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.

Since Harvey Cushing's extensive study on brain meningiomas no similar study has been conducted on spinal cord meningiomas. The high scientific value of this book is based on the careful elaboration of data from patients affected by spinal meningiomas who have been examined and operated on over the last 33 years (1962-1995) at the Neurosurgical School of the University of Florence, Italy. The main focus of this study was on the anatomic and clinical relationship that enabled early diagnosis of spinal meningiomas. More over this book emphasizes the interaction between neurology and neuroradiology in the form of "dynamic neurology." Myeloradiculographic findings are described together with those using more recent techniques such as CT and MRI.

S. Price: Advances in imaging low-grade gliomas - M. J. Riemenschneider, G. Riefenberger: Molecular neuropathology of low-grade gliomas and its clinical impact - I . R. Whittle: What is the place of conservative management for adult supratentorial low-grade glioma - D. Kurzwelly, U. Herrlinger, M. Simon: Seizures in patients with low-grade gliomas -- incidence, pathogenesis, surgical management, and pharmacotherapy - L. Bello et al: Present day's standards in microsurgery of low-grade gliomas - B. Baumert and R. Stupp: Is there a place for radiotherapy in low-grade gliomas? - F. W. Kreth et al: The place of interstitial brachytherapy and radiosurgery for low-grade gliomas - M. Klein: Health- related quality of life aspects in patients with low-grade glioma.

This full-length translation of Professor Luria's book introduces to the English speaking world a major document in neuropsychology, summarizing Professor Luria's earlier contributions to that area for nearly a third of a century. It is a monumental contribution. Nothing of this scope exists in the Western literature of this field, with the possible exception of Ajuriaguerra and Hecaen's book (in French) on the cerebral cortex. Professor Luria's book thus marks a further and decisive step toward the eventual coalescence of neurology and psychology, a goal to which only a few laboratories in the East and West have been devoted over the last decades. The book is unique in its organization. The first half deals with observations and interpretations concerning the major syndromes of man's left cerebral hemisphere: those grievous distortions of higher functions traditionally described as aphasia, agnosia, and apraxia. There is also a detailed and brilliant analysis of the syndrome of massive frontal-lobe involvement. The entire second half of the book is given over to a painstaking description of Professor Luria's tests, many of them introduced by himself, and set out in such detail that anyone could repeat them and thus verify Professor Luria's interpretations."

It is, of course, a real challenge to summon together an International Sym- posium in and around the Brain Stem and Third Ventricle. Up to this mo- ment the various experiences and papers on this subject were distributed throughout the world literature, making it very difficult for someone in- terested in the matter to have access to the actual state of knowledge. Therefore I believe such a meeting was long overdue and is a considerable attempt to open closed doors for present and future ambitious neurosurgi- cal activities. After succeeding in previous symposiums of similar interest in Hanno- ver, it was obvious that Prof. Madjid Samii and his coworkers took the in- itiative of organizing such a meeting, bringing together - in the pure sense of the word - Neurosurgeons with Anatomists, Neurologists, Neuro- physiologists, Neuroradiologists, ENT-, Maxillofacial-, Stereotactic-, and Radiosurgeons as well as other colleagues. One contribution after the other followed, from the basic sciences up to the operative management con- sidering very new and actual concepts. Through the application of new microsurgical techniques and the incorporation of new understanding for the many problems afflicting the midline of the eNS, and based on a growing closer cooperation between the various disciplines, a wide field has opened up which concerns us all.

Microdialysis is a minimally invasive method which enables continuous monitoring of parameters in the extracellular space of various tissues. It has been investigated in animal models for over a decade, and many publications have provided insight into its advantages and disadvantages. However, in spite of its enormous potential for revealing metabolic processes in normal and pathological tissue, microdialysis in humans is still in its infancy. Clinical neurointensive medicine nowadays demands much more than conventional monitoring methods. As already shown by jugular bulb measurements of oxygen and lactate, in the future clinicians will want to have access to continuous neurochemical information from the patient. This information could be used to prevent those enigmatic secondary lesions which play such a negative role in neurointensive medicine, or at least enable treatment of them at an early stage. The extensive information now available from the laboratory would help with the interpretation of clinical analogues. In the University Clinic of Neurosurgery in Basel we have been involved in the field of micro dialytic monitoring for several years and have recognised the problems, both technical and ethical, which are involved in taking the difficult step from animal experiments to clinical application. In 1994 we thought that research on clinical microdialysis had reached the stage which would enable scientists and clinicians to have many fruitful discussions.

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.

Ronald Brisman, M.D. This book will discuss three areas where the The multiplicity of procedures with varying neurosurgeon may provide an important degrees of risks and benefits sometimes re contribution to the relief of intractable pain: quires a sequential approach, but always an trigeminal and other facial neuralgias, chronic individual one, matching an appropriate treat noncancer pain, and cancer pain. By one ment plan or procedure for a particular patient intervention, the neurosurgeon often may pro at a specific time in his or her illness. vide long-lasting pain relief. New techniques, The neurosurgical chapters in this book which have developed since the 1970s and represent my experience with several hundred continue to evolve, dominate the neurosur patients during a 12-year period from 1975 gical armamentarium because they are not only through 1987. I have relied heavily on the effective, but safe. These include percutaneous works of others, which have been quoted from radio frequency electrocoagulation for trigem the neurosurgical literature, but this book is inal neuralgia, spinal stimulation for chronic not meant to be encyclopedic. noncancer pain, and intraspinal morphine in At least as important as knowing when to fusion for cancer pain. operate is knowing when not to do so, and this Sometimes a procedure relieves pain but the is particularly true of the treatment of pain. pain recurs; it may be necessary to repeat the Most patients with pain do not require neuro procedure, which in the case of radiofrequency surgical intervention."