Owing to their frequency and possible consequences and considering the fact they frequently affect young people, trauma tic lesions of the thoraco lumbar spine represent a special point of interest within the field of Neurotraumatology. Traffic accidents are the commonest cause, which accounts for the high peak of occurrence between 15 and 24 years of age. It is also worth noting that according to published series nearly 50% ofthe cases affect the thoraco-lumbar junction. From an anatomical point of view, we must note the severity of thoracic spinal cord lesions especially of the thoraco-lumbar junction and of the lumbar region and be able to associate injuries ofthe conus medullaris and of the ca uda equina where there is a possibility of neurological recovery. Clinical evaluation is not always easy, but remains the basis for diagnosis and prognosis. The neurological classification proposed by FRANKEL et al. in 1969 and used at STOKE MANDEVILLE Hospital seems to retain its value. A more sophisticated study of medullary evoked potentials, as described by TsUBOKAWA can allow a more precise localisation and appreciation of the extent ofthe lesion as well as a better evaluation ofthe prognosis and ofthe evaluation of treatment in the acute phase. The neuro-radiological study should include standard views ofthe whole of the spine with antero-posterior and lateral tomograms of the fractured or luxated area. At present, the unquestionable contribution of the CT.

This Acta Neurochirurica supplement distills the accomplishments of the Joint Convention of the Academia Eurasania Nuerochirurgica and the German Academy of Neurosurgery held in Bamberg, Germany from Sept. 1-3 2005. The main focus is "Medical Technologies for Neurosurgery," including: imaging, image processing, robotics, workflow analysis and ethics. Coverage extends from an overview of medical technologies, to robotic-assisted systems in neurosurgical operating rooms, to intraoperative MRI.

This book was born out of thirty years of didactic and practical experience with the intention of giving the reader concise neurosurgical elements and an appropriate selected iconography. This text wants to represent a practi cal and essential guide for the medical student and a useful reference point for specialists interested in pursuing more detailed literature studies. General practitioners and specialists in related subjects can consult this text to formulate a diagnosis and elaborate a proper therapy. November, 2000 The Authors Contents 1. CRANIAL DYSRAPHIAS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Arnold-Chiari malformation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Dandy-Walker malformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Encephalocele . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Cranial dermic sinus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Corpus callosum agenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2. BRAIN TUMORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Symptoms and signs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Intracranial hypertension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Focal symptoms and signs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Language disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Optic pathways disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Apraxias. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Psychic disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Cerebellar syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Frontal lobe tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Parietal lobe tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Temporal lobe tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Occipital lobe tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Posterior cranial fossa tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Cerebellar tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Fourth ventricle tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Ponto-cerebellar angle tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 VIII Contents Brainstem tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Clivus tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Tumors of the cerebral ventricles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Tumors of the lateral ventricles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Third ventricle tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Fourth ventricle tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Pineal region tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Sellar and parasellar region tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Anatomopathological classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Benign cerebral tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Leptomeningeal tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Nerve sheath tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Vascular tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Dysembryogenetic tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Mixed cerebral tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Malignant cerebral tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Pseudo tumor cerebri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Phacomatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 3. INTRACRANIAL ANEURySMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S9 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Functional Electromyography: Provocative Maneuvers in Electrodiagnosis integrates electrophysiology further into the physical examination than ever before. It introduces the use of electrodiagnostic studies to quantify the neurological changes brought about by three provocative maneuvers commonly used in contemporary medicine. This widens the scope of electromyography while sharpening physicians' diagnostic acuity. The book presents nerve conduction velocity (NCV) and H-reflex techniques to identify common conditions that are difficult to diagnose by any other means, often using the needle exam (EMG), MRI or musculoskeletal ultrasound to verify their clinical utility. Functional electromyography successfully diagnoses some cases of thoracic outlet syndrome, nearly all cases of piriformis syndrome, and offers a method for determining whether spinal stenosis or radiculopathy is the main pain generator when both are present in a single patient, even at the same level. This is particularly valuable because the standard conservative and surgical treatments for these two conditions are opposite, in spite of the identical symptom-set they produce. The book carefully describes each technique and persuasively documents their validity in statistical series and individual case presentations. It further guides the attentive electromyographer to adapt these methods to cases beyond those presented in its pages, suggesting a safe and scientific approach to other functional maneuvers of value to the electromyographer, and methods for validating one-time measures that may aid the electromyographer in clinical situations that are neither common nor easily analyzed. Hand drawn illustrations are included alongside text developed by experts in the field. An invaluable resource for physiatrists, neurologists, orthopedic surgeons, specialists in pain management and other providers, Functional Electromyography: Provocative Maneuvers in Electrodiagnosis represents a major contribution to the field of electrodiagnosis.

