It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters, successfully bring to the attention of physi cians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, patho anatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years and over this period, neurosurgeons have ob tained special training in pediatric neurosurgery and then dedicated them selves primarily to its practice. Centers, Chairs, and educational pro grams have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's ner vous system."

Research in the morphology-angioarchitecture and ultrastructure-of cerebral veins has been widely neglected in past decades; investigation was mainly focussed on the arterial side of brain circulation. This circumstance has certainly had a negative impact on the development of knowledge in clinical medicine about cerebral venous disease. Cerebra} venous pathology and its consequence is, however, a frequent problern in clinical neurosur gery, both with regard to operative techniques and conservative manage ment. Therefore, it is not surprising that the initiative to collect, for the first time, data on our present knowledge in basic research of cerebral veins, their structure and function under normal and pathological circumstances, came from clinicians. Regarding the cerebral veins the clinician has primarily in view the dysfunctions originating from embryogenetic malformations, phlebitic obstruction, tumourous shunts, or traumatic lesions. But in addition to that, particular attention should be paid to the microstructure ofthe venous vessel walls, their barrier function, and the venous vasomotor system. Studying these interrelationships has for a long time been both fascinating and of immediate interest to me."

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN, J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GUENOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE, M. SINDOU).- Child abuse - some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS, E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

The seventh annual multidisciplinary symposium on clinical oncology organised by the Royal College of Radiologists discussed the subject of malignant brain tumours. It was held in London in February 1985 and this volume collects together the edited texts of the papers which were presented at the meeting. Primary tumours of the central nervous system account for about 9070 of all malignant diseases but as much as 20% of all paediatric neoplasms. The prognosis ranges from excellent for some of the less aggressive tumours, through good for children's tumours such as medulloblastoma, to appalling for the high-grade adult astrocytomas. Improvements in pathological diagnosis and surgical and radiothera peutic techniques have led to considerable sequential improvements in outcome over those obtained in the past. In contrast the response to chemotherapy over the whole range of tumours remains disappoint ing, and clearly awaits new drugs and methods of delivery. The relative rarity of individual types of tumours, apart from the commoner high-grade adult astrocytomas, has made progress in terms of clinical trials difficult to organise. In spite of this much investigative work is in progress. The symposium, and the present volume, were designed to provide a comprehensive overview of the subject by experts, with an emphasis on the possible routes to future progress. The topics included aspects of pathology, imaging, diagno sis and treatment of both the common and uncommon primary tumours. It is hoped the papers will stimulate further interest and activity in this difficult area of clinical therapy and investigation."

This monograph analyses all aspects related to the etiopathogenesis, pathomorphology, diagnosis and treatment of lumbar disc herniation. It includes 24 chapters, over 500 illustrations, partly in colour, and 2800 bibliographic entries, going from the historical to the most recent ones. Five chapters are dedicated to biological and pathomorphologic aspects both of lumbar disc herniation and the conditions most often associated with herniation. The etiopathogenesis is analysed in the light of the most significant and recent studies. Five chapters deal with the clinical presentation and diagnostic tests in an extremely wide and detailed way. Large space is reserved to conservative management. The chapters on invasive treatments and on the results and complications of surgery define the advantages and limitations of the old and new percutaneous or surgical treatments. Two chapters are dedicated to surgical management of patients with spinal conditions associated with herniation, and two other deal with the surgical failure. This monograph is aimed at satisfying the requirements of both experts and young doctors. Some chapters are of particular interest to the spine specialist, whilst others are useful to the novice to acquire a general knowledge of the subject.

