 1040, 1052

hematocrit 1052hyperemia (cerebral) 1010, 1014

and malignant cerebral edema 853distinguishing from vasospasm 1048following evacuation of chronic subdural 902following head injury 867

in pediatrics 917harmful effect of mannitol 882indications of 874occlusive 1104

hyperflexion sprain 971hyperfractionated radiation therapy 608hyperglycemia

in head injury 879in stroke 1019

hyperhidrosis 514, 544facial 235with acromegaly 640

hyperkalemiadue to NSAID nephrotoxicity 45due to succinylcholine 26in Addisonian crisis 34

hyperlordosis of the cervical spine 486hypernatremia 14hypernephroma (see renal-cell carcinoma)hyperostosis

hyperostosis cranialis interna 1203hyperostosis frontalis interna 700vertebral

differential diagnosis 1233hyperpathia

with central cord syndrome 948with meralgia paresthetica 819

hyperpigmentationdifferential diagnosis 639in Cushing’s syndrome 638in Nelson’s syndrome 639

hypersensitivity vasculitis 79hypertension

and risk of stroke 1011in Cushing’s syndrome 638induced (to treat vasospasm) 1052treatment 19

hypertensive encephalopathy 73hypertensive hemorrhage 1118hyperthermia

malignant 5with hypothalamic lesion 664

hyperthyroidism 642and ophthalmopathy 1219

hyperthyroidism (cont’d)Graves’ disease 1219primary 645secondary (central) 640, 645signs and symptoms 641

hypertonic salinefor traumatic brain injury

guidelines 882to lower ICP 883

hypertrichosiswith diastematomyelia 256with tethered cord syndrome 254

hyperventilationand hypocalcemia 861for brain relaxation during surgery 1062in coma 282in the E/R 861neurogenic 282producing symptoms in moyamoya disease

1171to lower ICP 880, 881

hypocortisolism 34post-op pituitary surgery 661screening test 643

hypofractionation 775hypoglossal artery 107hypoglossal canal 89, 115hypoglossal nerve

anastomosis to facial nerve 847injury from carotid endarterectomy 1154mobilizing for carotid endarterectomy 1155

hypogonadotropic hypogonadismfollowing head injury 910

hypoid 101hypokalemia

hypokalemic alkalosis in Cushing’s syn-drome 638

in spinal cord injury 936hyponatremia 7, 11

following SAH 1043pseudohyponatremia 7work-up 8

hypophysitis 1217hypopituitarism

and septo-optic dysplasia 247and suprasellar germ cell tumors 693due to aneurysm 1071due to pituitary apoplexy 650due to pituitary tumor 635due to radiation therapy 655, 771due to suprasellar germ cell tumors 1216following head trauma 863following pituitary surgery 659

hypotensionand ischemic optic neuropathy 335causing blindness 335causing spinal cord infarction 1186during aneurysm surgery 1063following head trauma

etiologies 854prognostic significance 863

INDEX 1279

hypotension (cont’d)following spinal cord injury (spinal shock)

930, 935from contrast media reaction 125impact in severe traumatic brain injury 878intracranial (see intracranial hypotension)orthostatic 60treatment 21

hypothalamic glioma 603, 606hypothalamic hamartomas 226hypothermia

and determining brain death 290and effect on CMRO2 1and wound infection 348as cause of fixed pupils 283for cerebral protection

during aneurysm surgery 1063with closed head injury 880

prophylactic 883for spinal cord injury 937

hypothyroidismand pituitary tumors 645danger of precipitating adrenal crisis 650from aminoglutethimide 654

hypoxiafollowing head trauma

prognostic significance 863hypoxic coma 287

hypsarrhythmia 396Hystoacril for dural AVMs 1110

Iibuprofen 45

suspension 46“ice pick in the ear” (symptom) 564ICH score (see intracerebral hemorrhage - score)ICP (see intracranial pressure)ICU neuropathy (see critical illness polyneuropa-

thy)IDET (see intradiscal endothermal therapy)idiopathic brachial plexus neuropathy 794idiopathic cranial polyneuropathy 1203idiopathic intracranial hypertension 713

and empty sella syndrome 717, 719papilledema in 714without papilledema 714

IDTA (see intradiscal endothermal therapy)IGF-1 (see insulin-like growth factor-1)ileus

following lumbar laminectomy (Ogilvie’s syndrome) 450

following spinal cord injury 935iliac crest bone graft 200

and meralgia paresthetica 819iliac screws 197iliopsoas 789imatinib for chordomas 677imminent aneurysm rupture 1061immunohistochemical staining patterns 720impedance - during trigeminal rhizotomy 557

impedance plethysmography 43Inapsine® (see droperidol)incidental aneurysms 1055, 1077incidental durotomy 450incomplete spinal cord injury syndromes 948incubation period with stereotactic radiosurgery

777Inderal® (see propranolol)indigo carmine 144Indium-111 labeled WBC scan

for vertebral osteomyelitis 382Indocin® (see indomethacin)indocyanine green angiography 135indomethacin 45

in treating/diagnosing hemicrania continua 563

to prevent subependymal hemorrhage 1133induced arterial hypertension 1052infantile acute subdural hematoma 899infantile hemiplegia syndrome 420, 1163infantile spasms 396infarction

cerebellar 1021cerebral 1010, 1011cerebral (see also cerebrovascular accident)cerebral (see also stroke)myocardial 1022spinal cord 1186venous 1166watershed 1029

infectionabscess

cerebral 350spinal epidural 376

AIDS 364bone flap 349Creutzfeldt-Jakob disease 361disc (see discitis)echinococcosis 373fungal

CNS 374general information 342herpes simplex encephalitis 358ICP monitors and 869in craniospinal trauma 344Lyme disease 368meningitis 343

(see also meningitis) 343neurocysticercosis 370prions 361shunt (see shunts - problems - infection)skull 349slow virus 361spine 376

vertebral osteomyelitis 380syphilis (neurosyphilis) 365viral encephalitis 358wound

craniotomy 349laminectomy 348

1280 INDEX

infectious aneurysm 1082inferior hypophyseal artery 99inferior orbital fissure 89inferior petrosal sinus

anatomy 104sampling for Cushing’s disease 646

inferior temporal gyrus 84, 85, 735informed consent vinfratentorial tumor/mass 590

and coma 285differential diagnosis 1209

Infumorph® 571infundibular granular cell tumor (see pituicyto-

ma)infundibulum 1039Infusaid pump 571Infuse® (see bone morphogenic protein)inguinal hernia

and VP shunt 316inhalational anesthetic agents 1iniencephaly 232, 254injection injuries

sciatic nerve 1194injection therapy

for low back pain 439for low-back pain 437

injuryhead (see trauma - head)spine (see trauma - spine)

Innohep® (see tinzaparin)INO (see internuclear ophthalmoplegia)Inocor® (see amrinone)INR (see International Normalized Ratio)insensitive space 435insonation windows 1048instability (spinal) (see spinal stability)insulin tolerance test 647insulin-like growth factor-1 111

levels 647Integrilin® (see eptifibatide)intercostal nerve block 216intercostal neuralgia

intercostal nerve block for 216spinal cord stimulation for 573

intercristal line 89, 202interhemispheric approach 172

for anterior cerebral artery aneurysms 1068for anterior communicating artery aneurysms

1067for colloid cysts 169

interhemispheric scissure 898interhemispheric subdural hematoma 898

from ruptured aneurysm 1037interleukin-2

and cerebral edema 705, 707intermuscular septum (medial, in ulnar nerve sur-

gery) 814, 815internal auditory canal (IAC) 90internal capsule 107internal carotid artery

anatomy 99

internal carotid artery (cont’d)dissection 1162occlusion

management 1157syndromes 1027

stenosis 1144angiographic criteria 1145asymptomatic 1147indications for surgery 1150

internal cerebral vein 105, 105filling in AVM grading 1101inferior displacement 691retrograde filling with AVMs 1112

internal disc disruption 448internal genu (facial nerve) 844internal jugular vein

thrombosis of 465internal jugular veins 104International Normalized Ratio (INR) 39

safe levels for neurosurgical procedures 37therapeutic levels for warfarin 39

International Subarachnoid Hemorrhage Aneu-rysm Trial (ISAT) 1059

internuclear ophthalmoplegia 283, 286, 834in multiple sclerosis 62

interpediculate distance 480, 987interscapular pain

following ACDF 466in cervical radiculopathy 1197

interspinous distance 137interspinous fusion 482interspinous plates 482interspinous process decompression 482interspinous spacer 482

contraindications 482interstitial brachytherapy 779intervertebral disc 428

anular tears 1193as a source of pain 436degenerated

on MRI 435destruction

with ankylosing spondylitis 1233with discitis 1233

herniation 442balloon disc 455cervical 440, 461

ACDF for 462arthroplasty for 467keyhole foraminotomy for 469

intravertebral disc herniation 455lumbar 442

and spondylolisthesis 475conservative treatment 437definition 429extreme lateral 453foraminal 453in asymptomatic patients 433in pediatrics 455indications for surgery 445intradural 455percutaneous procedures 447physical findings 443

INDEX 1281

intervertebral disc - herniation - lumbar (cont’d)radiographic evaluation 433recurrent 460SPORT study 452surgical treatment 445upper lumbar 453

Schmorl’s node 455, 1193sequestered 429surgical options 447syndromes

cervical 461lumbar 445

thoracic 470infection (discitis) 383, 1233lumbar

degeneration 429pathology nomenclature 429

sparing with tumors 1233vacuum disc 429

intoxicationcocaine 276ethanol 273opioid 275

intraarterial chemotherapy 589, 601intracarotid amytal test 421intracerebral hemorrhage 1118

and alpha-adrenergic agonists 1121and cerebral amyloid angiopathy 1122and leukemia 1131and migraine 1120and prosthetic heart valves 1128and sympathomimetics 1121and vasculitis 74angiogram, indications for 1127anticoagulation

following the hemorrhage 1127preceding the hemorrhage 1020, 1123

cerebellarfollowing craniotomy 1122surgical technique 1130treatment guidelines 1130

during percutaneous trigeminal procedures 558

etiologies 1119following carotid endarterectomy 1153

emergency endarterectomy 1156following craniotomy 1121following evacuation of chronic subdural

901, 902following MERCI clot retrieval 1018from brain tumors 1123from depth electrodes 421from lesioning with a cryoprobe 535grading system 1126in the newborn 1131in young adults 1131lobar 1119

clinical syndromes 1124mortality 1131

management 1126after tPA 1018

MRI appearance 1125

intracerebral hemorrhage (cont’d)postpartum 1121rebleeding 1124recurrent 1122score 1126spot sign (on CTA) 1124stereotactic aspiration of 782surgical treatment 1128

STICH study 1129tissue plasminogen activator

injection into clot to treat 782intraventricular injection to treat 1130preceding the hemorrhage 1017, 1120,

1123traumatic (see hemorrhagic contusion)treatment 1126volume

estimation 1125prognostic value 1129

vs. ischemic infarct 1011with aneurysmal rupture 1055with ICP monitor 869

intracranial aerocele (see pneumocephalus)intracranial atherosclerosis 1023intracranial cysts 1217intracranial hemorrhage (see intracerebral hemor-

rhage)intracranial hypertension (see intracranial pres-

sure)intracranial hypotension 305

from overshunting 325spontaneous 305

intracranial pressure 866converting mm Hg to cm water 870definitions 867elevation

from histamine release 3with nipride 19with nitroglycerin 20with succinylcholine 26

following SAH 1044hypertension

heavy sedation for 879management 876, 877

hypothermia 880prophylactic hypothermia 883second tier therapy 879surgery for 877

with cryptococcal meningitis 374hypotension 305, 325

spontaneous 305indications to treat 868management

heavy sedation for 879protocol 876, 877

monitoring 868and hemorrhage 869and prophylactic antibiotics 869complications 869estimating ICP in infants 870fontanometry 870

1282 INDEX

intracranial pressure - monitoring (cont’d)in gunshot wounds 915in multiple trauma 863indications 868infection and 869monitor insertion technique 208treatment threshold 876

normal values 867respiratory variations 872secondary rise 867waveforms 871

intradiscal electrothermal anuloplasty (see intra-discal endothermal therapy)

intradiscal endothermal therapy 447, 448intradiscal pressure 437, 448intradiscal procedures 447intradural disc herniation 455intramedullary spinal cord tumors 730

management 733intranasal/intracranial lesions 1229intraoperative aneurysm rupture

with coiling 1060with craniotomy 1064

intraoperative cortical mapping 150intraoperative dyes 144intraoperative evoked potentials 267

anesthesia requirements 4intraoperative pneumoencephalogram 863intraoperative ultrasound

for spine fracture 990intraosseous meningiomas 613intraperitoneal pressure 315intrasellar lesions (see sellar lesions)intraspinal cysts 1234intraspinal narcotic administration 570

implantable pump 571intraspongious disc herniation (see Schmorl’s

node)intrathecal baclofen

withdrawal syndrome 540intrathecal drugs

antibioticsfor shunt infection 347

baclofen 539contrast agents 122

inadvertent use of ionic agent 122iohexol 123

implantable pump 571methotrexate 675

treatment for overdose 675morphine

for pain 570for spasticity 538

narcotics 570implantable pump 571

rituximab 675steroids for postherpetic neuralgia 566

intravascular lymphomatosis 674and cauda equina syndrome 446

intravenous pyelography 119

intraventricular catheter 870, 871, 871insertion technique 871(see also ventricular catheterization)

intraventricular hemorrhageand vasospasm 1045etiologies 1228from closed head injury 858in the newborn 1131with aneurysmal rupture 1037, 1056

PICA aneurysms 1072with intracerebral hemorrhage 1127, 1130

in newborns 1131yield of angiography 1127

intraventricular lesions 1224surgical approaches 168

intraventricular narcotic administration 572intravertebral disc herniation 429, 455intubation

in severe TBI 879indications 861

Invanz® (see ertapenem)invasive pituitary adenoma 637

treatment 650inverse ptosis 833inverted radial reflex 488iodinated contrast

adverse reactions 125with metformin (Glucophage®) 122

agents used in neuroradiology 122allergy

kyphoplasty and 995prep 124

prep for renal insufficiency 124iodixanol 124iohexol 122

for arteriography 123for myelography 123, 140for ventriculo-atrial shunt 211intrathecal 123

ionic contrast agents 122iopamidol 123Iopidine® (see apraclonidine)iopromide 124ioversol 123

for arteriography 124IPG (see impedance plethysmography)iridoplegia, traumatic 831ISAT (see International Subarachnoid Hemor-

rhage Aneurysm Trial)ischemia (cerebral) (see cerebral ischemia)ischemic cerebral edema 109ischemic optic neuropathy

following lumbar spine surgery 450from hydrocephalus 335

isoflurane 2and cerebral protection 1063

isolated angiitis of the CNS 78isolated CNS vasculitis 78isolated fourth ventricle 309isolated posterior circulation 1159isoproterenol 23

INDEX 1283

Isoptin® (see verapamil)Isovue® (see iopamidol)isthmus

of the axis (C2) 959Isuprel® (see isoproterenol)IV solutions

and elevated ICP 878Ivalon® sponge (see polyvinyl alcohol)IVC (see ventricular catheterization)ivory bone 498

differential diagnosis 1233

JJ shaped sella turcica 138jackknife spasms 396Jackson classification of glomus tumors 681Jakob-Creutzfeldt disease (see Creutzfeldt-Jakob

disease)Japanese Orthopedic Association scale 487jaw claudication 75jaw jerk 488JC virus 364Jefferson fracture 933, 958jejunal feedings 908Jendrassik maneuver 786jet ventilation 880Jewett hyperextension brace 989Joubert's syndrome 240jugular bulb 680jugular foramen 89

syndromes 115jugular venous oxygen monitoring 874

oxygen saturation (SjVO2) 874jugular venous oxygen saturation

treatment threshold 876jumped facets (see locked facets)junctional scotoma

with ophthalmic artery aneurysms 1071with optic nerve excision 606with pituitary tumors 643

juvenile myoclonic epilepsy 395, 412juvenile pilocytic astrocytoma 603juvenile spinal AVM 507juxtafacet cyst (spinal) 456

Kkakosmia 395Kallmann syndrome 635Kapp-Gielchinsky shunt 887Karnofsky scale 1182

and survival with astrocytoma 602Katzman test for NPH 332Keen’s point 207Kefzol® (see cefazolin)Keppra XR® 415Keppra® (see levetiracetam)Kernig sign 1036Kernig’s sign 343, 377

Kernohan grading system (for astrocytomas) 594Kernohan’s phenomenon 287, 894ketamine

for anesthesia induction 2ketoconazole

for Cushing’s disease 654ketoprofen 45ketorolac tromethamine 46

dosing forms (oral) 46keyhole foraminotomy

for cervical radiculopathy 469in cervical myelopathy 492

Ki-67 proliferation index 720in meningiomas 616

kindling 396kissing spines 478Kleeblattschadel syndrome 232Klippel-Feil syndrome 253Klonopin® (see clonazepam)Klumpke's palsy 802knee jerk (see patellar reflex)Kocher’s point 207Korsakoff’s syndrome/psychosis 275kuru 361kyphoplasty 995kyphosis

in cervical spondylotic myelopathy 486measurement 430Scheuermann's kyphosis 506thoracic

in ankylosing spondylitis 502thoracic spine

normal 441kyphotic deformity

following anterior cervical discectomy 465stability criteria

thoracolumbar burst fracture 989thoracolumbar compression fractures 989thoracolumbar fracture-dislocation 989

Ll’etat lacunaire 1026L1 syndromes 308labetalol 20, 21

for AVM surgery 1103for glomus tumors 681in strokes 1019

lacertus fibrosus compression of median nerve 807

lacosamide 418Lacricert® 159lacrimal glands

involvement in sarcoidosis 72lacrimation

absence with pseudo-CSF rhinorrhea 302with cluster headache 58with hemifacial spasm 542with SUNCT 549with trigeminal neuralgia 549

1284 INDEX

lactotroph hyperplasia 1215lacunar strokes 1026

and arteriosclerotic parkinsonism 60Ladd epidural monitor 870lambda 86lambdoid plagiocephaly 230lambdoid synostosis 230lamina cribrosa (of IAC) 89lamina fracture

thoracolumbar 986laminectomy

cervical 468, 492and subluxation 462and swan neck deformity 492

lumbarand complex regional pain syndrome 450and complex regional pain syndrome

(AKA RSD) 1197and subluxation 483complications of epidural fat graft 448epidural fat graft 448for herniated disc 447post-op check 452post-op orders 451risks 449urgent (indications) 445

thoracic 471wound infection 348

laminotomies 481lamotrigine 417language disturbance

differential diagnosis 1208lansoprazole 1042laparoscopic surgery in patients with VP shunts

328Larodopa® (see levodopa)Lasègue’s sign 443laser disc decompression 448Lasix® (see furosemide)lateral bending test 453lateral canthal advancement 230lateral cervical puncture 206lateral cutaneous nerve of the forearm 792lateral femoral cutaneous nerve 818lateral fissure - surface anatomy 87lateral lumbar interbody fusion (LLIF)

approach for thoracic disc herniation 474for lumbar fusion 194

lateral mass screws (see posterior spinal instru-mentation)

lateral mass fracture of atlas 958lateral medullary syndrome 1028

and vertebral artery dissection 1163vs. brainstem compression 1021

lateral oblique position 152, 154, 154lateral recess syndrome 484lateral rectus palsy 836lateral ventricle

surface anatomy 88surgical approaches 168

latex allergy - in myelomeningocele 248

laughing (with gelastic seizures) 226law of Laplace 326lazaroids

for severe TBI 883Lazarus sign 290lazy lambdoid 230lead poisoning

and foot drop 1196and macrocephaly 1206and wrist drop 817from retained bullet 998vs. Guillain-Barré syndrome 68

