Neurosurgery for cognitive disorders
- DOI:
- 10.1093/med/9780199655946.003.0040
This chapter reviews the role of neurosurgery in treatment of cognitive impairment. Neurosurgical intervention to address deteriorating cognitive performance associated with structural abnormality reduces raised intracranial pressure secondary to space-occupying lesions or hydrocephalus. The management of controversial entities such as idiopathic normal pressure hydrocephalus is less straightforward. Whether individuals with a neurodegenerative process might benefit from deep brain stimulation to modulate neuronal firing within a degenerating cognitive brain circuit is less clear. This topic remains firmly in the ‘experimental’ sphere without a strong evidence base. The use of neurosurgery in treating cognitive impairment presents recurrent issues of patient selection, capacity to provide consent, outcome measurement and variability of the intervention. While the subject matter is potentially broad, this chapter focuses on the use of shunt surgery, resective surgery for refractory epilepsy and the potential use of functional procedures such as deep brain stimulation.
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