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This book takes readers on a journey around the world and through time, accompanied by a modern neurosurgeon who reviews historical techniques and instruments used for cranial opening. The author draws on original medical and surgical books to provide a comprehensive history of these techniques and tools. To complement the general overview and offer readers a more ‘hands-on'sense of context and atmosphere, extensive historical references, stories, media news and illustrative cases have been included for each historical and geographical scenario. In addition, original illustrations and plates of these archaic instruments and techniques are supplied. Neurosurgical surgeons, nurses, technicians, medical historiographers, paleo-pathologists and researchers interested in surgical techniques for cranial opening will find the volume a valuable guide, intended to increase the historical and cultural awareness of this core topic in neurological surgery.

This book illustrates in a unique way the most common diseases affecting the human nervous system using different imaging modalities derived from radiology, nuclear medicine, and neuropathology. The features of the diseases are visualized on computerized tomography (CT)-scans, magnetic resonance imaging (MRI)-scans, nuclear medicine scans, surgical intraoperative as well as gross-anatomy and histology preparations. For each disease entity, the structural changes are illustrated in a correlative comparative way based on the various imaging techniques. The brain diseases are presented in a systematic way allowing the reader to easily find the topics in which she or he is particularly interested. In Part 1 of the book, the imaging techniques are described in a practical, straightforward way. The morphological built-up of the normal human brain and its vascular supply are presented in Part 2. The chapters of the subsequent Parts 3 to 10 deal with the following diseases involving the nervous system including: hemodynamic, vascular, infectious, neurodegenerative, demyelination, epilepsy, trauma and intoxication, and tumors. The authors incite the clinician to see the cell, the tissue, the organ, the disorder by enabling him to recognize brain lesions or interpreting histologic findings and to correlate this knowledge with molecular biologic concepts. Thus, this book bridges the gap between neuro-clinicians, neuro-imagers and neuro-pathologists. The information provided will facilitate the understanding of the disease processes in the daily routine work of neurologists, neuroradiologists, neurosurgeons, neuropathologists, and all allied clinical disciplines.

This book aims to facilitate readers to understand the origin, growth pattern and relationship between tumor and adherent structure of craniopharyngioma, so as to improve the cure rate and safety of surgery. It's contributed by Neurosurgery Department of Nanfang Hospital, Southern Medical University, China, which focuses on the management of craniopharyngioma. This book covers histoembryology of craniopharyngioma, together with anatomical morphology and abundant clinical data, systematically showing an innovative classification method, i.e. QST classification. This classification method can better reflect the different origin and growth pattern of craniopharyngioma，the relationship between tumors and surrounding structure of the tumor growth pattern, and clinical significance in surgery. The 70 clinical cases with different classification and treatment history are discussed as an important reference for surgical treatment of craniopharyngioma. The anatomy, morphologyand pathology of sellar region also have great reference value for researchers in the field of neural science. The underlying intention of this book is to help bring a change in the concept that “craniopharyngioma is an incurable benign tumor only due to its anatomical location”.

The cerebrospinal fluid (CSF) is an invaluable diagnostic tool in clinical neurology, not only in the evaluation of inflammatory, degenerative, and malignant diseases of the nervous system, but also in the diagnosis of all forms of cerebral and subarachnoidal bleedings. The CSF can be easily obtained by lumbar puncture and a set of basic analyses can be conducted using relatively simple laboratory methods. By combining different CSF parameters, a wide range of diagnostic entities can be identified. However, properly interpreting the test results requires a high level of expertise and cannot be achieved by just reporting on individual analytic values. This book covers essential aspects of cerebrospinal fluid analysis and its use in the diagnosis of common neurological diseases. The first part addresses preclinical aspects such as the history of CSF, as well as the anatomical, physiological, and biological background of this valuable fluid. In addition, CSF collection, its preanalytical and methodological implications, and the increasing number of disease-specific markers in CSF are discussed in detail. Lastly, CSF analyses are put into context with clinical syndromes, demonstrating their diagnostic value in neurological clinical practice. Cerebrospinal Fluid in Clinical Neurology helps readers understand the preanalytical and analytical aspects of CSF diagnostics and offers a valuable reference guide for interpreting CSF results during the clinical work-up for neurological patients.