LeFort fractures 890, 890left-right confusion 113Lennox-Gastaut syndrome 396, 403lenticulostriate arteries 97, 100, 100

lateral 101leopard man sign 72lepirudin 40leptomeningeal carcinomatosis (see carcinoma-

tous meningitis)leptomeningeal cysts 222

posttraumatic 892lesion in continuity

use of NAP recording 790lesser occipital nerve

dermatome 551lethal midline granuloma 78, 1229leukemia

and intracerebral hemorrhage 1131and PML 364

leukoaraiosis 1227leukoencephalopathy

differential diagnosis 1214from intra-arterial BCNU 601from RTX + methotrexate 771

leuteinizing hormone releasing hormone (see go-nadotropin releasing hormone)

levelC-spine surface landmarks 89in spinal cord injuries 930

Level I, II, III, A, B… recommendations - defini-tions iv

levetiracetam 415dosing forms 415

Levine classification (hangman’s fracture) 960Levo-Dromoran® (see levorphanol)levophed 23

for vasospasm 1051levorphanol 47, 48levoscoliosis 430Lewy bodies 60Lhermitte’s sign 1198

differential diagnosis 1198in central cord syndrome 948in cervical spondylotic myelopathy 488in Chiari I malformation 234in multiple sclerosis 62in radiation myelopathy 771, 773

Lhermitte-Duclos disease 593Librium® (see chlordiazepoxide)

INDEX 1285

Licox® monitor 874lidocaine

for ICP management 880in neuroanesthesia 3patch for postherpetic neuralgia 565

lidocaine patchfor neuropathic pain 549for postherpetic neuralgia 566

Lidoderm® (see lidocaine patch)lifetime risk of hemorrhage from AVM or aneu-

rysm 1100Li-Fraumeni syndrome 588ligamentotaxis 990ligaments

cervical spineinjury of

atlanto-occipital dislocation 951MRI findings 941

occipito-atlanto-axial joint 91, 91ligamentum flavum

inbuckling ofin cervical spine 486in lumbar spine 478

ossification ofcervical 486lumbar 479

ligation (proximal) for aneurysms 1058light reflex 830light-near dissociation 830Liliequist’s membrane 1085limbus fracture 442lindane

and idiopathic intracranial hypertension 715Lindegaard ratio 1048linea nigra 639linear-quadratic (LQ) equation 770lipohyalinosis 1026, 1120lipoma

intracranial 225with agenesis of corpus callosum 246

of the cauda equina 251spinal cord 732

and dorsal dysraphism 251lipomatosis

spinal epidural 516differential diagnosis 1186

lipomatous medulloblastoma (see cerebellar lipo-neurocytoma)

lipomyelomeningocele 251lipomyeloschisis 251liponeurocytoma (central) 612liponeurocytoma (cerebellar) (see cerebellar lipo-

neurocytoma)lipothymia 1199Lisch nodules 723lissencephaly 243lithium

as a cause of diabetes insipidus (DI) 15for SIADH 13

lithotomy position - and neuropathy 799liver failure and ICP monitoring 869

LLIF (see lateral lumbar interbody fusion)LOAF muscles 791, 806lobar hemorrhage 1119

clinical syndromes 1124mortality 1131

lobectomytemporal 163

localization of thoracic levels 175localizing levels in spine surgery 173locked facets

C2-3 in hangman’s type III fracture 960, 962subaxial C-spine 972

locked-in syndrome 266, 281, 1027Lodine® (see etodolac)Logiparin® (see tinzaparin)lomustine (see CCNU)long portal veins 110long thoracic nerve 792Lopressor® (see metoprolol)lorazepam 52

for ethanol withdrawal seizures 274for status epilepticus 405, 406

Lortab® (see hydrocodone)Lou Gehrig’s disease (see amyotrophic lateral

sclerosis)Lovenox® (see enoxaparin)low back pain (see back pain)low density areas (in moyamoya disease) 1172low grade glioma 590low ICP syndrome 325low molecular weight heparins 39

discontinuation prior to neurosurgical proce-dures 38

low-dose heparin 42, 938discontinuation prior to neurosurgical proce-

dures 38lower motor neuron paralysis 786lower motor neurons 786LP shunt (see lumboperitoneal shunt)lucid interval 894lückenschädel 239lumbar corsets and support belts 439lumbar disc (see intervertebral disc - lumbar)lumbar drainage 205

for aneurysm surgery 1062for CSF fistula 304for intracranial hypertension 880for NPH 332for pituitary macroadenomas 657for post-op pseudomeningocele 158

lumbar laminectomycomplications 449post-op orders 451risks 449urgent surgery (indications) 445with fusion (see fusion - lumbar spine)

lumbar pseudodisc 475lumbar puncture 201

complications 203central herniation 203, 204, 352, 357cerebrovascular venous thrombosis 1166

1286 INDEX

lumbar puncture - complications (cont’d)epidermoid tumor 203headache 58spinal epidural abscess 377spinal epidural hematoma 39, 515

contraindications 201for carcinomatous meningitis 711for cerebral abscess 352for CSF fistula 304for suspected SAH 1037in AIDS patients 367in normal pressure hydrocephalus 332in spinal epidural abscess (precautions) 378needles 204opening pressure 202

in NPH 332normal values 202

serialfor hydrocephalus after ventricular hem-

orrhage 314for pseudotumor cerebri 718

technique 202traumatic

vs. SAH 298lumbar spinal fusion 440

anterior lumbar interbody fusion (ALIF) 195axial lumbar interbody fusion (Ax-LIF) 195facet fusion 197for spinal stenosis 483lateral lumbar interbody fusion (LLIF) 194posterior lumbar interbody fusion (PLIF) 193transfacet pedicle screws for 196transforaminal lumbar interbody fusion

(TLIF) 193lumbar spinal stenosis 477

differential diagnosis 478evaluation 479treatment 480

interspinous process decompression 482laminectomy 481

lumbar spine fractures 986lumbar stenosis (see lumbar spinal stenosis)lumbar sympathetic block 216lumbar translaminar screw fixation 193lumboperitoneal shunt

and tonsillar herniation 317evaluation 214for pseudotumor cerebri 718placement 213tapping 214

lumbosacral plexopathy 795lumbosacral sprain 1192lumbralized S1 vertebrae 174Lundberg waves 872lung cancer (see bronchogenic cancer)lupus anticoagulant 41, 1025

(see also systemic lupus erythematosus)luxury perfusion 874, 1014Lyme disease 368

and Bell’s palsy 1202and facial palsy 845

lymphangiomaof the orbit 1218

lymphocytic hypophysitis 1217lymphoma

cerebraland PML 365differential diagnosis 1226nonenhancing 674

intraocular 675intravascular lymphomatosis 674of the skull 698primary CNS 672, 1203

in AIDS 364imaging findings 366prognosis 367

spinal 730differential diagnosis of myelopathy 1186

lymphomatoid granulomatosis 78lymphomatous meningitis 711Lyodura®

and Creutzfeldt-Jakob disease 362Lyrica® (see pregabalin)Lysodren® (see mitotane)lytic skull lesions 1220

Mma huang 1121MACE Study 1149Macewen’s sign 312macrocephaly 1206

differential diagnosis 1206macrocrania 312, 1206Macrodantin® (see nitrofurantoin)macroencephaly (macrencephaly) 245macroprolactinemia 644macular sparing 1028mad cow disease 361magnetic gait 329magnetic resonance angiography (MRA) 132

for aneurysm screening 1081for carotid stenosis 1145for cerebral aneurysms 1038for vasospasm 1047

magnetic resonance imaging (MRI) 129and aneurysm clips 131blood

best sequence for parenchymal blood (gradient-echo T2WI) 1107

best sequence for SAH (FLAIR) 1038intracerebral hemorrhage 1125signal characteristics 132

cervical spinein cervical spondylosis 489increased signal in spinal cord 490

contraindications 130contrast 130diffusion tensor tractography 134diffusion-weighted imaging (DWI) 132dynamic MRI for pituitary tumors 648FIESTA image 624

INDEX 1287

magnetic resonance imaging (MRI) (cont’d)FLAIR images 129

in SAH 1038for failed back surgery syndrome 459gadolinium contrast 130gradient echo 130, 1101in head trauma 860in multiple sclerosis 64in pregnancy 1087in spinal mets 744lumbar spine 434

Modic’s classification 430to select patients for fusion 434

perfusion-weighted imaging 132magnetic resonance spectroscopy (MRS) 133

and cerebral abscess 352and radiation necrosis 771

Magnevist® (see gadopentetate dimeglumine)main en griffe 813malcavernin 1107malignant astrocytomas 595malignant cerebral edema 853, 917malignant hypertension

and hypertensive encephalopathy 73, 1199and optic disc edema 716

malignant hyperthermia 5malignant meningioma 616malignant middle cerebral artery territory infarc-

tion 1022malignant peripheral nerve sheath tumor 583

in neurofibromatosis type 1 722malignant transformation of astrocytomas 595mandibular nerve 551manganese toxicity 60, 1229man-in-the-barrel syndrome 284manipulation therapy (see spinal manipulation)mannitol

and aneurysmal rebleeding 1062contraindication in pregnancy 1087for cerebral protection 1052, 1063for ICP management

complications 882dosing 879effect & indications 882

for stroke 1020in E/R 862masking DI 16to improve blood rheology 1052use in hyperemia 882

manufacturerCordis Corporation 320Heyer-Schulte 320Infusaid, Inc. 571NeuroCare 320Pudenz-Schulte Medical 318, 320Sophysa USA 319

MAO inhibitors (see monoamine oxidase inhibi-tors)

marantic thrombosis 1166marble bone disease 1204Marcaine® (see bipuvicaine)

marche á petits pas 59, 1026Marcus Gunn

phenomenon 838pupil 831

Marfan syndromeand arterial dissections 1161and intracranial aneurysms 1057and stroke in young adults 1025

Marie-Strümpell disease (see ankylosing spondylitis)

martensitic aneurysm clips 131masking effect (on CT after CVA) 1012Masson’s vegetant intravascular hemangioendot-

heliomacausing facial palsy 845causing intracranial hypertension 716causing spinal cord compression 729

mastoid air cells 156, 228mastoid emissary vein 560maxillary nerve 551Mayfield head-holder 145MBEN (see medulloblastoma - with extensive

nodularity)McComb reservoir 1136McCune-Albright syndrome 701McDonald criteria for MS 64McGregor’s line 135, 139McRae’s line 135, 139mean carotid pressure 866meant transit times (on CT perfusion) 128mechanical clot disruption 1018mechanical embolectomy 1018

timing 1016mechanical heart valves (see prosthetic heart

valves)Meckel’s cave

glycerol injection 554location 99

meclizine HCl 843meclofenamate 45Meclomen® (see meclofenamate)medial branch block for facet joint pain 478medial gap 1055medial intermuscular septum (in ulnar nerve sur-

gery) 814, 815medial lemniscus 94medial longitudinal fasciculus 834medial orbitotomy 718medial posterior choroidal artery 98medial striate artery (see artery - Heubner’s)medial temporal lobe lesions 1228medial thalamotomy 567, 575median artery thrombosis 808median eminence 109, 110median nerve 791, 791

anatomy 806entrapment 806perioperative neuropathy 799

Medical Research Council strength grading 786mediolongitudinal myelotomy 570Medpor® transsphenoidal sellar implant 659

1288 INDEX

Medtronic shunts 318medulloblastoma 686

differential diagnosis 1210with extensive nodularity (MBEN) 686

medullocytoma 612mefenamic 45mega cisterna magna 240megalencephaly 245Mehringer-Hieshima maneuver 1113Meige’s syndrome 542Melacine® vaccine 705melanin

on MRI 129melanocyte–stimulating hormone 111melanoma

and carcinomatous meningitis 711and CSF carcinoembryonic antigen 721and intramedullary spinal cord mets 732and spinal epidural metastases 742metastatic to brain 704

differential diagnosis 1212orbital 1218primary CNS 697

Mellanby effect 273membrane - Liliequist’s 1085Meniere’s disease 842

differential diagnosis of tinnitus 1208meningeal carcinomatosis (see carcinomatous

meningitis)meningeal cyst (spinal) 509meningeal gliomatosis 598meningeal thickening/enhancement 1227meningiomas 613

and intracerebral hemorrhage 1123angiographic findings 617asymptomatic 615atypical 616brain invasion 616cavernous sinus 774CP angle 1210

surgery 619vs. vestibular schwannoma 1211

differential diagnosis 616extraneural metastases 703falx (see parasagittal and falcine)following radiation therapy 771foramen magnum 614, 711

surgery 619hemangiopericytomas (meningeal) 616incidental 615intraosseous 613Ki-67 proliferation index 616location 613malignant 616meningioma en plaque 613meningothelial 615olfactory groove 614

surgery 619parasagittal and falcine 614

surgery 618

meningiomas (cont’d)parasellar

MRI findings/differential diagnosis 1216pathologic classification 615pediatric 697planum spehnoidale 614radiation induced 778rhabdoid 616sphenoid wing 613

surgery 618spinal 729, 729subcutaneous 613tuberculum sellae 614

surgery 619meningismus 1036meningitis 343

amebic 375aseptic

with epidermoid cyst 690with microvascular decompression 544,

555, 561carcinomatous 711chronic

with cysticercosis 371cryptococcal 366following PSR for trigeminal neuralgia 558hemogenic 544, 555, 561in CSF fistula 302

following vestibular schwannoma surgery 631

lymphomatous 711Mollaret’s 690Naegleria fowleri 375posttraumatic 344recurrent 232, 252, 253, 301, 344with neurenteric cyst 227with ventriculostomy 869

meningocelecranial 232spinal 248

meningohypophyseal trunk 99dural AVMs of 1109

meningothelial/meningotheliomatous meningio-ma 615

meniscus sign 733, 746meperidine 48

and delerium 275and seizures 397

meralgia paresthetica 818following cardiac catheterization 800in AIDS 798post-laminectomy 800

MERCI retriever 1018(also see mechanical clot disruption)

mercury density compared to water 870merlin 724mesencephalothalamic syndrome 1026mesencephalotomy 567mesenchymal, non-meningothelial tumors 620mesial temporal sclerosis 395

differential diagnosis 1228

INDEX 1289

mesoneurium 801metabolic craniopathy 700metabolic requirements 908metabolic syndrome due to growth hormone defi-

ciency 635Metaprel® (see metaproterenol)metaproterenol - for contrast media reaction 126metastases

cerebral 702biopsy 707CT scan 706differential diagnosis 707evaluation 706management 707

chemotherapy 708radiation therapy 708solitary vs. multiple lesions 709surgery 709

micro-metastases 708outcome 710radiosensitivity 708recursive partitioning analysis 707solitary 702, 706stereotactic radiosurgery for 710, 777,

778survival 710unknown primary 707use of steroids 708, 710work-up for primary 706

CSF seeding (see metastases - spinal seeding)intramedullary spinal cord 732of CNS tumors through CSF 702of primary CNS tumors 703

meningiomas 616spinal 742

evaluation 743indications for surgery 745radiation therapy for 747radiosensitivity 747treatment 747upper cervical spine 743vertebroplasty/kyphoplasty for 747work-up for primary 747

spinal seeding 702choroid plexus tumors 695ependymomas 682

post-op LP for 684malignant gliomas 597medulloblastoma 686pilocytic astrocytomas 605pineal region tumors 692, 693shunt tumor filter for 317

metformin 122methadone 48methimazole 655methocarbamol 50method of An (lateral mass plating) 188methohexital 24

for seizure surgery 422methotrexate

and leukoencephalopathy 771

methotrexate (cont’d)intraventricular

for CNS lymphoma 675overdose treatment 675

methsuximide 414dosing forms 414

methylene blue 144methylenedioxymethamphetamine

and hypercoagulability 1025methylenedioxymethamphetamine (MDMA)

and Parkinsonism 60and SIAD 9

methylmethacrylateand pulmonary embolism 995cranioplasty for hyperostosis frontalis interna

701for spine fractures 978for vertebroplasty/kyphoplasty 994strut graft with Steinmann pins 748to strengthen spinous process for interspinous

spacer 482methylprednisolone 31, 824

epidural use following discectomy 448for iodine contrast allergy prep 124for spinal cord injury 936for stereotactic radiosurgery 778

metocurine 25metopic synostosis 230Metopirone® (see metyrapone)metoprolol 21metronidazole

for bowel prep 195for cerebral abscess 354for subdural empyema 358

Metubine® (see metocurine)metyrapone

for Cushing’s syndrome 655metyrapone test

for ACTH reserve 661for localizing ACTH secretion 646

mexiletine for painful diabetic neuropathy 797Mexitil® (see mexiletine)Meyer’s loop 424MGMT 601Miacalcin® (see calcitonin)MIB-1 index 720

in astrocytomas 596in oligodendrogliomas 610

MIBG scintigraphy 679Mickey Mouse ventricles 310microadenoma 634microaneurysms of Charcot-Bouchard 1122microcephaly 245, 312

and maternal cocaine abuse 245following CSF shunting 328with TORCH infections 1206

microcystic meningioma 615microfibrillar collagen 146microglioma 672micrographia 59micro-metastases 708

1290 INDEX

microscope (see operating microscope)microvascular decompression

for hemifacial spasm (CrN VII) 543for torticollis (CrN XII) 541for trigeminal neuralgia (CrN V) 554, 559

midazolam 51drip 52for EtOH withdrawal 274for intracranial hypertension (ICP) 879for status epilepticus 405, 406

middle cerebral artery 101angiogram 101pseudotrifurcation 98trifurcation 98

middle frontal gyrus 84approach to lateral or third ventricle 172

middle temporal gyrus 84, 85, 735approach to amygdala 423

midline shiftand coma 280in trauma 909with strokes 1012

migraine 57and intracerebral hemorrhage 1120as a cause of stroke 1025crash 1035thunderclap headache 1035

migrated disc (disc migration) 429migration abnormalities 243mild traumatic brain injury 850miliary aneurysms 1122Millard-Gubler syndrome 114Miller-Fisher variant Guillain-Barré 68milrinone

for neurogenic stunned myocardium 1054mineralocorticoids 31, 34mini-dose heparin (see low-dose heparin)minimally invasive spine surgery

lumbarjuxtafacet joint cyst 457spinal stenosis 482

percutaneous pedicle screws 192mini-open lumbar laminectomy 482Minnesota Multiphasic Personality Inventory

(MMPI)and low back problems 436and nonepileptic seizures 401

miosisfrom narcotics 275, 282in Horner’s syndrome 833

mirror motions 254misery perfusion 1165MISME syndrome (see neurofibromatosis type 2)misoprostol 45missile wounds - to peripheral nerves 804mithramicin (see plicamycin)mitotane 655mitral valve prolapse and stroke 1024mixed gliomas 610, 612mixed neuronal-glial tumors 612

mJOA (see modified Japanese Orthopedic Asso-ciation scale)

MLS (see midline shift)MMPI (see Minnesota Multiphasic Personality

Inventory)Möbius syndrome 1202Modic’s classification 430

response to fusion 440modified ellipsoid volume 1125modified Japanese Orthopedic Association scale

(cervical myelopathy) 487modified Rankin scale 1183Mollaret’s meningitis 690monoamine oxidase inhibitors

interaction with meperidine 49monoclonal gammopathy 799mononeuropathy

definition 793mononeuropathy multiplex

definition 793ischemic 796

Monro-Kellie doctrine 867moon facies (in Cushing’s syndrome) 638Morgagni’s syndrome 700morphine 48

disadvantages in neuro patients 3extended release oral forms 48for pulmonary edema 126intraspinal 571intrathecal 538, 570

Morquio syndrome 494, 1185mosaic pattern in Paget’s disease 498most anterior mastoid point 87motion-preservation lumbar surgery 481motor cortex

cortical anatomy 84stimulation

for facial pain 554for facial postherpetic neuralgia 567

surface anatomy 87motor evoked potentials 267motor neuron disease (see amyotrophic lateral

sclerosis)motor neuron diseases 65motor oil fluid 899motor point block 538motor strip 84motor unit action potential (on EMG) 270motorcycle helmets 898Motrin® (see ibuprofen)moyamoya disease 1170

and arterial dissections 1161angiographic stages 1172asymptomatic 1174secondary moyamoya 1171

MPNST (see malignant peripheral nerve sheath tumor)

MPTP 60MRA (see magnetic resonance angiography)MRI (see magnetic resonance imaging)MRS (see magnetic resonance spectroscopy)

