Fifty-two patients operated on for this type of spondylogenic myelo- pathy by the anterior approach were reexamined. The male: female re- lation was 2 : 1. Fifty percent were males in the 5th decade. About 20% had a congenital narrow spinal canal with an ap-diameter below the minimal standard values (3). The maximum of spondylogenic narrow- ing was found between C4 and C6 in 2/3 of the cases. Results: good 44%, satisfactory 31%, unchanged 13%, deteriorated 12%, mortality O. The duration of the neurological symptoms before operation had no in- fluence on the surgical results. Final neurological restitution was reached within 1 week to 3 months after the operation. The operative results in patients with congenital narrow spinal canal showed the same percentual distribution as the results of the entire group. No factors could be found to explain the groups of unsatisfactory results. References 1. DECKING, D. , STEEGE, W. ter: Rontgenologische ParametAr der Hals- wirbelsaule im seitlichen Strahlengang. Die Wirbelsaule in Forschung und Praxis, ~ (1975) 2. HERRMANN, H. D. : Neurologie in Praxis und Klinik. HOPF, H. C. , POECK, K. , SCHLIACK, N. (Hrsg. ). Stuttgart: Thieme (in press) 3. PIEPGRAS, U. : Neuroradiologie. S. 88-89. Stuttgart: Thieme 1977 114 Classification and Prognosis of Cervical Myelopathy E. HAMEL, R. A FROWEIN, and A KARIMI-NEJAD Introduction Up to the present, 104 patients with cervical myelopathy caused by cervical disk lesions, have been operated on in our clinic.

The main aim of this study is to define the clinical criteria which must be considered in order to come to an adequate decision whether a patient with intracranial arteriovenous malformation (AVM) should be operated upon or treated conservatively. A special method was used to reduce the effects of selection. This method made it possible to evaluate the therapeutic efficacy of conservative treatment versus surgery. The method implies that patients with equal combinations of variables (risk profiles) were compared in the two treatment lines. The variables building up the risk-profile pattern were chosen by analysing the decision process, as it was originally practiced by the surgeon who selected and treated the patients of this study. The risk profiles thus described relevant characteristics of the patient and his malformation. The variables were assigned numerical values accord ing to their prognostic value. Summation of the variables making up the risk profile then gives each risk profile a certain value. A low value symbolizes a bad prognosis and a high value a good prognosis in both treatment groups. There were many risk profiles with the same value in both groups and a comparison could be made over a large part of the risk-profile scale. This comparison showed that surgical treatment of A VM can always be justified, although the indications for surgery are less strong in patients with low risk profile values."

The Neurosurgeons of Berlin are happy to welcome their colleagues from Germany and from foreign countries to our Annual Meeting, being held in this city once again after many years. The external appearance of the city may have changed in many respects since our winter meeting in 1965. This ist not the case, however, as concerns the outstanding quality of its cultural life. We hope that you take as much profit of it as possible. When choosing the scientific themes of this congress, we were led by the idea that problems should be discussed which are not dealt with at special symposia this year. Thus, the problems related to lumbar disc surgery and its complications were chosen as one main topic. This important chapter of neurosurgery worries (and not seldom depresses) us in our daily work. A joint statistic analysis has been made, for which we are indebted to the colleagues from the following university clinics: Essen, Freiburg, Graz, Hannover, Heidelberg, Kiel, Koln, Mainz, Wiirzburg, Berlin-Charlottenburg, Berlin Steglitz, of the Neurosurgical Department of the BG-U nfallklinik Frankfurt/Main, of the Neurosurgical Department Wagner-J auregg-Krankenhaus Linz, of the Neurosurgical Clinic of the Katharinen-Hospital Stuttgart, and of the Neurosurgical Clinic of the Stadt. Krankenhaus Berlin-N eukolln."