This book serves as a comprehensive guide to the rapidly evolving field of molecular neuropathology of nervous system tumors, as well as the underlying biology and emerging molecular targeted therapies. Special emphasis is given to already established and emerging molecular diagnostic tests in neuropathology, as well as molecular targeted therapies. The book is organized by clinico-pathologic disease entities, and each chapter is written by a team of experts in their field. Molecular Pathology of Nervous System Tumors is of great value and utility for physicians and scientists involved with or interested in the up-to-date diagnosis and treatment of patients with brain tumors.

Peripheral nerve analysis is a challenging task for pathologists, given the advent of new diagnoses and techniques of analysis and the impact of molecular genetics. This book presents a simple, logical method for constructing a differential diagnosis based on pathology and clinical presentation. It also provides advice on the selection of ancillary molecular, immunohistochemical and genetic techniques to establish a definitive diagnosis. Clear, authoritative guidance is offered on diagnosis of the full range of neuropathies with the aid of a wealth of high-quality color photomicrographs and electron micrographs. The pathologist will benefit greatly from the identification of a variety of artifacts and normal structures occasionally encountered in nerve biopsies that need to be distinguished from specific pathologic alterations. This user-friendly, practical text will be an invaluable aid in achieving the most specific diagnosis possible.

Every year dozens of physicians-in-training face, for the first time, the responsibil­ ity of examining and diagnosing central nervous system tumors or biopsies of the central nervous system, the peripheral nerves or muscles, whose surgical resection has been decided on both as a form of treatment (in the case of tumors) and as means to confirm a presumptive diagnosis. The selection of the most appropriate form of post surgical treatment for most tumors is predicated on the precise identification of the tumor cells. The evaluation of the specimen, by a pathologist, will not only determine whether the lesion is truly neoplastic, but also whether there are histologic indicators of malig­ nancy. Moreover, in some cases, the pathologist will be asked to determine whether the tumor cells contain certain hormone precursors or receptors, as an example. Recognition of many of the features that one must search for requires the judicious application of methods that may not be readily known to the physicians involved in the various diagnostic procedures. The handling and processing of the tissues as they arrive in the pathology laboratory for the above reasons vary as a function of the organ (or site) of origin of a given tumor as well as a function of the presumptive clinical diagnosis. The material contained in this book series has been organized in an attempt to help the pathologists-in-training, the general pathologists, the neurosurgeons, and neu­ rologists to understand the logic behind such special requirements.

Diese Monographie gibt auf der Grundlage umfangreicher eigener Untersuchungen einen aktuellen Überblick über die Möglichkeiten und Grenzen der Immunhistochemie in der klinischen und experimentellen Neuroonkologie. Der Schwerpunkt liegt auf der Bedeutung des Nachweises von Differenzierungsmarkern und Proliferations-assoziierten Antigenen für die Differentialdiagnostik und das Tumorgrading der Tumoren des Nervensystems. Daneben werden aber auch neue Resultate zum Nachweis von Onkoproteinen, Wachstumsfaktoren und Rezeptoren sowie Befunde an experimentell induzierten Tumoren der Ratte vorgestellt. Der Text wird durch Abbildungen und Tabellen ergänzt. Das Buch bietet somit für neuroonkologisch interessierte Pathologen und Kliniker eine kompakte Zusammenfassung des Themas.

In the Preface to the first volume of the Photographic Atlas of Practical Anatomy, we explained our special interpretation of the structure of the superficial fascia of the hu­ man body. The second volume of the Atlas retains this concept and further substanti­ ates its validity. The order in which the anatomic regions are presented may seem unconventional, but it is intended to reflect the importance of'transitional regions'in understanding ana­ tomic relationships. Wherever possible, regions that border one another are presented in sequence. Additionally, we wanted the format of the second volume to follow that of the first, so the joints are placed at the end of the book and the preceding pages are de­ voted to the upper limb. We start with the neck, as it provides a logical transition to the head. The nuchal region serves the same function for the back, which, as part of the thoracic cage, forms a gate­ way to the lateral and anterior chest wall and finally to the upper limbs, which original­ ly developed from the torso as ventral buds. A photographic presentation, more than any other, is bound to reflect individual varia­ tions. This is not necessarily a disadvantage, and we hope that our approach will serve to'flesh out'general and abstract principles. Our reference list covers only works that relate directly to the second volume. Other sources may be found by consulting the more comprehensive bibliography and preface ofVolume I.

Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic ‘storm', that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.

