'Samii's Essentials in Neurosurgery' contains selected papers written by internationally recognized contributors who were trained by Professor Madjid Samii in Hannover, Germany. The main topics deal with cutting-edge technology in neurosurgery, skull-base surgery, and specific peripheral nerve, spine, and vascular surgeries. The texts and a wealth of illustrations review and reinforce guidelines on the diagnosis and management of situations that readers are likely to encounter in everyday practice. This book will be of great interest to neurosurgeons, neurologists, ENT surgeons, neuroradiologists, and neurophysiotherapists."

The idea for this treatise on the radiological anatomy of superficial and deep spinal cord vasculature evolved from daily routine neuroradiological work. This was also the reason for subdividing the monograph into a postmortem anatomical and a clinical part. The actual importance of a clear conception of radio anatomic fundamentals was made clear by many clinical conferences with neurologists, neurosurgeons and orthopedists, where a lack of knowledge about medullary syndromes of suspected vascular origin became evident. Also among neuroradiologists there is still widespread uncertainty in the interpretation of myelograms and angiographies in such cases. A study of the spinal cord's angioarchitecture is all the more justified and necessary considering the vast number of descriptions of cerebro vascular anatomy and pathology. The clinical challenge posed by patients suffering from partial or complete transverse spinal lesions has grown due to new diagnostic and therapeutic approaches. Myelography using water-soluble contrast media, X-ray computed tomography, magnetic resonance imaging and spinal angiography today allow and require both earlier and topographically and pathogenetically more exact classification of diseases of the spinal cord and its surrounding structures. Due to progress in microneurosurgery and interventional neuroradiology, even intramedullary lesions have become more and more accessible and treatable. Therefore this monograph mainly addresses those concerned with invasive therapeutic techniques and who are familiar with the interpretation of radio anatomic findings. A comprehensive description of medullary vascular syndromes would be beyond the scope of this treatise."

Many different opinions exist as to the appropriate diagnostic workup and therapy for spinal tumors. With the advent of new imaging techniques and therapeutic regimens, an up-to-date reference work has become an urgent requirement. This book is designed to meet this need, and is the first of its kind to offer an overview of the opinions of internationally renowned specialists in the field. By addressing in detail all of the relevant topics and areas of contention, it should prove of great value in establishing rational imaging and therapeutic protocols for spinal tumors.

The decision of Harvey Cushing to leave general surgery and concentrate on the infant field of central nervous system surgery was in retrospect a landmark in the history of neurosurgery. His concentrated work, and also that of his colleague Walter Dandy, originated with the desires of both pioneers to understand surgical anatomy and neurophysiology. The fundamental knowledge and surgical techni ques that they provided became the standard of excellence for several generations of neurosurgeons; so much so that the general belief was that the surgical techniques could not be improved upon. Twenty-five to thirty years ago microtechniques began to appear in a few surgical research centers, they were then gradually applied to clinical neurosurgery and have contributed to a new level of understanding in surgical anatomy and neurophysiology. We are now fortunate to have a new standard of morbidity and mortality in the surgical treatment of intrathecal aneurysms, angiomas, and tumors. It has been said that microneurosurgery was reaching its limits, especially when treating lesions in and around the cavernous sinus and skull base; those lesions notorious for involvement of the dural and extradural compartments, with a tendency to infiltrate adjacent nerves and blood vessels. The dangers of uncontrollable hemorrhage from the basal sinuses and post-operative CSF rhinorrhea appeared unsurmountable. The lateral aspects of the petro-clival region have been of interest to a few pioneering ENT surgeons and neurosurgeons but the cavernous sinus in most respects has remained the final unconquered summit."

Neurointerventional Management: Diagnosis and Treatment, Second edition has been re-titled from the original Interventional Neuroradiology reflecting the revolutionary changes occurring in this rapidly advancing field. Since the publication of the first edition, interest in neurointerventional therapy has developed at an increasing pace. New device development has expanded the range of disorders amenable to neurointerventional treatment and additional emphasis is present within medical and surgical specialities on subspecialisation in neurointerventional therapy. Physicians from all specialities involved in the care of disorders of the head, neck, and central nervous system, including neurosurgery, neuroradiology and neurology, are currently specializing in neurointerventional therapy. Neurointerventional Management: Diagnosis and Treatment, Second edition is written by a panel of today's leading experts in the field of neurointerventional therapy and edited by two neuroendovascular practitioners whose training and experience represents all three major specialties involved in neurointerventional therapy. The book is intended to provide the clinical practitioner with background information and specific descriptions of the anatomy, techniques, disorders, procedures, and decisions more commonly encountered in this field. Each chapter is illustrated with scientifically concise images, depicting pertinent neuroanatomy, imaging, neuroendovascular techniques, and related procedures. The new edition includes more diagnostic aspects of cerebrovascular disease of neurointerventional interest and discusses the treatment of disorders not covered in the first edition. Nine new chapters address increased interest in the field and provide in-depth focus on a range of new topics including normal cerebrovascular variants, non-shunting cerebrovascular malformations, the endovascular aspects of cerebrovascular disease in pregnancy, neurocritical care

Brain Repair, addresses all relevant issues underlying the mechanisms of brain damage, brain plasticity and post-traumatic reorganisation after CNS lesions. This book is divided the three major sections that follow; cellular and molecular basis of brain repair, plasticity and reorganisation of neural networks, and experimental therapy strategies.