Rehabilitation in Neurosurgery is not a new task but on Neurosurgical Rehabilitation in Munster, offering rather an indispensable part of neurological surgery the opportunity to visit various types of neurosurgical from the beginning, intended to avoid or to improve rehabilitation facilities. During this conference it be- diagnosable or impending damage to the CNS, and came apparent that neurorehabilitation had been ne- to prevent secondary and tertiary complications by glected by most of the neurosurgeons around the world adequate therapeutic measures. Rehabilitation should during the second half of the last century and it was agreed to improve on this situation by publishing the start right at the onset and site of the acute impact to the brain, spinal cord or peripheral nerves. Thanks results of their work as a special volume. to the tremendous progress in modern neurosurgery Selected papers from another two meetings (the regarding microsurgical techniques, instruments, so- 5th Annual Meeting of the Euroacademy of Multi- disciplinary Neurotraumatology, organised in con- phisticated technologies, multidisciplinary team ap- junction with the Meeting of the European Brain proaches, neuro-imaging, neuropharmacology, anti- Injury Society and France Traumatism Cranien, Paris, biotics, neuroanaesthesiology, and intensive care organized by the Congress President Jean Luc Truelle, treatment, more and more patients frequently survive on September 20-23, 2000; Workshop on Early Re- even life threatening lesions to the brain and spinal habilitation, Maribor, Chair Matej Lipovsek, March cord, however, at the expense of severe sensory, motor

This volume contains selected works from the 25th Anniversary of the International Conference on Intracranial Pressure (ICP) held in Williamsburg, Virginia. The theme of the meeting was Intracranial Pressure and Neuromonitoring and focused on all the current state of the art brain monitoring methodologies and their application to brain injury. The brain monitoring techniques covered a wide spectrum from neurochemical monitoring of the injured brain to specialized techniques for assessing shunt function in normal pressure hydrocephalus. It also includes the most recent advances in monitoring of the brain oxygen levels using electrodes or the less invasive Near Infrared Sprectroscopy devices. Controversial issues regarding the management of ICP and CPP or both are also addressed and there are several works dealing with this topic. Of particular interest is the group of papers describing diagnosis and outcome in normal pressure hydrocephalus. It is the first compilation of papers which covers all the latest brain monitoring studies in both ischemia, trauma and hydrocephalus. The manuscripts in this volume have been selected from over 300 abstracts submitted to this international symposium. The abstracts are also published in order to provide the most comprehensive view of the progress made in brain injury research.

The present volume is based upon the invited review lectures delivered to the European Brain and Behaviour Society's Workshop on Recovery of Function Following Brain Damage held at Goldsmiths' College, University of London, in April 1991. Coming exactly ten years after the Society's ftrst meeting on this subject, held at Erasmus University, Rotterdam, a major objective of the Workshop was to review progress in the intervening years. This task was begun by Professor D. G. Stein in his opening presentation. Looking ahead to possible developments in recovery research in the next decade was the subject of Professor B. Kolb's closing lecture. The intervening presentations reviewed progress made in speciftc areas of recovery research. In addition to reviewing progress over the last decade we sought to achieve an additional objective in the way that the invited review lectures were organised. This was to bring together those doing basic research, usually animal research, and those whose of the lectures were "paired," research interests are more clinically orientated. Thus some one concentrating on the results of animal studies and one on clinical research findings.

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their post graduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons."

From recent developments in the rapidly growing area of neuroscience it has become increasingly clear that a simplistic description of brain function as a broad collection of simple input-output relations is quite inadequate. Introspection already tells us that our motor behavior is guided by a complex interplay between many inputs from the outside world and from our internal "milieu," internal models of ourselves and the outside world, memory content, directed attention, volition, and so forth. Also, our motor activity normally involves more than a circumscribed group of muscles, even if we intend to move only one effector organ. For example, a reaching movement or a reorientation of a sensory organ almost invariably requires a pattern of preparatory or assisting activities in other parts of the body, like the ones that maintain the body's equilibrium. The present volume is a summary of the papers presented at the symposium "Sensory Interaction in Posture and Movement Control" that was held at Smolenice Castle near Bratislava, Slovakia, as a Satellite Symposium to the ENA Meeting 1994 in Vienna. The focus of this meeting was not only restricted to the "classical" sensory interactions such as between vestibular and visual signals, or between otolith and semicircular canal inputs. Rather, the symposium tried to consider also the interplay between perception and action, between reflexive and volitional motor acts as well as between sensory driven or self-initi ated motor acts and reafferent inputs."

