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These proceedings from the Xth Congress of the European Society for
Stereotactic and Functional Neurosurgery in Stockholm reflect the
growing interest in these fields of neurosurgery. It is the most
extensive volume in this series of publications and it contains a
large number of original articles pertaining to the most recent
advances in stereotactic and functional neurosurgery. Not long ago
stereotactic neurosurgery was considered an esoteric sub speciality
practised only by those involved in treating movement disorders and
pain. In the last decade we have witnessed the incorporation of
stereotactic methodology in the management of common neurosurgical
diseases, and the stereotactic technique is now practised in all
major neurosurgical centers. As with other surgical techniques and
tools, however, the utilization of stereotactic methods requires
special knowledge and training. This book comprises articles which
give insight into new stereotactic applications and technology. For
example, the usage of stereotaxis without a frame and the so-called
navigator systems in open tumor surgery is dealt with in two
papers. The introduction and development of radiosurgery is closely
linked to the advancement of stereotactic technique. Radiosurgical
treatment of tumors and cerebrovascular diseases has been one of
major achievements in modern neurosurgery. This publication
contains several original reports illustrating the efficacy of
radiosurgery in problematic neurosurgical diseases.
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."
The last ten years has witnessed a resurgence of interest in
stereotactic surgery although this has been mainly in the field of
the comparatively simple stereotactic biopsy of intracranial
tumours. There is also evidence of a returning interest in
functional neurosurgery other than pain which has always sustained
high levels of endeavour. The present work comprises selected
papers from a much larger group of interesting and important
communications to the European Society for Stereotactic and
Functional Neurosurgery. They represent modern views on a wide
variety of stereotactic surgical topics from internationally
acclaimed experts in this field. The neurosurgeon who has little or
no acquaintance with this fruitful sub-specialty will be surprised
to find very broad applications of the technique which is gradually
replacing many con ventional neurosurgical procedures. This is
particularly evident in the papers on tumours but there is also a
section on the treatment of vascular disease which marks an
extension of neurosurgical practice. The Society has always
regarded technical advances as important and some of the most
recent devel opments appear in this book. Finally, an exciting new
development of neural transplantation marks the beginning of what
may be an important part of neurological surgery in the future."
Technological improvements in neurosurgery are disussed. The use of
surgical lasers, ultrasound aspirators, bipolar coagulator and
operative microscopes for surgery of deep-seated neoplasms and
vascular malformations is discussed. Intraoperative monitoring,
chronotherapy, chronic neurostimulation and stereotactic
interstitial irradiation are covered and indications for
interventional neuroradiology are reviewed.
Craniopharyngioma represents a major challenge for neurosurgeons,
pediatricians, and endocrinologists. This so-called benign tumor is
a real threat to quality of life and life itself. This book
discusses the various therapeutic strategies and suggests
multimodal treatment approaches, including microsurgery,
stereotaxis, and alternative treatments. The rationale for choice
of therapy is supported by biological, clinical, and
neuroradiological data and therapeutic results of a large series of
case studies from all over the world are reported. Finally,
guidelines for further development and new topics for research and
treatment are offered.
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.
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