It is amazing to discover how little importance has been attached to narrow lumbar canal syndromes up to now. Though H. VERBIEST gave a very accurate description in 1949, the neurologist's and neurosurgeon's preoccupations were mainly focused on discal pathology, disregarding the problem of an exclusively bony origin in canalar stenosis. A. WACKENHEIM and E. BABIN have the merit of becoming aware of the impor tance and originality of this problem; they organized in the beautiful surround ings of the Bischenberg near Strasbourg, a postgraduate course, in which the most eminent European specialists in this field participated. I am very honored to have been asked to write the introduction to this mono graphy, which contains all the studies reported and commented on during this meeting. Before considering the problem from the various radiologic points of view, it is in my opinion indispensable to define the term "stenosis." We could not do so more accurately than by assuming the definition proposed by A. WACKENHEIM and E. BABIN and unanimously confirmed by all those who attented the session."

H.P. HIGER 1 In the seventeenth century people dreamed about a machine to get rid of evil spirits and obsessions, which were thought to be the main source of mis fortune and disease. I am not going to question this approach, because in a way it sounds reasonable. They dreamed of a machine that would display im ages from the inner world of men which could be easily identified and named. Somehow these are the roots of MR imaging. Of course, we now view disease from a different point of view but our objectives remain the same, namely to make diseases visible and to try to characterize them in order to cure them. This was the reason for setting up a symposium on tissue characterization. About 300 years later the clinical introduction of MRI has great potential for making this dream come true, and I hope that this symposium has con stituted another step toward its realization. When Damadian published his article in 1971 about differences in T1 relaxation times between healthy and pathological tissues, this was a milestone in tissue characterization. His results initiated intensive research in to MR imaging and tissue parameters. Actually his encouraging discovery was not only the first but also the last for a long time in the field of MR tissue characterization.

The concept of the ISS was developed in 1972 by three Internationally renowned radio logists; Harold G. Jacobson M. D. , Ronald O. Murray M. D. , and Jack Edeiken M. D. Their hard work and dedication allowed their vision to become a reality when the first meeting of the Society was held in 1974. The ISS is an interdisciplinary society dedicated to the learning, understanding, and teaching of musculoskeletal disorders. From the beginning, the Society established itself as a premier society, and its members, all experts in their respective fields, continue to make significant contributions to the field of medicine. The sharing of knowledge and a feeling of camaraderie by the members has made this truly a unique society. The Book of Members is in part a historical compilation of information about the Society. The first edition was compiled by Friedrich W. Heuck, Dr. med. , and spanned the first fifteen years of the Society. Dr. Heuck's contribution to the first edition is immeasurable". In the book, Harold Jacobson M. D. presented his historical perspective of the beginnings of the Society and Dr. Heuck presented information of the years that followed. I have brought that information up to date in this edition, and have added new facts about the Society and its membership. The amount of information about each member of the Society is purposefully less than that which was presented in the first edition, as the Society has grown to 427 members and 20 Honorary members .

The use of ultrasound for various diagnostic techniques in medicine continues to increase in popularity and complexity. It seems possible that the prediction of the National Science Foun dation that ultrasonic techniques may be used as frequently as X-ray techniques by the end of the decade may indeed be fulfilled. The annual scientific meeting of the American Institute of Ultra sound in Medicine is the only meeting held regularly on the North American continent and devoted solely to the diagnostic use of ultrasound. Under these circumstances it is not surprising to find that both the attendance at these meetings and the number of papers submitted for presentation, are increasing markedly each year. The papers presented at these meetings probably reflect the "state-of-the-Art" reasonably accurately. The Proceedings of these annual meetings are therefore a valuable record of the current state of ultrasonic diagnostic techniques in the U.S.A. Even though it is not possible to print in extenso every paper presented at the meeting, an attempt has been made with this volume, by increasing the length of the papers printed in abstract form, to enable the reader to obtain an overall view of current developments and research on this continent in all fields of ultrasonic medical diagnostic technology. Speed of publication is essential if this volume is to contain current information.