INDEX 1291

MS (see multiple sclerosis)MS Contin 48Mt. Fuji sign 891, 891MTHFR gene and neural tube defects 245MUAP (see motor unit action potential)mucin secretion with neurenteric cyst 228mucocele 1229

post-op 890mucormycosis 836, 1024, 1203, 1219Müller’s muscle 830, 833multicentric (multifocal) gliomas 598multifocal motor neuropathy 1188, 1197multifocal necrotizing encephalomyelitis (see en-

cephalitis - herpes simplex)multifocal varicella-zoster leukoencephalitis 360multiple aneurysms 1080multiple concussions 852multiple endocrine adenomatosis 634

and acromegaly 640multiple hamartoma syndrome 593multiple intracranial lesions 1212multiple myeloma 740

and amyloidosis 800and carpal tunnel syndrome 800, 810of the skull 1221of the spine 743work-up for 741

multiple sclerosis 61and multiple primary gliomas 598and trigeminal neuralgia 62, 551, 555and urinary bladder dysfunction 118concentric sclerosis of Balo 64diagnostic criteria 64McDonald criteria 64MR spectroscopy appearance 133myelopathy 1187

multiple system atrophy 60Munchausen’s syndrome

and nonepileptic seizures 400mural nodule

in hemangioblastoma 671in pilocytic astrocytoma

of cerebellum 605in pilocytic astrocytomas 604in pleomorphic xanthoastrocytoma (PXA)

592Murphy’s tit 1080muscle innervation 787muscle relaxants 50

for low back pain 438muscle strength grading 786muscle stretch reflex

following lumbar spine surgery 452grading 786in alcohol withdrawal syndrome 274in amyotrophic lateral sclerosis 66in cauda equina syndrome 446in cervical spondylotic myelopathy 488in extreme lateral lumbar disc herniations 454

muscle stretch reflex (cont’d)in Guillain-Barré syndrome 67in herniated cervical disc 461in herniated lumbar disc 445in herniated upper lumbar discs 453in lateral recess stenosis 485in lumbar spinal stenosis 478in multiple sclerosis 63in odontoid fracture 964in radiculopathy 428, 443in spinal cord injury 936, 945in trauma exam 856in whiplash associated disorder 931reinforcement 786

muscle weakness/wasting(see weakness - muscle)(also see atrophy)

musculocutaneous nerve 792muzzle velocity 913myalgia 1193myasthenia gravis

and abducens palsy 836and painless ophthalmoplegia 837

Mycobacterium avium complex vertebral osteo-myelitis 381

mycotic aneurysms 1082Mydfrin® (see phenylephrine - ophthalmic)Mydriacyl® (see tropicamide)mydriasis

from cocaine abuse 276in botulism 1191pharmacologic vs. third nerve compression

832traumatic 831(see also pupillary dilatation)

myelinopathy (Grinker’s) 277myelitis 69myelocele 243myelogram (see myelography)myelography 140

capping 746causing arachnoiditis 458contraindications 140emergency “blockogram” 745for drop metastases 684, 686for low back problems 435for spinal metastases 745for trauma 941in diagnosing arachnoiditis 458paintbrush effect 733, 746

myeloma (see multiple myeloma)myelomeningocele 248

and latex allergy 248closure 249definition 247intrauterine defect closure 248

myelopathydifferential diagnosis 1185due to cervical disc herniation 461

1292 INDEX

myelopathy (cont’d)due to cervical spondylosis 486from nonunion of odontoid fracture 965from Paget’s disease 500radiation myelopathy (see radiation injury

and necrosis)vs. myelitis 69

myelotomyBischof's 538commissural 570for spasticity 538punctate midline 570

myocardial infarction in cerebral embolism 1022myoclonic status 407myoclonus

following intrathecal injection of ionic con-trast agent 122

in Creutzfeldt-Jakob disease 362in hypoxic coma 287in metabolic coma 284in West’s disease 396juvenile myoclonic epilepsy 395myoclonic status 407

myopathyof critical illness 68steroid 34

Mysoline® (see primidone)myxedema coma 659myxoid liposarcoma metastatic to spine 743myxopapillary ependymoma 683, 731

NNAA (see N-acetyl aspartate) on MRSnabumetome 45N-acetyl aspartate (NAA) on MRS 133N-acetyl cysteine - for iodine study prep 124Naegleria fowleri meningoencephalitis 375naevus flammeus 255nafcillin

for cerebral abscess 354for shunt infections 347for surgical prophylaxis 342

naked facet sign 973nalbuphine 49

following spinal narcotics 571Nalfon® (see fenoprofen)nalmefene 276naloxone

for opioid overdose 276for reversal of spinal narcotics 571for spinal cord injury 936in coma 281

Naprosyn® (see naproxen)naproxen & naproxen sodium 45Narcan® (see naloxone)narcoleptic cataplexy 1200narcotics

analgesics 46anesthetics 3

narcotics (cont’d)effect on pupils 275, 282naloxone for overdose 276

nasal glial heterotopia 1230nasal glioma 1230nasal quadrantanopsia 1056NASCET trial 1150

measurement criteria 1145nasogastric tube

and frontal basal skull fractures 888intracranial placement 888

NBCA for AVMs 1103Neck Disability Index 487neck pain

differential diagnosis 1197with cervical disc herniation 461with cervical spondylosis 486

needle aspirationof cerebral abscess 355

Nelson’s syndrome 634, 639, 654treatment 650

Nembutal® (see pentobarbital)Neofrin® (see phenylephrine - ophthalmic)neonatal brain tumors 697neostigmine 27Neo-Synephrine® (see phenylephrine)nephrogenic diabetes insipidus (DI) 15nephrogenic systemic fibrosis 130nerve action potentials 789nerve block 215

for occipital neuralgia 805ganglion impar (ganglion of Walther) 517intercostal 216lumbar sympathetic 216medication mixture 824stellate ganglion 215

nerve conduction velocitiesfor low back problems 433in carpal tunnel syndrome 809in ulnar nerve entrapment 814

nerve of Wrisberg 564nerve palsies - in HNPP 793nerve root anomalies 256nerve root avulsion 801

from motorcycle trauma 802treatment for pain 575

nerve root enhancement 1234nerve root syndromes

cervical 461lumbar 445

tension signs 443nerve root tension signs 443nervi erigentes 117nervus intermedius 90, 563nervus intermedius neuralgia 563neural canal width (see posterior atlantodental in-

terval)neural tube defects 243neuralgia

geniculate 563

INDEX 1293

neuralgia (cont’d)glossopharyngeal 563intercostal 216, 573occipital 804, 961, 964postherpetic 216, 564supraorbital 562supratrochlear 563trigeminal 551

neuralgic amyotrophy 794neurectomy

for trigeminal neuralgia 554peripheral 568supraorbital 554supratrochlear 554

neurenteric canal 227neurenteric cyst 227

differential diagnosiscerebellopontine angle (CPA) 1210spinal 1185

neurites 722neuroanesthesia 1

inhalational agents 1intravenous agents 2paralytics for intubation 4

neuroblastomascentral nervous system 685sympathetic nervous system 748

neurocardiogenic syncope 1199NeuroCare shunt 320neurocentral synchondrosis of C1 137, 137neurocritical care 7neurocutaneous disorders 722neurocutaneous melanosis (NCM) 726neurocysticercosis 370

giant cysts 371intraventricular - differential diagnosis 1225

neurocytoma (central) 612extraventricular 612

neuroectodermal cysts 1217neuroendocrine stains 721neuroendocrine tumors 721neuroendovascular intervention 262

stents 263neuroepithelial cysts (see colloid cysts)neurofibromas

in neurofibromatosis 1 723in neurofibromatosis 2 (dermal) 724spinal 729vs. schwannomas 722

neurofibromatosis 722and meningiomas 613and moyamoya disease 1171and optic gliomas 606, 723and vestibular schwannoma 620type 1 723type 2 724

neurofibromin 723neurogenic bladder 117neurogenic claudication 477

differential diagnosis 478from spinal synovial cyst 456

neurogenic dysphagia 239neurogenic motor evoked potentials (see de-

scending evoked potentials)neurogenic pulmonary edema 28

and subarachnoid hemorrhage 1042neurogenic shock 22neurogenic stunned myocardium

following SAH 1054neurohypophysis 109neurological assessment

in coma 281in head trauma 855in myelomeningocele 248in spinal cord injury 944in stroke 1014

neurology 56neurolysis of the median nerve at the wrist 811neuroma

acoustic (vestibular schwannoma) 620facial nerve 845, 1210trigeminal 1210

neuroma in continuity 803neuromeningeal trunk 98neuromonitoring 866

brain tissue oxygen tension (pBt O2) 874cerebral microdialysis 875intracranial pressure (ICP) 866jugular venous oxygen 874regional blood flow (rCBF) 875

neuromuscular blockand pupil size 290

neuromuscular blocking agents 25neuromyelitis optica 1187neuron specific enolase 721Neurontin® (see gabapentin)neuroparalytic keratitis

eye protection measures 557following trigeminal rhizotomy 558in Guillain-Barré syndrome 68

neuropathic pain 548neuropathy 793

alcohol 794amyloid 800associated with monoclonal gammopathy 799brachial plexus 794diabetic 796drug-induced 797entrapment 804femoral 798following cardiac catheterization 800in giant cell (temporal) arteritis 75in HIV infection 798lumbosacral plexopathy 795perioperative 799sensory neuropathy and neoplasms 794ulnar

entrapment 812uremic 800

neuropathy of critical illness (see critical illness polyneuropathy)

neurophthalmology 828

1294 INDEX

neurophysiology 109bladder 116pupillary 829

neuroporeembryologic closure 248

neuropraxia 802cervical cord 980

neuroradiology 122neurosarcoidosis 71

and gyral enhancement 1013as a cause of coma 280as a cause of cranial nerve palsies 1203vs. pseudotumor cerebri 716

neurosyphilisas a cause of myelitis 69as a cause of stroke 1018, 1024in AIDS 365pupillary findings 830

neurotmesis 802neurotology 840neurotoxicology 273

amphetamines 277carbon monoxide 277cocaine 276ethanol 273lead poisoning 998manganese toxicity 60, 1229opioid 275

neurovascular compression syndromes 542neurulation defects 243neutral position splint 811nevus flammeus 726new onset seizures 396new variant CJD (see Creutzfeldt-Jakob disease)NEXUS criteria 938nicaraven 1049nicardipine

for cerebral vasospasm 1053prolonged release implants 1049

for hypertension 19nickel factory workers and SNUC 1230Niclocide® (see niclosamide)niclosamide 372nidus (AVM) 1098Niemeyer approach

for amygdalo-hippocampectomy 423nifedipine

for autonomic hyperreflexia 1001for hypertension 21for migraine 58for strokes 1019for vasospasm 1053

night cramps 51night pain

with carpal tunnel syndrome 809with diabetic amyotrophy 796with extraspinal tumors 1190with osteoid osteoma and osteoblastoma 736with spinal cord tumors 732

NIH stroke scale 1014Nimbex® (see cisatracurium)

nimodipine 1053for aneurysmal SAH 1053for posttraumatic SAH 862in pregnancy 1087

Nimotop® (see nimodipine)nimustine (see ACNU)Nipride® (see nitroprusside)nitrofurantoin

and peripheral neuropathy 797nitrogen balance 908nitroglycerin

IV for hypertension 20nitroprusside 19

for autonomic hyperreflexia 1001in neurogenic pulmonary edema 28

nitrosoureas 589nitrous oxide anesthesia

and pneumocephalus 2Nizoral® (see ketoconazole)NMDA receptor antagonists 1049N-methyl-D-aspartate receptor antagonists 1049NMO (see neuromyelitis optica)NMO-IgG 1187Nocardia cerebral abscess 356

modified acid-fast stain for 355nocturnal pain (see night pain)nodular enhancing intraspinal lesions 1234Nolvadex® (see tamoxifen)non-aneurysmal SAH 1084non-communicating hydrocephalus 307nonepileptic seizures 400nonfunctional pituitary adenomas 641

management 649non-missile penetrating head trauma 916non-small-cell lung cancer 704nonsteroidal anti-inflammatory drugs 44

and nonunion of bone 484Norco® (see hydrocodone)Norcuron® (see vecuronium)norepinephrine 23normal perfusion pressure breakthrough 778,

1104, 1120normal pressure hydrocephalus 329

differential diagnosis 330Katzman test 332resistance testing 332tap test for 332treatment 333

normal pressure hyperperfusion breakthroughfollowing carotid endarterectomy 1153

normal saline infusion test 9normal volume hydrocephalus 326Normiflo® (see ardeparin)Normodyne® (see labetalol)Norpramin® (see desipramine)North American Symptomatic Carotid Endarter-

ectomy Trial (NASCET) 1150nortriptyline

for postherpetic neuralgia 566Norvir® (see ritonavir)NovoSeven® (see factor VII)

INDEX 1295

NPH (see normal pressure hydrocephalus)NSAIDs (see nonsteroidal anti-inflammatory

drugs)NSF (see nephrogenic systemic fibrosis)NSM (see neurogenic stunned myocardium)NTG (see nitroglycerine)Nubain® (see nalbuphine)nuclear medicine studies (see scintigrams)nucleoplasty 448nucleotome 447nucleus pulposus - definition 428numb-clumsy hand syndrome 488Numorphan® (see oxymorphone)numular headache 563Nurick grade (disability from cervical spondylo-

sis) 505Nuromax® (see doxacurium)nutrition in head injuries 907nystagmus 828

downbeat 828with Chiari I malformation 235

monocular 834nystagmus retractorius 114, 828optokinetic 284seesaw 828

OOALL (see ossification - of the anterior longitu-

dinal ligament)oat cell lung cancer (see small-cell lung cancer)Obersteiner-Redlich zone 108, 542obesity

and hyperostosis frontalis interna 700and idiopathic intracranial hypertension 713,

715as a risk factor for neural tube defects 245

oblique cervical spine x-rays 939obliteration of basal cisterns on CT

following head injury 909in cerebellar infarct 1021

observer eyepiece position on operating micro-scope 144

obsessive compulsive disordersdeep brain stimulation for 532

obstructive hydrocephalus 307obturator nerve entrapment 820obturator neurectomy 538obturator neuropathy

following cardiac catheterization 800occipital artery 98

as collateral for vertebral artery occlusion 1027

occipital condyle fracture 954occipital condyle screws 180occipital craniotomy 164occipital nerve entrapment 804occipital neuralgia 804

with hangman’s fracture 961with odontoid fractures 964

occipital neurectomy 806occipital plagiocephaly 230occipital vs. frontal skull fractures 858occipital-C1 transarticular screws 180, 181occipital-cervical fusion (see occipitocervical fu-

sion)occipital-frontal circumference 312

graphchildren (inside front cover)for preemies 313related to weight and height 313

measurement technique 312occipitalization of the atlas

and Chiari I malformation 234occipital-parietal burr hole 207occipitoatlantal dislocation (see atlantooccipital

dislocation)occipitoatlantal junction

normal motion 180(see also atlantooccipital dislocation)

occipitocervical fusion 179indications 179keel plate method 180occipital condyle screws 180occipital-C1 transarticular screws 181

occipitomastoid suture 86occiptoatlantoaxial complex anatomy 91occlusion syndromes 1027occlusive cerebrovascular disease 1144occlusive hyperemia 1104occult cerebrovascular malformations 1105octreotide

for glomus jugulare tumors 682for growth hormone-secreting pituitary ade-

nomas 653LAR Depot formulation 653

for TSH-secreting pituitary adenomas 655octreotide scan 648ocular bobbing 283, 838ocular dysmetria 828ocular hemorrhage - from SAH 1036Oculinum® (see botulinum toxin)oculocephalic reflex 283, 289oculomotor nerve compression

as cause for anisocoria 832oculomotor palsy 834

from p-comm aneurysm 1061(see also ophthalmoplegia)

oculosympathetic palsy 1163oculovestibular reflex 283, 289odontoid process

distance to C1 (see atlantodental interval)fractures 963

compression screw fixation 181, 184in rheumatoid arthritis 495nonunion 965

pannus 495retroversion 234

odontoid screw fixation 181odynophagia - following ACDF 466OFC (see occipital-frontal circumference)

1296 INDEX

Ogilvie’s syndrome 450OK sign 807olfactory groove meningiomas 614olfactory hallucinations 395olfactory neuroblastoma (see esthesioneuroblas-

toma)oligoastrocytoma 590, 610, 612

anaplastic 612oligoastrocytoma WHO grade II 612

oligoclonal bandsin Lyme disease 369in multiple sclerosis 64, 65

oligodendroglioma 609grading 610treatment 611

olivopontocerebellar degeneration 60Ommaya® reservoir 211

insertion 212Omnipaque® (see iohexol)oncocytoma 641ondansetron 1042Ondine’s curse 568Onyx

for aneurysms 1058for AVMs 1102for dural AVMs 1110

open lipped schizencephaly 243opening pressure (on LP) 202

in NPH 332normal values 202

operating microscope 144operating room equipment 144operations and procedures 144ophthalmic artery 99, 1070

aneurysms 1070involvement in giant cell arteritis 75retrograde (collateral) flow 1027

ophthalmic nerve 551ophthalmic segment aneurysms 1070ophthalmoplegia

abducens palsy 836due to cavernous carotid artery aneurysms

1079, 1204in Guillain-Barré 68internuclear (see internuclear ophthalmople-

gia)multiple extraocular muscle involvement 836oculomotor palsy 834painful 836painless 837trochlear nerve palsy 835

opioidanalgesics 46effects on pupils 275, 282naloxone for overdose 276toxicity 275withdrawal syndrome 276

opisthion 86, 87OPLL (see ossification - of the posterior longitu-

dinal ligament)opsoclonus 839

optic glioma 606in neurofibromatosis 723

optic nervedecompression

for indirect optic nerve injury 863in osteopetrosis 1204

indirect injury 863optic nerve sheath fenestration

for cerebrovascular venous thrombosis 1169for pseudotumor cerebri viii, 718

optic neuritis 62, 832vs. papilledema 829

Optiray® (see ioversol)optokinetic nystagmus 113, 284oral contraceptives

and cerebrovascular venous thrombosis 1166and idiopathic intracranial hypertension 715and seizure medication 419and stroke in young adults 1025

oral glucose suppression test (for growth hor-mone secretion) 648

orbital apex syndrome 836orbital lesions 1218orbital pseudotumor (see pseudotumor - orbital)orders

admittingfor minor head injury 860for moderate head injury 860subarachnoid hemorrhage 1041

post-opaneurysm clipping 1076baclofen pump insertion 539cervical disc arthroplasty 468craniotomy 148lumbar laminectomy 451transsphenoidal pituitary surgery 660VP shunt 210

pre-opcraniotomy 148transsphenoidal pituitary surgery 660

organ donation 293after cardiac death 295

organ transplant patientsand cerebral abscess 351and primary CNS lymphoma 673

Orgaran® (see danaparoid)orgasmic cephalgia (see benign orgasmic cephal-

gia)orthostatic hypotension 1199

with Shy-Drager syndrome 60Orudis/Oruvail® (see ketoprofen)os odontoideum 966oscillopsia 839

following vestibular neurectomy 841Osler-Weber-Rendu syndrome 1106

and capillary telangiectasia 1106and cerebral abscess 350and cerebral AVMs 1098and CVA in young adults 1024and intracranial aneurysms 1057

INDEX 1297

osmolalityserum 8, 19

calculated 19in diabetes insipidus (DI) 15in SIADH 11

urinein diabetes insipidus (DI) 16normal range 16

osmotic demyelination syndrome 11osmotic therapy 879ossiculum terminale 966ossification

of the anterior longitudinal ligament 506of the ligamentum flavum 479, 486of the posterior longitudinal ligament (OPLL)

486, 504differential diagnosis 1186

ossification centersatlas (C1) 137axis (C2) 137

ossification of the yellow ligament (see ossifica-tion - of the ligamentum flavum)

Ostac® (see clodronate)osteitis condensans ilii 1194osteitis deformans (see Paget’s disease)osteoblastic spinal lesions 744osteoblastic spinal metastases 728, 736osteoblastoma

of the skull 1222of the spine 736

osteochondroma of the spine 728osteoclastoma (see giant cell tumor)osteoconduction 198osteogenesis 198osteogenic sarcoma

of the skull 698of the spine 729

osteoid osteomaof the skull 1222of the spine 736

osteoinduction 198osteolytic skull lesions 1220osteoma (skull) 698

differential diagnosis 1222osteomyelitis

of the skull 349vertebral 380

work-up 382osteopenia 992osteopetrosis 1204osteoporosis 992

and interspinous spacers 482and spine fractures 992DEXA scan to assess 992from chronic heparin therapy 39in Cushing’s syndrome 638in multiple myeloma 741steroid induced 33, 992treatment 993with prolactinomas 637with reflex sympathetic dystrophy 577

osteoporosis circumscripta (see Paget’s disease of the skull)

osteosarcomacerebral metastases 704of the spine 738

osteosclerosis 1204osteosynthesis

for cervical lateral mass fractures 977for hangman’s fracture 963for odontoid fractures 181