This volume represents the proceedings of the 2nd annual symposium on the Brain Immune Axis and Substance Abuse held at the Breakers Hotel in Palm Beach, FL in June 1994. The history of productive studies concerning the relationship between the nervous and the immune systems is relatively recent. Studies on the effects of drugs of abuse on the immune system and on infections among individuals who abuse drugs are also of recent vintage. Only in the last decade have investigators begun to describe the role of drugs of abuse and their endogenous counterparts on the brain-immune axis. Thus, the involvement of the neuroendocrine system in the interactions of drugs of abuse and the immune system has only recently been appreciated. In addition, it has been recognized that direct neural inputs impact immune function. Given the complexity of these interactions, characterization of biologically significant phenomena and elucidation of their mechanisms of action often requires a multidisciplinary approach. This meeting, on which the chapters in this book are based, brought together scientists from an array of biomedical disciplines whose work is focused on the effects of drugs of abuse on the neuro-endocrine immune axis. The meeting was unique in focusing on the brain-immune axis from the viewpoint of drugs of abuse rather than either immunity itself or the brain itself. Presentations addressed the direct effects of drugs of abuse on various components of the immune system, as well as those mediated indirectly by the central nervous system and the neuroendocrine system.

It was only in 1980 that the first recognisable magnetic resonance images of the human brain were published, by Moore and Holland from Nottingham University in England. There then followed a number of clinical trials of brain imaging, the most notable from the Hammersmith Hospital in London using a system designed by EMI, the original manufacturers of the first CT machines. A true revolution in medicine has ensued; in only a few years there are thousands of scanning units, and magnetic resonance imaging (MRI) has assumed a central importance in medical investigation. It is an extraordinary fact that within a few years of development, the esoteric physics of nuclear spin, angular momentum, and magnetic vector precession were harnessed to provide exquisite images of living anatomy; modem science has no greater tribute. That indisputable king of neurology and the oldest of recorded conditions, epilepsy, has not been untouched by the new technology; indeed, it is our view that the introduction of MRI of electroencephalography (EEG) in the late has been as important to epilepsy as was that 1930s. Now, for the first time, the structural and aetiological basis of the condition is susceptible to thorough investigation, and MRI can provide structural detail to parallel the functional detail of EEG. MRI has the same potential as had EEG over 50 years ago, to provide a new level of understanding of the basic mechanisms, the clinical features and the treatment of epilepsy.

Brain edema is a simple phenomenon - an abnormal increase of brain tissue volume by the increase of brain tissue water content. However the etiology is not simple and relating to a wide variety of neurological disorders including ischemia, trauma, tumor, hemorrhage and hydrocephalus. It is still a major cause of death in the neurological/neurosurgical ward. This volume is an up-to-date report on progress in brain edema research, diagnosis and treatment, including papers presented at the 12th International Symposium on Brain Edema and Brain Tissue Injury in 2002. Major topics include molecular biology and blood-brain barrier disorders, ischemic and traumatic brain edema, imaging and diagnosis of brain edema, treatment and radiation effect. Various papers in the rapidly growing fields of neuroimaging and molecular medicine are also included.

We are most pleased to present Volume 3 of Developmental-Behavioral Disorders: Selected Topics, designed to serve as a companion for standard reference textbooks that address cogent issues in developmental pedi atrics. Periodic publications such as Selected Topics and theme-related articles, as well as continuing education programs, attempt to supple ment in a timely fashion the rapidly changing knowledge base in devel opmental-behavioral pediatrics. These media are important as forums for enhancing the quality of clinical practice, teaching skills, and re search activities. The need is critical for periodically disseminating and updating information about issues in developmental medicine, in as much as this field of study continues to expand at a meteoric pace. During the past several decades, developmental medicine has been recognized as a defined subspecialty in pediatrics. The spectrum of problems encompassed by this discipline is relatively broad and at times clinically overwhelming. The ultimate goal of preventing delays, disor ders, and/or dysfunctions from becoming chronic handicapping condi tions has, by volume per se, created clinical dilemmas for pediatric health care providers. There are numerous facets of providing efficient and effective care, which in the field of developmental-behavioral pediatrics are often exaggerated impediments to the delivery of services by pri mary health care specialists, e. g., time, clinical skills, need for inter disciplinary management, medical-legal responsibilities, financial reim bursements. These issues, as well as clinical problems, are still very much part of the information base to be disseminated to concerned pro fessionals."

