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Like the author's previous publications - "Atlas of the Department of Radiodiagnostics, University of Topographical Anatomy of the Brain and Surround Freiburg; Prof. Dr. K. Kendel, Director of the Neu ing Structures" (1978) and "Microsurgery of the rological Clinic, District Hospital Lahr, and his col Brain" (1980) - this book is based on over ten league Dr. G. Reinshagen; Prof. Dr. J. Dichgans, years' experience in microsurgery in addition to Director of the Department of General Neurology, more than ten year's experience in the performance University of Tiibingen; and Prof. Dr. K. Voigt, Di of macrosurgical operations in the region of the rector of the Department of Neuroradiology, Uni spine and spinal cord. versity of Tiibingen, for undertaking a considerable The author is indebted to Prof. G. Ya{sect}argil for en amount of the diagnostic work in the clinical cases couragement in carrying out intramedullary opera described in this book. Apart from a few excep tions. Discussions with R.B. Cloward and study of tions, mentioned in the course of the book, myelo his well-known publications provided important ini grams and recently also computertomograms in tiatives in relation to the adoption of microsurgical cases of spinal disease were carried out mainly in dimensions in ventral approaches to the craniospinal these departments. As in the previous volumes, the junction and to the cervical spine, although the ac topographical anatomical examinations were sup tual fusion procedures are - just as orthopaedic ported by Prof. Dr. J.
The 17th volume of the "Advances in Neurosurgery" contains a selection of the scientific reports of the 39th annual meeting of the German Society for Neurosurgery, which was held in Cologne from May 8-11, 1988. The first section deals in particular with the long-term results of severe head injuries, as well as with problems of the acute traumatic hematomas and brain edema. The second section covers microsurgical experiences. Attention is focused on the anatomy and operative technique for lesions in and around the jugular foramen and the craniospinal transition. The third section describes the special new results of brain death determination. Beyond this, numerous contributions on clinical and research results were presented in a poster exhibition which was systematically studied in order to give younger neurosurgeons the opportunity for extensive discussion. The volume contains new information which will bring specialists up-to-date on the latest clinical and research developments in the field.
Advances in Neurosurgery presents the experience and research results of modern neurosurgeons confronted with urgent diagnostic and therapeutic problems. The first topic here is spontaneous intracerebral hematomas, whose localization determines the form of treatment and usually its outcome. Newer therapeutic approaches such as stereotactic removal, endoscopy and fibrinolysis supplement the results of standard operative methods. Secondly, the hydrocephalus malresorptivus is covered, presenting experience with the diagnostic value of intrathecal infusion tests, CT-cisternography, evoked potentials, and MRI CSF-flow studies, as well as aspects of neurosurgical intensive care such as barbiturate treatment, respiratory problems in head injury patients, auto-regulation mechanisms, and hospital infection. The last section is devoted to peripheral nerve surgery, reports on experience with microsurgery and various forms of anastomosis in both traumatic and tumorous nerve lesions.
The traditional education of the neurosurgeon and duce simultaneous contrast preparations of the ar the clinician working in related specialties is based teries and veins and thus obtain a complex photo on their presumed knowledge of the macroscopic graphic representation of the structures of the prep anatomy of the brain as traditionally taught. Most aration. neurosurgical textbooks, therefore, provide macro The manuscript and drawings were completed in the scopic views of sections of the operative site. The years 1974-1976 after almost two decades of neu literature that has accumulated in recent years on rosurgical work. The data worked out in the early the subject of microneurosurgical operations also stages (Chapter 1 in particular) were used by the follows this principle. author as the basis for teaching programmes at the For some years, however, the customary macro University of Giessen. Chapters 2-7, dealing with scopic representation of the anatomy of the brain the operative technical aspects, were produced after has been inadequate for the needs of the neurosur mid-1975 and used by the author as the basis for geon using refined modern operative techniques. microneurosurgical teaching of his colleagues at the Furthermore, despite their detailed presentation, University of Freiburg. stereotactic atlases are also insufficient for neuro My thanks are due to Doz. Dr. E.
The author describes in his unique style the anatomical variants of the brain and skull. This atlas is a continuation of his last work on "Neuronavigation and Neuroanatomy". Most anatomical reference volumes show a large number of common and rare variations. This atlas concentrates on well known and little known variants which are especially important for the clinicians, in particular the neurosurgeons and the radiologists. The variants have been grouped after areas of trepanation. The author presents also a number of so far unknown variants gathered from his personal theoretical and clinical experience of 50 years. Exact knowledge of anatomical variations which the surgeon may encounter helps to plan operations and to avoid unexpected complications. Variants of no clinical relevance, even rather common ones, have not been included.