The development of magnetic resonance imaging (MRI) will deep ly change the relationship between neuroanatomy and the neuro logical sciences, particularly neuroradiology. Presentation of nor mal or abnormal brain structures is sometimes more precise in MRI sections than in brain or spinal-cord sections under macro scopic examination. It is our conviction that a better exchange be tween neuroanatomy and neuroradiology will improve knowledge of the brain. This international meeting held in Marseille, 26-27 September 1986 (under the Presidency of G. Lazorthes and G. Di Chiro in collaboration with M. Habib, secretary of redaction for the Congress and its publication) would like to contribute to this field. Marseilles, January 1988 A. Gouaze G. Salamon Table of Contents Introduction G. Lazorthes 1 External References of the Bicommissural Plane U. Bergva71, C. Rumeau, Y. Van Bunnen, J. M. Corbaz, and M. Morel. . . . . . . . . . . . . . . . . . . . . . . 2 Identification of Cortical Sulci and Gyri Using Magnetic Resonance Imaging: a Preliminary Study C. Rumeau, A. Gouaze, G. Salamon, J. LafJont, F. Gelbert, H. Einseidel, M. Jiddane, P. Farnarier, M. Habib, and S. Perot . 11 The Hippocampal Formation and Related Structures of the Limbic Lobe: Anatomic - Magnetic Resonance Correlation T. P. Naidich, D. L. Daniels, V. M. Haughton, A. Williams, P. Pech, K. Pojunas, and E. Palacios. . . . . . . . . . . . . 32 Brain Stem and Cerebellum: Normal and Pathological Anatomy C. M. Strother and C. Raybaud . . . . . . . . . . . . . . . . . 65 Magnetic Resonance Imaging of the Eyes and the Optic Pathways J. C. Tamraz, M. T. Iba Zizen, and E. A. Cabanis . . . . . . ."

Estimates reveal that there are some 200 million heterozygous carriers of abnormal hemoglobins genes worldwide, and tens of thousands of severely affected patients. Effective application of imaging techniques is essential to combat the continuing development of the disease and to ensure risk-free follow-up of the chronically ill. This is the first book to offer complete coverage of such radiologic applications with both conventional and the most modern imaging modalities. Interventional radiology, marrow transplantation, prenatal diagnosis by ultrasonography, and radiotherapy for bone marrow heterotopia are also featured.

Although in the last few years more experience in the field of epilepsy surgery with amygdalo-hippocampectomies was gained in several hos- pitals, a detailed microanatomical and microsurgical description meet- ing the requirements of the modern neurosurgeon has not been achieved so far. Recently the allocortex - the so-called "limbic system" - has doubtlessly received more attention, as can be gathered from the recently published monography by Duvernoy, which however only considers anatomical points of view. Lately not only epilepsies but also tumorsurgical operations on the border between temporal lobe and basal ganglia can be - thanks to modern MR-examinations - carried out more exactly. Here the tumor-conditioned deformations of the temporo-medial area and its connections with the adjacent basal gang- lia as well as their blood supply are of great importance. Using conven- tional techniques the postoperative morbidity was especially high until recently. The author has at the suggestion of his teacher G. M. Ya argil approached the problem first of all morphologically by developing his own techniques of brain dissection. After some developmental and topographic-anatomical descriptions he has described the vessel-supply by using injection-preparations. Particular aspects of A. chorioidea ant. with her lateral, medial and Tractus opticus penetrating perforat- ing arteries to the basal ganglia and Capsula into have never been described in such a convincing manner before. It is of great importance in the operative removal of the amygdalo- hippocampal area to realize that it is not sufficient to preserve the A.

