This atlas gives careful step-by-step guidance for endoscopic sinus surgery. In doing so, it provides exciting firsthand accounts of modern advanced endoscopic sinus procedures. In the first part of the book the surgical anatomy of the nose and sinuses and the basic surgical techniques are described. The second part deals with advanced techniques and postoperative care. The detailed, step by step narratives - integrated with many intraoperative photographs - accurately convey both surgical fundamentals and nuances. For each procedure the authors give a piece of advice ("golden rules"), making it ideal for those who want to implement well-coordinated surgical approaches to sinus disease.

For the beginner or for the accomplished sinus surgeon, mastering the anatomy of the lateral nasal wall is an ongoing challenge. Even though there are excellent standard anatomical references and equally outstanding sinus courses with cadaver dissection, a reference depicting the surgical anatomy is needed. A step-by-step surgical approach on the anterior nasal spine to the anterior wall of the sphenoid is presented. The sinus surgeon is confronted with a wide range of different spaces created by the ethmoid bone. No other bone in the human body has so many anatomical variations. Four critical anatomical structures are emphasized as the foundation for a precise approach to surgery of the maxillary, anterior ethmoid, frontal, and posterior ethmoid sinuses. The goal of this book is to meet the tremendous challenge of offering an anatomical approach which will serve the sinus surgeon of every level of experience and expertise.

Of all the therapies that comprise psychiatric practice, the use of brain surgery to modify behaviour is the most contentious. That such behavioural neuro surgery, or psychosurgery, provokes opposition is far from surprising. The paramount status of the brain seems to belie mechanical intervention. The irreversible nature of the intervention seems to aggravate the outrage. Thus, opponents of the practice contend that psychosurgical procedures constitute a grievous assault on the integrity of the personality. Its proponents, on the other hand, confidently testify that it is a valid and efficacious form of treat ment for many seemingly intractable psychiatric disorders. Argument and counterargument have pursued the practice since its initial upsurge in the 1940s, although the decline in its popularity in the 1960s occasioned a tem porary cease-fire. However, the recent resurgence of psychosurgery has ensured that it is once again a matter of controversy. In the United Kingdom the characteristically subdued tenor of the debate frequently obscures the popularity of the practice and the commitment of its opposition. A recent application by the Royal College of Psychiatrists to the Medical Research Council for funds to mount a large controlled trial of psychosurgical procedures was turned down. Several opposition lobbyists might claim some credit for the proposal's lack of success. The Schizophrenia Association of Great Bri tain clearly and publicly expressed their disapproval of the trial. The Patient's Protection Law Committee presented Parliament with a petition condemning the Royal College's submission."

The Sixth International Meeting on Cholinesterases and Related Proteins, Choli nesterases '98, was organized by Palmer Taylor and his associates at the University of California-San Diego and convened in La Jolla, California, USA, in March of 1998. This was the first conference of the series to be held in the United States, let alone on the Pa cific Rim. Nearly 200 delegates from twenty countries-from Asia, Australia, Europe, and North and South America-heard 75 oral presentations and viewed 90 posters on current research on cholinesterases and related proteins. The meeting framework was structured to include two days of plenary sessions, followed by two days of concurrent sessions and workshops in specific areas. Communication at the concurrent sessions was facilitated by the conference settings of the Martin Johnson House, on a scenic bluff overlooking the blue Pacific Ocean, and the San Diego Supercomputer Center, which enabled projection and rotation of protein structures in three dimensions for a large audience. This book is the compilation of the presentations at the Sixth International Meeting on Cholinesterases and Related Proteins into a volume that describes recent investigations on the structure, catalytic and non-catalytic functions of acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), and related proteins, as well as studies on the molecular and cellular biology of these enzymes and the genes that encode them.

The intracarotid amobarbital (or Amytal) procedure is commonly referred to as the Wada test in tribute to Juhn Wada, the physician who devised the technique and performed the fIrst basic animal research and clinical studies with this method. Wada testing has become an integral part of the pre operative evaluation for epilepsy surgery. Interestingly, however, Wada initially developed this method as a technique to assess language dominance in psychiatric patients in order that electroconvulsant therapy could be applied unilaterally to the non-dominant hemisphere. Epilepsy surgery has matured as a viable treatment for intractable seizures and is no longer confmed to a few major universities and medical institutes. Yet, as is increasingly clear by examining the surveys of approaches used by epilepsy surgery centers (e.g., Rausch, 1987; Snyder, Novelly, & Harris, 1990), there is not only great heterogeneity in the methods used during Wada testing to assess language and memory functions, but there also seems to be a lack of consensus regarding the theoretical assumptions, and perhaps, even the goals of this procedure.