The scientific contribution of Mike Bradbury to the study of the blood-brain barrier is considerable and wide-ranging, starting with his M.D. thesis in 1962 and still continuing today. The varied spectrum of topics relating to the blood-brain barrier presented in this volume and the many geographical locations from which both speakers and participants gathered to attend the symposium are a fitting testament both to Mike's wide-spread influence in the field and to the esteem in which he is held. When we first had the idea of afestschrift to mark Mike's retirement as Professor of Physiology at King's College London and the beginning of a new vie libre as scientist and yachtsman the plan was initially for a gathering of all of the many colleagues, collaborators and students who had worked with him over the years. However what we had not taken into account was the closeness of the international community of workers in the field, the widespread influence that Mike had wielded and the speed with which word would spread. We should have anticipated all three. The final outcome was an excellent symposium with the majority of the world's key workers either contributing or attending. We hope that this volume presents an adequate record of the meeting.

Die exzellenten Photos von Walter Thiel erregen Aufsehen. Ein vom Autor entwickeltes neuartiges Konservierungverfahren ermöglicht nicht gekannte optische Dimensionen. Entstanden sind Präparate, die durch ihre Natürlichkeit bestechen. Erstmals werden Organe in ihrer wahren Konsistenz, ihrer natürlichen Verlagerungsmöglichkeit dargestellt. Die hervorragenden Photos der minuziös präparierten Sektionen sind Kunstwerke von großer Aussagekraft. Bei dieser Darstellung der topographischen Anatomie werden neben den für die Chirurgie wichtigen Zugängen auch die Punktionen der Gelenke in unübertroffener Detailtreue dokumentiert. Der Atlas ist somit nicht nur für Anatomen von Interesse, sondern für operativ tätige Ärzte und alle, deren Arbeit eine räumliche Vorstellung der menschlichen Anatomie erfordert.

Ein einfacher Zugang zur Liquorzelldiagnostik wird anhand eines umfangreichen Farbbildteiles und leicht verständlicher Erläuterungen sowohl zu den theoretischen und technischen Grundlagen der Liquorzytologie als auch zur Bearbeitung der Proben im Labor ermöglicht. Normale und pathologische Liquorzellbilder – auch aus atypischen Liquorproben (Drainagen, Liquorrhoe) – werden ausführlich beschrieben und den entsprechenden neurologischen Erkrankungen zugeordnet. Als Ergänzung dazu werden die Grundprinzipien der Proteindiagnostik im Liquor cerebrospinalis und deren Beurteilung dargestellt. Die übersichtliche, prägnante Aufbereitung erleichtert sowohl die Arbeit der im Labor Tätigen als auch die Diagnosestellung durch den Facharzt.

Die traumatischen Schäden von Gehirn und Rückenmark werden in den drei aufeinanderfolgenden Bänden (Band 13/VI A bis C der Speziellen Pathologischen Anatomie) umfassend behandelt. Was auch dieses Werk auszeichnet,sind u.a. drei übergreifende Besonderheiten: 1. Die systematische Darstellung der wichtigeren traumatisch-bedingten Schäden von Hirn und Rückenmark, geordnet nach Topologie und Pathogenese. 2. Die epidemiologischen Besonderheiten der Traumafolgen durch Sportunfälle, durch Unfälle im Straßen-, Eisenbahn-, Luftverkehr. 3. Die Analyse der patho-anatomischen Befunde unter Berücksichtigung der klinisch-funktionellen Konsequenzen. In diesem Band 13/VI C stehen die traumatischen Schäden des Gehirns im Vordergrund.

Die traumatischen Schäden des Rückenmarks und seiner Hüllen werden in diesem Beitrag systematisch abgehandelt. Die Darstellung beginnt mit der allgemeinen Neuropathologie der traumatischen Gewebeschäden des Rückenmarks und dessen Hüllen. Im zweiten Teil wird die spezielle Neuropathologie des Rückenmarks, geordnet nach Syndromen, dargestellt. Auch die traumatischen Schäden der Wirbelsäule, der Zwischenwirbelscheiben und des Bandapparates werden mitberücksichtigt, denn sonst wäre die Nosologie der verschiedenen Syndrome unvollständig und lückenhaft. Hier werden - neben historischen - auch biomechanische und klinische Aspekte abgehandelt. Ein ausführliches Kapitel ist den indirekten Verletzungen von Hals und Kopf gewidmet, die unter verschiedenen Termini wie Whiplash-, Schleuder- oder Peitschenschlagverletzungen bekannt sind.