Brain Repair is written by high profile, international experts who describe in detail the newest results from basic research and highlight new model systems, techniques and therapy approaches. Based on a careful analysis of the cellular and molecular reaction patterns of the CNS to lesions, the contributions cover possibilities for endogenous reorganisation and repair as well as exciting new therapies emerging from basic research, some of which have already been introduced into the clinics. Thus, this book is unique in bridging the gap between basic and clinical research. It will be a valuable tool for all students, researchers and clinicians interested in understanding the brain's capacity to cope with lesions and interested in learning about emerging new therapy concepts.

Monitoring of Cerebral and Spinal Haemodynamics During Neurosurgery is a comprehensive description of subdural monitoring of intracranial pressure (ICP) during neurosurgery. It offers thorough analysis of a comprehensive database consisting of measurements of ICP, cerebral perfusion pressure and other relevant physiological data from more than 1,800 patients subjected to intracranial surgery at Aarhus University Hospital. Features of anaesthesia, both inhalation and total intravenous, are discussed, and measures to reduce ICP are described. A majority of the patients had supratentorial tumours, but the database also includes patients with infratentorial tumours and patients with no intracranial space-occupying lesions. A chapter is reserved for discussion of the special features of children with cerebral tumours.

This comprehensive volume is the current final word on the subject. It contains more than 90 papers, giving a summary of clinical and basic studies on cerebral vasospasm. It includes reviews by leading researchers in the field. Several new subjects are proposed for future research that will not only promote research from neurosurgery and neurology but also from other interconnecting fields of emergency medicine, electrophysiology, molecular biology, and vascular biology.

This text is a review of current management techniques for pituitary tumors, incorporating recent advances and discussions by experienced clinicians. The use of both endocrinologists and neurosurgeons as chapter authors allows differing perspectives to be incorporated. The book is organized around individual tumor types, with additional chapter topics added for those subjects requiring special emphasis. Appropriate photographs and illustrations are incorporated as warranted.

Recognized clinical leaders in neurosurgery and neuroradiology review the cutting-edge techniques and technologies now available and describe how minimally invasive techniques have influenced their subspecialties. On the radiology side, the authors explain the latest developments in magnetic resonance spectroscopy, functional imaging, and brain mapping, with emphasis on the application of image navigation directly in the operating room, using both preoperative and intraoperative systems. On the surgical side, some of the world's leading surgeons in pediatric neurosurgery, cerebrovascular surgery, neurosurgical oncology, spinal and peripheral nerve surgery, and trauma surgery detail how they use the powerful new minimally invasive techniques in the own practices. Among the novel approaches discussed are radiofrequency, radiosurgery, thermal therapy, and minimally invasive techniques that allow "molecular neurosurgery" via gene and viral vectors and local delivery systems.

All over the world research is going on to improve the outcome of the treatment of peripheral nerve lesions. Yet, there exist many questions, such as: Is the autologeous nerve grafting still the golden standard in bridging defects? Have alternative techniques to overcome defects reached a level to replace autografting? What can be expected from end to side coaptation? The contributions in this book give answers to all of these questions.

This is the second part in a two-volume work on neuromodulation. It describes the techniques and procedures applied by direct contact with the central nervous system or cranial nerves (in order to modulate the function of neural networks) or in deeply located structures inside the nervous system (in order to alter the function on specific networks).

To date, more than three thousand brain and skull base tumors, along with various vascular problems, have been treated by using advanced, fully endoscopic, minimally invasive surgical techniques. In this book, Dr. Hrayr K. Shahinian, director of the Skull Base Institute, compiles these techniques. The book is highly specific and amply illustrated. The step-by-step operating room procedures provide a definitive guide to the difficult yet essential art of skull base surgery.

Phantom pain is an intriguing mystery that has captured the imagination of health care providers and the public alike. How is it possible to feel pain in a limb or some other body part that has been surgically removed? Phantom pain develops among people who have lost a limb or a breast or have had internal organs removed. It also occurs in people with totally transected spinal cords. Unfortunately, phantom pain is a medical night mare. Many of the people reporting phantom pain make dispropor tionately heavy use of the medical system because their severe pains are usually not treated successfully. The effect on quality of life can be devas tating. Phantom pain has been reported at least since 1545 (Weir Mitchell as related by Nathanson, 1988) and/ or experienced by such diverse people as Admiral Lord Nelson and Ambroise Pare (Melzack & Wall, 1982; Davis, 1993). The folklore surrounding phantom pain is fascinating and mirrors the concepts about how our bodies work that are in vogue at any particu lar time. Most of the stories relate to phantom limbs and date from the mid-1800s. The typical story goes like this: A man who had his leg ampu tated complained about terrible crawling, twitching feelings in his leg. His friends found out where the leg was buried, dug it up, and found maggots eating it. They burned it, and the pain stopped. Another man complained of a swollen feeling with frequent stinging or biting pains."

