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 scientific conferences 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 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 recent years much progress has been made in the field of neurochemical monitoring for the acutelly injured brain. The development of safe continuous microdialysis techniques coupled with microanalytical methodology can generate semi-continuous time profiles of the changes in numerous brain analytes such as lactate, glucose, pyruvate, excitatory amino acids, structural amino acids, indicators of free radical generation, cytokines, adenosine, and neuroprotective drugs. Descriptive studies have shown profound, prolonged, and severe abnormalities in many of the analytes measured and the next phase is to determine the effects of therapeutic interventions upon these parameters. This field of research has contributed tremendously to our understanding of pathomechanisms in acute human brain damage.

Praise for the first edition: A superb overview ... each chapter is well written and concise ... provides a succinct summary of the clinical, radiological, and pathological features of each tumor ... a useful reference for the treatment of pediatric central nervous system tumors. -- Journal of Neurosurgery Tumors of the Pediatric Central Nervous System, Second Edition, provides readers with both medical management and surgical perspectives on the clinical, pathological, and radiological diagnoses and treatment of pediatric CNS tumors. It includes complete coverage of the latest diagnostic and management techniques, state-of-the-art technologies, and trends in the surgical treatment of pediatric tumors. Highlights of the Second Edition: Contains 19 new chapters on such topics as recent advances in the cytogenetics and molecular biology of pediatric brain tumors, gangliogliomas and miscellaneous spinal cord tumors in children, post-chemotherapy morbidity, and many more Addresses the important issues of long-term chronic treatment of pediatric tumor patients and related outcome measures Includes summary boxes and tables that distill large amounts of information for quick review Written by editors and contributors who are world-renowned experts in the field of pediatric neurosurgery and oncology Neurosurgeons, neurologists, oncologists, radiation oncologists, and pediatricians caring for patients with tumors of the central nervous system will find this book to be an essential resource that they will repeatedly consult as they strive to enhance patient care.

The definitive guide to performing vertebroplasty, kyphoplasty, and implant augmentation from national and international experts Vertebral compression fractures (VCFs) result from trauma or pathologic weakening of the bone and are associated with conditions such as osteoporosis or malignancy. Worldwide, VCFs impact one in three women and one in eight men aged 50 and older, with more than 8.9 million fractures incurred annually. Copublished by Thieme and the Society of Interventional Radiology, Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation provides a practical, clinical discussion of these minimally invasive spine interventions. Written and edited by Douglas Beall along with associate editors Allan Brook, M. R. Chambers, Joshua Hirsch, Alexios Kelekis, Yong-Chul Kim, Scott Kreiner, and Kieran Murphy, this richly illustrated book presents a multidisciplinary and international perspective. It features contributions from renowned experts in interventional radiology, neurosurgery, pain medicine, and physiatry. This resource fills a gap in the literature, with extensive updates on a vast amount of new information and techniques that have been introduced during the past decade. Thirty-five chapters address treatment of spine fractures, starting with a history and introduction to vertebral augmentation, discussion of VCFs, patient assessments, physical exam findings, pain management, and much more. Key Features Procedural chapters cover vertebroplasty, sacroplasty, cervical and posterior arch augmentation, balloon kyphoplasty, and vertebral augmentation with implants and for challenging pathologies Special topics include radiation exposure and protection, post-procedure physical therapy, osteoporosis treatment, postural fatigue syndrome, the effect on morbidity and mortality, and cementoplasty outside the spine Treatment of complex cases are also discussed extensively, including chronic vertebral compression fractures, neoplastic vertebral compression fractures, instrumented spinal fusions, and severe benign and malignant fractures The final chapter features 16 subchapters from global masters of vertebral augmentation, with personal tips, tricks, and pearls they use in their own practices This is a must-have resource for interventional radiology, neurosurgery, interventional pain management, and orthopaedic surgery residents and fellows, as well as seasoned clinicians who wish to incorporate these procedures into practice. This book includes complimentary access to a digital copy on https://medone.thieme.com.

