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Our understanding of human neuro-anatomy, and ability to safely
access lesions in complex locations, are in continuous evolution.
The subcortical white matter space is among the most intricate, yet
least understood, regions of the brain, with regards to its
billions of connections and the subtle clinical and clinical
functions it subserves. Neurosurgical procedures in the subcortical
space and intraventricular system have been traditionally very
difficult due to their depth, the need for brain retraction, and
limited understanding and imaging capability of this region. Common
lesions encountered in the subcortical space include brain
metastases, gliomas, and intracerebral hemorrhage. Surgical access
to this region has classically been hindered, and is highly limited
by evolving technological applications to medicine and surgery.
Traditionally, the technology (optics, imaging, resection devices,
illumination) needed to perform safe subcortical surgery was not
commensurate with the surgeon's needs. Over the past decade, major
strides in our ability to image, navigate, and safely access
subcortical tumors and other lesions have been made. These include
parafascicular, trans-sulcal approaches that may be channel-based
to provide safe retraction of the cortical and subcortical matter.
A confluence of optical, computational and mechanical technology
have greatly enabled our ability to treat such lesions, and include
advanced MR imaging such as diffusion tractography,
neuronavigation, channel-based access ports, exoscopic
visualization, fiber-optic illumination, and novel resection
devices. Parafascicular, channel-based subcortical surgery is a
relatively new field with evolving indications and approaches that
promises to evolve considerably over the next several decades. We
aim to develop the first comprehensive reference text compiling the
known evidence and experience from expert practitioners in the
field of subcortical parafascicular surgery. This book will provide
a major foundation for future development of the field, and be a
first and definitive reference for decades to come. Subcortical
Neurosurgery: Open and Parafascicular Channel-Based Approaches for
Subcortical and Intraventricular Lesions will be the definitive
reference on surgery of the subcortical region. It will
comprehensively discuss all aspects of treatment of subcortical and
intraventricular lesions, including neuroanatomy and neuroimaging
of the subcortical space, principles of parafascicular subcortical
channel-based surgery, common indications and approaches, and
focused chapters for common subcortical lesions. The first section
of the reference focuses on the intricate anatomy and neuro-imaging
of the subcortical space and ventricular system, with special
emphasis on intricate white matter tracts and diffusion
tractography imaging. The next section of the book discusses
principles of both open and parafascicular, channel-based
approaches to subcortical and intraventricular lesions, in addition
to workhorse approaches to common subcortical compartments.
Finally, specific pathological subcortical lesions that can be
commonly addressed via parafascicular channel-based approaches,
including brain metastases, gliomas, and intracerebral hemorrhage
will be addressed. Authored by experts in the field of subcortical
neurosurgery, this book was developed to provide a unique,
comprehensive text for neurosurgeons, neuro-radiologists, and
trainees from a variety of specialties interested in evolving
minimally disruptive access and treatment of the subcortical space.
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