During recent years, major advances in surgical techniques, diagnostic methods, anesthesia and adjunctive treatment in the care of patients with subarachnoid hemorrhage have been achieved. Nevertheless, the overall outcome of patients with SAH cannot be regarded as satisfactory. The first part of the book concentrates on the pathogenetic mechanisms underlying vasospasm and edema, the principal causes of poor outcome. Recent progress in the field of membrane lipid metabolism has allowed the problem to be approached from an entirely new perspective. The possible participation of free radicals, membrane lipids and eicosanoids is thoroughly discussed. The second part features the problems of practical management of SAH patients. Timing and indication of surgery of aneurysms and the surgical techniques are described in detail.

Percutaneous nuclectomy according to the Onik method is an avantgarde method used to remove the intervertebral disc by percutaneous access and with closed surgery. The instrumentation and the procedure are simple. The main feature is the smaller diameter of the probe (2mm) which fragments and aspires the small chips of pulpy nucleus. It reduces the risk of discitic infections (occurring in various percentages with all methods of percutaneous discectomy) because the hole in the anulus, being small, closes spontaneously after the probe is removed. Moreover postoperative acute lumbar pain has been reported to occur less frequently. This method is carried out under local anesthesia, with radioscopic and intraoperative discographic monitoring. By consulting this atlas orthopaedists, neurosurgeons and neuroradiologists may learn this method easily, because every detail is clearly presented and illustrated with a great number of coloured pictures.

Since Bailey and Cushing (1926), all brain tumor classifications have been called histogenetic. The nosographic position that the tumor types progressively acquired in the classification systems derived from the resemblance of tumor cells to those of the cytogenesis, modified whenever new information became available from different biological research fields and especially from molecular genetics. Classically, on the basis of the rough correspondence between the mature/immature aspect of tumor cells and the benign/malignant biological behavior of the tumors, the histological labels contained a prognostic significance. The supposed origin of the tumors was thus a factor for prognosis. Later on, with the concept of anaplasia (Cox, 1933; Kernohan et al., 1949) new criteria were introduced for establishing the malignancy grades of tumors. Immunohistochemistry and later molecular genetics further refined the prognostic diagnoses, substantially increasing the opportunities to recognize the cell origin of tumors, beside revealing the pathogenetic mechanisms. Prognoses became more accurate, as required by the greater and more targeted possibilities of therapy.

The management of vascular and tumorous lesions of the parasellar region still remains one of the most demanding tasks in neurosurgery. It is only a short time ago that the major concepts of the anatomy of the so-called cavernous sinus were described in detail. Surgical interventions in this region are very complex, they are time-consuming and require an extensive back ground of experience in surgery of the cranial base. Pioneer anatomical studies of the parasellar region done by Taptas, and the daring direct operative approach introduced by Parkinson pro moted the development of modern neuroradiological intervention proce dures, which were initiated by Serbinenko and further refined by Debrun, Vifiuela and others. The technique of the detachable balloon catheter stimulated surgeons to proceed with the direct operative approach to lesions of the parasellar region. Today, it is hard to imagine a successful man agement of vascular pathologies of this region without a complementary use of the two techniques."

This volume contains the papers presented at the International Symposium on Spine and Spinal Disorders in Growth and Aging held in Niigata on November 22-23, 1992. The symposium commemorates the 75th anniversary of the foundation of the Department of Orthopedic Surgery, Niigata University School of Medicine. . The purpose of the symposium was to investigate the field of spine and spinal disorders in growth and aging. Topics ranged from osteoporosis, other of the spinal column to degenerative metabolic bone diseases, and deformity spinal disorders and heterotopic ossification with resultant myelopathy. Spinal manifestations of systemic and local diseases were also included. Symptoms of spinal disorders in both the lower and upper extremity were presented and biomechanics and bone mineral measurement of the spine were also discussed. The organizing committee would like to thank the following for their sponsorship and support of this international symposium: Japan Osteoporosis Foundation, Japan-North America Medical Exchange Foundation, Japan Russia Medical Exchange Foundation, Niigata Prefectural Government, and Niigata City Government. We deeply appreciate their support and contributions to the success of the symposium. The chairman of the organizing committee is most grateful for the contributions and support of the International Advisory Committee, Dr. B.D. Burr (USA), Dr. H.M. Frost (USA), and Dr. R.R. Recker (USA); the Local Advisory Committee, Dr. S. Kono (Prof. Emeritus of Niigata University) and Dr. T. Tajima (Prof. Emeritus ofNiigata University); and the members of the organizing committee, Dr. Y. Watanabe (Yamagata University), Dr. K.

