With the exploding progress we are experiencing in the field of lasers in neurosurgery it was felt that a new volume devoted to lasers in neurosurgery is needed. As opposed to other early laser publications which were limited to North American contributors we have decided to publish Lasers in Neurosurgery which presents the findings of neurosurgeons from throughout the world. The decision to publish all contributions in English, regardless of the native language of the author, makes Lasers in Neurosurgery truly a forum for international neurosurgeons. Our intent is to make available the findings of international neurosurgeons, which are frequently published in less fa miliar languages, to neurosurgeons beyond the boundaries of the authors' countries. We hope that neurosurgeons not only in North America and Europe, but throughout the world, will profit by Lasers in Neurosurgery. November 1988 Edward F. Downing, M. D. , F. A. C. S. Contents FRANK, F. : Basic Physics and Biophysics 1 TEW JR. , J. M. , TOBLER, W. D. , ZUCCARELLO, M. : The Treatment of Arteriovenous Malformations of the Brain with the N- dymium: YAG Laser. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 CLARK, W. C. , ROBERTSON, J. H. : Laser Resection of Meningiomas 49 ASCHER, P. W. : Tumours on and in the Pons and Medulla oblongata 69 NEBLETT, C. R. : Reconstructive Vascular Neurosurgery: Micros- gical CO Laser Application. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 2 CRONE, K. R. , BERGER, T. S. , TEW JR. , J. M. : Laser Applications in Pediatric Neurosurgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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."

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."

Every year, millions of dollars and countless hours are spent in a futile search for spiritual peace and security. For many Christians, this effort is often motivated by a lack of peace in their earthly lives and a persistent insecurity with regard to their afterlife. They attend self-help seminars, which claim to provide the answers for peace in their daily lives. They search the scripture, attend church and Bible studies, and often adhere to strict doctrinal beliefs that purport to lead one to salvation. Yet so many are still filled with anxiety and doubt. However, when John the Revelator looked to the end of time through God's prophetic lens, he saw a multitude no man could count - of all nations, tribes, peoples, and tongues - all rejoicing in their salvation. How could all these people, representing every part of the world through the millennia of time, have access to the knowledge of salvation? Certainly our traditional view of how the gospel is spread could not possibly account for such diversity of peoples, geography, and ages. Just as clearly, this knowledge was not obtained through any modern invention such as the self-help movement. So, how did this multitude obtain peace and salvation? The answer is simple: "There is a spirit in man, and the breath of the Almighty gives him understanding" (Job 32:8). The Spirit Within explores this mystical statement and finds within it the secrets to peace, a spirit-filled life, and God's saving power.

Every year, millions of dollars and countless hours are spent in a futile search for spiritual peace and security. For many Christians, this effort is often motivated by a lack of peace in their earthly lives and a persistent insecurity with regard to their afterlife. They attend self-help seminars, which claim to provide the answers for peace in their daily lives. They search the scripture, attend church and Bible studies, and often adhere to strict doctrinal beliefs that purport to lead one to salvation. Yet so many are still filled with anxiety and doubt. However, when John the Revelator looked to the end of time through God's prophetic lens, he saw a multitude no man could count - of all nations, tribes, peoples, and tongues - all rejoicing in their salvation. How could all these people, representing every part of the world through the millennia of time, have access to the knowledge of salvation? Certainly our traditional view of how the gospel is spread could not possibly account for such diversity of peoples, geography, and ages. Just as clearly, this knowledge was not obtained through any modern invention such as the self-help movement. So, how did this multitude obtain peace and salvation? The answer is simple: "There is a spirit in man, and the breath of the Almighty gives him understanding" (Job 32:8). The Spirit Within explores this mystical statement and finds within it the secrets to peace, a spirit-filled life, and God's saving power.