Table of Contents

1. OVERVIEW OF NEUROLOGICAL DISORDERS………………………………….1-1
1.1 Alzheimer’s Disease………………………………………………………………..1-1
1.2 Amyotrophic Lateral Sclerosis…………………………………………………..1-3
1.3 Arteriovenous Malformation………………………………………………………1-4
1.4 Bipolar Disorder………………………………………………………………………1-5
1.5 Depression…………………………………………………………………………….1-6
1.6 Epilepsy…………………………………………………………………………………1-6
1.7 Huntington’s Disease……………………………………………………………….1-7
1.8 Hydrocephalus………………………………………………………………………..1-8
1.9 Multiple Sclerosis…………………………………………………………………….1-9
1.10 Parkinson’s Disease………………………………………………………………1-10
1.11 Schizophrenia……………………………………………………………………….1-11
1.12 Stroke………………………………………………………………………………….1-12
Exhibit 1-1: United Kingdom, Neurosurgery, Procedure Volumes Forecast, by Type, 2010-2016…………………………………………………………………1-2
Exhibit 1-2: United Kingdom, Neurological Diseases/Disorders, Incidence and Prevalence………………………………………………………1-14
2. NEUROLOGICAL AND PSYCHIATRIC DISORDERS…………………………..2-1
2.1 Alzheimer’s Disease and Dementia……………………………………………2-1
2.1.1 Etiology……………………………………………………………………2-1
2.1.2 Epidemiology……………………………………………………………2-2
2.2 Amyotrophic Lateral Sclerosis…………………………………………………..2-3
2.2.1 Etiology……………………………………………………………………2-3
2.2.2 Epidemiology……………………………………………………………2-7
2.3 Bipolar Disorder………………………………………………………………………2-8
2.3.1 Etiology……………………………………………………………………2-8
2.3.2 Epidemiology………………………………………………………….2-10
2.4 Cerebrovascular Disorders……………………………………………………..2-11
2.4.1 Arteriovenous Malformation………………………………………2-11
2.4.1.1 Etiology…………………………………………………..2-13
2.4.1.2 Epidemiology……………………………………………2-13
2.4.2 Stroke……………………………………………………………………2-14
2.4.2.1 Etiology…………………………………………………..2-14
2.4.2.2 Epidemiology……………………………………………2-17
2.5 Depression…………………………………………………………………………..2-19
2.5.1 Etiology………………………………………………………………….2-19
2.5.2 Epidemiology………………………………………………………….2-20
2.6 Epilepsy……………………………………………………………………………….2-21
2.6.1 Etiology………………………………………………………………….2-23
2.6.2 Epidemiology………………………………………………………….2-24
2.7 Huntington’s Disease……………………………………………………………..2-24
2.7.1 Etiology………………………………………………………………….2-26
2.7.2 Epidemiology………………………………………………………….2-26
2.8 Hydrocephalus………………………………………………………………………2-27
2.8.1 Etiology………………………………………………………………….2-29
2.8.2 Epidemiology………………………………………………………….2-29
2.9 Multiple Sclerosis…………………………………………………………………..2-30
2.9.1 Etiology………………………………………………………………….2-32
2.9.2 Epidemiology………………………………………………………….2-34
2.10 Myasthenia Gravis…………………………………………………………………2-36
2.10.1 Etiology………………………………………………………………….2-36
2.10.2 Epidemiology………………………………………………………….2-38
2.11 Parkinson’s Disease………………………………………………………………2-40
2.11.1 Etiology………………………………………………………………….2-41
2.11.2 Epidemiology………………………………………………………….2-42
2.12 Schizophrenia……………………………………………………………………….2-42
2.12.1 Etiology………………………………………………………………….2-44
2.12.2 Epidemiology………………………………………………………….2-45
Exhibit 2-1: 2010, Europe, Diagnosed and Undiagnosed Dementia, Incidence Rates, by Age and Gender…………………………………………2-4
Exhibit 2-2: 2010, Europe, Diagnosed and Undiagnosed Dementia, Prevalence Rates, by Age and Gender………………………………………2-5
Exhibit 2-3: 2010, United Kingdom and Europe, Alzheimer’s Disease, Comparative Incidence and Prevalence……………………………………..2-6
Exhibit 2-4: 2010, United Kingdom and Europe, Amyotrophic Lateral Sclerosis, Comparative Incidence and Prevalence……………………………………..2-9
Exhibit 2-5: 2010, United Kingdom and Europe, Bipolar Disorder, Comparative Incidence and Prevalence……………………………………2-12