The international interdisciplinary gathering of top of secondary brain damage in brain trauma, as ac- level clinical and laboratory scientists in Mauls, Italy knowledged from the beginning of these workshops in has developed from its beginning in 1984into a fruitful Mauls, the significance of inflammation is all but clear. tradition where worldwide experts active and knowl- Although inflammatory phenomena are seen in trauma edgeable in cerebral ischemia and trauma convene for and ischemia ofthe brain, as activation ofwhite blood update and exchanges of their most recent clinical and cells with emigration into the tissue presumably en- experimental findings and concepts. These meetings hancing damage, inflammatory cells may have benefi- have, of course, experienced shifts in emphasis from cial properties as well. Thechapter on the Janus-faceof the past until now, corresponding to the most actual inflammation isanalyzing this ambiguity. developments, which were fascinating clinicians and The exploration of novel cell-biological mechanisms laboratory scientists alike. The current Supplement of on a molecular or more systemic basis causing apop- Acta Neurochirurgica is an example in case. Its virtue totic cell death, inflammation, or regeneration, provide as before is that authors contribute articles in a review- useful objectives for therapeutical interventions ex- like manner on their own field of research, according pected to be more specific than the present treatment to the platform presentations at the meeting as indis- modalities.

Gamma knife radiosurgery has grown continually in importance in recent years. However, there was a lack of established clinical and physical quality standards and a good knowledge of the possibilities of radiosurgical treatment for brain lesions. This book fills the gap by giving an overview of the current status of European gamma knife radiosurgery. Leading european experts report on their specialities in this field which is a state-of-the-art summary of the possibilities and results of their current work. The book encompasses all important as well as the more rare indications. All relevant technical and clinical quality standards are addressed. Tailored planning strategies are described for different indications. All professionals who care for patients with neurosurgical disease, such as neurosurgeons, radiosurgeons, radiologists, radiation oncologists and neurologists will find the book highly useful for the management of patients with benign and malignant brain lesions in a multidisciplinary setting.

As an addition to the European postgraduate training system for young neurosurgeons, we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbuhl. Thus were established the principles of European co operation which have been born from the European spirit, flourished in the European Association, and have been associated throughout with this senes. The fact that the English language is now the international medium for communication at European scientificconferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contri butions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume for scrutiny and suggestions for revision. Our series is not intended to compete with the publications of original scientificpapers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fieldsand constitute the first part of each volume."

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbiihl. Thus were established the principles of European co operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publi cation of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume.

Surgical skill and imaging technology in the field of neurosurgery have developed remarkably during the past decade. Magnetic resonance imaging (MRI), with high contrast resolution and multiplanar capabilities, allows for accurate preoperative localization and postoperative assessment of syringomyelia. Recent advances in dynamic MRI techniques have made it possible to evaluate normal and abnormal cerebrospinal fluid (CSF) flow at the foramen magnum, within the syrinx, and in the spinal subarachnoid space, without invasion of the closed CSF system. These developments have yielded substantial information concerning various aspects of syringomyelia. However, many issues related to the pathophysiology and treatment of syringomyelia remain controversial. This book contains the scientific contributions presented at the international sym posium "Syringomyelia 2000:' held in Kobe, Japan, June 16-17,2000. The purpose of the symposium was to bring together experts in the fields of neurosurgery, neurol ogy, and neuropathology, in order to enhance the level and scope of their knowledge by making them more aware of work done in complementary fields. The contribu tions also report on clinical and basic studies pertinent to the topic of the sympo sium. This volume thus represents a comprehensive description of the state of the art regarding this disease in the hope that it may help to define comprehensively what is already known and to find new ways toward a better understanding of the patho physiology, diagnosis, and treatment of syringomyelia.