A workshop on Dynamic Aspects of Cerebral Edema was organized to pro vide an opport nitY, for interdisciplinary and detailed consideration of this subject, so crucial in neurology and neurosurgery. The previ ous workshops were held in Vienna in 1965 and in Mainz in 1972. In the meantime, our ideas on mechanisms of resolution of cerebral edema had been changing drastically. Controversy had arisen regarding the role of biogenic amines in the development of edema. Active work in several centers had indicated the possibility of a reversible compo nent in edematous changes associated with ischemia, the control of which could be of therapeutic significance in the problem of stroke. It was felt that a thorough discussion, at this time, by those involv ed in these various studies should help to resolve the controversies, to crystallize the implications of the new findings, and to evaluate their application for patient care. In preparing the proceedings for publication we have edited the manu scripts and selected the discussions with an aim to highlight new find ings, to make this volume readable, and to eliminate duplication. We gratefully acknowledge financial support from the institutions and organizations previously listed. Many individuals contributed to the success of the workshop and the preparation of the proceedings for publication. Doctors J.B. Brierley, I. Klatzo, H.J. Reulen, and A.G."

On this occasion we look back on 25 years of the Deutsche Gesellschaft fur Neuro chirurgie. They hold a great deal: founding and development of the society, comple tion and extension, communication between the individual members and contacts to other societies beyond our borders. They also stand for close co-operation with those who transfer their patients to u- the neurologists and specialists in internal medicine, the ophthalmologists and ear nose-and throat specialists as well as the general surgeons. This 25th annual meeting will deal with two examples of diseases that present common problems to the neurologist and to the neurosurgeon, namely meningiomas and multiple sclerosis. In view of their long histories often going back over many years, both of these lesions lead to diagnostic errors and indequate treatment. And yet it should be possible to recognize meningiomas at an early date and to initiate the only possible treatment, the operation, if all diagnostic measures are repeatedly carried out. The diagnosis MS, on the other hand, with the multiplicity of symptoms which are peculiar to this disease, should continue to be re-examined until every other lesion has been excluded with certainty. The increasing number of legal proceedings because of diagnostic and therapeutic measures as well as the doctor-patient talk preceding the written consent for these measures are further problems in need of discussion. For this reason, the topic "medical liability in special reference to the neurosurgeon" was chosen for this meeting. Many questions necessitate many answers."

This volume contains the papers presented at the 26th Annual Meeting of the Deutsche Gesellschaft fUr Neurochirurgie, held in Heidelberg, Western Germany, on May 1-3,1975. Since at recent meetings of the German Neurosurgical Society central pathophysiological problems such as "central dysregulation" and "brain edema" had been discussed extensively, it seemed appropriate to choose another major area of cerebral patho- physiology for the meeting in Heidelberg. CEREBRAL HYPOXIA is, as LANGFITT once emphasized, "the final common denominator" of various cerebral lesions with which the neurosurgeon is confronted every day. Raised intracranial pressure, respiratory disorders and disturbances in systemic arterial blood pressure, etc. may lead, if not treated, to a focal or global lack of oxygen in the brain tissue. Anoxia finally results in cell death and thus in irreversible cerebral damage or even death. Main interest has therefore been focussed on disturbances in cerebral perfusion pressure ("ischemic hypoxia") and in arterial oxygenation ("hypoxic hypoxia"). The importance of cerebral autoregulatory mechanisms protecting the brain against tissue hypoxia, of patho- morphological alterations of the cerebral vessels (e. g. the "no-reflow-phenomenon") in the course of severe hypoxia, and of changes in brain metabolism have been discussed on a large scale. The organizing committee was particularly happy to have obtained internationally well-known scientists who presented their work in the field of cerebral hypoxia.