Neuronavigation enables the surgeon to define each cranial and cerebral structure before and during surgery but the problem of brainshifting remains. This atlas shows drawings of anatomical landmarks for neuronavigation for preoperative planning. The authors show the relationships between bony landmarks which are unchanged during the operation, and landmarks which are no more available after opening of the skull but still recognizable during the operation, e.g. by ultrasonic sector scan. It further includes the description of many important anatomical variants, which are important for microsurgeons when using minimal invasive modern techniques (endoscopy, sterotaxy) to avoid errors and complications. The book describes unknown projections for MRI and CT which may be adapted for special surgical problems. The anatomical drawings are the result of a twenty-five-years study of the topographical anatomy of the brain and the surrounding structures combined with the experience of modern microsurgery.

Since the first edition of this book was published (Duvernoy 1988), considerable advances have been made. The new edition therefore includes current concepts about functions of the hippocampus and a study of its external and internal vas­ cularization. Head sections and magnetic resonance imaging (MRI) views have also been added to the previous atlas of sections. The book is divided into four sections, preceded by an introduction (Chap. 1) and a short comment on the material and methods (Chap. 2). The first section ( Chap. 3) deals briefly with the structure, functions, and connections of the hip­ pocampus. This is followed in Chap. 4 by a description of the anatomy of the hippocampus and its relations with adjacent structures. The next section ( Chap. 5) is concerned with the vascularization of the hippocampus, and the final sec­ tion ( Chap. 6) is devoted to sectional anatomy and MRI. This work has benefitted from the invaluable help of many of my colleagues. First of all, I would like to express my gratitude to the late Professor Roger War­ wiek, who helped me clarify the difficult description of hippocampal anatomy. This book would not have been possible without the excellent illustrations by J.L. Vannson, the helpful advice given by Professor J. Guyot, Dr. P.Y. Risold, and Dr. F. Cattin, and the contribution made by Mr. A.E. Cabanis. I would also like to thank the members of the Department of Anatomy in Besans;on: Professor G.

During recent years, major advances in surgical techniques, diagnostic methods, anesthesia and adjunctive treatment in the care of patients with subarachnoid hemorrhage have been achieved. Nevertheless, the overall outcome of patients with SAH cannot be regarded as satisfactory. The first part of the book concentrates on the pathogenetic mechanisms underlying vasospasm and edema, the principal causes of poor outcome. Recent progress in the field of membrane lipid metabolism has allowed the problem to be approached from an entirely new perspective. The possible participation of free radicals, membrane lipids and eicosanoids is thoroughly discussed. The second part features the problems of practical management of SAH patients. Timing and indication of surgery of aneurysms and the surgical techniques are described in detail.

Veröffentlicht für Studienzwecke

Dieses weltweit bewährte Standardwerk über die zerebrale Computertomographie wurde völlig neu überarbeitet und durch Einbeziehung der Kernspintomographie erweitert. Der Leser erhält eine systematische Darstellung der Diagnose und Differentialdiagnose von nahezu allen Hirngeschwülsten im Computer- und Kernspintomogramm unter Berücksichtigung klinischer Aspekte. Auch Schädelbasis- und Orbita-Prozesse werden mit einbezogen. Grundlage dieses Werkes bildet die umfangreiche Erfahrung der Autoren mit der Computer- und Kernspintomographie bei fast 10.000 Patienten mit verifizierten raumfordernden intrakraniellen Prozessen und Orbita-Erkrankungen. Hervorzuheben ist der umfangreiche Abbildungsteil, in dem nicht nur die häufigsten Geschwulstarten anhand typischer Computer- und Kernspintomogrammen besprochen, sondern auch die seltenen Tumoren und atypischen Lokalisationen demonstriert werden. Für die Einteilung der Tumorgruppen war die neue WHO-Klassifikation maßgebend. In der sehr ausführlichen Differentialdiagnose werden sämtliche nicht tumorbedingten raumfordernden intrakraniellen Prozesse ausführlich erörtert: entzündliche Gehirnerkrankungen, Gehirnerkrankungen im Zusammenhang mit AIDS, akute Entmarkungskrankheiten, Granulome, Zysten, Parasiten, Hirnblutungen, Gefäßmißbildungen und Hirninfarkte.