These collected papers represent only a small part of the large amount of new work in the field of stereotaxy. The number of contributions to the Birmingham meeting was such that only selected papers, chosen as representative of advances in the field, could be printed. These papers present the most up to date accounts of major advances in stereotactic imaging and the renewed interest in the stereotactic treatment of movement disorders. Contents Section I. Stereotactic Imaging, Tumours and Haematomas Lipinski, H. G., Struppler, A., Birk, P.: Transformation Modes in Computerized Human Thalamic Brain Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3 . . . Giunta, F., Marini, G., Bertossi, M.: Stereotactic Computer Graphic System with Brain Maps. . ., 7 Giorgi, c., Cerchiari, U., Broggi, G., Contardi, N., Birk, P., Struppler, A: An Intraoperative Interactive Method to Monitor Stereotactic Functional Procedures . . . . . . . . . . . . . ., . . . 10 Giorgi, c., Cerchiari, u., Broggi, G., Passerini, A.: 3-D Reconstruction of Cerebral Angiography in Stereotactic Neurosurgery . . . . . . . . . . . . . . . . . . . . . . .. . . . 13 . . Vandermeulen, D., Suetens, P., Gybels, J., Oosteriinck, A: Angiographic Localizer Ring for the BRW Stereotactic System . . . . . . . . . . . . . . . . . . . . . . . . . ., . . 15 . . . Uematsu, S., Rosenbaum, A. E., Erozan, Y. S., Gupta, P. K., Moses, H., Nauta, H. J., Rigsby, W. H., Wang, A, Weiderman, L., Kumar, A J.: Intraoperative CT Monitoring During Stereotactic Brain Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 18 . . .

In June 1989, a third conference concentrating on the progress in quantita tive coronary angiography and related techniques was held in Rotterdam, again very successful as the two preceding events in 1985 and 1987. Tech nical as well as clinical aspects of digital and digitized coronarography, morphometry, parametric imaging and functional quantification of the human coronary circulation were presented and discussed by prominent exponents of those groups who have been active in this particular field for many years. This book contains the chapters representing the lectures held by leading experts during the symposium that update the knowledge currently available, including most recent aspects in angioscopy and intravascular ultrasound imaging. It also includes a historical review on the development of angiogra phic techniques from the very early days on to our times given by one of the pioneers in heart catheterization and angiography, Dr. Kurt Amplatz. Those who had the chance to listen to his talk, will surely remember his impressive, humorous lecture as one of the highlights of this meeting."

Das vorliegende Buch enth{lt die Beitr{ge eines internatio- nalen Symposiumszum Thema "Stimulierte Hirndurchblutung." Vorgestellt werden zun{chst neue Erkenntnisse zur Regulation der Hinrdurchblutung. Im 2. Abschnitt kommen verschiedene Methoden zur Messung der Hirndurchblutung zur Sprache, die sowohl unter experimentellen als auch unter klinischen Be- dingungengetestet wurden. Es folgt ein Abschnitt, der ver- schiedene M-glichkeiten zur Stimulation der Hirndurchblutung aufzeigt. Im letzten Abschnitt wird aufdie Bedeutung der stimulierten Hirndurchblutungsmessung zur Bestimmung der ce- rebrovascul{ren Reservekapazit{ten hingewiesen. Dieser Para- meter hat nach den vorliegenden Untersuchungen klinisch- praktische Bedeutung, beispielsweise f}r die Indikations- stellung bei cerebrovascul{ren Eingriffen zur Isch{mie-Pro- phylaxe.

This book was conceived with the object of presenting to doctors and medical students with a potential interest in the disciplines of orthopaedic surgery, diagnostic radiology and orthopaedic pathology, a volume which would contain basic and essential information concerning those disorders of the skeleton in which a common interest exists. Diagnosis in such conditions is dependent on close collaboration between specialists in these subjects. As medical knowledge has advanced, so the necessity for detailed specialisation has increased. As a result co-operation in a combined approach has become of great importance. The method of presentation, in the form of Exercises, is designed to permit readers to test their own diagnostic ability. The book consists of ninety-four problems of diagnosis which might be encountered in any orthopaedic unit. The case material has been chosen to emphasise those conditions in which appreciation and integration of the clinical, radiological and pathological features are required in order to establish the diagnosis.

The European School of Oncology came into existence to respond to a need for information, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons }Vhy such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Universities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

The region of the skull base was long considered a surgical barrier because of its complex anatomy. With few exceptions, the region immediately beyond the dura or bony skull base constituted a "no man's land" for the surgeon working from the other direction. A major reason for this was the high morbidity associated with operative procedures in that area using traditional dissection techniques. This situation changed with the advent of the operating microscope. Used initially by ear, nose and throat specialists for resective and reconstructive surgery of the petrous bone and parana sal sinuses, the operating microscope was later introduced in other areas, and neurosurgeons began using it in the mid-1960s. With technical equality thus established, the groundwork was laid for taking a new, systematic, and interdisciplinary approach to surgical problems of the skull base. Intensive and systematic cooperation between ear, nose and throat surgeons and neurologic surgeons had its origins in the departments of the University of Mainz bindly supported by our chairmen Prof. Dr. Dr. hc Kurt Schiirmann (Department of Neurosurgery) and Prof. Dr. W. Kley (Depart ment of Ear, Nose and Throat Diseases, Head and Neck Surgery). The experience gained from this cooperation was taught in workshops held in Hannover from 1979 to 1986, acquiring a broader interdisciplinary base through the participation of specialists from the fields of anatomy, patholo gy, neuroradiology, ophthalmology, and maxillofacial surgery.