This text examines the dominant ways of looking at patient/clinician relationships in healthcare. By challenging these dominant views the author can explore presuppositions that are defective. She further explains how they come to be so readily and uncritically held and reinforced; and, why their implications can have such a profound affect on how we think and act. Using the methodology of philosopher, John Dewey, the author proposes an alternative bio/psycho/social approach to understanding the patient/clinician relationship and for resolving increasingly common bioethical issues that arise in healthcare settings.

This volume contains 121 representative works on hydrocephalus which are collected from 24 listed journals and books in the field of neuroscience published in 1988. We express OUf sincere thanks to all authors, listed publishers and editorial boards for their cooperation and permission on this publication. It isour pleasure ifthis book willprovide you with an up-to-date review of the works on hydrocephalus. The editors ACKNOWLEDGMENT Greatful acknowledgments for permission to reproduce copyright material are made to the editors and the publishers listed below: Acta Neurochirurgica: Springer-Verlag, Wien American Journal of Neuroradiology (AJNR): American Roentgen Ray Society American Journal of Psychiatry: The American Psychiatrie Association Archives of Neurology: American Medical Association Brain and Development: (Official Journal) The Japanese Society of Child Neurology Brain Research: Elsevier Science Publishiers B. V. Child's Nervous System: Springer-Verlag, Berlin CT Kenkyu/Progress in Computerized Tomography: Neuron Publishing Co. Journal of Neurology, Neurosurgery and Psychiatry: British Medical Journal Journal of Neurosurgery: The American Association of Neurological Surgeons Journal of Pediatric Neurosciences: Springer-Verlag, Heidelberg Journal of Pediatric Surgery: Grune & Stratton, Inc. Nervenarzt: Springer-Verlag, Berlin Neurologia Medico Chirurgica (Tokyo): (OfficialJournal) The Japan Neurosurgical Society Neurology: Modern Medicine Publications, Inc.

The scientific contribution of Mike Bradbury to the study of the blood-brain barrier is considerable and wide-ranging, starting with his M.D. thesis in 1962 and still continuing today. The varied spectrum of topics relating to the blood-brain barrier presented in this volume and the many geographical locations from which both speakers and participants gathered to attend the symposium are a fitting testament both to Mike's wide-spread influence in the field and to the esteem in which he is held. When we first had the idea of afestschrift to mark Mike's retirement as Professor of Physiology at King's College London and the beginning of a new vie libre as scientist and yachtsman the plan was initially for a gathering of all of the many colleagues, collaborators and students who had worked with him over the years. However what we had not taken into account was the closeness of the international community of workers in the field, the widespread influence that Mike had wielded and the speed with which word would spread. We should have anticipated all three. The final outcome was an excellent symposium with the majority of the world's key workers either contributing or attending. We hope that this volume presents an adequate record of the meeting.

Patients with neurosurgical conditions are almost always referred from either primary care physicians, neurologists, internist or a specialist in family medicine. This guide will answer commonly asked questions about common neurosurgical conditions related to brain and spinal cord, in an attempt to fill in the gap and answer numerous questions that arises after a diagnosis is made on the loved ones. There are over 1500 academic and private hospitals in USA who have dedicated tertiary Neurosurgery services and cater millions of people in need, in addition to numerous centers that have level I and II trauma care. We aim to reach these centers and the families of the patients undergoing neurosurgical procedures. This book has been specially written and illustrated for families of patients undergoing neurosurgical procedures. It is straightforward, with non-technical language explaining the basics of neurosurgical diseases and their management including legal, ethical and financial issues.

This book presents the development and experimental validation of the structural test strategy called Oscillation-Based Test - OBT in short. The results presented here assert, not only from a theoretical point of view, but also based on a wide experimental support, that OBT is an efficient defect-oriented test solution, complementing the existing functional test techniques for mixed-signal circuits.