This volume contains the papers presented at the 24th Annual Meeting of the Deutsche Gesellschaft fur Neurochirurgie, held in Mainz, Western Germany, on April 30 - May 3, 1973. Deliberate choice was made of two crucial still hotly debated subjects which, for ages, have meant a source of constant worry, and nights without sleep to every neurosurgeon. Just as long as our special field exists, there have been the problems of how to control brain edema and .of how to reduce lethality and the secondary lesions in surgery of cerebello-pontine angle tumors. Concerning the first subject, new pathological, pathophysiological and chemical aspects, the mechanisms of brain edema formation and resolution are presented in the hope for better understanding. Furthermore, the relationship between brain edema, intracranial pressure, cerebral blood flow and metabolism are discussed. Finally, the therapeutical consequences as well as the results of experimental and clinical work are presented, and a comparison of effects between different methods (hypertonic solutions, diuretics, steroids, controlled hyperventilation, hyperbaric oxygen) is given. Concerning the second main subject, any important contributions to the early diagnosis of cerebello-pontine angle tumors have been included. Nevertheless, it is of utmost interest for the neurosurgeon to know which approach he is to prefer for the different stages of tumor size and to be familiar with the trans labyrinthine approach or the posterior craniotomy, as well as with the importance of the use of the microscope in neurosurgery, the preservation of the facial nerve and, in certain cases, its repair."

The control of brain edema is still one of the major problems in surgical and conservative treatment of various cerebral lesions. Many attempts have been made to develop methods for reducing the high mortality associated with brain edema. Mter many years of using hypertonic solutions it can be stated that this type of therapy has not yielded satisfactory results. During recent years increasing evidence has been accumulated on the efficacy of steroids on brain edema. Steroids were reported to result in rapid relief of signs and symptoms of increased intracranial pressure and neurological dysfunction accompanying cerebral edema. It was the aim of this workshop to evaluate the effect of corticosteroids on brain edema as an advance in therapy. It was hoped that this could be achieved by a multi disciplinary approach. Though, the volume contains the contributions of various experts - internists, neurochemists, neurologists, neuropathologists, neurosurgeons, pharmacologists, physiologists - who have added considerable experimental and clin ical evidence on the action of steroids on brain edema. New pathophysiological aspects regarding the mechanisms underlying the formation and resolution of brain The effectiveness of corticosteroid therapy in various forms edema are presented. of clinical and experimental brain edema, e. g. accompanying brain tumors, head injury, spinal cord injury, cerebrovascular lesions, etc. as well as dosage and duration of treatment are critically discussed.

This book is the first to offer a comprehensive guide to understanding the brain's architecture from a topographical viewpoint. Authored by a leading expert in surgical neuroanatomy, this practical text provides tri-dimensional understanding of the cerebral hemispheres, and the relationships between cerebral surfaces and the skull's outer surfaces through detailed brain dissections and actual clinical cases with operative photographs and correlative neuroimaging. For neurosurgeons, neuroradiologists and neurologists at all levels, this book emphasises the anatomy of the sulci and gyri of the cerebral surface. It is an essential resource for the general neurosurgery practice, and more particularly for planning surgical access routes for intracranial tumors.

Drawing from original correspondence penned by lobotomy patients and their families as well as from the professional papers of lobotomy pioneer and neurologist Walter Freeman, The Lobotomy Letters gives an account of the widespread acceptance of this controversial procedure. The rise and widespread acceptance of psychosurgery constitutes one of the most troubling chapters in the history of modern medicine. By the late 1950s, tens of thousands of Americans had been lobotomized as treatment for a host of psychiatric disorders. Though the procedure would later be decried as devastating and grossly unscientific, many patients, families, and physicians reported veritable improvement from the surgery; some patients were even considered cured. The Lobotomy Letters gives an account of why this controversial procedure was sanctioned by psychiatrists and doctors of modern medicine. Drawing from original correspondence penned by lobotomy patients andtheir families as well as from the professional papers of lobotomy pioneer and neurologist Walter Freeman, the volume reconstructs how physicians, patients, and their families viewed lobotomy and analyzes the reasons for its overwhelming use. Mical Raz, MD/PhD, is a physician and historian of medicine.

This book aims to provide an overview of the basics of anesthesia for neurotrauma. It showcases how management of different neurotrauma cases may differ, especially those involving spine and or polytrauma. It provides quick and easy access to understand anesthesia for neurotrauma.