No other book covers as extensively all aspects of peripheral nerve surgery. This includes the pathology and pathophysiology of compression neuropathies, traumatic nerve lesions and nerve tumours, and their treatment with various techniques. All body regions are described adequately. The second part of the book deals with palliative surgery for reconstruction of lost function. This includes a comprehensive array of muscle and tendon transfers, functional muscle transplantation and intramuscular neurotisation.

Cerebral hemorrhage is a common and often fatal subtype of stroke. while in the past it has received relatively little attention compared to ischemic stroke, there have been major advances in our understanding of this devastating form of stroke. The papers by world experts cover the field from molecular biology to clinical trials.

Targeted at clinicians and residents, this series has already become a classic, with one volume published each year. The Advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The Technical Standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions have been written by experienced clinicians and are reviewed by all members of the editorial board.

The latest in this already classic series presents recent progress and detailed descriptions of standard procedures, to assist young neurosurgeons in their post-graduate training. With contributions from experienced European and American clinicians.

86 short papers originating from the 13th International Symposium on Intracranial Pressure and Brain Monitoring held in July 2007 in San Francisco present experimental as well as clinical research data on invasive and non-invasive intracranial pressure and brain biochemistry monitoring. The papers have undergone a peer-reviewing and are organized in eight sections: brain injury: ICP management and cerebral physiology; hydrocephalus and cerebrospinal fluid dynamics; advanced neuromonitoring; biomedical informatics; imaging; ICP: brain compliance, biophysics, and biomechanics; stroke, subarachnoid hemorrhage, and intracerebral hematoma; and experimental studies and models. The papers address the increasing use of decompressive craniectomy for the treatment of brain edema as well after brain injury and the rapidly expanding field of advanced neuromonitoring and neuroimaging.

This series has already become a classic. In general, one volume is published per year. The advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The technical standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions are written by experienced clinicians and are reviewed by all members of the editorial board.

In July 2004 specialists in neurosurgery, neuroradiology, neurology and neurointensive care discussed recent trends at the 2nd Swiss Japanese Joint Conference on Cerebral Stroke Surgery, held in Zurich, Switzerland. New concepts were worked out during the conference and are published in this volume. The book starts with the topic intracranial aneurysms, discussing microsurgical and endovascular treatment modalities, as well as new surgical approaches. Further chapters deal with the management of unruptured aneurysms and with subarachnoid hemorrhage. Practical guidelines for vasospasm treatment are given. Together with contributions about arteriovenous malformations and fistulas, cerebral revascularization techniques and surgery related to the intracranial venous system a comprehensive overview about stroke surgery is given with an interdisciplinary approach. The book will be of interest for all specialists involved in therapy of cerebrovascular disease.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...2 8 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...1 3 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...4 3 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...1 9 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...5 2 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...72 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno, M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore, progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis, itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied, thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for ''evidence-based medicine'' is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe''Decadeof limitsoffeasibility, especiallywherecontrolledthe- theBrain''. Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide, accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control, paincontrol, aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology, forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree cientpreventionin many of these processes involve the major tra- thefuture, themeasuresthatstandrightatthefore- mitters. Furthermore, biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells, bone-marrowcells, macrophages, andother withthemoretask-speci?c, intensive, andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade, andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients."

Gliomas, which comprise astrocytic, oligodendroglial, and ependymal lesions, are the most frequent primary intracranial tumors. This volume summarizes the enormous advances in our knowledge of gliomas that have occurred during recent years. The first part of the book focuses on the glial tumor entities, with detailed discussion of diagnosis, molecular genetics, and tumor origin. This section also contains a chapter on hereditary tumor syndromes associated with gliomas and the molecular mechanisms underlying these specific diseases. The second part is devoted to the clinical management of gliomas and provides insights into novel developments regarding neuroimaging, surgical management, radiation therapy, adjuvant therapy, experimental approaches, and the neurotoxicity of treatment. The final part of the book addresses angiogenesis and epigenetic regulation of gene expression in gliomas.

This detailed atlas illustrates the anatomical structures of the upper basal cisterns, their topography and relationship to other intra- and extradural structures. The author expands his well-established efforts to convey his outstanding neuroanatomical knowledge to the basal cisterns. His famous anatomical drawings are based upon anatomical preparations, cadaver dissections and intraoperative pictures, in order to point out important aspects concerning microsurgical and endoscopic approaches to these parts of the brain.