Fugleholm Kåre
Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
Handb Clin Neurol. 2013;115:781-802. doi: 10.1016/B978-0-444-52902-2.00045-X.
Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter provides background knowledge of surgical peripheral nerve disease and some general and practical guidance toward its clinical management.
周围神经系统的外科病理学包括创伤性损伤、卡压综合征和肿瘤。最近在周围神经变性和再生的病理生理学及细胞生物学理解方面取得的重大进展尚未转化为改进的外科技术以及周围神经损伤后更好的治疗效果。周围神经外科手术中的决策仍然是一项复杂的挑战,其中损伤机制、反复的临床评估、神经放射学和神经生理学检查以及对周围神经系统损伤反应的详细了解是获得最佳治疗效果的先决条件。手术仍然是周围神经肿瘤的主要治疗方式,辅助肿瘤治疗的进展改善了恶性周围神经肿瘤后的治疗效果。本章提供了周围神经外科疾病的背景知识以及对其临床管理的一些一般实用指导。