Increasing specialisation in pathology reflects the progressive changes in medical practise. The advent of a specialist with a new interest in a hospital or clinic may present the pathologist with a need to extend his or her knowledge to be able to work closely with the clinical practi­ tioner in order to provide adequate clinical care. Some sub-specialisations are long established, such a one is neu­ ropathology. However, an exclusive specialist practise is generally con­ fined to neurosurgical centres and much neuropathology is of necessity, executed by geneni.l pathologists. The areas covered by this volume are those which are commonly managed by the generalist. Professor Adams'account of how the skull and brain should be examined here will give confidence to many by defining a good technique and the careful description of various kinds of vascular injury lesions resulting from raised intracranial pressure will help to clarify repeated difficulty. More subtle forms of damage are also considered in detail. Professor Weller provides a detailed account of how the central nervous system may be examined in a way which permits all of us to prepare material which will allow adequate investigation of central nervous system disease and the proper examination of peripheral nerves. This chapter will become a'handbook'and will be of interest to those in training and established practitioners. Muscle biopsy is also dealt with; this is an area of investigative concern for many gener­ alists. The role of that singular neuropathological technique is very clearly emphasized.

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their post­ graduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons.

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The topographical and functional architecture of the human brain is highly complex. This stereoscopic atlas provides new insight into the human brain. The illustrations in this stereoscopic atlas have been developed using a new 3D-visualization computer model. In combination with the CD-ROM, which contains all 173 illustrations as rotatable 3D models, this innovative atlas provides a new conception of spatial structures. It has never been so easy to understand the architecture of the human brain!

Various textbooks on stereotactic neurosurgery have been published during the last few years (Riechert 1980, Schaltenbrand and Walker 1982, Spiegel 1982), all of them dealing with functional stereo tactics as the major subject in the field. Diagnostic and therapeutic stereotactic interventions are only briefly described, whereas localization techniques are not yet mentioned. Since 1980, however, an increasing number of reports has been published on CT guided and computer monitored stereotactic performances which enable the surgeon to combine diagnostic and therapeutic efforts in one session. With recent progress in scanning techniques, including high resolution CT, NMR, and PET imaging of the brain, it has become possible to study and localize any brain area of interest. With the concomitant advances in computer technology, 3-dimensional reconstruction of deep seated lesions in stereotactic space is possible and the way is open for combined surgery with stereotactic precision and computer guided open resection. This type of open surgery in stereotactic space is already being developed in some centers with the aid of microsurgical, fiberoptic, and laser beam instrumentation. With these advances stereotactic techniques will rapidly become in­ tegrated into clinical neurosurgery. Stereotactics has become a metho­ dology which enables the surgeon to attack deep seated and subcortical small tumors. Neurosurgeons may abandon therapeutic nihilism, still frequently seen in glioma treatment, in the near future when stereotactic resection will be feasible and remaining tumor cells may be killed by adjuvant treatment modalities still in development.

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 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 aim of the book is to describe the current approach to meningiomas on the basis of experience gained in the fields of histopathology, biology, radiology and surgery. The first section of the book deals with general diagnostic aspects. The typical histopathological features of meningiomas and the various abnormalities shown by imaging methods are discussed. The second section elucidates the growth pattern of meningiomas arising in various specific locations. Separate chapters are devoted to particular aspects of meningioma and to peritumoral edema. The third section covers the treatment of meningiomas. Surgical removal remains the basic therapy, while adjuvant methods include preoperative embolization, irradiation, and endocrine therapy.

Magnetic resonance imaging (MRI) is a new and still rapidly developing imaging technique which requires a new approach to image interpreta­ tion. Radiologists are compelled to translate their experience accumulat­ ed from X-ray techniques into the language of MRI, and likewise stu­ dents of radiology and interested clinicians need special training in both languages. Out of this necessity emerged the concept of this book as a manual on the application and evaluation of proton MRI for the radiolo­ gist and as a guide for the referring physician who wants to learn about the diagnostic value of MRI in specific conditions. After a short section on the basic principles of MRI, the contrast mechanisms of present-day imaging techniques, knowledge of which is essential for the analysis of relaxation times, are described in greater de­ tail. This is followed by a demonstration of functional neuroanatomy us­ ing three-dimensional view of MR images and a synopsis of frequent neurological symptoms and their topographic correlations, which will fa­ cilitate examination strategy with respect to both accurate diagnosis and economy.