Wireless Cortical Implantable Systems examines the design for data acquisition and transmission in cortical implants. The first part of the book covers existing system level cortical implants, as well as future devices. The authors discuss the major constraints in terms of microelectronic integrations are presented. The second part of the book focuses on system-level as well as circuit and system level solutions to the development of ultra low-power and low-noise microelectronics for cortical implants. Existing solutions are presented and novel methods and solutions proposed. The third part of the book focuses on the usage of digital impulse radio ultra wide band transmission as an efficient method to transmit cortically neural recorded data at high data rate to the outside world. Original architectural and circuit and system solutions are discussed.

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.

Filling a gap in the anatomical and ENT literature, the authors show the various approaches to the middle ear which allow safe surgical manipulations, such as through the tympanic membrane or the Eustachian tube.

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.

A brain-computer interface (BCI) establishes a direct output channel between the human brain and external devices. BCIs infer user intent via direct measures of brain activity and thus enable communication and control without movement. This book, authored by experts in the field, provides an accessible introduction to the neurophysiological and signal-processing background required for BCI, presents state-of-the-art non-invasive and invasive approaches, gives an overview of current hardware and software solutions, and reviews the most interesting as well as new, emerging BCI applications. The book is intended not only for students and young researchers, but also for newcomers and other readers from diverse backgrounds keen to learn about this vital scientific endeavour.

Radiologists, orthopedic and neurological surgeons present the different minimally invasive methods. Peripheral nerve problems and problems concerning differential diagnosis in special situations such as between radicular and peripheral nerve trunk lesions are discussed, pinpointing the significance of different diagnostic tools. Minimally invasive techniques, utilized nowadays to minimize bone demolition, scarring and risk of recurrence are analyzed. Microdiscectomy is compared with the results of intradiscal techniques, and new methods are discussed facing problems such as epidural fibrotisation, microinstability, osteoporotic or neoplastic or posttraumatic vertebral lesions.

Information is provided from the basic and clinical sciences on the mechanisms damaging the brain from trauma or ischemia. New aspects involve the endoplasmic reticulum, mitochondrial failure, pathobiology of axonal injury, molecular signals activating glial elements, or the emerging therapeutical role of neurotrophins. Experimental issues involve a better analysis of the ischemic penumbra, the salvagable tissue. Therapeutic contributions reach from the environmental influence to gene expression, including neuroprotection, such as hibernation - mother nature's experiment - or hypothermia which is reported to induce cell swelling. Treatment issues deal also with thrombolysis and combination therapies, or with the clearance of adverse blood components - LDL/fibrinogen - by a novel procedure using heparin. Other highlights are discussing the specificities of pediatric vs. adult brain trauma, or the evolving role of the Apolipoprotein-E e4 gene in severe head injury. An update is also provided on an online assessment of the patient management during the pre- and early hospital phase in Southern Bavaria. The empirical observation of neuroworsening is analyzed in further details, whether this is a specificity autonomously driving the posttraumatic course. Finally, the unsolved question why drug trials in severe head injury have failed so far in view of the promising evidence from the laboratory is subjected to an expert analysis.

Indispensable for both the trainee and experienced professional, this is the only truly comprehensive account of the major role of the neurosurgeon in the diagnosis and treatment of chronic pain. The elite panel of contributors were chosen due to their expertise and international reputations. The result of their achievement covers the whole spectrum from criteria for patient selection and the details of operative techniques, to the risks, complications, and expected outcomes for a wide variety of anatomic, ablative, and augmentative neurosurgical procedures in treating chronic, intractable pain. The neurosurgeon will find here chapters on the latest neuroaugmentative advances utilizing electrical stimulation and implantable drug infusion systems as well as a useful section providing algorithms and guidelines for the evaluation and treatment of specific pain syndromes. Over 100 photographs and exquisite line drawings - many specifically commissioned for this book - enhance the text. Invaluable for acquiring the critical judgement and clinical skills necessary to apply the procedures involved.