Oswestry disability index 430otalgia 550

in geniculate neuralgia 564in glossopharyngeal neuralgia 563

otic artery 107otitic hydrocephalus 716, 1166otorrhea, CSF 301otosclerosis 848outcome assessment 1182overflow incontinence 117overshunting 325owl’s eyes (pedicles on AP x-ray) 744oxaprozin 45oxcarbazepine 412

dosing forms 412for postherpetic neuralgia 566for trigeminal neuralgia 553

oxidized cellulose 146Oxycel® (see oxidized cellulose)oxycephaly 231oxycodone 48

for postherpetic neuralgia 565OxyContin® 48

(also see oxycodone)oxygen

for cluster headache 58for pneumocephalus 892

oxygen extraction fraction 880, 1165OxyIR® 48

(also see oxycodone)oxymorphone 48oxytocin 112

PPA-catheter (see pulmonary-artery catheter)pacchionian bodies 1220pachygyria 243Paget’s disease 498, 1194

and increased skull density 1221and lumbar spinal stenosis 479as a cause of cranial neuropathies 1204as a cause of myelopathy 1186of the skull 1221of the spine 499

differential diagnosis 1233pain 548

back (see back pain)causalgia 576craniofacial 549

1298 INDEX

pain (cont’d)discogenic 436from metastatic bone disease 44in diabetic neuropathy 796medication 44meralgia paresthetica 818neck (see neck pain)neuropathic 548nocturnal (see night pain)procedures 567

commissural myelotomy 570cordotomy 568deep brain stimulation 574dorsal root entry zone lesions 575for trigeminal neuralgia 553intraspinal narcotics 570intraventricular narcotics 572punctate midline myelotomy 570spinal cord stimulation 572

reflex sympathetic dystrophy 576visceral 44

pain pump (see intrathecal drugs - implantable pump)

Paine retinaculatome 811painful disc syndrome 436painful ophthalmoplegia 836paintbrush effect (on myelography) 733, 746palatal myoclonus 542Palladone® (see hydromorphone)pallidotomy

for Parkinson’s disease 534Pallister-Hall syndrome 226palmar cutaneous branch 806palmaris longus tendon 806palsies, nerve - in HNPP 793PAM (primary amebic meningoencephalitis)Pamelor® (see nortriptyline)pamidronate 501Pancoast tumor

and brachial plexopathy 794, 802and Horner’s syndrome 833Pancoast syndrome 794

pancuronium 4, 27effect on pupil 833pre-treatment before succinylcholine 26reversal 27

panhypopituitarism (see hypopituitarism)pannus

odontoid 495Pantopaque® (see iophendylate meglumine)papaverine

intra-arterial for vasospasm 1050papillary ependymomas 683papillary meningioma (see malignant meningio-

ma)papilledema 828

and lumbar puncture 204from high altitude 916unilateral

differential diagnosis 829with idiopathic intracranial hypertension 714

para-articular heterotopic ossification 1000paracentral lobule 85, 86paradoxical embolism

air embolism 153cerebral embolism 1023, 1024

paradoxical pupillary reaction 833Parafon Forte® 50paraganglioma 678paralysis

ascending (in Guillain-Barré) 67from spinal cord injury

grading 936upper vs. lower motor neuron 786

paralytics 25early use in neurotrauma 860

paramedian pontine reticular formation 834paraneoplastic syndrome 69paraneoplastic syndromes 794paraplegia

differential diagnosis 1190parasellar lesions 1215parasitic infections 369parasympathetic

supply to bladder 117supply to pupil 830

parietal boss 207parietal craniotomy 169parietal lobe syndromes 112parietal thinning 1220parietomastoid suture 86Parinaud’s syndrome 114, 283, 286, 312, 1026park bench position 154, 154Parkinson, triangular space of 106Parkinson’s disease 59

secondary parkinsonism 60treatment

surgical 61, 532deep brain stimulation 534

parkinson-dementia complex of Guam 60parkinsonism 59

in NPH 330(see also Parkinson’s disease)

Parlodel® (see bromocriptine)paroxetine

for emotional incontinence 1030for painful diabetic neuropathy 797

paroxysmal headache (see headache - paroxys-mal)

pars distalis of the pituitary gland 109pars interarticularis 476

defect in spondylolisthesis 476of the axis (C2) 959, 959

pars intermedia of the pituitary gland 109pars marginalis 85

bracket sign 85pars tuberalis of the pituitary gland 109Parsonage-Turner syndrome 794partial status epilepticus 403patch graft

for carotid endarterectomy 1156

INDEX 1299

patellar reflexcrossed adductors 444in herniated lumbar disc 445in herniated upper lumbar discs 453in Holmes-Adie syndrome 832in lumbar spinal stenosis 478

patent foramen ovale in cerebral embolism 1023pathologic fracture of the spine

differential diagnosis 1232osteoporotic compression fractures 992sacral insufficiency fracture 1193

pathologic lid retractiondifferential diagnosis 1206

Patrick’s test (FABER) 444, 502, 1193Pavlov ratio 489

in assessing stability 970in contact sports 982

Pavulon® (see pancuronium)Paxil® (see paroxetine)pBtO2 or pBO2 (see brain tissue oxygen tension)PCV chemotherapy

for low grade gliomas 599for malignant gliomas 601for oligodendrogliomas 611

pearly tumor 689PediaProfen® (see ibuprofen)pediatrics

brain tumors 697cervical spine anatomy 137cervical spine injuries 933head injury 917

pedicle screw/rod instrumentation(see also posterior spinal instrumentation)cervical

C1 lateral mass 185C2

for C1-2 fusion 185technique 187

C7 190lumbar 191

screw placement angles 192use with PLIF 193with posterolateral fusion for spondylolis-

thesis 483with posterolateral fusion without

spondylolisthesis 440x-ray evaluation 192

percutaneous pedicle screws 192rod diameters 193S2 197thoracic 190

pedicle subtraction osteotomy 442PEEP and ICP 880pegvisomant 653pelvic tilt (Trendelenburg sign) 444pelvic traction 439penetrating trauma

headand posttraumatic seizures 398arrow 916gunshot wounds 912

penetrating trauma - head (cont’d)non-missile 916

spinegunshot wounds 998neck 998

pentazocine 47, 49pentobarbital 23

high dose therapy 884low dose therapy 879pentobarbital coma

for ICP management 884for status epilepticus 406

Pentothal® (see thiopental)penumbra 1010, 1012, 1019, 1062

on DWI/PI MRI 133Penumbra System®

for arterial occlusion 1018Penumbra® system (clot removal) 1169peptic ulcers (see ulcers)perched facets 972Percheron, artery of 104, 1028Percocet/Percodan® (see oxycodone)percutaneous cordotomy 568percutaneous endoscopic discectomy 448percutaneous laser disc decompression 448percutaneous pedicle screws 192percutaneous radiofrequency lesion

cordotomy 568for cluster headache 58for spasticity (spinal) 538for trigeminal neuralgia (see percutaneous

trigeminal rhizotomy)percutaneous trigeminal rhizotomy 553, 556

balloon microcompression 554for atypical facial pain 555glycerol injection 554indications 554microcompression rhizolysis (balloon) 557radiofrequency lesion 556

complications 558post-op orders 557pre-op orders 556results 559technique 556

percutaneous vertebroplasty (see vertebroplas-ty/kyphoplasty)

perfusion imagingCT 128perfusion-weighted MRI 132

pergolidefor prolactinoma 652

Periactin® (see cyproheptadine)periarteritis nodosa 77peridural scar and radiculopathy 458perimedullary AVM (spinal) 507perimesencephalic cisterns 1085perimesencephalic nonaneurysmal subarachnoid

hemorrhage 1085perinatal brachial plexus injury 802perineural cysts 509perineurial cysts 456

1300 INDEX

perineurium 801periodic alternating gaze 283periodic lateralizing epileptiform discharges 266

following carotid endarterectomy 1153in herpes simplex encephalitis 359

periodic spikes (on EEG)in Creutzfeldt-Jakob disease 363

perioperative neuropathies 799perioral numbness 1208peripheral nerve

tumors 696peripheral nerves 786

anatomy of 801definition 786injuries of 801

lesion in continuity 790regeneration 801

peripheral nervous system 786peripheral neuropathy 793peritoneal pressure 315peritonitis in patients with VP shunts 348perivascular pseudorosettes 683periventricular enhancement

differential diagnosis 1227periventricular lesions

differential diagnosis 1226periventricular-intraventricular hemorrhage

(PIVH) (see intracerebral hemorrhage - in the newborn)

Permax® (see pergolide)pernicious anemia

and combined system disease 1187peroneal muscular atrophy (see Charcot-Marie-

Tooth syndrome)peroneal nerve

functional anatomy 820palsy 820

differential diagnosis 1195perioperative 799surgical decompression 822

Persantine® (see dipyridamole)persistent fetal carotid-vertebrobasilar anasto-

moses (see carotid-vertebrobasilar anas-tomoses)

persistent primitive trigeminal artery 107as cause of trigeminal neuralgia 551

persistent stapedial artery 1208PET scan

for dysembryoplastic neuroepithelial tumors (DNT) 591

for grading astrocytomas 597for low-grade gliomas 591for lung cancer staging 704for mesial temporal sclerosis 395for metastatic melanoma 705for radiation necrosis 771for seizure surgery 421for spinal metastases 745

petit-mal seizure (see absence seizure)petrolingual ligament 99petrous apex lesions 1211

petrous pyramid fractures 888PHACES syndrome 1210phakomatoses 722Phalen’s test 809phantom limb pain 575pharmacologic pupil 832pharyngeal-cervical-brachial variant Guillain-

Barré 68phase reversal potentials 150, 267phenazopyridine 1002

dosing forms 1002phencyclidine producing seizures 397Phenergan® (see promethazine HCl)phenobarbital 413

dosing forms 413for alcohol withdrawal 274for febrile seizures 402for status epilepticus 405, 406to prevent periventricular hemorrhage 1133

Phenoptic® (see phenylephrine - ophthalmic)phenothiazines

as analgesics 50for diabetic amyotrophy 797for DTs 275

phenoxybenzaminefor autonomic hyperreflexia 1001for glomus tumors 681

phentolamine 681phenylbutazone 45phenylephrine 22

for hyperdynamic therapy 1052for vasospasm 1051in spinal cord injuries 935ophthalmic (for pupillary dilatation) 832

phenylpropanolamineand intracerebral hemorrhage 1121

Phenytek® 410(see also phenytoin)

phenytoin 409and nasogastric feeding 410as a cause of diabetes insipidus (DI) 16dosing forms 410drip loading 411drug-drug interaction 411for ethanol withdrawal seizures 274for intracerebral hemorrhage 1126for posttraumatic seizures 399for status epilepticus 405fosphenytoin 411intravenous 410toxicity 411with renal failure 409

pheochromocytoma 679, 679in neurofibromatosis 723in von Hippel-Lindau disease 668

pheresed platelets 35Philadelphia collar 979photophobia

following concussion 911following SAH 1035, 1085

phrenic nerve stimulation 948

INDEX 1301

Phynox (aneurysm clip alloy) 131physaliphorous cells 676physical therapy

for back pain 437, 438physiological blind spot 829phytonadione (see vitamin K)pial ependymal line 357PICA (see artery - PICA)PICA syndrome (see lateral medullary syndrome)“pie in the sky” visual defect (see junctional sc-

otoma)pillar view of cervical spine 940pilocarpine - in pupil testing 832pilocytic astrocytoma 593, 603

intraventricular 1226pilomyxoid astrocytoma 606pilonidal cysts 252pin care

for cranial-cervical traction 943pincer mechanism in c-spine 486pinch sign 807pineal cysts 691

follow-up 692pineal gland tumors of (see pineal region tumors)pineal region tumors 691pineocytoma and pineoblastoma 692ping-pong ball skull fractures 886ping-pong gaze 283pinpoint pupils 282, 286PION (see posterior ischemic optic neuropathy)piriformis muscle 1189piriformis syndrome

differential diagnosis 1189from sitting position 153

piroxicam 45pitocin 17Pitressin® 17

(see also vasopressin)pituicytoma 641

differential diagnosis 1215pituitary apoplexy 635, 650

differential diagnosis 1199pituitary cachexia 635pituitary gland 109

adenoma 633, 634ACTH secreting 634, 638

evaluation 646management 654medical treatment 654stereotactic radiosurgery 654transsphenoidal surgery for 654

differential diagnosis 1215endocrine evaluation 643

(table) 642giant 637growth-hormone secreting 639

evaluation 647management 652medical treatment 653

hydrocephalus, and 637following surgery 659pituitary apoplexy 636

pituitary gland - adenoma (cont’d)invasive 637

treatment 650management 649microadenoma 634nonfunctional 641

management 649oncocytoma 641surgical indications 649

prolactinoma 637evaluation 643management 651medical management 651

radiation therapy for 655recurrent 663screening (endocrine) 642stereotactic radiosurgery for 774, 775surgical treatment 656

approach to sphenoid sinus 659for Cushing’s disease 658indications for hormonally inactive macroad-

enomas 649medical preparation 656post-op orders 660pre-op orders 660transcranial (pterional) approach 660transsphenoidal approach 657

thyrotropin (TSH) secreting 634, 640evaluation 645management 655outcome 663

treatment decisions 649vs. tuberculum sellae meningioma 1216work-up 642

carcinoma 634degeneration from cocaine abuse 276embryology 109enlargement

differential diagnosis 1215hyperplasia 1215in pregnancy (lactotroph hyperplasia)

1215with intracranial hypotension 305

hemorrhage into 635(see also pituitary apoplexy)

hormones 109sensitivity to compression 634

hypophysitis 1217neurohypophysis 109

bright spot 648normal size 648plain films 138pseudotumor 645, 1215suppression following steroid use 31surgery 656thyrotroph hyperplasia 645trauma to 863tumors 633

adenoma 633differential diagnosis 1215granular cell tumors 641pituicytoma 641

1302 INDEX

pituitary stalkavoiding injury during surgery 660deviation 648stalk effect and prolactin level 644thickening of 648

PIVH (see intracerebral hemorrhage - in the new-born)

placental alkaline phosphatase (PLAP) 693plagiocephaly 230

lambdoid 230occipital 230

plantar reflex 116planum spehnoidale meningiomas 614PLAP (see placental alkaline phosphatase)plaque morphology in carotid stenosis 1145plaques

amyloid (see amyloid - plaques)Hollenhorst 1144in multiple sclerosis (MS) 62

plasma protein fraction 36plasmacytoma

definition 741of the skull 1221

Plasmanate® 36plasminogen activator (see tissue plasminogen

activator)plate

anterior cervicalfusion rates 492placement 492

occipital keel 180plateau waves 872platelets 34

inhibitionagents 1146by aspirin 1146by calcium channel blockers 1053by clopidogrel (Plavix®) 38

reversal of 38by dobutamine 22by NSAIDs 45by valproic acid 413

pheresed 35role in DVT 42thrombocytopenia

and Avitene® 146with heparin 39

transfusioncriteria 35

Platinol® (see cisplatinum)platybasia 138Plavix® (see clopidogrel)PLEDs (see periodic lateralizing epileptiform

discharges)pleomorphic xanthoastrocytoma 592plexal point 100, 100plexiform neurofibromas 723plexopathy

brachial plexus 794lumbosacral plexus 795

plicamycin 501

PLIF (see posterior lumbar interbody fusion)plumb line

for sagittal balance 441plumbism (see lead poisoning)PML (see progressive multifocal leukoencephal-

opathyPMMA (see methylmethacrylate)PMR (see polymyalgia rheumatica)PNET (see supratentorial primitive neuroectoder-

mal tumor, and also embryonal tumors)pneumatacele (see pneumocephalus)pneumatic compression boots 42pneumocephalus 2, 890

and nitrous oxide anesthesia 2differential diagnosis 890etiologies (differential diagnosis) 890treatment 891with basal skull fracture 888, 889with CSF fistula 301, 302

pneumoencephalogram in trauma 863pneumosinus dilatans 1222

with tuberculum sellae meningiomas 1216poikilothermy

following spinal cord injury 936poker spine 502Polaris shunt valve 319polka-dot sign in hemangioma 739pollakiuria with NPH 331polyarteritis nodosa (see periarteritis nodosa)Polycitra® (see tricitrate)polycystic kidney disease (see autosomal domi-

nant polycystic kidney disease)polycythemia with hemangioblastoma 668polymethylmethacrylate (see methylmethacry-

late)polymicrogyria 243polymorphic reticulosis 78, 1229polymyalgia rheumatica 77polyphasic potentials (on EMG) 270polyvinyl alcohol

particles for AVMs 1103sponge for microvascular decompression

543, 561POMC (see proopiomelanocortin)Ponstel® (see mefenamic)popcorn pattern (on MRI) 1107porencephaly 243

following germinal matrix hemorrhage 1134Portnoy (on-off) device 328Portnoy device

shunt (CSF) 328port-wine facial nevus 726porus acusticus 89, 90positional flattening (molding) 230positive predictive value viiipositive sharp waves 270postconcussive syndrome 910poster braces 979posterior approaches to the spine

cervicalfor trauma 978

INDEX 1303

posterior atlantodental interval (PADI) 136, 136in rheumatoid arthritis 495

posterior axial line 953posterior cerebral artery 104posterior choroidal artery

medial 98posterior circulation 102posterior commissure 535posterior cord syndrome 951posterior fossa

arteriogram 103craniotomy 152

complications 157epidural hematoma 896lesions (differential diagnosis) 1209traumatic mass lesions 905tumors 590, 1209venogram 106

posterior iliac crest bone graft 200posterior inferior cerebellar a. (see artery - PICA)posterior interosseous nerve 791

neuropathy 817posterior ischemic optic neuropathy 450posterior loop of ICA 99posterior lumbar interbody fusion (PLIF) 193posterior reversible encephalopathy syndrome 73posterior spinal instrumentation

C2 lateral mass screws 188C2 pedicle screws 187C3-6 lateral mass screws 186, 189C7 190

lateral mass screw 190pedicle screw 190

cervical 179lumbosacral 191occipitocervical fusion 179S2 "pedicle screws" 197T1 lateral mass screws 190thoracic pedicle screws 190thoracic spine 190

posterior tibial nerve entrapment 822posterolateral fusion

following decompressive laminectomy 483for LBP from degenerative disc disease 439

postfixed chiasm 643postherpetic neuralgia 564

intercostal nerve block for 216postneurulation defects 243post-op check

anterior cervical discectomy (ACD) 464carotid endarterectomy 1152lumbar laminectomy 452p-fossa craniectomy 157

postoperative 450postoperative visual loss 450postpartum cerebral angiopathy 1121postpartum intracerebral hemorrhage 1121postspinal headache (see headache - post myelo-

gram/LP)posttraumatic aneurysms (see aneurysms - trau-

matic)

posttraumatic cerebral edema 853posttraumatic hydrocephalus 906posttraumatic meningitis 344posttraumatic seizures 398

and depressed skull fractures 886prophylaxis 862

posttraumatic subarachnoid hemorrhage (see sub-arachnoid hemorrhage - posttraumatic)

posttraumatic syringomyelia 513posturing 279Pott puffy tumor 349Pott’s disease 381, 474

and discitis 385and spinal epidural abscess 376

POVL (see postoperative visual loss)Powers’ ratio

for atlantooccipital dislocation 952, 953PPRF (see paramedian pontine reticular forma-

tion)PPV (see positive predictive value)practice guideline

anterior cervical plating 464assessment of SCI in the hospital 935assessment of subaxial fusion 467asymptomatic carotid stenosis 1147atlanto-occipital dislocation injuries 952atlas fractures 958BMP in cervical interbody fusion 464brace therapy for low-back pain 483central cord injuries 949cervical disc arthroplasty 467cervical immobilization after trauma 938cervical laminoforaminotomy 469cervical pseudarthrosis

assessment 467management 467

cervical spondylotic myelopathychoice of surgical approach 491conservative management 490use of intra-operative electrophysiologic

monitoring 491use of pre-op SEPs 490

combination atlas & axis fractures 967critical care management of SCI in the hospi-

tal 935CT scan in minor pediatric head injury 917depressed skull fracture - surgical treatment

886diagnosis of NPH 330DVT in SCI 937epidural hematoma

surgical treatment 895facet dislocations 973fractures of the axis body 967hangman’s fracture 961hemorrhagic contusion - surgical treatment