More than 40 articles provide an extensive coverage of clinical and basic science advances over the last three years of research on subarachnoid hemorrhage-induced brain injuries. Early brain injury, the new frontier of subarachnoid research, which may be a key contributor to the high mortality and morbidity, promotes collaborative efforts from neurosurgery, neurology, neuro-ICU into other interrelated fields and basic neurosciences. For the first time, subarachnoid hermorrhage research is almost equally divided by early brain injury and cerebral vasospasm, mechanistic investigations and therapeutic approaches, demonstrating a translational feature of the future direction.

More than 40 articles provide an extensive coverage of clinical and basic science advances over the last three years of research on subarachnoid hemorrhage-induced brain injuries. Early brain injury, the new frontier of subarachnoid hemorrhage research, which may be a key contributor to the high mortality and morbidity, promotes collaborative efforts from neurosurgery, neurology, neuro-ICU into other interrelated fields and basic neurosciences. For the first time, subarachnoid hemorrhage research is almost equally divided by early brain injury and cerebral vasospasm, mechanistic investigations and therapeutic approaches, demonstrating a translational feature of the future direction.

Cerebral stroke is a common and widespread phenomenon affecting a large number of the human population worldwide. Various surgical methods have been developed for its treatment and the therapeutic results have steadily improved. This is a reassuring trend that promises further progress will be made in the future. This volume contains important contributions by leading clinicians and researchers in the field to the "International Symposium on Surgery for Cerebral Stroke" held in Sendai, Japan, May 24 - 27, 1987.

When I first proposed this book, one of the hopes was that it would be the stage upon which would be conducted a quiet, well reasoned discussion of the various techniques of stereotactic radio surgery. At that time, there was quite a bit of rancorous debate that tended to obscure the scientific and medical merits of each of the separate methods. At the present time, I am happy to report that the field of stereotactic radiosurgery is much less riven by such inappropriate posturing. The field has taken many steps towards maturity, both technically and medically. In the course of this mat uration process, there have been many grandiose plans and speeches made on behalf of stereotactic radiosurgery. Inevitably, the reality will not live up to the hype, but such is the natural course of devel opment in these sorts of matters. However, even though events may not match our hopes, we should keep in mind the words of Herbert Parker. Recognizing that new modalities for the treatment of cancer do not stand much chance of revolutionary success, nevertheless, he quite correctly pointed out that " . . . with any type of radiatiQn, the margin between success and failure is small. If the chance of success is a little greater . . . thi~ might well be classed as a great advance. " Mark H.

How does the brain code and process incoming information, how does it recog nize a certain object, how does a certain Gestalt come into our awareness? One of the key issues to conscious realization of an object, of a Gestalt is the attention de voted to the corresponding sensory input which evokes the neural pattern underly ing the Gestalt. This requires that the attention be devoted to one set of objects at a time. However, the attention may be switched quickly between different objects or ongoing input processes. It is to be expected that such mechanisms are reflected in the neural dynamics: Neurons or neuronal assemblies which pertain to one object may fire, possibly in rapid bursts at a time. Such firing bursts may enhance the synaptic strength in the corresponding cell assembly and thereby form the substrate of short-term memory. However, we may well become aware of two different objects at a time. How can we avoid that the firing patterns which may relate to say a certain type of move ment (columns in V5) or to a color (V 4) of one object do not become mixed with those of another object? Such a blend may only happen if the presentation times be come very short (below 20-30 ms). One possibility is that neurons pertaining to one cell assembly fire syn chronously. Then different cell assemblies firing at different rates may code different information."

Intraoperative imaging technologies have taken an ever-increasing role in the daily practice of neurosurgeons and the increasing attention and interest necessitated international interaction and collaboration. The Intraoperative Imaging Society was formed in 2007. This book brings together highlights from the second meeting of the Intraoperative Imaging Society, which took place in Istanbul-Turkey from June 14 to 17, 2009. Included within the contents of the book is an overview of the emergence and development of the intraoperative imaging technology as well as a glimpse on where the technology is heading. This is followed by in detail coverage of intraoperative MRI technology and sections on intraoperative CT and ultrasonography. There are also sections on multimodality integration, intraoperative robotics and other intraoperative technologies. We believe that this book will provide an up-to date and comprehensive general overview of the current intraoperative imaging technology as well as detailed discussions on individual techniques and clinical results.