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.

Intracranial germ cell tumors are a group of uncommon neoplasms of the central nervous system. The clinical features and natural history of these lesions are quite unique and variable. While intracranial germ cell tumors have been a fascination to neurooncologists for decades, the relatively small number of patients seen in any single institution has hampered the important clinical investigation that is so needed. This text is complete with detailed information concerning the epidemiology, pathology, oncological biology, clinical findings, radiology, and treatment options including surgical strategy, radiotherapy, and chemotherapy for this heterogeneous group of neoplasms. The ongoing clinical trials concerning the optimization of therapy are efficiently summarized. An important final segment addresses the late sequelae of therapy which is of great significance since the majority suffering from these tumors are young patients. This first and only book on intracranial germ cell tumors includes excellent and comprehensive data sheets, illustrations, and radiograms. It provides a detailed and outstanding reference source for physicians taking care of patients with intracranial germ cell tumors, and will be a very welcome edition to their reference libraries.

The recent progress of medical imaging due to the scanner, the MRI, and the three-dimensional reconstruction of cerebral structures calls for a better knowledge of brain anatomy; it is to be noted, though, that the accurate anatomy of the brain surface was already known thanks to the pio­ neering work of late-nineteenth-and early-twentieth-century research workers, such as Eberstal­ ler (1884), Cunningham (1892), Dejerine (1895), Retzius (1896), Zuckerkandl (1903), Elliot-Smith (1907) [14, 15,22,29, 30, 56, 751. Since then, more recent techniques have led to a precise view of the deeper structures. But, as those details were not visible in vivo before the diffusion of scanner and magnetic-resonance-imaging (MRI) exploration, such knowledge was deemed superfluous, or even useless. Nowadays, this situation has drastically changed and the neurologists, neurosur­ geons, and neuroradiologists acknowledge the need to know more about anatomy. The aim of this volume is to provide those specialists with that information for their own research. A number of atlases do exist at the present time [15,52,58, 156-195], but we felt that the serial were not enough if not made obvious, being defined in relation with the sections by themselves brain surface as shown in Figs. 26, 139, and 175. However, this three-dimensional-representation technique of coronal, sagittal, and horizontal sections makes the study of only one hemisphere ne­ cessary so as to locate each section with respect to its several aspects.

At the 8th European Congress of Neurosurgery, which took place in Barcelona, September 6-11, 1987, a great number of papers from all fields of neurosurgery were presented, reflecting the major advances that have been achieved in recent years. The Programme Committee of the European Association of Neurosurgical Societies has selected the highlights of the congress for publication. These contributions were carefully edited and compiled in two supplement volumes of Acta Neurochirurgica.

The Leitmotiv of the Second Convention of the Academia Eurasiana Neurochirurgica was'Cerebrum convalescit'- literally'the brain recovers'. The focus of the meeting was on plasticity of the central nervous system, one of the most decisive factors in recovery and readaption after cerebral lesions. Distinguished experts from the fields of neurosurgery, neurology, neurophysiology, anatomy, pathology, oncology, and pharmacology discussed the following topics: - Molecular and cellular basis of plasticity - Regeneration and growth in the CNS - Self-organization of neuronal network - Brain oedema - a reparatory process? - Growth factors and carcinogenesis

This supplement to'Acta Neurochirurgica'contains a selection of papers which were presented at the 9th Scientific Meeting of the European Society for Paediatric Neurosurgery on Space Occupying Lesions of the Cerebral Midline in Vienna, October 10-13,1984. This meeting was arranged at the same location where the ESPN was founded exactly seventeen years ago. Although the presentations in this meeting dealt with numerous important problems encountered in paediatric neurosurgery, the main emphasis was on that special problem which exemplifies the extraordinary advances in paediatric neurosurgery and its related fields. Therefore the main topic of this scientific meeting was dedicated to the subject of'Space Occupying Lesions of the Cerebral Midline'. Recent diagnostic procedures, such as computerized axial tomography and magnetic resonance imaging, now enable the neurosurgeon preoperatively, to obtain precise data on the location, and in many cases also on the nature of a lesion deep within the brain. Fundamental new knowledge in neuroanatomy and neurotopography has now transformed previous high-risk procedures into routine ones for the neurosurgeon, and an abundance of new surgical techniques has improved the success rate in the treatment of many patients. The scientific meetings of the ESPN have proved to be a successful forum for the exchange of experiences, opinions and even critical discussions. The present selection of papers will undoubtedly support this endeavour. Wolfgang T. Koos Gerhard Pendl Contents A. Statistics Koos, Wo To, Horaczek, Ao: Statistics of Intracranial Midline Tumors in Children 0 1 B.