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and of European co Hugo Krayenbtihl. Thus were established the principles operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publi cation of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume.

At the request of a Subcommittee of the United States Senate, in February, 1975, the National Institute of Neurological Disorders and Stroke (now the National Institute of Neurological and Communi cative Disorders and Stroke) conducted a Workshop on the Research Status of Spinal Manipulative Therapy. The Workshop was held in response to the Senate Subcommittee's request for an "independent unbiased study of the fundamentals of the chiropractic profession. " Since spinal manipulative therapy is a key tenet of chiropractic, the Institute felt a research workshop focused on that issue would provide a useful base upon which to examine the broad concept of the role of biomechanical alterations of the spine in health and disease. This would include the pathophysiologic and clinical hypotheses formulated by medical and osteopathic physicians as w~ll as chiropractors. Why the relatively sudden interest of the Senate Subcommittee in chiropractic? There were probably many reasons for that interest, but suffice to say anticipation of discussion on the role of chiro practic in any national system of health insurance could in itself have provided adequate stimulus for the request. In any case, the NINCDS was asked to review what was and what was not known about the fundamentals of chiropractic. I stress "fundamentals" since as a research organization, the NINCDS is not charged with review ing matters such as clinical education, licensure or clinical prac tice. A small expert committee of scientific consultants helped the Institute design the format and agenda for the Workshop.

In addition to surgery and radiotherapy, local treatment modalities for the management of brain tumours are increasingly being developed and clinically tested. This book describes for the first time basic tumour biology as well as all current procedures in progress at the most recent level of knowledge, presented by leading experts in the respective fields. Image guided resection procedures, fluorescence guided surgery, developments in interstitial radiosurgery are addressed, just as intracavitary chemotherapy and all current concepts and studies of interstitial targeted therapy. Owing to its topicality this book will remain for long the standard for this comprehensively treated subject.

These proceedings from the Xth Congress of the European Society for Stereotactic and Functional Neurosurgery in Stockholm reflect the growing interest in these fields of neurosurgery. It is the most extensive volume in this series of publications and it contains a large number of original articles pertaining to the most recent advances in stereotactic and functional neurosurgery. Not long ago stereotactic neurosurgery was considered an esoteric sub speciality practised only by those involved in treating movement disorders and pain. In the last decade we have witnessed the incorporation of stereotactic methodology in the management of common neurosurgical diseases, and the stereotactic technique is now practised in all major neurosurgical centers. As with other surgical techniques and tools, however, the utilization of stereotactic methods requires special knowledge and training. This book comprises articles which give insight into new stereotactic applications and technology. For example, the usage of stereotaxis without a frame and the so-called navigator systems in open tumor surgery is dealt with in two papers. The introduction and development of radiosurgery is closely linked to the advancement of stereotactic technique. Radiosurgical treatment of tumors and cerebrovascular diseases has been one of major achievements in modern neurosurgery. This publication contains several original reports illustrating the efficacy of radiosurgery in problematic neurosurgical diseases.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub specialization" are occurring at approximately an equal rate. Historically, estab lished journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops, and newsletters success fully bring to the attention of physicians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, pathoanatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years. Over this period, neurosurgeons have obtained special train ing in pediatric neurosurgery, and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's nervous system."

Because stroke is essentially a disease of the vessels and blood flow, the most fundamental aspects of ischemic blood flow in the brain are under investigation by researchers. Their work was the focus of the sixth in the series of Keio University International Symposia for Life Sciences and Medicine, held in Tokyo in 1999. Selected here are 55 papers from the symposium, covering the buffy coat (glycocalyx) of endothelial cells, the blood-brain barrier and permeability, gene expression, vascular reactivity, dysregulation, inflammatory deterioration, cortical spreading depression, edema, microvascular derangement, and pathology, in ten major sections. The book includes the thought-provoking discussions that followed the presentations, thus providing an invaluable source of up-to-date information not only for researchers investigating microcirculation but also for clinicians implementing the most effective treatment for stroke patients.