Neurosurgery o/the Future: Computers and Robots in Clinical Neurosurgical Practice and in Training - a Philosophical Journey into the Future Many present day neurosurgeons believe that they already obtain good results in operative surgery with the benefit of the operating microscope and other aids which have become available in the last three decades and that the introduction of computers and robots to the operating theatre is superfluous. However, it is clear from analogy with the function of the airline pilot, another profession where there are great demands on manual skill and on spatial awareness, that these devices do have much to offer neurosurgery. Classical neurosurgery, in the time of Cushing, Dandy and Scarff, was based on a three dimensional picture of the patient's brain formed in the surgeon's mind and often illustrated in elegant drawings. Such pictures were based on neuroradiological studies by pneumoencephalography, ventriculography or by angiography. Generally these stud ies showed the presence and position of a lesion by displacement of normal brain structures and the picture was built up by interference. This was then converted by the experienced neurosurgeon into a plan for the craniotomy site and the trajectory of the surgical approach. Once the brain was exposed further pre-operative information was obtained by visual inspection and by palpation with the brain needle. These classical forms ofneuroradiology have largely been superseded by computerised tomography and by magnetic resonance imaging."

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."

The small neck of the aneurysm afforded an easy surgical attack. An ordinary flat silver clip was placed over the sac and tightly compressed obliterated it completely. The clip was flush with the wall of the carotid artery. The sac, lateral to the silver clip, was then picked up with the forceps and thrombosed by the electocautery. Walter Dandy reporting his successful operation of a posterior communicating aneurysm on March 23, 1937. Walter Dandy's patient left the hospital in good health 2 weeks later, and from his report one may gain the impression that the operation was an easy task. Despite continuous developments during the following decades, it was not until the introduction of the operating microscope and microsurgical techniques that surgical treatment was generally accepted. During the microsurgical era surgical results have continued to improve due to diagnostical, neuroanaesthesi ological, and microsurgical refinements, and improved neurointensive care. Endovascular obliteration has become an important treatment alternative but this has not been included in this particular volume. The purpose of the present supplement of the ACTA NEUROCHIRURGICA is to review some of the elements in the neurosurgical management of patients with aneurysmal subarachnoid haemorrhage that are important for a successful outcome. Professor Helge Nornes has been a major force in the development of new techniques and research strategies in this area for a number of years and has recently retired from the National Hospital in Oslo."

More than 800 papers were presented by neurosurgeons from 66 countries during the 7th International Congress of Neurological Surgery, held in Munich on 12-18 July 1981. With the present scope and problems of neurosurgery as its theme, the congress achieved its aims in making possible the exchange and dissemination of new knowledge and ideas and in facilitating personal contact between neurosurgeons from aU parts of the world. Of such importance are the regional differences within our branch of science that we should spare no effort in acquainting ourselves with those neurosurgical problems which lie beyond the boundaries of our local horizons. From the vast number of papers the editor has selected those whose high scientific standard merits greater exposure than that given by the conference itself. I should like to thank the editor for his work and Springer-Verlag for their involvement in our disci pline. It is to be hoped that this book will find a worldwide audience, in accordance with the intentions of the World Federation of Neurosurgical Societies. Prof. Dr. K.-A. Bushe President of the Congress v Editor's Preface This is the first volume of a new series which aims to provide an overview of the state of the art of neurosurgery every four years. It will contain papers covering various fields of our specialty, selected from among those presented at each International Congress of Neurological Surgery."

Recovery of mimic function after facial nerve transection is poor: the successful regrowth of axotomized motoneurons to their targets is compromised by (i) poor axonal navigation and excessive collateral branching, (ii) abnormal exchange of nerve impulses between adjacent regrowing axons and (iii) insufficient synaptic input to facial motoneurons. As a result, axotomized motoneurons get hyperexcitable and unable to discharge. Since improvement of growth cone navigation and reduction of the ephaptic cross-talk between axons turn out be very difficult, the authorsa concentrated on the third detrimental component and proposed that an intensification of the trigeminal input to axotomized electrophysiologically silent facial motoneurons might improve specificity of reinnervation. To test the hypothesis they compared behavioral, electrophysiological and morphological parameters after single reconstructive surgery on the facial nerve with those obtained after identical facial nerve surgery, but combined with direct or indirect stimulation of the ipsilateral infraorbital (ION) nerve. The authors found that in all cases trigeminal stimulation was beneficial for the outcome by improving the quality of target reinnervation and recovery of vibrissal motor performance.