893ICP

barbiturates, use of 883brain tissue oxygen tension monitoring

876

1304 INDEX

practice guideline - ICP (cont’d)CPP issues 876hyperventilation for ICP management 881hypothermia (prophylactic) 883indications for monitoring 868infection prophylaxis 869propofol, use of 885treatment threshold 876

initial closed reduction in fracture/dislocation cervical SCI 942

injection therapy for low-back pain 437intra-operative electrophysiologic monitoring

491lumbar fusion

bone graft extenders/substitutes 197correlation with outcome 198for disc herniation 440for low back pain 439fusion with stenosis and spondylolisthesis

483fusion with stenosis without spondylolis-

thesis 483pedicle screw fixation 440radiographic assessment 198use of posterolateral fusion and/or inter-

body fusion 439methylprednisolone in SCI 936MRI & discography as indication for lumbar

fusion 434NPH

diagnosis 330occipital condyle fractures 954odontoid fractures 964os odontoideum 966pediatric C-spine injuries 932posterior fossa mass lesions 906prophylactic anticonvulsants with brain tu-

mors 588reduction in cervical fracture/dislocation 942SCIWORA 975severe head injury

antibiotics for intubation 907cerebral edema 893diffuse injury (surgical indications) 893early sedation and paralysis 860extubation timing 907hyperventilation

early/prophylactic 861initial resuscitation and BP management

860intubation, antibiotics for 861intubation, indications for 861mannitol

early use of 862use of 882

nutrition 907prophylactic anticonvulsants after TBI

862tracheostomy timing 907use of glucocorticoids (steroids) 883

skull x-ray in minor pediatric head injury 917

practice guideline (cont’d)sports related concussion 851subdural hematoma - surgical treatment 897vertebral artery injuries 985x-rays in cervical SCI 938

pravastatinfor vasospasm 1049

praziquantel 372Precedex™ (see dexmedetomidine)precocious puberty

etiologies 226with arachnoid cysts 223with hypothalamic hamartomas 226with pineal region tumors 693with septo-optic dysplasia 247

precuneous 86prednisolone

for Bell’s palsy 846prednisone 31

for giant cell arteritis 76for iodine contrast allergy prep 124for orbital pseudotumor 837

preeclampsiaand vasospasm 1045

prefixed chiasm 664prefrontal lobes 112pregabalin

for painful diabetic neuropathy 797preganglionic peripheral nerve injury 801pregnancy

and accelerated growth of vestibular schwan-noma 724

and antiepileptic drugs 419and benzodiazepines 51and bone scan 433and bromocriptine therapy 651and carpal tunnel syndrome 808and cerebrovascular venous thrombosis 1167and de Quervain’s syndrome 809and enlargement of pituitary adenomas 651and hydrocephalus management 336and idiopathic intracranial hypertension 719and intracerebral hemorrhage from eclampsia

1121and intracranial hemorrhage 1086and methylprednisolone protocol 937and MRI 130and neural tube defects 245, 336and prolactin levels 644and seizures 419and steroids 34and stroke in young adults 1025and ultrasound/diathermy for back pain 439and vertebral hemangioma 738vasospasm with eclampsia 1045

premotor area 84, 84, 85, 735pre-op & post-op orders (see orders - pre-op &

post-op)PRES (see posterior reversible encephalopathy

syndrome)pressure - intraperitoneal 315

INDEX 1305

pressure palsies - in HNPP 793pressure palsies (see hereditary neuropathy with

liability to pressure palsies)pretectal nuclear complex 830pretruncal nonaneurysmal subarachnoid hemor-

rhage 1085Prevacid® (see lansoprazole)prevertebral soft tissue 137priapism 936, 946primary amebic meningoencephalitis 375primary cerebellar ectopia (see Chiari malforma-

tion, type I)primary CNS lymphoma (see lymphoma - prima-

ry CNS)primary glioblastoma 596primary lateral sclerosis 65, 1188primary progressive aphasia of adulthood 1209primidone 413

dosing forms 414primitive neuroectodermal tumor (see supratento-

rial primitive neuroectodermal tumor)primitive reflexes 488

in hydranencephaly 244prion 361proatlantal intersegmental artery 107Procardia® (see nifedipine)PROCESS trial (spinal cord stimulation) 573prochlorperazine

and parkinsonism 60progabide

for spasticity 538programmable shunt valves 317progressive multifocal leukoencephalopathy 364

and multiple gliomas 598due to steroids 365imaging findings 366in AIDS 364MR spectroscopy appearance 133

progressive muscular atrophy 65progressive supranuclear palsy 61prolactin 110, 111

elevation with empty sella syndrome 719hyperprolactinemia

differential diagnosis of 644symptoms of 637

levels 643during pregnancy 644following seizures 401follow-up after therapy 651hook effect 644with pituitary adenomas 643

macroprolactinemia 644prolactin release inhibiting factor 110prolactinoma (see pituitary gland - adenoma -

prolactinoma)Prolia® (see denosumab)prolifeprosan with BCNU (see BCNU - wafers)Prolixin® (see fluphenazine)pronator (teres) syndrome 807prophylactic antibiotics 342

with basal skull fractures 888

prophylactic antibiotics (cont’d)with CSF shunt 323

in pregnancy 336with ICP monitors 869

prophylactic anticonvulsants with brain tumors 588

prophylactic cranial irradiation (PCI)for small-cell lung Ca 704

prophylactic hypothermia (see hypothermia)propiomelanocortin 111propofol 3

for anesthesia induction 2for awake craniotomy 151for ICP management 885for neuroprotection 1064for sedation 24for status epilepticus 406propofol infusion syndrome 25

propofol infusion syndrome 25propoxyphene 47

and elevation of carbamazepine levels 412propranolol 20, 21

before AVM surgery 1103pre-op for glomus tumors 681

proptosis (see exophthalmos)prosopalgia 564prosthetic heart valves

and cerebral embolism 1023and intracerebral hemorrhage 1128

Prostigmin® (see neostigmine)protamine sulfate 41

to reverse low molecular weight heparins 41protein C or S deficiency 1025prothrombin complex concentrate 41prothrombin time (PT)

safe levels for neurosurgical procedures 37therapeutic levels for warfarin 39

proton beam therapyfor chordoma 677for pituitary tumors 655

protruded disc (disc protrusion) 429proximal dural ring 99proximal muscle weakness 1188, 1203Prozac® (see fluoxetine)PS Medical shunt 318psammoma bodies 615pseduocyst

abdominaltreatment 325

pseudarthrosisfollowing anterior cervical discectomy 467

pseudoaneurysmcarotid

after transsphenoidal surgery 659following carotid endarterectomy 1153from arterial dissection 1160traumatic 1081

pseudo-angina 461pseudobulbar palsy 61pseudocholinesterase deficiency

and paralytics 290

1306 INDEX

pseudoclaudication 477pseudocoma 281pseudo-CSF rhinorrhea 302pseudo-Cushing state 638, 646pseudocyst

abdominaland shunt infection 316, 347

brainwith cryptococcal infection 374

pseudodelta sign 1168pseudodisc 475pseudoephedrine

and intracerebral hemorrhage 1121pseudogrowing skull fracture 892pseudohydrocephalus 307pseudohyponatremia 7pseudomeningioma pattern 674pseudomeningocele

spinalfollowing unintended durotomy 449indicating preganglionic injury 802traumatic (from nerve root avulsion) 801

suboccipitalpost-op 158

pseudomonas meningitis 345pseudoneuropathy 794pseudo-obstruction of colon 450pseudopapilledema 716pseudoptosis 1205pseudoradiculopathy 479pseudorosettes (see perivascular pseudorosettes)pseudosciatica

with piriformis syndrome 1189pseudoseizures (see seizures - nonepileptic)pseudospread of the atlas 933pseudosubluxation 933pseudotumor

cerebri 713sinovenous obstruction 716

orbital 837differential diagnosis 1205, 1219

pituitary 645, 1215pseudoxanthoma elasticum 1057

and moyamoya disease 1171and stroke in young adults 1025

PSNP (see progressive supra-nuclear palsy)psoas abscess

in Pott’s disease 381in spinal epidural abscess 377

psoas hematoma 1189following LLIF 194

psoas muscle 377weakness following LLIF 194

PSR (see percutaneous trigeminal rhizotomy)PSW (see positive sharp waves)psychogenic seizures (see nonepileptic seizures)PT (prothrombin time) (see prothrombin time)pterion 86, 86pterional craniotomy 159

for anterior communicating artery aneurysm 1067

pterional craniotomy (cont’d)for suprasellar tumor 660modified 1075

pterygium colli 254ptosis

differential diagnosis 1205in Horner’s syndrome 833with pituitary apoplexy 636

PTTelevation pre-op 41

pudendal neurectomy 538Pulmonaid® 1000pulmonary edema

from contrast media reaction 126in spinal cord injury 935neurogenic 28

pulmonary embolismfollowing lumbar discectomy 450from methylmethacrylate 995

pulmonary hypertension 317pulmonary-artery catheter

for SAH 1041for vasospasm 1051

pulped brain 877pulsatile proptosis 1205pulsation artifact on MRI 1083punch drunk syndrome (see dementia pugilistica)punctate midline myelotomy 570pupil sparing ophthalmoplegia 831, 835pupillary diameter 829

and ophthalmoplegia 835anisocoria 831effect of cocaine 276effect of narcotics 275, 282effect of neuromuscular blocking agents 833in brain death 289in Horner’s syndrome 833paradoxical reaction 833pinpoint pupils 282, 286

pupillary dilatationand anoxic encephalopathy 288and carotid-cavernous fistula 1113and central herniation 286and epidural hematoma 894and exploratory burr holes 864, 865and herniation in the E/R 861and hypothermia 283and uncal herniation 287ciliospinal reflex 284differential diagnosis

(see also anisocoria)with oculomotor palsy 835

in trauma 856pupillary escape 830pupillary innervation 829pure motor hemiparesis 1026pure sensory CVA 1026purkinjoma 593Purtschers retinopathy 919putaminal hemorrhage 1124PWI (see perfusion-weighted imaging (MRI))

INDEX 1307

pyramidal cells of Betz 84pyridoxine-dependent seizures 404pyrimethamine for toxoplasmosis 367

Qquadrangular fracture 971quadrantanopsia

nasal 1056quadriceps weakness

from femoral neuropathy 798from lumbosacral plexus neuropathy 795from upper lumbar disc herniation 453

quadriplegiadifferential diagnosis 1190with sitting position 153, 1186

quasi-moyamoya disease 1171Queckenstedt’s test 202, 733question-mark skin incision 163Quincke (LP) needle 204quinine sulfate 51

Rraccoon’s eyes 855, 888

with neuroblastomas 749racemose angioma 722radial nerve 791

injuries 816radial tunnel syndrome 817radiation dose

with CT scan 127with radiology studies 127

radiation injury and necrosisbrachial plexus neuropathy 795cranial 771differentiating from recurrent glioma 771effect on IQ in children 771following pituitary radiation 655following stereotactic radiosurgery 778myelopathy

differential diagnosis 1187following radiation therapy 772

neuropathy 795radiation induced tumors 778with interstitial brachytherapy 779

radiation neuropathy (see radiation injury and ne-crosis)

radiation safety 126radiation therapy 770

effect on IQ in children 771for cerebral metastases 708for chordoma 677for CNS lymphoma 675for low grade gliomas 599for malignant astrocytomas 600for malignant gliomas 601for melanoma metastatic to brain 705for meningiomas 619for multiple myeloma 741

radiation therapy (cont’d)for pituitary adenomas 655for plasmacytome 742for spinal metastases 747hyperfractionated 608prophylactic cranial 704stereotactic radiosurgery 773stereotactic radiotherapy 775test dose for pineal tumors 693(see also radiation injury and necrosis)

radiculomedullary arteries 96radiculopathy

C5following cervical decompression 493from disc herniation 461

C6from disc herniation 461mimicking MI 461

C7from disc herniation 461

C8from disc herniation 461

cervical 461keyhole foraminotomy for 469mimicking MI 461

definition 428differential diagnosis 1188L4

from disc herniation 445vs. femoral neuropathy 1190

L5and foot drop 1195differential diagnosis 1195from disc herniation 445from sacral fracture 997

lumbarphysical findings 443radiographic evaluation 433upper 453

S1from disc herniation 445localizing 1190

thoracic 471radiobiology 770radiographic vasospasm 1045radionuclide cisternography

for CSF leak 303for NPH 333, 334

radionuclide scanning 140radionuclide shuntography 324radiosensitivity of metastases

cerebral 708spinal 747

rads (radiation dose) 126Raeder’s paratrigeminal neuralgia 838raloxifene 994

dosing forms 994Ramsay Hunt syndrome 564Ranawat grading scale 494Ranchos Los Amigos cognitive scale 1182ranitidine - use with steroids 878

1308 INDEX

RANK ligand 994inhibitors

for metastatic tumor 747for osteoporosis 994

Rankin scale 1183rapid sequence tranquilization 24Rathke’s cleft cyst 636, 665Rathke’s pouch 109RCVS (see reversible cerebral vasoconstrictive

syndrome)rebleeding

with aneurysms 1043with angiogram negative SAH 1084with AVMs 1100with intracerebral hemorrhage 1124with perimesencephalic nonaneurysmal SAH

1085rebuildup in moyamoya disease 1172recombinant activated coagulation factor VII (see

factor VII)recombinant tissue plasminogen activator (see

tissue plasminogen activator)rectal exam 946recurrent artery of Heubner 97recurrent herniated lumbar disc 449, 460recurrent intracerebral hemorrhage 1122recurrent laryngeal nerve 463

injury during ACDF 465prevention 463

recurrent meningitis 344with basal encephalocele 232with CSF fistula 301with dermal sinus 252, 253

recursive partitioning analysisfor brain metastases outcome 707for glioblastoma outcome 603

red flags (in low back problems) 432reduced recruitment on EMG 270reflex sympathetic dystrophy (see complex re-

gional pain syndrome)reflexes

abdominal cutaneousin multiple sclerosis 63in spinal cord injury 936

anal cutaneous 946cremasteric 936muscle stretch (see muscle stretch reflex)primitive 244, 488

reflexology 931Refludan® (see lepirudin)refractory seizures 420regeneration of peripheral nerves 801regional brain syndromes 112regional diagnoses 1209Regitine® (see phentolamine)Reid’s base line 87reinforcement of muscle stretch reflexes 786Reiter syndrome 1193Relafen® (see nabumetome)relative afferent pupillary defect (RAPD) 831rem (see roentgen-equivalent man)

remifentanil 3, 24renal failure

and destructive spondyloarthropathy 1233from intrathecal contrast media 122with mannitol 882

renal-cell carcinomain von Hippel-Lindau disease 669metastatic to brain 705metastatic to spine 745

pre-op embolization 748Rendix® (see dabigatran)Reno-60/Reno-dip® (see diatrizoate meglumine)reoperation

for failed back surgery syndrome 460for recurrent glioma 602

ReoPro® (see abciximab)repeat angiography

for SAH 1084reservoir sign 302resistance testing

for NPH 332respiratory patterns in coma 282Restoril® (see temazepam)rests, aneurysm 1061rete mirabile 1170, 1172reticulum cell sarcoma 672retinaculatome 811retinal hemangioblastomas 669retinal hemorrhage

and platelet transfusion 35differential diagnosis 919from high altitude 916in child abuse 919in infantile acute subdural hematoma 899in subarachnoid hemorrhage 1036with chronic extra-axial fluid collections 905

retinoblastoma 1218retraction syndrome 838retrobulbar neuritis 62, 832retroepicondylar groove 812retrograde ejaculation

with ALIF 195retrograde flow

through internal cerebral vein (with vein of Galen malformations) 1112

through ophthalmic artery 1027with dural AVMs 1111

retroperitoneal approach to spine 179retropulsed bone in spinal canal

in cervical compression fractures 970spontaneous resorption 990with burst fractures 987with osteoporotic spine fractures 992

retrosigmoid approachfor vestibular schwannoma 628

retroversion of the odontoid 234Retrovir® (see zidovudine)return to play guidelines

following C-spine injury 980following head injury 851

INDEX 1309

return to play guidelines (cont’d)with foramen magnum abnormalities 851with hydrocephalus 851

reversalof benzodiazepines 52of heparin 41of muscle blockade 27of narcotic intoxication 276of warfarin 40

reverse straight leg raising 444reversible cerebral vasoconstrictive syndrome

1035reversible posterior leukoencephalopathy syn-

drome (see posterior reversible encephal-opathy syndrome)

Revex® (see nalmefene)Rexed lamina 93, 93Reye’s syndrome

and decompressive craniectomy 165and ibuprofen 46

rFVIIa (see factor VII)rhabdoid meningioma 616rhabdomyolysis

in atypical Guillain-Barré 68in malignant hyperthermia 5with IT injection of ionic contrast 122with statins 1193

rheologic properties of bloodwith calcium channel blockers 1053with mannitol 882, 1052with vasospasm 1052

rheumatoid arthritisand atlantoaxial subluxation 495and basilar impression 495, 497and CNS lymphoma 673and craniocervical abnormalities 494and entrapment neuropathies 804and subaxial subluxation 498

rheumatoid spondylitis (see ankylosing spondyli-tis)

rhinorrheaCSF (see cerebrospinal fluid - rhinorrhea)pseudo-CSF rhinorrhea 302with cluster headache 58with opioid withdrawal 276with SUNCT 549

rhizotomyfor spinal spasticity

dorsal 538foraminal 538

trigeminal 553Richie-Cannieu anastomosis 792Richmond agitation-sedation scale (RASS) 23Richmond subarachnoid bolt 208rifampin

for cerebral abscess 354for shunt infection 347

RIHSA cisternography 303Rilutek® (see riluzole)riluzole 66ring sign 302

ring-enhancing lesions on CTdifferential diagnosis 1214gliomas 597

Rinne test 848with vestibular schwannoma 621

risedronatefor osteoporosis 994for Paget’s disease 501

risksanterior cervical discectomy 465carotid endarterectomy 1153cerebral arteriogram 1145craniotomies 147lumbar laminectomy 449microvascular decompression for hemifacial

spasm 544pallidotomy 536suboccipital craniectomy for vestibular schw-

annoma 631ritonavir 798rituximab

intraventricular for CNS lymphoma 675Robinul® (see glycopyrrolate)Rocaltrol® (see calcitriol)Rocephin® (see ceftriaxone)rocuronium 26

for intubation 4roentgen-equivalent man 126Rolandic fissure

surface anatomy 87Roland–Morris disability questionnaire 430Romazicon® (see flumazenil)Rosai-Dorfman disease 616Rosenmüller’s fossa 301Rosenthal fibers 604rosettes (in ependymomas) 683rostral-caudal deterioration 284rotating paralysis 712rotatory atlantoaxial subluxation/fixation 955Rovamycine® (see spiramycin)RPA (see recursive partitioning analysis)RPLS (see posterior reversible encephalopathy

syndrome)RPLS (see reversible posterior leukoencephalop-

athy syndrome)RSD (reflex sympathetic dystrophy) (see com-

plex regional pain syndrome)rt-PA (see tissue plasminogen activator)rule of 2’s (CT enhancement after CVA) 1013rule of Spence 136, 139, 957"rule of the pupil" 835rule of thirds, Steele’s 959ruptured disc - definition 429

SS-100 protein

in Creutzfeldt-Jakob disease 363used clinically 721used histologically 720

1310 INDEX

S2 screws 192, 197saccular aneurysms 1055sacral agenesis 1234sacral cordotomy 568sacral fractures 997sacral insufficiency fracture 1193sacral lesions

differential diagnosis 1233sacral promontory 441sacral sparing 930sacralized L5 vertebrae 174sacrococcygeal chordoma 676sacroiliitis 1192saddle anesthesia

with cauda equina syndrome 446with sacral fractures 997

saddle nose deformity 78sagittal balance 441, 441sagittal split fracture 970sagittal suture

relationship to superior sagittal sinus 87sagittal synostosis 229

following CSF shunting 328SAH (see subarachnoid hemorrhage)salaam seizures 396saline infusion test 9salivary cortisol test 646salsalate 45salt and pepper skull 1221Saltzman variants of trigeminal artery 107Sandostatin®

long-acting (LAR) formulation 653Sandostatin® (see octreotide)sarcoidosis - intrasellar 1216sarcoidosis (see neurosarcoidosis)Saturday night palsy 817SCA (see artery - SCA)scalenectomy

for thoracic outlet syndrome 823scalenus (anticus) syndrome 823scalloping of vertebral bodies

differential diagnosis 1233scanning speech 62scaphocephaly 229scar tissue causing radiculopathy 458Schanz screws 991Scheuermann's kyphosis 506Scheuermann’s kyphosis 441Schiff-Sherrington phenomenon 931Schilling test 1188schizencephaly 243, 246Schmorl’s node (intravertebral disc herniation)