The purpose of this series of volumes is to present a comprehensive view of the complications that result from the use of acceptable diagnostic and therapeutic proce dures. Individual volumes will deal with iatrogenic complications involving (I) the alimentary system, (2) the urinary system, (3) the respiratory and cardiac systems, (4) the skeletal system and (5) the pediatric patient. The term iatrogenic, derived from two Greek words, means physician-induced. Originally, it applied only to psychiatric disorders generated in the patient by autosug gestion, based on misinterpretation of the doctor's attitude and comments. As clinically used, it now pertains to the inadvertent side-effects and complications created in the course of diagnosis and treatment. The classic categories of disease have included: (1) congenital and developmental, (2) traumatic, (3) infectious and inflammatory, (4) metabolic, (5) neoplastic, and (6) degenerative. To these must be added, however, iatrogenic disorders-a major, although generally unacknowledged, source of illness. While great advances in medical care in both diagnosis and therapy have been accom few decades, many are at times associated with certain side-effects plished in the past and risks which may result in distress equal to or greater than the basic condition. Iatrogenic complications, which may be referred to as "diseases of medical progress," have become a new dimension in the causation of human disease."

In the last two decades imaging of the brain, or neuroimaging, has become an integral part of clinical and research psychiatry. This is due to recent advances in computer technology, which has made it relatively easy to generate brain images representing structure and function of the central nervous system. Currently used clinical diagnostic imaging modalities, such as X-ray computed tomography (CT) and magnetic resonance imaging (MRI) , provide predominantly anatomic information. CT images reflect X-ray attenuation distribution within the brain, whereas MRI signals depend primarily on proton sensitivity and tissue relaxivity. The chapter "Structural Imaging Methods" reviews CT and MRI studies on schizophrenic and affective disorders and degenera tive central nervous system diseases. The impact of fast three dimensional (3-0) imaging and the automatic transfer from 3-D elements in the brain to artificial diagrams based on this information is considered. Since the original report of the findings of Ingvar and Franzen in 1974 and the introduction of regional cerebral blood flow (rCBF) measurements, single photon emission computed tomography (SPECT) has been gaining acceptance as one of the major imaging techniques, and it is available in most nuclear medicine depart ments. The section "Functional Imaging Methods (Cerebral Blood Flow - CBF, Single Photon Emission Computerized Tomography - SPECT)" describes rCBF studies with the 133Xe inhalation method utilizing a 254 detector system and rCBF images measured by SPECT using the tracer 99mTc-HMPAO.

Ischemic colitis is becoming increasingly one of the most important conditions involving the colon. This is due to a combination of multiple factors: (1) increasing age of the world population due to improved public health conditions and advances in medicine; (2) diagnostic advances in recognizing the condition; and, (3) education of physicians who suspect the disease in elderly individuals with colonic symptoms. The disease is a great masquerader of other conditions and can be mistaken for ulcerative colitis, Crohn's disease or almost any other inflammatory disease of the large bowel. It can have shallow ulcers, deep ulcers, filiform polyps, and pseudomembrane. It can produce fistulae or toxic megacolon. The thumb printing and other acute findings are not always seen and the site of involvement may be atypical. It is therefore so important to have a book dealing with this condition extensively and in detail. This scholarly presentation based on large clinical experience significantly contributes to the knowledge of this important disease that will assume even more importance as other conditions involving the colon are successfully treated. As physicians, radiologists and even pathologists have difficulty in diagnosing this condition that appears under multiple guises the information contained here should be invaluable. Alexander R. Margulis, M. D. March 1984, San Francisco PREFACE First of all, I would like to congratulate the authors on their successful publication of this monograph with many diagnostic radiographs of new touch taken by the modern technique."