This volume contains the most recent works on intracranial pressure and neuromonitoring in brain injury selected from 300 abstracts submitted to the 10th International Symposium on Intracranial Pressure. It includes state of the art monitoring of the brain injured patient in intensive care as well as the current state of knowledge in neurochemical and oxygen monitoring of the injured brain. Recent advances in molecular mechanisms of injury and the pathophysiology of ischemia and trauma are also included.'... this publication presents a comprehensive survey of the present state of art in the field and thus gives directions for further research to those engaged in ICP measurement and neuromonitoring”. Intensive Care Med

As an addition to the European postgraduate training system for young neurosurgeons, we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbuhl. Thus were established the principles of European co­ operation which have been born from the European spirit, flourished in the European Association, and have been associated throughout with this senes. The fact that the English language is now the international medium for communication at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contri­ butions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume for scrutiny and suggestions for revision. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume.

The tumors of the brain similar to other pathological changes of that particular organ claim for a separate position in scientific medicine regarding biology, morphology, features of clinical manifestation, diagnostics and therapy. During the past years due to rapid progress in basic neurosciences and medical biotechnics the situation of the neuroclinician in front of brain tumors has been dramatically changed. The prerequisites for early and accurate diagnosis as well as for successful treatment also of malignant neoplasms have increased and remarkably improved. At the same time the information necessary for an appropriate pragmatic use of the available cognitive methods and therapeutic means increased along the same scale and is permanently being critically modified or changed due to fundamental new insights which come up in always shorter intervals. These facts necessitate the preparation of publications in which the state of the art is presented in possible completeness, systematic order and proper disposability for rational management and therapeutic strategies.

The idea for this treatise on the radiological anatomy of superficial and deep spinal cord vasculature evolved from daily routine neuroradiological work. This was also the reason for subdividing the monograph into a postmortem anatomical and a clinical part. The actual importance of a clear conception of radio anatomic fundamentals was made clear by many clinical conferences with neurologists, neurosurgeons and orthopedists, where a lack of knowledge about medullary syndromes of suspected vascular origin became evident. Also among neuroradiologists there is still widespread uncertainty in the interpretation of myelograms and angiographies in such cases. A study of the spinal cord's angioarchitecture is all the more justified and necessary considering the vast number of descriptions of cerebro­ vascular anatomy and pathology. The clinical challenge posed by patients suffering from partial or complete transverse spinal lesions has grown due to new diagnostic and therapeutic approaches. Myelography using water-soluble contrast media, X-ray computed tomography, magnetic resonance imaging and spinal angiography today allow and require both earlier and topographically and pathogenetically more exact classification of diseases of the spinal cord and its surrounding structures. Due to progress in microneurosurgery and interventional neuroradiology, even intramedullary lesions have become more and more accessible and treatable. Therefore this monograph mainly addresses those concerned with invasive therapeutic techniques and who are familiar with the interpretation of radio anatomic findings. A comprehensive description of medullary vascular syndromes would be beyond the scope of this treatise.

During the last decades, research on spinal cord has attracted a great deal of attention because of problems such as sensory-motor and autonomic dysfunctions associated with traumatic and other injuries. Recording of spinal cord evoked potentials is one of the most promising approaches to understand the spinal cord function. However, the details of the evoked potentials and their significance in various pathological conditions are not yet fully characterized. This book summarizes new findings in the field of electrophysiology and relates this knowledge to pathology and regeneration research. It is the first one which deals in great detail with various ways to monitor spinal cord function in experimental and clinical situations. It provides an up-to-date knowledge regarding spinal cord bioelectrical activity and its modification with pharmacological agents and covers new aspects of regeneration studies, particularly the role of myelin associated inhibitory molecules. A section is devoted to clinical studies dealing with electrical activity, pathology, and current therapeutic measures. This volume will be useful both to basic and clinical neuroscientists engaged in the field of neurology, neurophysiology, neurochemistry, neurosurgery, neuropathology, and related disciplines in order to understand basic functions of the spinal cord and to stimulate further research in this rapidly advancing field.