The preceding volumes having considered micro ENT-Hospital, for his critical review of the chapter on surgery of the brain as well as microsurgery of the oro-nasal hypophysis approach. Special appreciations Medulla spine, with its surrounding structures, it go to my colleagues Doz. Dr. J.M. Gilsbach, Dr. H. then seemed logical to cover microsurgery of the R. Eggert, Dr. W. Hassler, and Dr. E. Grabner for areas near the brain. In addition to daily work at suggestions and assistance in providing literature. the operation table, the increasing experience of Several anatomical preparations were made possible the University of Freiburg Neurosurgical Hospital with the help of Prof. Dr. N. Boehm, Deputy Direc in the bordering areas of ophthalmology and ENT tor of Freiburg University Institute of Pathology and was stimulating. Of significance was the work Prof. Dr. J. Staubesand, Director of Freiburg Univer with Prof. Dr. Renate Unsold, Freiburg University sity Anatomical Institute I. The translation of the text Ophthalmological Hospital (Director: Prof. Dr. was undertaken by my colleague, Dr. E. Grabner, G. Mackensen) whose experience, published together and Mrs. S. Godine, Freiburg. I am grateful to Mrs. with C.B. Ostertag, J. DeGroot, and T.H. Newton E. Hilsenbeck-Hottek for typing the manuscript. in "Computer Refprmations of the Brain and Skull Once again I am especially grateful to Dr. W. Base" offered valuable diagnostic ideas. Some of the Schwabl, and his colleagues, of the Springer-Verlag, findings attributed to Prof. Dr. R. Unsold and Doz.
Preface Drawings and scripts were selected from those tion of the operative routes and their alternatives which were produced by the author in the last for well-defined anatomical target areas alone. This three years to help educate young neurosurgeons viewpoint becomes more and more important, be in Freiburg and in other clinics. cause today there is no anatomical structure of the This programm for education may be managed in 2 brain which cannot be approached with a minimal steps: risk for surviving the operation. But more and more - Learning techniques for performing of trepana the risk for neurologicalor psychological postopera tions from opening of the skin onto dura incision tive complications will rise if the anatomical and (step 1) neurophysiological knowledge is insufficient. These - Learning of techniques for routine operations viewpoints are most important in operations at the (e. g. , for extirpation of gliomas of cerebral lobes) cranial base and operations transcrossing midline (step 2) structures of the brain. An intensive anatomical - Learning of techniques for operative approach es training helps to understand MRI before opera in problematic areas of the cranial and cerebral tion. Often the modern MRI demonstrates more base and of the midline, especially for the often anatomical details than the unexperienced neurosur performed operations, e. g. for basal meningeo geon has understood.
Introducing a brand-new volume of The Core Curriculum--a series of textbooks that will be indispensable as guides for radiology residents' rotations and study tools for written boards or recertification exams. Each volume of The Core Curriculum focuses on one key area--such as ultrasound, neuroradiology, cardiopulmonary imaging, head-and-neck imaging, or interventional radiology--and features key review points and sample board-format questions and answers. The user-friendly presentation includes chapter outlines...tables...bulleted lists...boxed text...margin notes...key review points...hundreds of illustrations...and an easy-to-follow layout.
A description of cerebral veins under operative versely, where there are large arterial vessel stems (at the base of the brain) the veins somewhat lose their technical aspects is practically a description of opera significance. They become important again in the tive approaches and their obstruction by cerebral region of the basal Dura, the Tentorium, and the Falx veins. It is this which constitutes the major difference but (with the exception of the region of the Sinus between arteries and veins. The arteries of the brain originate from only four large vessel stems, which cavernosus) away from the large arterial stems. This justifies writing a microneurosurgical textbook exclu bridge the CSF space and then run along the surface sively under the aspect of the cerebral veins. of the brain or inside the brain. Arterial vessels hardly interfere with operative approaches, even in the deep That we know so much about cerebral veins is due CSF spaces such as the Sylvian fissure, the Tentorium primarily to the work of neuroradiologists. It is not fissure, and the ventricle system. Veins, on the other the objective of the present volume to provide a hand, can appear in almost every location of the brain compreherisive and comparative survey of the large as so-called bridging veins. They are extremely vari number of individual results of attempts at establish able and can bloc~ the approach to deep CSF spaces ing vein types.
This practical, step-wise text covers the surgical approaches, resection strategies and reconstruction techniques used for each type of presenting tumor of the spine. Demonstrating the variety of anterior, posterior and intradural approaches and stabilization techniques, and spanning from pathologies of the craniocervical region to sacral and intradural pathologies, each chapter is generously illustrated with figures, radiographs and intraoperative photos. The chapters themselves follow a consistent and user-friendly format: the anatomy and biomechanics of a specific region, patient evaluation, essential oncologic principles, the decision-making process, and technical steps of surgery. A representative case illustration is provided at the conclusion of each chapter, exemplifying pertinent concepts described. Additionally, video segments accompany selected chapters, providing real-time illustration of surgical techniques. Technical and in-depth, yet highly accessible, Spinal Tumor Surgery: A Case-Based Approach is an essential resource for orthopedic spine surgeons, neurosurgeons, and surgical oncologists operating on tumors of the spine.