Ronald Brisman, M.D. This book will discuss three areas where the The multiplicity of procedures with varying neurosurgeon may provide an important degrees of risks and benefits sometimes re­ contribution to the relief of intractable pain: quires a sequential approach, but always an trigeminal and other facial neuralgias, chronic individual one, matching an appropriate treat­ noncancer pain, and cancer pain. By one ment plan or procedure for a particular patient intervention, the neurosurgeon often may pro­ at a specific time in his or her illness. vide long-lasting pain relief. New techniques, The neurosurgical chapters in this book which have developed since the 1970s and represent my experience with several hundred continue to evolve, dominate the neurosur­ patients during a 12-year period from 1975 gical armamentarium because they are not only through 1987. I have relied heavily on the effective, but safe. These include percutaneous works of others, which have been quoted from radio frequency electrocoagulation for trigem­ the neurosurgical literature, but this book is inal neuralgia, spinal stimulation for chronic not meant to be encyclopedic. noncancer pain, and intraspinal morphine in­ At least as important as knowing when to fusion for cancer pain. operate is knowing when not to do so, and this Sometimes a procedure relieves pain but the is particularly true of the treatment of pain. pain recurs; it may be necessary to repeat the Most patients with pain do not require neuro­ procedure, which in the case of radiofrequency surgical intervention.

Springer Book Archives

1. Introduction.- I. Basic Science of Pain.- 2. Neuroanatomical, Neurophysiological, and Neurochemical Basis of Pain.- II. Trigeminal Neuralgia.- 3. Trigeminal Neuralgia and Other Facial Pains: Diagnosis, Natural History, and Nonsurgical Treatment.- 4. Overview of Neurosurgical Treatment of Facial Neuralgias.- 5. Treatment of Trigeminal Neuralgia by Radiofrequency Electrocoagulation.- 6. Retrogasserian Glycerol Injection With or Without Radiofrequency Electrocoagulation for Trigeminal Neuralgia.- 7. Suboccipital Craniectomy and Treatment of Trigeminal Neuralgia.- 8. Trigeminal Neuralgia and Brain Tumors.- 9. Bilateral Trigeminal Neuralgia.- 10. Trigeminal Neuralgia and Multiple Sclerosis.- 11. Neuralgia of the Seventh, Ninth, and Tenth Nerves.- III. Chronic Benign Pain.- 12. Anesthesiologic Management of Chronic Benign Pain.- 13. Psychiatric Management of Chronic Benign Pain.- 14. Physiatric Management of Chronic Benign Pain.- 15. Neurosurgical Aspects of Chronic Pain.- 16. Spinal Cord Stimulation for Relief of Chronic Pain.- 17. Intraspinal Morphine for Treatment of Chronic Noncancer Pain.- 18. Deep Brain Stimulation for Relief of Chronic Pain.- 19. Noncancer Pain, Other Operations: Sympathectomy, Dorsal Root Entry Zone Lesions, Dorsal Rhizotomy, Facet Denervation.- IV. Cancer Pain.- 20. Cancer Pain: Natural History and Pharmacological Treatment.- 21. Introduction to Neurosurgical Treatment of Cancer Pain.- 22. Anterolateral Spinal Cordotomy for Cancer Pain.- 23. Neurosurgical Treatment (Other Than Cordotomy) for Cancer Pain.- V. Appendix.- 24. Trigeminal Neuralgia Questionnaire.