During the last decade, the effects of anaesthetics on cerebral blood flow, cerebral metabolic rate of oxygen and intracranial pressure have been studied experimentally and clinically. In this review studies of CBF and CMRO2 during craniotomy have been performed with the classical technique described by Kety and Schmidt. In chapter 1 general considerations concerning the effects of anaesthetics on cerebral blood flow and metabolism are reviewed. In chapters 2 and 3 the effects of inhalation agents and hypnotics on flow and metabolism are considered. Chapters 4 and 5 cover the effects of central analgetics, and neuromuscular blocking agents. In chapter 6 the effects of other drugs in common use in neuroanaesthetic practice are summarized. Chapter 7 considers the effects of drugs used for controlled hypotension. In chapter 8 the application of Kety's method in studies of CBF and metabolism is reviewed, the studies of cerebral circulation and metabolism during nine different techniques of anaesthesia for craniotomy are presented, and other studies of cerebral circulation during neuroanaesthesia are reviewed. In chapter 9 considerations concerning central and cerebral hemodynamics during anaesthesia in the sitting position are considered. This review is primarily addressed to anaesthetists, but it will also be of interest to those working within neurosurgery, neuroradiology and clinical neurophysiology.

The author John L. Fox shares his many years of teaching and surgery through more than three hundred illustrations and photographs (including over one hundred in color). Dr. Fox has published many works on neuroscience and clinical neurosurgery and is well-known for his color images of live neurosurgical anatomy as viewed through the operating microscope. Historic techniques, instrumentation and positioning, photographic techniques, cranial anatomy and the cranial flap, and intracranial anatomy as seen from the frontolateral or pterional approach are clearly discussed and illustrated from the operating (right sided) surgeons' perspective. The operations seen in this atlas for the main part involve aneurysms and some tumors. Directed toward neurosurgeons, neuroscientists, and anatomists, the book is intended to serve as an atlas of anatomy as well as a guide to clinical neurosurgery.

Neurological signs or symptoms are present in approximately 20% of all chil dren admitted to the hospital. These may be the reason for admission or may be part of preexisting and often unrelated problems. In ambulatory practice, acute neurological disease is not seen as frequently, but issues relating to normal and abnormal development are constantly being faced. For these reasons, familiarity with the progress of normal development and factors interfering with it, as well as knowledge of the major acute and chronic disorders of the nervous and neu romuscular systems, is important for any practitioner, specialist, or generalist who cares for children. The pathophysiology of neurological disorders in childhood is based on the same principles of the organization, structure, and function of the nervous sys tem as apply to adults. Two pitfalls are present for the student, however. First, the abnormalities are superimposed on a changing, developing brain, not a rather static, mature organ. The manifestations of the disease may vary, there fore, in seemingly unpredictable fashion depending on the rate of progression of the disorder and the rate and adequacy of the ongoing developmental changes in the nervous system. The second problem is the large number of unfa miliar conditions, many of which have no counterpart in adult neurology or medicine. These include developmental malformations, disorders specific to the neonatal period, and many hereditary and metabolic 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, 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."

Accurate interpretation of indications for treatment is the cornerstone of success in medicine. This book carefully examines the relation between clinical features, diagnosis, and choice of minimally invasive technique for a range of spine pathologies. It explains how selection of technique is intimately related to clinical and diagnostic aspects and how recognition of this relation forms the foundation for an optimal outcome. In addition to examining the various minimally invasive options, including the latest techniques, careful attention is paid to the role of medical treatment in avoiding recurrence after initial therapy. Nerve blocks, epidural injections, and intradiscal procedures are among the many options available in the armamentarium of the interventionalist, and advice is given on their use in different contexts. This volume will be of great value for neuroradiologists and others responsible for treating patients with spine disorders.

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.

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).