th The 8 European Congress of Neurosurgery which took place in Barcelona from September 6 to 11, 1987, was an unforgettable experience. Many factors contributed to its success: the splendid ambience of Barcelona, the generous hospitality and warm friendship of the hosts, and the marvellous organization and high scientific standard of papers, workshops and discussions. For financial reasons it would not have been possible to publish all the papers presented during the congress. In order to preserve as much as possible of the scientific results, the Programme Committee of the European Association of Neurosurgical Societies had already selected before the congress a certain number of abstracts to be published as full papers. These are compiled in two supplement volumes of Acta Neurochirurgica and deal with the following main topics: Volume 1: 1. Intraoperative and posttraumatic monitoring and brain protection 2. Cerebro-vascular lesions 3. Intracranial tumours 4. Benign intracranial cystic lesions, hydrocephalus, CSF-volumes 5. Central pain syndromes Volume 2: 6. Spinal cord and spine pathologies 7. Basic research in neurosurgery. The Editors F. Isamat, A. Jefferson, F. Loew, L. Symon Contents Listed in Current Contents VI. Spinal Cord and Spine Pathologies Fornari, M., Pluchino, F., Solero, C. L., Giombini, S., Luccarelli, G., Oliveri, G., Lasio, G.: Microsurgical Treatment of Intramedullary Spinal Cord Tumours ...3 Yasui, T., Hakuba, A., Katsuyama, 1., Nishimura, S.: Microsurgical Removal of Intramedullary Spinal Cord Tumours: Report of 22 Cases ...9 . .

At the 8th European Congress of Neurosurgery, which took place in Barcelona, September 6-11, 1987, a great number of papers from all fields of neurosurgery were presented, reflecting the major advances that have been achieved in recent years. The Programme Committee of the European Association of Neurosurgical Societies has selected the highlights of the congress for publication. These contributions were carefully edited and compiled in two supplement volumes of Acta Neurochirurgica.

Biomechanics of the Brain will present an introduction to brain anatomy for engineers and scientists. Experimental techniques such as brain imaging and brain tissue mechanical property measurement will be discussed, as well as computational methods for neuroimage analysis and modeling of brain deformations due to impacts and neurosurgical interventions. Brain trauma between the different sexes will be analyzed. Applications will include prevention and diagnosis of traumatic injuries, such as shaken baby syndrome, neurosurgical simulation and neurosurgical guidance, as well as brain structural disease modeling for diagnosis and prognosis. This book will be the first book on brain biomechanics. It will provide a comprehensive source of information on this important field for students, researchers, and medical professionals in the fields of computer-aided neurosurgery, head injury, and basic biomechanics.

The endothelial cells of the cerebral vasculature constitute, together with perivascular elements (astrocytes, pcricytes, basement membrane), the blood-brain barrier (BBB), which strictly limits and specifically controls the exchanges between the blood and the cerebral extracellular spacc.The existence of such a physical, enzymatic, and active barrier isolating the central nervous system has broad physiological, biological, pharmacological, and patho logical consequences, most of which are not yet fully elucidated. The Cerebral Vascular Biology conference (CVB '95) was organized and held at the "Carre des Sciences" in Paris on July I 0-12, 1995. Like the CVB '92 conference held in Duluth, Minnesota, three years ago, the objectives were to provide a forum for presentation of the most recent progresses and to stimulate discussions in the ticld of the biology, physiology. and pathology of the blood-brain barrier. The Paris conference gathered more than 50 participants. including investigators in basic neuroscience, physicians. and stu dents, who actively contributed to the scientific program by their oral or poster presentations. This volume contains a collection of short articles that summarize most of the new data that were presented at the conference. Six thematic parts focus on physiological transports. drug delivery, multidrug resistance P-glycoprotein, signal transduction at the BBB. interactions between the immune system and the cerebral endothelial cells, and the blood-brain barrier-related pathologies in the central nervous system. In addition, two introductory articles present new insights in the rapidly evolving topics of cerebral angiogenesis and gene transfer to the brain."