429, 455differential diagnosis 1193

Schober test 502schwannoma

spinal 734dumbbell 735in neurofibromatosis 724

vestibular 620vs. neurofibroma 722

schwannomin 724Schwartz technique (cervical cordotomy) 569Schwartz-Bartter syndrome (see syndrome - an-

tidiuretic hormone secretion)sciatic nerve 820

injection injuries 1189, 1194perioperative neuropathy 800sciatic trunk innervation 789

sciatic notch tenderness 443sciatica

caused by extraspinal tumors 1190definition 429differential diagnosis 1188localizing lesion 1190sciatic nerve anatomy 1188

scintigramsfor brain death determination 291for cerebral abscess 352for discitis 385for normal pressure hydrocephalus (NPH)

333for reflex sympathetic dystrophy 577for shunt patency 324for vertebral osteomyelitis 382(see also bone scan)

SCIWORA (see spinal cord - injuries - without radiographic abnormality)

sclerosisof vertebral body 744with radiographic skull lucencies 1220

scoliosisand MRI 435from laminectomy for LP shunt 317in myelomeningocele 254in tethered cord 255nomenclature 430

"Scotty dog" on LS spine x-ray 476screw fixation

cervical spineC1-2 facet 184C7 options 190odontoid screw fixation 181

lumbar spinetransfacet pedicle screws 196

seat-belt type fracture 987second impact syndrome 851secondary germinal layer 591secondary glioblastoma 596sedatives 23

early use in neurotrauma 860sedatives and paralytics 23Seddon classification of nerve injury 802seesaw nystagmus 828Seesel’s pouch 227seizure surgery 420

amygdalo-hippocampectomy 423corpus callosotomy 422deep brain stimulation (DBS) 422perioperative management 424temporal lobectomy 423vagal nerve stimulation 424

INDEX 1311

seizures 394and cocaine abuse 276and newly diagnosed brain tumors 588and shunt infection 345antiepileptic drugs 407auras 394classification 394drug related 397ethanol withdrawal 399factors that lower seizure the threshold 396febrile 397, 402

and mesial temporal sclerosis 395preceding status epilepticus 403

following carotid endarterectomy 1153following closed head injury (see seizures -

posttraumatic)following flumazenil administration 397following penetrating head injury 398following SAH 1041following stereotactic radiosurgery 778following stroke 396following surgery for subdural hematoma

898, 902from contrast media reaction 126from hypertensive encephalopathy 73gelastic 226in brain tumor patients 585in infantile acute subdural hematoma 899in pregnancy 419new onset 396nonepileptic 400posttraumatic 398, 399, 862, 886

prophylaxis 862prophylaxis

following SAH 1041posttraumatic 398with alcohol withdrawal 399with chronic subdural hematoma 900

pseudoseizures 400pyridoxine-dependent 404refractory (definition) 420seizure threshold 396status epilepticus 402surgery

for deep brain stimulation (DBS) 422surgery for 420with AVMs 1100with chronic extra-axial fluid collections 905with CSF shunts 316with eclampsia 1086with motor evoked potentials 267with neurocysticercosis 371with tuberous sclerosis 726

Selfotel® (see NMDA)sella turcica

plain x-rays 138size change after shunting 328

sellar lesions 1215semi-Fowler position 437sensorineural hearing loss 848

sensory evoked potentialsfor brain death 292in cervical spondylotic myelopathy 490intraoperative 267

anesthesia requirements 4for intramedullary spinal cord tumors 734for mapping sensory/motor cortex 150interventions for deterioration 268

(see also evoked potentials) 268sensory level

with cervical spondylotic myelopathy 488with spinal cord injury 936, 946with spinal metastases 743

sensory nerve action potential (SNAP) 270in lumbar disc disease 271in nerve root avulsion 271in plexopathy 271, 795

sensory nervesdiagram 94

sensory neuropathyand neoplasms 794

sentinel hemorrhage 1035SEP (see sensory evoked potentials)separation fracture of lateral mass 976septal vein 105, 171septo-optic dysplasia 246, 247septum pellucidum

absencedifferential diagnosis 247in agenesis of corpus callosum 246in Chiari 2 malformation 238in septo-optic dysplasia 247

cavum 171, 1218sequential compression devices 42sequestered disc (disc sequestration) 429Serratia marcescens shunt infection 347serum osmolality 19

calculated 19in diabetes insipidus (DI) 15in SIADH 11

serviceable hearing 623setting sun sign 114, 312severe head injury

definition 853(see also trauma - head)

sevoflurane 2shaken baby syndrome 918shaking palsy (see Parkinson’s disease)shallow cervical canal 485Sheehan’s necrosis 99shift (on CT scan) 280shine-through on MRI 132shingles (see herpes zoster)shock (see hypotension)shopping cart sign 478Short Form 36 disability scale 430short-lasting unilateral neuralgiform headache

with conjunctival injection and tearing (SUNCT) 549

shoulder abduction test 462

1312 INDEX

shoulder paindifferential diagnosis 1197with cervical spondylosis 486

shunt nephritis 346shunt series 324shunt-o-gram

with LP shunt 214with VP shunt

with iodinated contrast 325with radionuclide tracer 324

shunts (CSF) 315and CSF protein 1137antisiphon device 317, 323, 327by manufacturer 318

Codman 320Cordis 320Cordis (Hakim) 320Heyer-Schulte 320Holter 321Medtronic 318NeuroCare 320PS Medical 318Salmon-Rickham 321Sophysa (Polaris valve) 319

complications (see shunts (CSF) - problems)connectors 209horizontal-vertical valve 317insertion techniques 208laparoscopic surgery and 328lumboperitoneal 213, 317, 718Ommaya® reservoir 212problems

with insertion 321problems with 321

blockage 323craniosynostosis 328infection 345

Candida spp. 346intracranial hypotension 325overshunting 325peritoneal catheter 316peritonitis 348seizures 316shunt occlusion 323silicone allergy 316slit ventricle syndrome 326subdural hematoma 327tumor seeding 687undershunting 323

programmable valveCodman Hakim 320Polaris (Sophysa) 319Strata (Medtronic) 319

programmable valves 317removal 309slit valves (distal) 209, 316subgaleal 1136surgical technique 208syringo-subarachnoid 512tapping 322

shunts (CSF) - tapping (cont’d)LP shunt 214reservoir 212

Torkildsen 310, 315tumor filter 317ventricular access device 211

insertion technique 212ventricular catheterization 209ventriculo-atrial 315, 317

and pulmonary hypertension 317insertion technique 210

ventriculoperitoneal 316insertion technique 209

ventriculopleural 316in pregnancy 336insertion technique 210

wire reinforced 209x-ray appearance 318

shunts (other than CSF)for arachnoid cyst 224subdural-peritoneal 905syringo-subarachnoid or -peritoneal 512tumor cyst 211

Shy-Drager syndrome 60SIAD (see syndrome of inappropriate antidiure-

sis)SIADH (see syndrome of inappropriate antidi-

uretic hormone secretion)sickle cell anemia

and cerebral venous thrombosis 1166and moyamoya syndrome 1171and stroke in young adults 1025and subarachnoid hemorrhage 1034

sievert 126sign

Babinski 116banana 1210Battle’s 855, 888Beevor’s 946bow hunter’s 183bowstring 444bow-tie 973Brudzinski 1036cord 1168cortical vein 308crescent 1162cutoff 1014delta 1168double lumen 1162empty delta 1168Fajersztajn’s 444Froment’s 813Furstenberg 1230halo 302harlequin eye 230Hoffman’s 116hollow skull 292Homan’s 43hyperdense artery 1013Kernig 1036

INDEX 1313

sign (cont’d)Kernig’s 377Lasègue’s 443Lazarus 290Lhermitte’s 62, 1198Macewen’s 312meniscus 733, 746Mt. Fuji 891naked facet 973OK 807pinch 807pseudodelta 1168reservoir 302reverse Tinel’s 809ring 302setting sun 114, 312Spurling’s 461string 999, 1014, 1162string and pearl 1162string of pearls (on DWI MRI) 1157Tinel’s 809, 816, 821, 822transsylvian 359Trendelenburg 444Uhthoff 63Wartenberg’s 813Westphal's 445

SIH (see spontaneous intracranial hypotension)silicone allergy and CSF shunts 316silver reticulum stain 673Simmonds’ cachexia 635simple skull fracture (see skull fractures - simple)Simpson grading for meningioma removal 619simvastatin

for vasospasm 1049Sinequan® (see doxepin)sinonasal undifferentiated carcinoma (SNUC)

1230sinovenous obstruction

in pseudotumor cerebri 716sinus thrombosis (see cerebrovascular venous

thrombosis)siphon

carotid 100effect with shunts 326

sitting knee extension test 444sitting position

for cervical laminectomy 492for suboccipital craniotomy 153

Six 1172Sjögren’s syndrome

and CNS lymphoma 673Skelid® (see tiludronate)skew deviation 114, 283skip lesions, in giant cell arteritis 75skull block 145, 151, 151skull fractures 885

basal 855, 887and traumatic aneurysms 1081

compound 885craniofacial 889depressed 885

skull fractures (cont’d)differentiating from suture 885growing 892in epidural hematoma 894linear non-displaced 857, 885occipital 858ping-pong ball 886simple 885

skull lesions 1219differentiating tumors 1220lytic 1220neoplastic 698non-neoplastic 700

skull tumors 698skull x-ray 138

differentiating fracture from suture 885for lambdoid craniosynostosis 231in Chiari 2 malformation 239indications (in trauma) 859lucencies, evaluation 1220

sleep apnea (see apnea - sleep apnea)SLIC (see subaxial cervical spine injury classifi-

cation)slit valves in VP shunts 209, 316slit ventricles 326

and pregnancy 336in pseudotumor cerebri 714slit ventricle syndrome 326

Slow Fluoride® (see fluoride)slow virus 361small-cell lung cancer 703

and cerebral metastases 704chemotherapy & XRT for 704, 708neuroendocrine stains 721

intramedullary spinal cord metastases 732smell - loss of (see anosmia)Smith-Peterson (facet) osteotomy 442Smith-Robinson

anterior cervical discectomy 467C1-C2 wiring technique 184

smokingand atherosclerosis 1146and cerebral vasospasm 1046and intracerebral hemorrhage 1119and nonunion of bone 484and risk of stroke 1011and SAH 1035and small-cell lung cancer 703and spinal degenerative disease 475and stroke in young adults 1025

snake eyes in cervical spondylotic myelopathy 490

SNAP (see sensory nerve action potential)SNUC (see sinonasal undifferentiated carcinoma)sodium

in CSF 298serum 7

hypernatremia 14hyponatremia 7

Solu-Cortef® (see hydrocortisone)Solumedrol® (see methylprednisolone)

1314 INDEX

Soma® (see carisoprodol)somatomammotropin (see prolactin)somatomedin-C (see insulin-like growth factor-1)somatosensory cortex 84somatosensory evoked potentials 268

for low back problems 432somatostatin 111somatostatin analogues

for acromegaly 653somatotroph hyperplasia 1215Somavert® (see pegvisomant)SOMI brace 979Sophysa shunt 319Soto’s syndrome 1207souttar skin incision 164, 890SPAM (see subacute progressive ascending my-

elopathy)spasmodic torticollis 541spastic foot drop 1196spasticity 536

medical treatment 537surgical treatment 538

spear tackler’s spine 980specific gravity

CSF 297urine

in diabetes insipidus (DI) 16SPECT scan

for cerebral vasospasm 1048for Creutzfeldt-Jakob disease 363for radiation necrosis 772for seizure surgery 421in low back pain 433

Spetzler et al. spinal AVM classification 508Spetzler-Martin grade of cerebral AVMs 1101sphenoid dysplasia 723sphenoid pneumosinus dilatans 1216sphenoid sinusitis 351sphenopalatine ganglion blockade 58sphincter electromyography 119spike and wave (on EEG) 395spin density image (on MRI) 129spina bifida aperta 247spina bifida cystica 247spina bifida occulta 247

definition 247spinal accessory nerve-facial nerve anastomosis

847spinal angiography (see angiogram - spinal)spinal arteriovenous fistula (AVF) 507spinal AVM (see spinal cord - AVM)spinal canal 510spinal cord

anatomy 92AVM 507, 1187herniation

differential diagnosis 1186idiopathic 514

hypoperfusion 492infarction 1186

spinal cord (cont’d)injuries 930

complete vs. incomplete 930contusion 975following anterior cervical discectomy

465football related 980in ankylosing spondylitis 503incomplete injury syndromes 948indications for emergent surgery 944level 930management in hospital 935neuropraxia 980pediatric 932spinal shock 537, 930

management 935steroid usage 936surgical treatment 977

emergent 944syndromes 948without radiographic abnormality (SCI-

WORA) 974, 974"PNET" 685tracts 92tumors 728

in neurofibromatosis 724(also see tumors - spine)

vascular malformations 507vasculature 95

spinal cord stimulation 572for recurrent herniated lumbar disc 460

spinal cysts (see intraspinal cysts)spinal dysraphism 247spinal epidural abscess 376spinal epidural hematoma 515

and heparin(s) 39and vertebral hemangioma 1186differential diagnosis 1186in ankylosing spondylitis 503postoperative 449, 452traumatic with spine fracture 515

spinal epidural lipomatosis 516differential diagnosis 1186

spinal epidural massesdifferential diagnosis 1185

spinal epidural metastases 742evaluation 743treatment 747

spinal glomus AVM 507spinal H/A (see headache - post myelogram/LP)spinal hemangioma (see hemangioma - vertebral)spinal manipulation therapy

and vertebral artery dissection 985for neck or low back pain 438

spinal meningeal cyst 509spinal metastases (see metastases - spinal)spinal muscular atrophy 65, 1191spinal radiation 772spinal shock 537, 930

effect on bladder 118management 935

INDEX 1315

spinal stabilitycervical

delayed instability 982guidelines for assessment 969hangman’s fracture, with 962SLIC classification 968subaxial fractures, with 969treatment for instability 977White and Panjabi model 969

definition 930thoracolumbar

model for fractures 986Denis 986TLICS 990

spinal stenosis 477cervical 136, 485coincident cervical and lumbar 493lumbar 477

in asymptomatic patients 433thoracic 477

spinal subdural hematoma 515spinal tap (see lumbar puncture)spinal trigeminal tract 1208spinal tumors

metastatic 742primary 736

differential diagnosis 728, 1186(see also specific tumors)

spineand spinal cord 428cervical

atlantoaxial fusion 183follow-up schedule 979fractures 951

surgical treatment 977fusion after discectomy 464fusion techniques 179occipitocervical fusion 179, 187whiplash injuries 931x-rays 135, 938

craniocervical junction 494fracture

and spinal epidural hematoma 515infections 376injuries (see trauma - spine, and fractures -

spine)lumbar

fusion 440, 483normal measurements 480

metastases 742sacrum

fractures 997spinal stenosis 477

(see also spinal stenosis)surface landmarks (levels) 89thoracolumbar

osteoporosis 992trauma (see trauma - spine)tumors 728

differential diagnosis 728in neurofibromatosis 724

spine - tumors (cont’d)osteoblastic 744

tumors of the bonemetastatic 742primary 736

Spine Trauma Study Groupsubaxial cervical spine injury classification

(SLIC) 968thoracolumbar spine injury classification 990

spinolaminar line 136spinous process fractures

cervical 969axis (C2) 967

thoracolumbar 986, 988spiramycin 367Spire™ interspinous fusion plate 482split cord malformation 256splitting the sylvian fissure 161sPNET (see supratentorial primitive neuroecto-

dermal tumor)spondylitis (see vertebral osteomyelitis)spondylodiscitis 380spondylolisthesis

lumbar 475and disc herniation 475grading scale (Meyerding) 475with spinal stenosis 477

traumatic C2 959spondylolysis 476

management 476spondyloptosis 475spondylosis 474

cervical 485spongy degeneration of the brain 1207spontaneous activity (on EMG) 270spontaneous bacterial peritonitis 348spontaneous intracranial hypotension 305spontaneous subdural hematoma

intracranial 902spinal 515

SPORT study for lumbar disc herniation 452sports

cervical spine injuries 980chronic traumatic encephalopathy 911concussion 850restrictions

after concussion 851after SCIWORA 975after spinal cord injury 980cerebral-related 851C-spine-related 980with arachnoid cysts 223

spot sign (on CTA) 1124spreading depression of Leao 1201Sprengel’s deformity 254sprung facets (see locked facets)Spurling’s sign 461squamosal suture 86squamous cell cancer

from epidermoid cyst 689lung 704

1316 INDEX

square vertebral bodies (in ankylosing spondyli-tis) 502

SSEP (see somatosensory evoked potentials) 268SSPE (see subacute sclerosing panencephalitis)St. Anne/Mayo grading system 594stability (spinal) (see spinal stability)Stadol® (see butorphanol)stalk effect 644STA-MCA bypass (see extracranial-intracranial

bypass)stapedial artery, persistent 1208Staphylococcus aureus

meningitis 344statins

for vasospasm 1049status epilepticus 402

medications for treatment 405status spongiosus 362status trigeminus 551stavudine 798Steele’s rule of thirds 959Steele-Richardson-Olszewski syndrome 61stenosis

aqueductal (see aqueductal stenosis)carotid artery (see carotid artery - stenosis)spinal (see spinal stenosis)

stent assisted coiling 1060stents (neuroendovascular) 263stephanion 86, 86steppage gait 1196stereotactic angiography 776stereotactic radiosurgery 773

and cranial nerve injury 776for acromegaly 656for AVMs 774, 1102

retreatment 777for hemangioblastomas in VHL 670for malignant glioma 601for spinal epidural metastases 748for tectal gliomas 609for trigeminal neuralgia 555, 774fractionated (see stereotactic radiotherapy)of the spinal cord or medulla 775premedication for 778target localization 776treatment morbidity and mortality 778

stereotactic radiotherapy 775stereotactic surgery 782

biopsy 783for pineal region tumors 694for suspected cerebral mets 707for suspected malignant glioma 600in AIDS 367indications 782

for cerebral abscess 355for colloid cyst 666mesencephalotomy 567radiosurgery (see stereotactic radiosurgery)

sternal splitting 178

steroid myopathy 937steroids

and osteoporosis 992effect on CT contrast enhancement 590effect on tissue plasminogen activator 34epidural

following discectomy 448for low back problems 438

equivalent doses 31following lumbar discectomy 448for Addisonian crisis 34for Bell’s palsy 846for brain tumor 588for bronchospasm following IV contrast in-

jection 126for carpal tunnel syndrome 811for cerebral abscess 354for cerebral metastases 708, 710for cysticercosis 372for discitis 388for giant cell arteritis 76for gunshot wounds

to the head 914to the spine 937

for head injury 883for intracerebral hemorrhage 1127for iodine contrast allergy prep 124for low back pain 438for myelitis 70for neurocysticercosis 372for orbital pseudotumor 837for pain 44, 50for pseudotumor cerebri 883for spinal cord injury 936for spinal metastases 745for stereotactic radiosurgery 778physiologic replacement 31replacement therapy 31side effects 33stress doses 32unmasking diabetes insipidus (DI) 16withdrawal 32(see also dexamethasone)

Stevens-Johnson syndromewith acetazolamide 416with carbamazepine 412with ethosuximide 414with lamotrigine 417with phenytoin 411

STICH study 1129Stimate® (see desmopressin)stinger (football injury) 980STIR images (MRI)

for vertebral factures 996STIR MRI image 130Stokes-Adams attacks 1199straight leg raising test 443Strata (programmable) shunt valve 319stress dose steroids 32

INDEX 1317

stretch testcervical spine 970femoral 444

striae - in Cushing’s syndrome 638stridor from Chiari malformation 239string and pearl sign 1162string of pearls sign

on angiographywith fibromuscular dysplasia 80with isolated CNS vasculitis 79

on DWI MRIwith occluded carotid artery 1157

string sign 999, 1014, 1162stroke 1010, 1011

and giant cell arteritis 74and new onset seizure 396and status epilepticus 403bow hunter’s stroke 1159cerebellar infarction 1021CT findings 1012etiologies 1011hemorrhagic transformation 1120in young adults 1024

evaluation 1025malignant MCA territory infarction 1022MR spectroscopy appearance 133NIH stroke scale 1014occlusion syndromes 1027risk factors 1011"stroke protocol" 1018venous infarction 163, 171, 356, 1166"wake-up" stroke 1017

