Advances and Technical Standards in Neurosurgery

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 Krayenbiihl. Thus were established the principles of European co­ operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this serIes. 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 spe­ cialists in the given fields and constitute the first part of each volume.

A. Advances.- Biological Markers for Tumours of the Brain.- Classification of Brain Tumours.- General Features of Brain Tumours.- Investigative and Diagnostic Neuro-Oncology Techniques.- 1. Tumours of Neuroepithelial Tissue.- 1.1. Astrocytic Tumours.- Astrocytomas.- Anaplastic (Malignant) Astrocytomas.- Glioblastoma Multiforme.- Pilocytic Astrocytomas.- Pleomorphic Xanthoastrocytomas.- Subependymal Giant Cell Astrocytomas.- 1.2. Oligodendroglial Tumours.- 1.3. Ependymal Tumours.- 1.4. Choroid Plexus Tumours.- 1.5. Neuronal and Mixed Neuronal-Glial Tumours.- Dysembryoplastic Neuroepithelial Tumour (DNT).- Ganglioglioma.- Desmoplastic Infantile Ganglioglioma.- Central Neurocytoma.- 1.6. Pineal Tumours.- 1.7. Embryonal Tumours.- Primitive Neuroectodermal Tumours (PNETs).- Neuroblastomas.- 2. Tumours of Cranial and Spinal Nerves.- 2.1. Schwannomas.- 2.2. Neurofibroma.- 3. Tumours of the Meninges.- 3.1. Meningiomas.- 3.2. Mesenchymal, Non-Meningothelial Tumours.- Haemangiopericytomas.- 3.3. Tumours of Uncertain Histogenesis.- Capillary Haemangioblastomas.- 4. Haemopoietic Neoplasms.- Primary Malignant Lymphomas.- 5. Germ Cell Tumours.- 6. Pituitary Adenomas.- 7. Local Extension from Regional Tumour.- 8. Metastatic Tumours.- References.- Histoprognosis of Gliomas.- Historical Considerations.- Intra-tumoral Heterogeneity of Gliomas.- Intra-tumoral Heterogeneity and Structure Type of Gliomas.- Structure Type of Gliomas and Imaging.- Structure Type of Gliomas and Treatment Planning.- Structure Type and Spatial Kinetics of Gliomas.- Intra-tumoral Heterogeneity and Tumor Progression: Recent Molecular Biology Data.- Intra-tumoral Morphological Heterogeneity of Gliomas: Issue of Sampling.- Current Problems in Histological Typing of Glial Neoplasms.- Histological Typing of Astrocytomas.- Pilocytic Astrocytomas versus Ordinary Astrocytoma Cell Types.- Microcystic Cerebellar Astrocytomas versus Pilocytic Astrocytomas.- Histological Typing of Oligodendrogliomas.- Histological Grading System of Astrocytomas.- Histological Grading of Oligodendrogliomas.- Histological Typing and Grading in Childhood Gliomas.- References.- Brain Protection.- I. Introduction: Historical Perspective.- II Pathophysiology of Brain Insults.- 1. Aspects of Brain Ischemia.- Energy Production in the Normal Brain.- Thresholds and Duration of Ischemia.- Global Ischemia and Delayed Neuronal Death.- Focal Ischemia and the “Penumbra” Zone.- 2. Secondary Brain Damage.- Evolution of Primary Insult.- Secondary Insults.- 3. Ischemic and Traumatic Insults: Common Mechanism.- III. Mechanisms of Damage and Related Protections.- 1. Energy Failure and Metabolic Protection.- Barbiturates and Similar Drugs.- Hypothermia.- 2. Ca++ Damage, Excitotoxic Mechanisms and Related Therapies.- Mechanism of Ca++ Increased Cytosolic Concentrations.- Consequences of Increased Cytosolic Ca++ Concentration.- Evidence of Ca++ Damage in CNS Injuries.- Pharmacologic Protection Against Ca++ Overload.