Percutaneous transluminal angioscopy is opening up exciting possibilities for the interventional radiologist, since it can picture vascular features with an accuracy and clarity that previously has not been possible. Dr. Beck paves the way for the use of this new tool in clinical diagnosis; he details the technical prerequisites, gives step-by-step instructions for applying the technique and discusses how to interprete the resulting images. The amazing results of percutaneous angioscopy are compared with the results of conventional angioscopy. This approach introduces the new and unknown in perspective with the tried and trusted of the past. Major advantages become obvious: unclear or uncertain angiographical findings can be cleared up, interventional procedures can be supported, and the effects of interventional radiology can be seen before and after vascular treatment. The author's unique insight and systematic approach to the vascular system make this atlas a truly pioneering work.

The imaging aspects of radiography have undergone con many sources and was in general freely given when requested siderable change in the last few years and as a teacher of and this is gratefully acknowledged. In particular I would radiography for many years I have often noticed the lack of a like to express my sincere thanks for help and information to comprehensive reference book for students. This book is an Mr J. Day of DuPont (UK) Ltd. particularly for the infor attempt to correct that situation and I hope this text will be mation and illustrations in the chapter on automated film of value not only to student radiographers but also prac handling; Mr D. Harper and Mr R. Black of Kodak Ltd. ; tising radiographers as well. Fujimex Ltd. ; CEA of Sweden; 3M (UK) Ltd. ; Wardray Much of the information is based on personal experiment Products Ltd. ; D. A. Pitman Ltd. ; Agfa-Gevaert; PSR Ltd. and the knowledge gained of students' difficulties in studying for their help with information on silver recovery, and this subject. I have attempted to gather together in one book Radiatron Ltd. for their help with safelighting. All were most all the information required to understand the fundamentals helpful in my many requests for information. of the subject both for examination and for practice. Some To Mrs A. Dalton and Mrs P.

The most meaningful reward to clinicians and researchers is the absence of recurrent malignancy in their patients. While in some patients the disease will be cured by resection alone, in other similarly staged cases the disease will recur despite adequate loco regional and systemic therapies. Hence, risk assessment is a complex issue with many related or unrelated prognostic factors determining outcome. The purpose of this volume is to review some of the most relevant prognostic factors of newly diagnosed breast cancer, focusing on fea tures determining the magnitude of risk. The ultimate value of establishing the significance of each prognostic factor in a given patient will be the resulting ability to plan individu alized therapies for patients at different risk of recurrence at the time of diagnosis. To secure the maximum benefit for high-risk patients, while avoiding undue toxicity in those with low-risk lesions, a well-integrated analysis of all known prognostic factors will be essential in the early postdiagnos tic period. In addition to well-established staging criteria such as axillary nodes, tumor size, receptors, scanning and radiographic examinations, the more sophisticated labora tory techniques, as discussed by several authors herein, will playa crucial role in risk assessment. Most of them, - ploidy determination, oncogenes, tumor markers, monoclonal anti bodies, growth factors, etc. -are presently available in only a minority of treatment centers.

Magnetic resonance imaging became clinical in 1981 and since that time, has spread in the United States, Europe and Japan like wild fire. The tremendous advantages of the method consisting of safety, superb soft tissue contrast resolution, the ability to study flow, the ability to image in any plane or acquire data in 3D and an almost infinite array of sequences capable of distinguishing between disease and normal tissue, normal and abnormal blood flow make it incomparable for the diagnosis and study of multiple diseases and is particularly valuable in studying the heart and major vessels. The authors of this book have understood that the secret of success of MR imaging in the study of the heart is to combine the knowledge of anatomy of the heart, the coronary vessels, the pericardium and large vessels with the intricacies of MR imaging. This is why they go deeply into the basic principles of NMR, starting from the essentials and going then into detailed techniques of acquiring images from traditional spin echo to gradient echo and ultra fast imaging approaches, such as the multi shot and EPI. The flow phenomena are also discussed in detail from flow and magnetic field gradients diastolic pseudogating.