Ideal for both neurosurgical residents and recertifying neurosurgeons, Neurosurgery Self-Assessment: Questions and Answers offers the most comprehensive, up to date coverage available. Over 1,000 clinically relevant multiple-choice questions across 46 topic areas test the candidate's knowledge of basic neuroscience and neurosurgical subspecialties to an unparalleled degree and provide detailed answer explanations to facilitate learning and assessment. Over 700 histology, pathology, radiology, clinical and anatomical images serve as an index of routinely tested-on images in neurosurgical examinations with high-yield summaries of each pathology to reinforce and simplify key concepts. Includes only multiple choice questions in both single-best-answer and extended matching item (10-20 options) format increasingly adopted by neurosurgery certification boards worldwide. Questions are organized by topic and classified by degree of difficulty through a highly visual "traffic light system" which codes each question in green, amber, or red. Includes coverage of the landmark studies in areas such as vascular, stroke, spine and neurooncology. Practical tips facilitate study with test-taking strategies and things to consider before sitting for an exam. Utilizes Imperial and SI units throughout. Expert Consult eBook version included with purchase. This enhanced eBook experience acts an interactive question bank which automatically scores and provides immediate answer feedback, as well as allowing you to search all of the text, figures, and references from the book.

Part of the Neurosurgery by Example series, this volume on neurotrauma presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within neurotrauma, including hematoma, injury to the sinuses, concussion, orbital trauma, penetrating brain injuries, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Neurotrauma is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

Mild traumatic brain injury can happen to anyone, anytime; in cars, sports, or workplace accidents, falls, or through physical assault, including domestic violence and shaken-baby syndrome. The National Center for Injury Prevention and Control estimates that 1.4 million Americans sustain a traumatic brain injury (TBI) each year, and that at least 5.3 million Americans currently have long-term or lifelong need for help to perform activities of daily living as a result of a TBI.

"Brainlash" provides the tools and facts to make the recovery process more intelligible-- and to support the wide range of people affected by MTBI. For patients, family members, physicians and other health care providers, attorneys, health insurance companies, employers and others, it covers options and services, health and vocational issues, medicolegal topics, psychological and emotional implications, and more

THE SUNDAY TIMES BESTSELLER *As heard on Chris Evans' Virgin Radio* 'You're amazing I could talk to you (Rahul) all day' Chris Evans 'This is a gripping new book' The Times World-leading neuroscientist and neurosurgeon Dr Rahul Jandial draws on his years of work with patients suffering from the most extreme cases of brain damage, disorders and illnesses to reveal what they can tell us about the science of the mind. From a languages teacher who has to choose whether to lose her ability to speak Spanish or English after brain surgery, to a former TV exec, now homeless, who discovers that his life-altering despondency is the result of a tumour, to a fainting teen who learns that deep breathing can mean the difference between life or death, these stories uncover the secret workings of the brain. Blending cutting-edge research and beautiful storytelling, Life Lessons from a Brain Surgeon is a vital resource on the best ways to boost your memory, control stress and emotions, minimize pain, unleash your creativity, raise smart kids and reduce the risk of Alzheimer's. This is a deeply practical and readable book, which will take you on an expedition through the anatomy of the most fascinating - and mysterious - of organs. Rahul's new book Life on a Knife's Edge is out now.