- 3. Peroxidative Damage and Antioxidant Therapy.- Free Radical Reactions.- Origin of Free Radicals in CNS Injury.- Evidence of Free Radicals Injury in CNS Insult.- Therapies Against Free Radicals.- 4. Acidotic Damage and Antiacidotic Therapies.- 5. Miscellaneous Mediators of Brain Damage and Neuroprotective Agents.- IV. Acute Brain Insults and Attempts at Protection.- 1. Intraoperative Brain Protection.- Cardiovascular Surgery.- Carotid Surgery.- Aneurysm Surgery.- 2. Subarachnoid Haemorrhage.- 3. Stroke.- 4. Brain Trauma.- 5. Spinal Trauma.- V. Concluding Remarks.- 1. Relevance of Experimental Research.- 2. Methodology of Clinical Trials.- 3. Overall Philosophy of Brain Protection.- References.- B. Technical Standards.- AIDS and the Neurosurgeon — an Update.- Summary.- Incidence and Epidemiology.- Neurologic Manifestations.- Intracranial Mass Lesions.- Nonviral Infections.- Cryptococcal Infection.- Toxoplasmosis.- Other Fungal Infections.- Neoplasms.- Primary CNS Lymphoma.- Metastatic Neoplasms.- Cerebrovascular Diseases.- Viral Infections.- Progressive Multifocal Leukoencephalopathy.- Multiple CNS Diseases.- Peripheral Neuropathic Syndromes.- Evaluation of the Symptomatic Patient.- Algorithms to Evaluate the AIDS Patient with Neurologic Symptoms.- Impact of AIDS on Neurosurgical Practice.- References.- The Surgery of Occult Spinal Dysraphism.- Embryology and Foetal Development of the Spinal Cord. Pathogenesis of Malformations.- I A. Neurulation.- I B. Deranged Neurulation.- II A. Canalization and Retrogressive Differentiation.- II B. Deranged Canalization and Retrogressive Differentiation.- Classification.- Age and Sex Distribution.- Clinical Presentation.- Indications for Investigations.- The Lesions.- I. Spinal Lipomas.- II. Anomalies of the Spinal Cord and Roots.- A. Adhesions and Bands.- B. Tight Filum terminale.- C. Diastematomyelia and Diplomyelia.- III. Anterior Meningoceles.- IV. Dermal Sinus.- V. Neurenteric Cysts.- VI. Sacral Agenesis.- Conclusion.- References.- Functional Stereotactic Neurosurgery for Psychiatric Disorders: an Experience in Belgium and The Netherlands.- Preface.- 1. Principles of Psychosurgery.- 1.1. Introduction.- 1.2. Historical Overview.- 1.3. Patient Data.- 1.4. Ethical and Legal Issues.- 1.5. Committee on Psychosurgery.- 1.6. Committee on Psychosurgery: Patient Material.- 2. Stereotactic Techniques.- 2.1. Psychosurgery in Obsessive Compulsive Disorder.- 2.1.1. Introduction.- 2.1.2. Anterior Capsulotomy (AC): the Operative Technique Followed by Caemaert.- 2.1.3. Subcaudate Tractotomy (SCT).- 2.1.4. Surgical Complications of Subcaudate Tractotomy.- 2.1.5. Technique of Progressive Leucocoagulation Followed by van Veelen and Haaijman.- 2.2. Psychosurgery in Aggressive Conduct Disorder.- 2.2.1. Intralaminar (i.La.) and Dorsomedial (MD) Thalamotomy.- 2.2.2. Amygdalotomy.- 3. Patients with Obsessive Compulsive Disorder (OCD).- 3.1. Patient Data.- 3.2. Post-Operative Psychiatric Evaluation.- 3.3. Comparison of the Results of the Two Stereotactic Techniques (SCT and PL).- 3.4. Post-Operative Psychiatric Evaluation: Particular Clinical Observations.- 4. Aggressive Conduct Disorder in Patients with Mental Retardation (IQ50).- 4.1. Patient Data.- 4.2. Post-Operative Psychiatric Follow-up.- References.- Subject Index Listed in Index Medicus.