The key contribution of the approach to x-ray mammographic image analysis developed in this monograph is a representation of the non-fatty compressed breast tissue that we show can be derived from a single mammogram. The importance of the representation, called hint, is that it removes all those changes in the image that are due only to the particular imaging conditions (for example, the film speed or exposure time), leaving just the non-fatty interesting' tissue. Normalising images in this way enables them to be enhanced and matched, and regions in them to be classified more reliably, because unnecessary, distracting variations have been eliminated. Part I of the monograph develops a model-based approach to x-ray mammography, Part II shows how it can be put to work successfully on a range of clinically-important tasks, while Part III develops a model and exploits it for contrast-enhanced MRI mammography. The final chapter points the way forward in a number of promising areas of research. Audience: This book has been written for a wide readership, including medical image analysts, medical physicists, radiologists, breast surgeons, and research students. The mathematics and algorithms have been relegated to boxes so that the book can be read and understood even if the mathematical detail is skipped. Large parts of the monograph will be of interest to clinicians generally and to patients.

Since the introduction of myocardial perfusion imaging and radionuclide angiography in the mid-seventies, cardiovascular nuclear medicine has undergone an explosive growth. The use of nuclear cardiology techniques has become one of the cornerstones of the noninvasive assessment of coronary artery disease. In the past 15 years major steps have been made from visual analysis to quantitative analysis, from planar imaging to tomographic imaging, from detection of disease to prognosis, and from separate evaluations of perfusion, metabolism, and function to an integrated assessment of myocardial viability. In recent years many more advances have been made in cardiovascular nuclear imaging, such as the development of new imaging agents, reevaluation of existing procedures, and new clinical applications. This book describes the most recent developments in nuclear cardiology and also addresses new contrast agents in MRI. What's New in Cardiac Imaging will assist the clinical cardiologist, the cardiology fellow, the nuclear medicine physician, and the radiologist in understanding the most recent achievements in clinical cardiovascular nuclear imaging.

Recent years have witnessed major developments in diagnostic imaging methods. The facilities for these new methods are sometimes expensive. and not always accessible. yet they continue to improve and to change. It is essential that those concerned with orthopaedic imaging should appreciate not only recent developments but also the changes likely to occur during the next few years. It is also important that the indications. contraindications. uses and complications for each individual imaging technique should be understood. This book is an attempt to provide such information for orthopaedic surgeons. diagnostic radiologists. and other clinicians. par ticularly those in training or those who are involved in management of patients with disorders of the musculoskeletal system. In the first part of the book the different imaging techniques are discussed. with emphasis on advantages and disadvantages. indications and contraindica tions. In the second part. authors have been asked to discuss ways in which specific groups of disorders might be investigated. It is hoped that the reader will obtain from this section a balanced view of the different diagnostic imaging methods. the indications for their use. and the sequence in which they might be carried out. The Editors are grateful to aU authors for the time and work they have put into their individual chapters. They are also grateful to the publishers. in particular Michael Jackson. for help given in the preparation of this book. Manchester C. S. B. Galasko I.

Cervical Spine Research Society European Branch "The Cervical Spine Research Society is an organization of individuals interested in clinical and research problems of the cervical spine. Its purpose is for the exchange and development of ideas and philosophy regarding the diagnosis and treatment of cervical spine injury and disease. The com position of the membership should reflect the varying specialities and disciplines dealing with the cervical spine; biochemical, engineering, neurology, neurosurgery, radiology, orthopedic surgery and others," wrote J. William Fielding, New York City, one of the Society'S founding members. In 1984 the membership list contained 118 names. The overwhelming majority of members came from the United States, four from Canada and 9 Europeans, amongst them Mario Boni. He was the organizer, in con junction with the members of the Cervical Spine Research Society, of a splendid "International Meeting for the updating on pathology and surgery Preface VI of the cervical spine" held in Pavia (Italy) in May 1982. It was from this meeting that the idea of a European branch of the Society first originated, with the purpose of establishing multi-disciplinary meetings in Europe. The first meeting of the European branch was organized by A. Weidner in September 1984 in Osnabriick (Federal Republic of Germany). Mario Boni was elected president. He was not only the initiator but also the drivinglorce who tirelessly promoted the development of the European branch. Mario Boni's death in 1986 at the age of 64 was a great loss to us."

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