This book is the first of four books on the core principles of acute neurology. This book is a primer - and a great deal more - on how to clinically recognize acute brain injury and to treat its consequences. Acute brain injury often changes the dynamics of cerebral blood flow, cerebrospinal fluid mechanics and eventually intracranial pressure. And furthermore, acute brain and spine injury impacts on heart function, blood pressure control, breathing regulation and even gastric and bladder function. It is necessary to not only understand these fundamentals but also how certain measures could influence or correct these manifestations. Major concepts are illustrated to facilitate understanding. Each chapter concludes with a section that explains its relevance to clinical practice.The book truly combines basic neuroscience with practical know- how in an easy to read prose useful for both the novice and expert.

In any acute neurologic condition situations come up which generate questions about management. In a deteriorating patient there is a strain in decision making and many acute problems are hard calls. Handling Difficult Situations includes solutions for these reoccurring dilemmas. Each topic is carefully chosen and reflects clinical practice. The book addresses how to recognize treatable coma, how to judge the severity of traumatic brain and spine injury, and discusses how to recognize neurosurgical emergencies. Handling Difficult Situations also includes recognition and management of acute respiratory neuromuscular failure. A separate chapter discusses errors in CT scan evaluation of acute neurologic conditions.

* . . . . At last the doctor will be freed from the tedious interpretation of screens and photographs. Instead, he will examine and scan through his patient directly. Wearing optical-shutter spectacles and aiming a pulsed laser torch, he will be able to peer at the beating heart, study the movement of a joint or the flexing of a muscle, press on suspect areas to see how the organs beneath respond, check that pills have been correctly swallowed or that an implant is savely in place, and so on. A patient wearing white cotton or nylon clothes that scatter but hardly absorb light, may not even have to undress . . . . *. David Jones, Nature (1990) 348:290 Optical imaging of the brain is a rapidly growing field of heterogenous techniques that has attracted considerable interest recently due to a number of theoretical advantages in comparison with other brain imaging modalities: it uses non ionizing radiation, offers high spatial and temporal resolution, and supplies new types of metabolic and functional information. From a practical standpoint it is important that bedside examinations seem feasible and that the implementations will be considerably less expensive compared with competing techniques. In October 1991, a symposium was held at the Eibsee near Garmisch, Germany to bring together the leading scientists in this new field.

Praise for "The Lobotomist"

"Written with such clarity and engaging detail that a reader has difficulty in putting it down."
--"The New York Review of Books"

"One of the many virtues of El-Hai's text is the rich detail he provides about Freeman's life and ideas."
--"Los Angeles Times"

"Fascinating . . . an important and disturbing contribution to the history of psychiatry."
--"New Statesman"

"Captivating. . . . No history of modern psychiatry is complete without this story."
--Andrew Solomon, author of "The Noonday Demon"

"The Lobotomist" explores one of the darkest chapters of American medicine: the desperate attempt to treat the hundreds of thousands of psychiatric patients in need of help during the middle decades of the twentieth century. Into this crisis stepped Walter Freeman, M.D., who saw a solution in lobotomy, a brain operation intended to reduce the severity of psychotic symptoms. Although many patients did not benefit from the thousands of lobotomies Freeman performed, others believed their lobotomies changed them for the better.

Drawing on a rich collection of documents Freeman left behind and interviews with Freeman's family, Jack El-Hai takes a penetrating look into the life of this complex scientific genius and traces the physician's fascinating life and work.

Computer technology has developed remarkably in the field of neurosurgery during the past 10 to 20 years. Great achievements have been made recently in neuroimaging techniques and computer technology for neuronavigation, from frameless, armless systems to robotic microscopes. Contained in the present volume are all the papers presented at the International Symposium on Computer-Assisted Neurosurgery and selected papers presented at the 6th Annual Meeting of the Japanese Society of Computers in Neurosurgery, which were held in Kobe, Japan, on January 24-26, 1997. This volume is a comprehensive description and review of current technical ad vancements in computer-assisted neurosurgery, with a special focus on advanced intraoperative neuroimaging, various neuronavigation system, robotic microscopes, and strategies for preoperative and intraoperative surgical planning using high-power workstations with three-dimensional software. We express our thanks to the contributors for their participation and cooperation, and to Springer-Verlag for personal and technical assistance in publishing this work. We sincerely hope that this volume will contribute to improving neurosurgical technology and outcomes.