The perioperative care of individuals with neurologic compromise is critically important, yet it is only one dimension of the rich relationship between anaesthesiology and the neurosciences. The mechanism of everyday therapeutic interventions such as anaesthesia and analgesia is exciting neuroscience in its own right. At the new frontier of outcomes studies lies the question of how the perioperative period might impact the brain. For example, questions related to anaesthetic neurotoxicity, delirium, and cognitive dysfunction pose critical challenges for the field. The Oxford Textbook in Neuroscience and Anaesthesiology addresses the exciting field of neuroanaesthesiology in a new and stimulating way. In twenty eight chapters, the neuroscientific basis of anaesthesiology, the full spectrum of clinical neuroanaesthesia, and the care of neurologic patients undergoing non-neurologic surgery are explored in one comprehensive textbook for the first time. The first section considers the neural mechanisms of general anaesthetics, cerebral physiology, the neurobiology of pain, and more. The second section explores the care of patients with neurologic disease in the operating room or intensive care unit. These clinical chapters systematically treat the perioperative considerations of both brain and spine surgery, and provide introductions to neurocritical care and pediatric neuroanaesthesia. The final section outlines the care of neurologic patients undergoing non-neurologic surgery. It examines key connections of neurology and anaesthesiology, examining how conditions such as dementia, stroke, or epilepsy interface with the perioperative period. Each chapter has been carefully crafted to be concise yet highly informative, reflecting the cutting edge of neuroscience and neuroanaesthesiology. This international textbook gathers the best available expertise of authors and leaders worldwide. Includes access to online-only content, including more than 20 cases and more than 90 questions that can be used in presentations and teaching sessions. By activating your unique access code, you can access and use the material.

Part of the Neurosurgery by Example series, this volume on surgical neuro-oncology presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore a number of different types of nervous systems tumors, including glioblastoma, medulloblastoma, skull tumors, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Surgical Neuro-Oncology is appropriate for neurosurgeons who wish to learn more about this subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

Neuroanesthesia: A Problem-Based Learning Approach provides an up-to-date and comprehensive review of the neuroanesthesia subspecialty. Its problem-based format incorporates a pool of practical, multiple-choice questions for self-assessment. Each of its 29 case-based chapters is accompanied by 10 questions and answers, accessible online in a full practice exam. The cases presented are also unique, as each chapter starts with a case description, usually a compilation of several actual cases; it then branches out through case-based questions, to increasingly complex situations. This structure is designed to create an authentic experience that mirrors that of an oral board examination. The discussion sections that follow offer a comprehensive approach to the chapter's subject matter, thus creating a modern, complete, and up-to-date medical review of that topic. This book is equally a solid reference compendium of neuroanesthesia topics and a comprehensive review to assist the general practitioner both in day-to-day practice and during preparation for certification exams. Its problem-based format makes it an ideal resource for the lifelong learner and the modern realities of education.

There are few books devoted to the topic of brain plasticity and behavior. Most previous works that cover topics related to brain plasticity do not include extensive discussions of behavior. The first to try to address the relationship between recovery from brain damage and changes in the brain that might support the recovery, this volume includes studies of humans as well as laboratory species, particularly rats. The subject matter identifies a consistent correlation between specific changes in the brain and behavioral recovery, as well as various factors such as sex and experience that influence this correlation in consistent ways.
Evolving from a series of lectures given as the McEachran Lectures at the University of Alberta, this volume originally began as a summary of the lectures, but has expanded to include more background literature, allowing the reader to see the author's biases, assumptions, and hunches in a broader perspective. In writing this volume, the author had two goals in mind:
* to initiate senior undergraduates or graduate psychology, biology, neuroscience or other interested students to the issues and questions regarding the nature of brain plasticity, and
* to provide a monograph in the form of an extended summary of the work the author and his colleagues have done on brain plasticity and recovery of function.

A large number of neurological conditions result in abnormal movements of the body; these are often characterized by changes in coordination and altered speed of voluntary movement. Many obscure diseases, conditions and environmental insults can cause movement disorders but these are often overlooked. This volume expands and differentiates the many varied clinical presentations of movement disorders. Written by an international team of authors, including some of the most prominent clinicians in the field, disorders are defined and expanded in a clinically useful manner. Pathophysiological theories, genetic discoveries, new classifications, differential diagnoses and therapies are discussed extensively. Uncommon Causes of Movement Disorders provides a broad and comprehensive review of the field, concentrating on conditions infrequently seen but essential for practitioners to recognize in order to implement appropriate management. This is a key text for movement disorders specialists and general neurologists at all stages of their career.