Professor Fox has undertaken the monumental In his Preface, Dr. Fox has quoted Cannon task of compiling the available data on intracra- and Rosenblueth in questioning where to stop nial arterial aneurysms. The magnitude and ex- the record. One can only document progress tent of the undertaking attest to the tremen- to date-and certainly the advances in this field dous amount of information which has are noteworthy-and then make some cau- accumulated in the past few decades and to tious predictions for the future. They have cor- the accelerated pace at which the field has ex- rectly made note that the overall morbidity panded, particularly since the end of World and mortality of these aneurysm patients re- War II. mains unacceptably high, largely as a result of Our heritage can be traced to many sources, the secondary complications of the subarach- among whom should be mentioned such nota- noid hemorrhage itself. More attention should bles as Willis, Quincke, Blackall, Moniz, Dott, be directed in the future to the recognition of Dandy, Hounsfield, and others. The modern era those patients with unruptured aneurysms and includes a number of investigators and clini- those with minimal bleeds. Hopefully infor- cians, some of whom have contributed to this mation will be forthcoming as to which indi- magnificent tome. The bibliography of over viduals are at risk because of some unusual con- 4000 references represents the increasing in- genital, metabolic, or acquired defect.

Normal cranial anatomy as seen by MRI in children aged 1 month to 21 years is comprehensively depicted in this atlas. As such it represents an invaluable tool for establishing normal baseline anatomy of the developing brain when evaluating suspected disease, trauma, or developmental delay in pediatric subjects. There are 124 normal cases presented, 62 each of boys and girls, at intervals from ages one month to 21 years. Six axial images are presented for each case. The images were obtained from Siemens, GE, and HI Standard machines. A brief introduction covers key issues in the development of white matter and special topics in pediatric neuroimaging.

Developments in the field of instrumentation of innovative instrumentation. Although laser applications have permeated nearly every aspect are among the major contributions to human advancement. The history of surgery has seen of surgical therapy, the expectations have fre many revolutionary developments cause quantum quently been unrealistic and the evaluation of leaps in progress. Electrocautery, the anesthesia technological development has always been machine, computed axial tomography, and the painfully slow. The properties of vaporization, surgical microscope are all revolutionary in coagulation, and cutting unified in an invisible struments that have irrevocably changed the shaft of light have enabled the neurosurgeon to direction of neurological surgery. vaporize inaccessible tumors of brain and spinal In the early stages of application, there are cord, harness recalcitrant bleeding sites, and cut always detractors and valid controversy concern through the most formidable calcified tumors. ing the value of a new instrument. Some will The application of this new energy form in remember those who argued that the magnifica tandem with the surgical microscope has, in my tion and illumination provided by the micro opinion, extended the scope of all aspects of scope were not valuable to the skilled surgeon neurosurgery. We have much more work to do. and would prolong the operative time and in lt is necessary to document improved results and crease infection rates. Others may recall that demand technological advances and safe inno Cushing was told to abandon the blood pressure vations."

As in any multiauthored textbook penned by When I was first approached by the publisher of this volume, Martinus Nijhoff, Boston, I writers of diverse backgrounds and interests, explored the possibility of writing a personal Modern Stereotactic Neurosurgery to some monograph on contemporary stereotactic extent suffers from incompleteness. Future surgery. After a review of available literature, volumes no doubt will include many additions several aspects became apparent. First, no cur from other authors who also are important rent, readily accessible, multiauthored text de specialists in the field. Because not all authors signed to survey the field was available. Those write in the same style (or even language), we books that were available tended to heavily have attempted to achieve a more cohesive text emphasize theory, physiology, and anatomy. in the editorial process. Each chapter has been Second, stereotactic surgeons were considered subdivided into pertinent headings for easier abstruse and for too long were relegated to a reference. Because of my own background, status outside of the mainstream of neuro some readers will note an Americanization (as surgery. This attitude probably reflected the opposed to anglicization) of the chapters. insufficient explanation of the practical uses While many chapters comprise primarily sum and advantages of stereotactic technique. maries of the authors' work within the field, Third, in recent years, the field has expanded each author was encouraged to review the liter so rapidly that it has become a major compo ature in that discipline if appropriate."

During the last decades, research on spinal cord has attracted a great deal of attention because of problems such as sensory-motor and autonomic dysfunctions associated with traumatic and other injuries. Recording of spinal cord evoked potentials is one of the most promising approaches to understand the spinal cord function. However, the details of the evoked potentials and their significance in various pathological conditions are not yet fully characterized. This book summarizes new findings in the field of electrophysiology and relates this knowledge to pathology and regeneration research. It is the first one which deals in great detail with various ways to monitor spinal cord function in experimental and clinical situations. It provides an up-to-date knowledge regarding spinal cord bioelectrical activity and its modification with pharmacological agents and covers new aspects of regeneration studies, particularly the role of myelin associated inhibitory molecules. A section is devoted to clinical studies dealing with electrical activity, pathology, and current therapeutic measures. This volume will be useful both to basic and clinical neuroscientists engaged in the field of neurology, neurophysiology, neurochemistry, neurosurgery, neuropathology, and related disciplines in order to understand basic functions of the spinal cord and to stimulate further research in this rapidly advancing field.