Exhibit 2-6: 2010, United Kingdom and Europe, Arteriovenous Malformation, Comparative Incidence and Prevalence……………………………………2-15
Exhibit 2-7: 2010, United Kingdom and Europe, Stroke, Comparative Incidence and Prevalence……………………………………2-18
Exhibit 2-8: 2010, United Kingdom and Europe, Depression, Comparative Prevalence………………………………………………………..2-22
Exhibit 2-9: 2010, United Kingdom and Europe, Epilepsy, Comparative Incidence and Prevalence……………………………………2-25
Exhibit 2-10: 2010, United Kingdom and Europe, Huntington’s Disease, Comparative Incidence and Prevalence……………………………………2-28
Exhibit 2-11: 2010, United Kingdom and Europe, Hydrocephalus, Comparative Incidence and Prevalence……………………………………2-31
Exhibit 2-12: 2010, United Kingdom and Europe, Multiple Sclerosis, Comparative Incidence and Prevalence……………………………………2-37
Exhibit 2-13: 2010, United Kingdom and Europe, Myasthenia Gravis, Comparative Incidence and Prevalence……………………………………2-39
Exhibit 2-14: 2010, United Kingdom and Europe, Parkinson’s Disease, Comparative Incidence and Prevalence……………………………………2-43
Exhibit 2-15: 2010, United Kingdom and Europe, Schizophrenia, Comparative Incidence and Prevalence……………………………………2-47
3. NEUROSURGICAL PROCEDURES…………………………………………………..3-1
3.1 The Brain……………………………………………………………………………….3-1
3.1.1 The Cerebrum………………………………………………………….3-1
3.1.2 The Cerebellum………………………………………………………..3-2
3.1.3 The Brainstem………………………………………………………….3-2
3.1.4 The Meninges…………………………………………………………..3-4
3.1.5 The Ventricular System……………………………………………..3-4
3.1.6 Cerebrospinal Fluid…………………………………………………..3-6
3.1.7 The Hypothalamus……………………………………………………3-6
3.1.8 The Pineal Gland………………………………………………………3-6
3.1.9 The Pituitary Gland……………………………………………………3-8
3.2 Selected Diseases/Disorders of the Central Nervous System and the Peripheral Nervous System…………………………………………..3-8
3.2.1 Hydrocephalus…………………………………………………………3-8
3.2.2 Movement, Seizure, and Tremor Disorders…………………3-10
3.2.2.1 Alzheimer’s Disease………………………………….3-10
3.2.2.2 Epilepsy…………………………………………………..3-12
3.2.2.3 Multiple Sclerosis……………………………………..3-14
3.2.2.4 Parkinson’s Disease………………………………….3-15
3.2.2.5 Deep Brain Stimulation………………………………3-16
3.2.2.6 Stereotactic Radiosurgery………………………….3-18
3.2.3 Traumatic Brain Injury……………………………………………..3-20
3.3 The Cerebrovascular System and Selected Diseases/Disorders….3-22
3.3.1 The Arterial System…………………………………………………3-22
3.3.2 The Venous System………………………………………………..3-25
3.3.3 Aneurysm………………………………………………………………3-25
3.3.4 Arteriovenous Malformation………………………………………3-27
3.3.5 Stroke……………………………………………………………………3-30
Exhibit 3-1: Structural Relationship between the Cerebrum, Cerebellum, and Brainstem………………………………………………………………………..3-3
Exhibit 3-2: Structure of the Meninges………………………………………………………..3-5
Exhibit 3-3: Ventricles of the Brain……………………………………………………………..3-7
Exhibit 3-4: United Kingdom, Ventricular Shunting and Ventriculostomy, Procedure Volumes Forecast, 2010-2016…………………………………3-11
Exhibit 3-5: United Kingdom, Deep Brain Stimulation and Stereotactic Radiosurgery, Procedure Volumes Forecast, 2010-2016……………………………………………………………………………3-19
Exhibit 3-6: United Kingdom, Evacuation of Subdural Hematoma, Procedure Volumes Forecast, 2010-2016…………………………………3-23
Exhibit 3-7: United Kingdom, Cerebral Aneurysm Clipping, Procedure Volumes Forecast, 2010-2016…………………………………3-28
Exhibit 3-8: United Kingdom, Arteriovenous Malformation Embolization, Procedure Volumes Forecast, 2010-2016…………………………………3-31
Exhibit 3-9: United Kingdom, Carotid Endarterectomy and Carotid Artery Stenting, Procedure Volumes Forecast, 2010-2016……………………………………………………………………………3-35