Struther's ligament 807Struther’s arcade 813STSG (see Spine Trauma Study Group)stunned myocardium (see neurogenic stunned

myocardium)Sturge-Weber syndrome 726

and choroidal hemangioma 1218stylomastoid foramen 844subacute combined columnal degeneration 1187subacute progressive ascending myelopathy 1000subacute sclerosing panencephalitis 266subarachnoid cyst (see arachnoid cyst)subarachnoid hemorrhage 1034

admitting orders 1041and cardiac problems

cardiac arrhythmias 1054neurogenic stunned myocardium 1054

and coma 1036and EKG changes 1054and hydrocephalus 1037, 1040, 1041, 1044and intraventricular blood 1037, 1056and neurogenic pulmonary edema 28, 1042and ventricular catheterization 1041aneurysm location based on blood on CT

1037angiogram negative 1083clinical features 1035CT localization of aneurysm from pattern of

blood 1037

subarachnoid hemorrhage (cont’d)differentiating from traumatic LP 298etiologies 1034from AVM 1034from cavernous carotid artery aneurysm 1080from cocaine abuse 276grading scales 1039

Fisher grade (vasospasm) 1046Hunt and Hess 1040World Federation of Neurosurgical Soci-

eties 1040in pituitary apoplexy 636in pregnancy 1086in the elderly 1035

outcome 1035in vasculitis 74laboratory and radiographic evaluation 1037lumbar puncture (LP) findings 1038management 1040nonaneurysmal 1084outcome 1034perimesencephalic nonaneurysmal 1085posttraumatic 858, 862

and hydrocephalus 906pretruncal nonaneurysmal 1085unknown etiology 1083vasospasm 1045with cerebral arterial dissection 1161work-up 1036

subarachnoid screw 870subaxial cervical spine injury classification

(SLIC) 968subaxial subluxation

in rheumatoid arthritis 498subclavian steal 1158subcutaneous meningiomas 613subdural drain for chronic subdural 901subdural empyema 356subdural hematoma 896

acute 896surgical indications/timing 897

and anticoagulation 897benign subdural collections of infancy 904chronic 899

and TIAs 1201anticoagulation as risk factor 899in children 905

CT scan 897delayed 899following CSF shunting 327, 334

use of third ventriculostomy 315following lumbar puncture 203four hour rule 898from aneurysmal rupture 1035, 1056in infancy 904infantile 899interhemispheric 898

from ruptured aneurysm 1037spontaneous

intracranial 902spinal 515

1318 INDEX

subdural hematoma (cont’d)subdural hygroma 903symptomatic chronic extra-axial fluid collec-

tions in children 905tap 201

subdural hematomasand spontaneous intracranial hypotension 305

subdural hygroma 899, 903subdural tap 201

for chronic extra-axial fluid collections 905subependymal cyst (see arachnoid cyst)subependymal enhancement 1227subependymal hemorrhage 1131

and hydrocephalus 1134subependymoma 683, 1225subfalcine herniation 284subgaleal hematoma 918subgaleal shunt 1136subhyaloid preretinal hemorrhage 1036, 1124Sublimaze® (see fentanyl)subluxation

atlantoaxialanterior 957in Down syndrome 498in Morquio syndrome 494in rheumatoid arthritis 495rotatory 955

cervical 933following laminectomy 462, 492in hangman’s fracture 959in rheumatoid arthritis 498normal 941traumatic 940, 972

lumbar 475following laminectomy 483

submental vertex view 138suboccipital approach

for vestibular schwannoma 628suboccipital craniectomy 152

for cerebellar infarction 1021for Chiari I malformation 236for vestibular schwannoma (see retrosigmoid

approach)suboccipital pseudomeningocele (post-op) 158subperiosteal hematoma 918subscapular nerve 792substantia gelatinosa 93subtemporal decompression

for pseudotumor cerebri 718for slit ventricle syndrome 327

subthalamic nucleus 533succinylcholine 4, 26

and malignant hyperthermia 5succussion splash (intracranial) 890sudden death

with aqueductal stenosis 242with arrested hydrocephalus 309with atlantoaxial subluxation 496with colloid cysts 666

sudden infant death syndrome (SIDS)and maternal cocaine abuse 276

sudden infant death syndrome (SIDS) (cont’d)and sleeping position 230due to vertebral insufficiency 1159

Sudek's atrophy (see reflex sympathetic dystro-phy)

sufentanil 3to control ICP 879

sugar coating 687sulfadiazine

for toxoplasmosis 367sulindac 45sunburst pattern (on skull x-ray) 1220SUNCT 549Sunderland classification of nerve injury 802sunitnib

for hemangioblastoma 672superficial radial nerve 817superficial temporal artery 98

biopsy 76middle cerebral artery (STA-MCA) bypass

1165sparing frontal branch with craniotomy 160

superior cluneal nerves 200superior hypophyseal artery 97, 99, 1070

aneurysms 1071superior orbital fissure 89

syndrome of 836superior petrosal sinus

anatomy 104superior sagittal sinus

and transcallosal approach 169involvement with depressed skull fracture

887involvement with meningioma 618reconstruction 618relationship to sagittal suture 87thrombosis 1167

CT findings 1168superior temporal gyrus 84, 85, 735

approach to amygdala 423approach to MCA trifurcation aneurysms

1069supinator syndrome 817supplemental motor area 84supraclinoid aneurysms 1070Suprane® (see desflurane)supraorbital nerve 151supraorbital neuralgia 562supraorbital neurectomy 554suprascapular nerve 787, 792

entrapment of 818suprasellar lesions 1215supratentorial primitive neuroectodermal tumor

686supratrochlear nerve 151, 562supratrochlear neuralgia 562, 563supratrochlear neurectomy 554sural nerve

anatomy 214biopsy 214

INDEX 1319

sural nerve - biopsy (cont’d)in diabetic amyotrophy 796

proximal origin 822surface anatomy

cerebrum 84for spine levels 89

surface EMG 433sutures (cranial) 86swallowing difficulties

differential diagnosis 1209following anterior cervical discectomy 464following carotid endarterectomy 1153, 1154with jugular bulb thrombosis 1167with ossification of anterior longitudinal liga-

ment 506Swann-Ganz catheter (see pulmonary-artery

catheter)swashbuckler’s disease 818swimmer’s view of cervical spine 940swinging flashlight test 830, 831sylvian fissure

dissection 161surface anatomy 87

sympathectomy 545cardiac (for angina pectoris) 545for hyperhidrosis 544for moyamoya disease 1173for reflex sympathetic dystrophy 577for vasospasm 1048upper extremity 545

sympathetic block 215for reflex sympathetic dystrophy 577

sympathetic dystrophy (see complex regional pain syndrome)

sympathetic nervous systeminnervation of bladder 117innervation of pupil 829

sympathomimeticsand intracerebral hemorrhage 1121

symptomatic chronic extra-axial fluid collections in children 905

symptomatic vasospasm 1045symptoms

(items that are not best covered in Differential Diagnosis, see also that section for others)

clumsy hands 488, 1026dysgeusia (with hyponatremia) 9laughing (with gelastic seizures) 226

synaptophysin 721synchondroses of pediatric C-spine 137synchondrosis of C1 spinous process 137synchronous germ cell tumors 692syncope

differential diagnosis 1199with glossopharyngeal neuralgia 563work-up for 1200

syncytial meningioma 615syndesmophytes in ankylosing spondylitis 502syndrome

acquired immunodeficiency (AIDS) 364

syndrome (cont’d)Ahumada-del Castillo (amenorrhea-galactor-

rhea) 637Aicardi 246alcohol withdrawal 273amenorrhea-galactorrhea 634, 637anterior cerebral artery 1045anterior choroidal artery 1028anterior cord 950anterior tibial compartment 450antiphospholipid-antibody 1025, 1166Anton’s 335Anton-Babinski 113Apert’s 230, 232arterial occlusion syndromes 1027Baastrup’s 478Bannwarth’s 368Behçet's 74, 78Benedikt’s 114Bernhardt-Roth 818bobble-head doll 223Brown-Séquard 950Brun 371Bruns-Garland 796burning hands 980carcinoid 680carpal tunnel 808cauda equina 446, 744caudal regression 1234cavernous sinus 1204central cord 948cerebellar 586cerebral hyperperfusion 1153cervical disc herniation 461Charcot-Marie-Tooth 793chiasmal 614Churg-Strauss 78Claude 1027Collet-Sicard 115craniofacial dysmorphic 231craniofacial pain 549CRASH (X-linked hydrocephalus) 308cubital tunnel 813Cushing’s 638Cushing’s, iatrogenic 33Dandy’s 841de Morsier 247de Quervain’s 809Dejerine-Roussy 1026Devic 1187diencephalic 606disconnection 170, 423double-crush 809Duane 838Eagle’s 1198empty sella 659, 719ethanol withdrawal 274failed back surgery 452, 457falx 898familial intracranial aneurysms 1057fetal hydantoin 411, 420

1320 INDEX

syndrome (cont’d)flat back 442floppy infant 1191foramen magnum compression 235Forbes-Albright (amenorrhea-galactorrhea)

637Foster Kennedy 112, 614Froin’s 733Gardner’s 698Gerstmann’s 113Gorlin’s 1224Gradenigo’s 838Grisel 956Guillain-Barré 66Hakim-Adams 329herniation 284Horner’s 833Hurler 138, 1185in cervical spondylosis 488inappropriate antidiuresis (SIAD) 10inappropriate antidiuretic hormone secretion

(SIADH) 10infantile hemiplegia 420Joubert's 240jugular foramen 115Kallmann 635Kleeblattschadel 232Klippel-Feil 253Korsakoff’s 275L1 (X-linked hydrocephalus) 308lateral medullary 1028lateral recess 484Lennox-Gastaut 396Letterer-Siwe 699Li-Fraumeni 588lumbar disc herniation 445malignant hyperthermia 5Marfan (see Marfan syndrome)McCune-Albright 701Meige’s 542mesencephalothalamic 1026middle cerebral artery 1045Millard-Gubler 114Möbius 1202Morgagni’s 700Morquio 494, 1185multiple hamartoma (Cowden’s disease) 593Munchausen’s 400Nelson’s 634, 639, 654nerve root 445neurocutaneous 722neurovascular compression 542of the jugular foramen 115of the Sylvian aqueduct 115of the trephined 149Ogilvie’s 450orbital apex 836Osler-Weber-Rendu 1024, 1106osmotic demyelination 11painful disc 436Pallister-Hall 226

syndrome (cont’d)Pancoast 794paraneoplastic 794parietal lobe 112Parinaud’s 114, 312, 1026Parkinson and related 59Parsonage-Turner 794PHACES 1210piriformis 153, 1189postconcussive 910posterior cord 951posterior reversible encephalopathy 73pronator teres 807propofol infusion syndrome 25Ramsay Hunt 564reflex sympathetic dystrophy 576Reiter 1193Reye’s 46scalenus (anticus) 823Schwartz-Bartter 10second impact 851shaken baby 918Shy-Drager 60Sjögren’s 673slit ventricle 326Soto’s 1207spinal cord injury 948spontaneous intracranial hypotension 305Steele-Richardson-Olszewski 61Stevens-Johnson 411, 412, 414, 416, 417Sturge-Weber 726superior orbital fissure 836supinator 817Terson 1036tethered cord 254thoracic outlet 822Tolosa-Hunt 837top o’ the basilar 1026Turcot 588vasospasm 1045Vernet’s 115Villaret’s 115Wallenberg’s (see lateral medullary syn-

drome)Waterhouse-Friderichsen 343Weber’s 114, 1026West 396wounded glioma 600Wyburn-Mason (racemose angioma) 722(see also individual listing)

syndrome of inappropriate antidiuresis (SIAD) 10

syndrome of inappropriate antidiuretic hormone secretion (SIADH) 10

following subarachnoid hemorrhage 1043synkinesis 254synovial cyst (spinal) 456syphilis

as cause of myelopathy 1188neurosyphilis and AIDS 365

syringobulbia 510

INDEX 1321

syringomyelia 510differential diagnosis

etiologies 510other conditions 510symptoms 1196

follow-up 512in Chiari type 1 malformation 234, 237in Chiari type 2 malformation 239in myelomeningocele patients 255management 512syringobulbia 510with spinal hemangioblastoma 668

syringo-subarachnoid or -peritoneal shunt 512syrinx (see syringomyelia)systemic lupus erythematosus

and cerebrovascular venous thrombosis 1166and kidney donation 293and primary CNS lymphoma 673and stroke in young adults 1025differential diagnosis on CT/MRI 1213vs. pseudotumor cerebri 716

TT2 shine-through on MRI 132T2* MRI 130tabes dorsalis 1188tachyzoites 369tadalafil - and low back pain 1193Taenia solium 370Tagamet® (see cimetidine)tagged WBC scan for vertebral osteomyelitis 382Takayasu’s arteritis 74Talacen® (see pentazocine)talipes equinovarus

in lipomyelomeningocele 251"talk and die" (delayed deterioration after TBI

854Talwin® (see pentazocine)tamoxifen

for osteoporosis 994tanycytic ependymomas 683tap and wrap (for pseudomeningocele) 158tap test

for NPH 332Tapazole® (see methimazole)tapering steroids (see steroids - withdrawal)tapping a shunt (see shunts (CSF) - tapping)tardy ulnar palsy 813Tarlov’s cyst 456, 509tarsal tunnel 822TASC (see transverse area of the spinal cord)Taylor-Haughton lines 87teardrop fracture 970

treatment 971technetium pertechnetate 140tectal beaking 239tectal gliomas 608tectorial membrane 91, 92TED Stockings® 42

Tegretol® (see carbamazepine)telangiectasia, capillary 1106temazepam 52Temodal®/Temodar® (see temozolomide)temozolomide 589, 602

for low grade gliomas 599for metastatic malignant melanoma 705

temporal arteritis (see giant cell arteritis)temporal artery (see superficial temporal artery)temporal bone anatomy 630temporal bone fractures 888temporal craniotomy 162temporal lobe agenesis syndrome 222temporal lobectomy 163

for seizures 423for trauma 880

temporary clippingin aneurysm surgery 1063, 1064, 1065

Tenormin® (see atenolol)TENS (see transcutaneous electrical nerve stimu-

lation)tension pneumocephalus (see pneumocephalus)tentorial herniation (see central herniation)teratoma 691, 692

sacral 1233Terson syndrome 1036test dose radiation for pineal tumors 693tethered cord syndrome 254

and scoliosis 255in myelomeningocele 250

tetralogy of Fallotand cerebral abscess 350

thalamic “subradiations” 108thalamic hemorrhage 1124thalamic lesions

differential diagnosis 1229surgical/therapeutic 533

thalamoperforating arteries 99, 104and basilar tip aneurysms 1076

thalamotomyfor Parkinson’s disease 61, 532, 534for spasticity 539for tremor 545

thalassemia major 43thalidomide

as a cause of peripheral neuropathy 797for Behçet’s syndrome 78

thalliumtoxicology on the nervous system 797, 1191

thermal diffusion flowmetry 875thermography

for low back problems 433for reflex sympathetic dystrophy 577

thiaminedeficiency 275for ethanol withdrawal 274for Wernicke’s encephalopathy 275in coma 281

thiazidecausing SIADH 9for diabetes insipidus (DI) 18

1322 INDEX

thickened filum terminaledefinition 255in tethered cord 254

thiopental 24coma 885during aneurysm surgery 1064

third nerve palsydifferential diagnosis 831

third ventricle 88surgical approaches 168

third ventriculostomyfor NPH 334indications 315

for pineal cysts 692technique 212

thoracic aortic aneurysmsin giant cell arteritis 75

thoracic disc herniation 470thoracic kyphosis

normal 441thoracic outlet syndrome 822

scalenectomy 823thoracic spinal stenosis 477thoracic spine

anterior approaches 175thoracic spine fractures 986thoracic stenosis (see spinal stenosis - thoracic)thoracodorsal nerve 792thoracolumbar injury classification score

(TLICS) 990thoracolumbar spine fractures 986thoracotomy

access to thoracic spine 175intra-op localization of levels 175

Thorazine® (see chlorpromazine)three column model of spine 986three phase bone scan 140thrombin 146

causing edema around hemorrhage 1125thrombocytopenia

and Avitene® 146and intracerebral hemorrhage 1119from intraarterial papaverine 1050platelets transfusion for 35with heparin 39

thromboembolism 42thrombolytic agents/therapy

for cerebrovascular venous thrombosis 1169for evacuating intracerebral hemorrhages 782for ischemic stroke 1016for vasospasm 1048preceding intracerebral hemorrhage 1120

thrombophilia 1166thrombophlebitis (see deep-vein thrombosis)thrombosis

cavernous sinus 1167, 1205cerebrovascular venous thrombosis 1166deep vein 42dural sinus 1166median artery 808of cerebral aneurysm 1058

Thrombostat® (see thrombin)thumb innervation 788thunderclap headache 1035thyroid hormone

evaluation of pituitary function 645replacement

precipitating adrenal crisis 650thyroid ophthalmopathy 1219thyroid-stimulating hormone (TSH) (see thy-

rotropin)thyrotoxicosis (see hyperthyroidism)thyrotroph hyperplasia 645

differential diagnosis 1215thyrotropin (TSH) 110, 111

endocrine evaluation 645thyrotropin-secreting pituitary adenomas 634,

640management 655outcome 663

thyrotropin releasing hormonethyrotropin releasing hormone (TRH)

stimulation test 645TIA (see transient ischemic attack)tiagabine 418tibial nerve entrapment 822tibialis anterior (see anterior tibialis)tic convulsif 542, 549, 564tic douloureux (see trigeminal neuralgia)tick paralysis 68tiger stripes (on MRI) 593"tight-fit” hypothesis 917tilt-table test 1200tiludronate 501timing of surgery

aneurysms 1060basilar bifurcation aneurysms 1074

AVM after embolization 1103carotid endarterectomy after stroke 1151cauda equina syndrome 447central cord syndrome 949cranioplasty 173decompressive craniectomy 893depressed skull fracture 886epidural hematoma 895facial nerve injury 846herniated disc

emergent 445myelomeningocele closure 249peripheral nerve injury 790posterior fossa masses 906subdural hematoma 897

Tinel’s sign 802in carpal tunnel syndrome 809in peroneal nerve palsy 821in Tarsal tunnel 822reverse 809with ulnar nerve entrapment in Guyon’s canal

816tinnitus

differential diagnosis 1207

INDEX 1323

tinnitus (cont’d)following concussion 910in idiopathic intracranial hypertension 714in Meniere’s disease 842

tinzaparin 40, 43tirilazad mesylate

for cerebral vasospasm 1049for severe TBI 883for spinal cord injury 936

tirofiban 262tissue plasminogen activator

contraindications 1017for cerebrovascular venous thrombosis 1169for ischemic stroke (CVA) 1016in stroke work-up 1026intraarterial 1018preceding intracerebral hemorrhage 1017,

1120, 1123to lyse intracerebral hemorrhage 782to lyse intraventricular hemorrhage 1130

tissue transplantationdonation following brain death 294for parkinsonism 533

titubition 586TLICS (see thoracolumbar injury classification

score)TLIF (see transforaminal lumbar interbody fu-

sion)TLJ (see thoracolumbar junction)TLSO (brace) 990Todd’s paralysis 396, 1199Tolectin® (see tolmetin)tolmetin 45Tolosa-Hunt syndrome 837, 837tomaculous changes in peripheral nerves 793tongue fasciculations in ALS 489tonsillar herniation

acute 285asymptomatic 236from LP shunt 317in Chiari malformation 234, 236on MRI 236

top o’the basilar embolism 1026Topamax® (see topiramate)topiramate 417topotecan 589Toradol® (see ketorolac tromethamine)TORCH infections 1206torcular herophili 104Torg ratio (see Pavlov’s ratio)Torkildsen shunt 310, 315torticollis 541

congenital 230differential diagnosis 541due to atlantoaxial subluxation 956

Tourette syndromedeep brain stimulation for 532

Towne’s view 138toxic epidermal necrolysis

with lamotrigine 417toxicology (see neurotoxicology)

toxoplasmosis 364, 369CT findings 365treatment in AIDS 367

TP53 tumor suppressor gene 588t-PA (see tissue plasminogen activator)tPA (see tissue plasminogen activator)trace image on DWI MRI 132tracheostomy, timing of 907Tracrium® (see atracurium)traction

cervical 942, 962causing atlantooccipital dislocation 943use in atlantoaxial rotatory subluxation