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.

Because of the topographic and pathophysiologic information obtained with contemporary neuroimaging techniques, CT and MR scanning now constitute the most important investigation in clinical neurology. In many instances of mass lesions, the images provide a reliable or near-definitive diagnosis, and make possible the accurate and even selective acquisition of biopsy samples. For pathologists and neuropathologists rendering a brain biopsy service, a basic knowledge of CT and MR scanning is now mandatory, and the objective of this atlas is to present the principles of neuroimaging through clinicopathological correlation. It contains a wide range of clinical material, with over 600 CT and MR images correlated with over 400 full-colour pathomorphological micrographs. A full discussion of differential diagnosis is complemented by extensive references. Although aimed mainly at pathologists in neurosurgical practice, the atlas will also benefit neurosurgeons and radiologists, especially those in training.

Brain Injury is the second volume in the book series, Molecular and Cellular Biology of Critical Care Medicine. In this volume, a group of internationally regarded experts in important areas of neuroscience and neurointensive care research address the molecular and cellular basis of acute brain injury. This text covers acute brain injury within a context relevant to the care of patients with critical neurologic injuries such as cardiac arrest, trauma and stroke. It includes recent data pertaining to established pathways such as neurotransmission, exitotoxicity, ionic-mechanisms, oxidative stress, inflammation, and cerebral vascular injury. In addition, rapidly developing areas such as cell signaling, adenosine pharmacology, apoptosis, mitochondrial dysfunction, neurocytoskeletal changes, and the role of trophic factors are reviewed from the level of in vitro modeling to human data. Other topics covered that are highly clinically relevant include the effect of genetic background and gender differences in outcome after brain injury, preconditioning, and the effects of currently used anesthetics and sedative agents in patients with brain injury.

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 KrayenbtihI. 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.

Both a theoretic text book and a descriptive atlas, this standard reference in the field presents the individual steps of each surgical procedure. It represents the current perspective in the management of the childs nervous system and discusses at great length the individual pathological entities which may be treated surgically. Numerous illustrations highlight both the operative technique and theoretic principles sections of the book, whereas the neuroimages are used in the theoretic principle section - accentuating the correlation of imaging with surgical planning and decision making. Recent world literature has been systematically reviewed, analysing critically different perspectives.

Intracranial injury, caused by a transorbital penetrating object, is a neglected topic in neurosurgery. With few exceptions, only occasional publications, often containing merely case histories, are present in the literature. Through a perusal of the world literature - for the first time - the author has collected and combined all available and relevant information, trying to give a thorough description of this rare, but extremely dangerous injury. This book is a major and definitive contribution to neurosurgery, but is also of importance to ophthalmology, neurology, traumatology, neuro-radiology and pediatrics.

This monograph highlights modern concepts of brain ischemia and strategies of neuroprotective therapy. The first part of the book is devoted to mechanisms of ischemic brain damage. The authors present the results of their own clinical and experimental studies conducted in the last two decades, as well as the achievements of native and foreign neurological researches that open a new stage in understanding how reversible changes of blood flow and metabolism are transformed into a permanent morphological lesion, i.e. brain infarction. The most important advances in areas of ischemic energy failure, main mechanisms of the glutamate-calcium cascade, influence of metabolic acidosis on ischemic damage, delayed neuronal death connected with microglial activation, local inflammation, autoimmune reactions, trophic dysfunction, and apoptosis, as well as of reaction of the stress-mediating endocrine system to focal brain ischemia are shown in animals and humans, and the relevant literature is cited and critiqued.The book also explores topics that recently have experienced substantial growth, such as gene expression and subsequent molecular events in response to acute brain ischemia, connected with both tissue damage and reparation. The authors demonstrate not only universal features of the process of brain ischemia, but also individual peculiarities of its course in patients and analyse their reasons.

In this first volume of the series Update in Plastic Surgery, internationally acknowledged experts give an up-to-date view of the clinical possibilities in plastic surgery which result from video-assisted microsurgery with the endoscope. Advantages and disadvantages are discussed, and reasons are presented why it can be assumed that this technique will be the standard in plastic surgery within a few years.

The book gives the most up-to-date information for the expanding field of stereotactic and functional neurosurgery from European and international experts. The newest developments in neural transplantation and stereotactic irradiation are included together with the reports on extensive trials of analgesic surgery and new techniques used in the treatment of a variety of functional disorders.