956use in atlanto-occipital dislocation (cau-

tions) 952, 954(see also cervical traction)

pelvic 439train of four

and reversal of neuromuscular blockade 27tramadol 47

dosing forms 47for neuropathic pain 549

tram-tracking in Sturge-Weber 726Trandate® (see labetalol)tranexamic acid 1043trans-abdominal approach to spine 179transarticular facet screws

C1-2 184, 184transarticular screw fixation (cervical) 189transcallosal approach 169

for colloid cyst 666for pineal region tumors 695

transcortical approach to lateral ventricle 172transcranial doppler

for brain death evaluation 292for laparoscopy in patient with VP shunt 328for vasospasm 1048, 1050

transcranial motor evoked potentials 267transcutaneous electrical nerve stimulation

for back pain 439for occipital neuralgia 805

transependymal absorption of CSF 310, 324differential diagnosis 1226in normal pressure hydrocephalus 333

transfacet pedicle screws 196transfacet screw - C7 190transfer of trauma patients 854transferrin (in CSF) 302transforaminal lumbar interbody fusion (TLIF)

193radiation dose 127

transient ischemic attackcrescendo TIA 1156definition 1010differential diagnosis 1200management 1016with arterial dissection 1160with vertebrobasilar insufficiency 1159

transient monocular blindness (see amaurosis fugax)

1324 INDEX

transient neurologic deficitdifferential diagnosis 1200

transient visual obscurationsin idiopathic intracranial hypertension 715

transillumination of the skull 244, 904transitional meningioma 615transitional vertebrae 174translabyrinthine approach to vestibular schwan-

noma 628translaminar C2 screws 187translaminar screw fixation

cervical/thoracic 189lumbar 193

transmissible spongiform encephalopathy agents 361

transmural pressure 1044transoral surgery 176

odontoidectomy 176stereotactic biopsy 783

transpedicular thoracic disc removal 473transsphenoidal surgery 657

approach to sphenoid sinus 659for Cushing’s disease 658pre-op orders 660

transsylvian sign 359transtentorial herniation (see central herniation)transthoracic approach to spine 178, 473transverse area of the spinal cord 490transverse crest (of IAC) 89transverse ligament 91, 92, 181

anatomy 92assessing integrity of 957disruption 183injuries 957

causing atlantoaxial instability 957classification 957

transverse myelitis 69differential diagnosis 1187from chymopapain 447

transverse process fracturethoracolumbar 986, 988

transverse scapular ligament 818transverse sinus 104

estimating location in surgery 560thrombosis 1167

Tranxene® (see clorazepate)tranzodone 548trauma

head 850admission criteria 856admitting orders 860and aneurysm 1081and apolipoprotein E 910and coagulopathy 869and hypopituitarism 863and vasospasm 1045CAT scan 858chronic traumatic encephalopathy 911delayed deterioration 854dementia pugilistica 911diffuse axonal shearing/injury 853

trauma - head (cont’d)from child abuse 918grading severity 853

Glasgow coma scale 279gunshot wounds 912hyperemia following 853, 867, 917intracranial pressure

indications to monitor 868indications to treat 868intracranial hypertension 866

late complications 910nutrition 907outcome 908patients who talk and die 854pediatric 917penetrating

arrow 916penetrating non-missile 916postconcussive syndrome 910posttraumatic cerebral edema 853primary brain injury 854second impact syndrome 851secondary injury 854severe head injury 853sports related 850

return to play guidelines 851transfer assessment 854

spine 930cervical

compression injuries 970delayed instability 982extension injuries 974flexion injuries 970fractures 951in ankylosing spondylitis 503lateral mass & facet fractures 976pediatric 933radiographic evaluation 938return to play guidelines 980sports injuries 980treatment 977vertebral artery injuries 985

gunshot wound 998incomplete spinal cord injury 948lumbar fractures 986methylprednisolone protocol 936pediatric 932penetrating non-missile 998radiographic evaluation 938sacral fractures 997steroids for 936surgical treatment 977

emergent (indications) 944thoracic fractures 986thoracolumbar fractures 986

stress doses of steroids for 33trauma flap 865, 865traumatic aneurysms 888, 1081traumatic cervical disc herniation 461traumatic intracerebral hemorrhage (see hemor-

rhagic contusion)traumatic iridoplegia 831traumatic mydriasis 831

INDEX 1325

traumatic spinal tap 298traumatic spondylolisthesis of the axis 959traumatic subarachnoid hemorrhage (see post-

traumatic subarachnoid hemorrhage)trefoil spinal canal 479tremor 545Trendelenburg sign 444TRH (see thyrotropin releasing hormone)triamcinolone - for severe TBI 883triangular space of Parkinson 106tricalcium phosphate 198tricitrate 314tricyclic antidepressants (see antidepressants)trifurcation

middle cerebral artery 98trigeminal ganglion

lesioning 553location 99tumor of 552

trigeminal neuralgia 551and epidermoid tumor 688and multiple sclerosis 62, 551bilateral 62, 551differential diagnosis 552due to aneurysm 1056due to tumors 552following treatment for vestibular schwanno-

ma 626stereotactic radiosurgery for 555, 774surgical therapy for 553

trigeminal neuroma 1210trigeminal trophic syndrome 558trigger point injection

for low back pain 439trigonocephaly 230Trileptal® (see oxcarbazepine)Trilisate® (see trisalicylate)triphasic response of DI 16triple flexor response 116triple-H therapy 1052trisalicylate 45triton tumors 633triventricular hydrocephalus 241, 307trocar insertion of peritoneal catheter 210trochanteric bursitis

vs. neurogenic claudication 478vs. radiculopathy 1189

trochlear nerve palsy 835trochleitis 563tropical (spastic) paraparesis of AIDS 1188tropicamide 832true rosettes (in ependymomas) 683TruFUSE® facet fusion 197trumpeting of the IAC 624tryptophan - for pain 50T-score (DEXA scan) 992

for interspinous spacers 482TSH (see thyrotropin)tuber cinereum

for third ventriculostomy 213hamartomas of 226

tuberculous meningitis 1202and ophthalmoplegia 837and SIADH 9CSF findings 300

tuberculous spondylitis (see Pott’s disease)tuberculum sellae 614

meningiomas 614tuberous sclerosis complex 725tumefactive demyelinating lesions 64tumor blush (on angiography) 597tumor filter

for CSF shunts 317tumor markers 720

in pineal region tumors 692Ki-67 proliferation index 720MIB-1 596, 720neuroendocrine tumors 721

tumor TIA 586, 706, 1201tumors

brainand deep vein thrombosis 42and headaches 587astrocytoma 593

cerebellar (pilocytic) 604classification 593fibrillary 593gemistocytic 594grading 594pilocytic 593, 603

central neurocytoma 612cerebellar liponeurocytomacongenital 697glioma 593

low grade 590glioneuronal tumors 612mixed neuronal-glial tumors 612neonatal 697pediatric 697primary 590prophylactic anticonvulsants for 588

brainstem glioma 607classification (WHO 2000) 582foramen magnum 711glomus jugulare 680immunohistochemical staining patterns 720markers 692, 720mesenchymal, non-meningothelial 620metastases

of CNS tumors through CSF 702of primary CNS tumors 703to brain 702to spine 742to upper cervical spine 743

of the lateral ventricle 1226of the third ventricle 168, 1226posterior fossa 590primary brain 590primary spinal 728skull 698, 1219spine 728

and disc space involvement 1233astrocytoma 731

1326 INDEX

tumors - spine (cont’d)axis vertebra

differential diagnosis 1231metastases 743

bone 736causing sciatica 1189dermoid/epidermoid 731ependymoma 731hemangioblastoma 732in neurofibromatosis 724intramedullary 730intramedullary metastases 732lipoma 732lymphoma 730meningiomas 729multiple myeloma 740primary 728

tumors of peripheral nerves 696Turcot syndrome 588twenty-four month rule (for peripheral nerve re-

pair) 79021-aminosteroids

following SAH 1049for severe TBI 883

twilight state 403Twining view of cervical spine 940twist drill craniostomy for chronic subdurals 901Tylenol® (see acetaminophen)Tylox® (see oxycodone)

UUhthoff sign in MS 63ulcers

antacids and H2 inhibitors for 52Cushing’s 878prophylaxis 52steroid 33, 878stress 52, 878

ulnar groove 812ulnar nerve 791

entrapment 812electrodiagnostic findings 814treatment

decompression 814non-surgical 814submuscular transposition 815surgical options 814

muscles innervated by 792perioperative neuropathy 799

ulnar neuropathy (see ulnar nerve)Ultane® (see sevoflurane)Ultiva® (see remifentanil)Ultram® (see tramadol)ultrasound (diagnostic)

for carotid stenosis 1145for dural sinus thrombosis 1169for neonatal intracerebral hemorrhage 1133,

1134for ulnar neuropathy 814intraoperative for spine fracture 990

ultrasound (therapeutic)for low back pain 439

Ultravist® (see iopromide)umbilical cord clamping and PIVH 1133uncal fits (see uncal seizures)uncal herniation 286

CT criteria 286uncal seizures 395

differential diagnosis 1228uncinate seizures (see uncal seizures)undershunting 323unintended durotomy (see durotomy - unintend-

ed)unruptured aneurysms 1077upgaze palsy

differential diagnosis 115with Parinaud’s syndrome 114

upper cervical spine abnormalities 494upper lumbar disc herniation 453upper motor neuron paralysis 786upper motor neurons 786upward cerebellar herniation 285urea

for hyponatremia 14uremia

and idiopathic intracranial hypertension 715uremic encephalopathy 73

and delerium 56uremic neuropathy 800urinary 17-hydroxycorticosteroids 646urinary retention

differential diagnosis 118in cauda equina syndrome 446

urine free cortisol 643urine osmolality 16

in diabetes insipidus (DI) 16normal range 16

urine specific gravity 16urodynamic testing 119urokinase

for cerebrovascular venous thrombosis 1169for intracerebral hematoma 782

urticaria 125uveocyclitis

with CNS lymphoma 673

V“V” shaped pre-dens space 957VA shunt (see ventriculo-atrial shunt)vacuum disc 429vagal nerve stimulation for seizures 424valacyclovir - for herpes zoster 565Valium® (see diazepam)valproate 412

and neural tube defects 245, 413dosing forms 413for geniculate neuralgia 564for myoclonic status 407

valproic acid (see valproate)

INDEX 1327

Valtrex® (see valacyclovir)Vancocin® (see vancomycin)vancomycin

for cerebral abscess 354for meningitis 343for shunt infections 347for subdural empyema 358for surgical prophylaxis 342

Vaprisol® (see conivaptan)varicella-zoster leukoencephalitis 360vascular claudication 477vascular dysautoregulatory encephalopathy 73vascular malformations 1098

angiographically occult 1105arteriovenous malformation (AVM) 1098spinal 507

vascular territories (cerebral) 96, 96vasculitis (cerebral) 74

drug induced 79vasculopathy 74

following stereotactic radiosurgery 778vasoconstrictive substances

and reversible cerebral vasoconstrictive syn-drome 1036

vasodepressor syncope 1199vasogenic cerebral edema 109, 883vasopressin 18

drip 1053preparations 17

8-arginine vasopressin (Pitressin®) 17vasospasm 1045

diagnostic criteria 1047following pretruncal nonaneurysmal SAH

1085optimal hematocrit 1049protocol 1050risk factors after SAH 1046statins for treatment 1049syndromes 1045tests for diagnosing 1047time course 1046treatment 1048

Vasotec® (see enalapril and enalaprilat)vasovagal response

differential diagnosis 1199from contrast media reaction 125

VBI (see vertebrobasilar insufficiency)vecuronium 26

for intubation 4vein of Galen malformation/aneurysms 1099,

1112veins

basal vein of Rosenthal 105cerebral venous anatomy 104, 105cortical vein sign 308internal cerebral vein 105, 105internal jugular 104supratentorial 104vein of Galen 105, 105vein of Labbe 104, 105vein of Trolard 104

Velcade® (see bortezomib)venogram (see angiogram)venous angiomas 1104, 1105venous anomaly (see venous angiomas)venous infarction

following transcallosal surgery 171with cerebral venous thrombosis 1166with subdural empyema 356with superior sagittal sinus occlusion 163

venous lakes (of the skull) 1220venous malformation (see venous angiomas)venous system

cerebral 104, 105ventricles

fifth 1218isolated fourth 309lesions/tumors within 1224slit 326surface anatomy 88third 88

ventricular access device 211ventricular catheterization 207

following SAH 1041for brain relaxation during surgery 1062infection of catheter 869insertion technique 208, 871third ventriculostomy 212, 315to monitor ICP 870with intracerebral hemorrhage 1130(see also ventricular tap)

ventricular needle 146ventricular tap 158

for neonatal intraventricular hemorrhage 1135

ventriculitis 345, 346, 1227ventriculo-atrial shunt 315, 317

insertion technique 210ventriculoperitoneal shunt 315

insertion technique 209trocar peritoneal insertion 210

ventriculopleural shunt 316insertion technique 210

ventriculoscopefor colloid cyst removal 667

ventriculostomy (see ventricular catheterization)verapamil

intra-arterial for vasospasm 1050Vernet’s syndrome 115

with cerebrovascular venous thrombosis 1167verocay bodies 622Versed® (see midazolam)Vertebra 1232vertebra plana 1232

differential diagnosis 1232with eosinophilic granuloma 729

vertebral arteryanatomy 102dissection 1163injury

from anterior cervical discectomy 465from C1-2 articular facet screws 184

1328 INDEX

vertebral artery - injury (cont’d)from C1-2 puncture 206from nonpenetrating cervical trauma 985from spinal manipulation therapy 438grading 983

segments 102vertebral bodies

abnormalities of 1231fatty infiltrate 1231scalloping 1233

vertebral body augmentation 994vertebral confluens 103vertebral corpectomy

cervical 978thoracolumbar 989

vertebral hemangioma 738treatment 739

vertebral osteomyelitis 380differential diagnosis 1233work-up 382

vertebrobasilar hypoplasia 1160, 1210vertebrobasilar insufficiency 1158

due to basilar artery migraine 58due to blunt cervical trauma 985

vertebroplasty/kyphoplasty 994for spinal metastases 747

vertex 86vertical crest (of IAC) 89vertical nystagmus 828vertigo 840

differential diagnosis 840due to Meniere’s disease 842due to vestibular schwannoma 626with basilar artery migraine 58with glomus jugulare tumors 680

vestibular dysfunctionfollowing vestibular schwannoma surgery

632vestibular evoked myogenic potential 624vestibular neurectomy

following vestibular schwannoma surgery 632

for vertigo 840vestibular schwannoma 620

and hydrocephalus 621, 627and trigeminal neuralgia 552and vertigo 626bevacizumab (Avastin®) for 624bilateral in neurofibromatosis 2 620, 724cranial nerve dysfunction post-op 632differential diagnosis

of CPA lesion 1210of tinnitus 1207

facial nerve palsyfollowing treatment 632

follow-up schedule 625growth rate 625hearing loss

following treatment 632from tumor 621, 622

management 624

vestibular schwannoma (cont’d)radiotherapy (conventional) for 633recurrence following treatment 632stereotactic radiosurgery for 775, 777

radiation dose 777stereotactic radiotherapy for 776treatment options 624vs. meningioma 1211

vestibule (of semicircular canals) 630as route for CSF leak 631

Vicodin® (see hydrocodone)vidarabine 360Videx® (see didanosine)vidian artery

anatomy 99as collateral 1027

vigabatrin 417Villaret’s syndrome 115Vimpat® (see lacosamide)viral encephalitis 358Visipaque® (see iodixanol)Vistaril® (see hydroxyzine)visual analogue scale 430visual cortex 84visual fields 829

deficits 829following pallidotomy 536with idiopathic intracranial hypertension

(pseudotumor cerebri) 714with ophthalmic artery aneurysm 1070with pituitary tumor 642

visual losspostoperative 450

vitamin B12 (cyanocobalamin) deficiency 1187vitamin D for osteoporosis 993vitamin K 41vitreous hemorrhage

at high altitude 916following SAH 1036

voiding cystourethrogram 119Voltaren® (see diclofenac)volume estimation on CT 1125von Hippel-Lindau disease 667

surveillance protocol 670von Recklinghausen’s neurofibromatosis (see

neurofibromatosis - type 1)von Willebrand’s factor

cavernous malformation staining 1107VP shunt (see ventriculoperitoneal shunt)vulnerable plaques in carotid stenosis 1145

WWackenheim’s clivus-canal line 135, 139Wada test 421

in mesial temporal-lobe epilepsy 395wake-up stroke 1017Wallenberg’s syndrome (see lateral medullary

syndrome)wallerian degeneration 802, 804, 821

INDEX 1329

warfarinand intracerebral hemorrhage 1123for anticoagulation 39for atrial fibrillation 1024for DVT prophylaxis 39for DVT treatment 43for stroke 1020holding for invasive procedures 37reversal with FFP 40reversal with vitamin K 41risks of interrupting therapy 1128use with lupus anticoagulant 41

warning headache 1035Wartenberg’s sign 813water deprivation test 17Water’s view 138water-hammer theory of Gardner 511Waterhouse-Friderichsen syndrome 343water-load test 11watershed infarct 1029watershed zone

and central cord syndrome 948in thoracic spinal cord 96

WBC scan (see tagged WBC scan)weakness

foot drop 1194hemiparesis/hemiplegia 1191paraplegia/quadriplegia 1190proximal muscles 1188, 1203upper extremity 1196with cauda equina syndrome 1193

Weber test 848in vestibular schwannoma 621

Weber’s syndrome 114, 1026Wegener’s granulomatosis 78, 1229Werdnig-Hoffmann disease 1191Wernicke’s aphasia 114Wernicke’s encephalopathy 275, 404Wernicke’s speech area 84West syndrome 396Westphal's sign 445WFNS (see World Federation of Neurosurgical

Societies)whiplash injuries 931White and Panjabi

criteria of cervical spine stability 969definition of clinical spinal stability 930

white matter lesions - differential diagnosis 1214WHO astrocytoma grading system 594Wilbrand (anterior knee of) compression 643,

1071Wilson’s disease 1228windshield wiper eyes 283winging of the scapula 792

in brachial plexitis 795winking owl sign 744Wolff’s law 492word recognition score 623work - time off and chronic low back pain 440worker’s compensation

and failed back surgery syndrome 457

worker’s compensation (cont’d)and outcome with herniated lumbar disc 460in history of low back problems 431

World Federation of Neurosurgical Societies grading scale 1040

World Health Organizationclassification of astrocytomas 594classification of nervous system tumors 582

wound infection 348craniotomy 349laminectomy 348

wounded glioma syndrome 600wrapping aneurysms 1058wrist drop 817wrong way gaze 283WRS (see word recognition score)wry neck 541Wyburn-Mason syndrome 722

XXanax® (see alprazolam)xanthoastrocytoma (see pleomorphic xanthoas-

trocytoma)xanthochromic CSF 298, 1038XLIF (see lateral lumbar interbody fusion)X-linked hydrocephalus 308x-rays

cervical spinefor trauma 938in atlas fractures 958in hangman’s fractures 961lateral view 135oblique views 939

for unilateral locked facets 973pediatric 137

craniocervical junctionAP view 139lateral view 135

lumbosacral spine 138, 434shunts 318skull 138

differential diagnosis of lesions 1219fractures 857, 885

growing skull fracture 892indications in E/R 859

spinein E/R 859with metastases 744, 745

X-Stop® (see interspinous spacer)

YYale brace 979yellow ligament (see ligamentum flavum)

Zzalcitabine 798Zantac® (see ranitidine)

1330 INDEX

Zarontin® (see ethosuximide)Zemuron® (see rocuronium)Zentel® (see albendazole)Zerit® (see stavudine)zidovudine 798Zofran® (see ondansetron)Zollinger-Ellison syndrome

and vitamin B12 deficiency 1187

Zonegran® (see zonisamide)zones of the neck 998zonisamide 416

for postherpetic neuralgia 566zoster sine herpete 564Zostrix® (see capsaicin)Zovirax® (see acyclovir)Z-score (DEXA scan) 992

NOTES