Advances and Technical Standards in Neurosurgery / Volume 23 (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 KrayenbtihI. 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 publi­ cation 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.

A. Advances.- A Critical Review of the Current Status and Possible Developments in Brain Transplantation.- Grafting in Parkinson’s Disease.- Experimental Background.- Graft-Host Brain Interactions.- Rationale for the First Clinical Experiments.- Ethical Considerations.- Preparation of Tissue Grafts.- Fetal Tissue.- Autologous Adrenal Medulla.- Surgical Techniques.- Stereotactic Techniques.- Open Microneurosurgery.- Human Clinical Trials.- Autologous Transplantation of Adrenal Medulla.- Transplantation of Human Fetal Mesencephalic Tissue.- Graft Survival.- Clinical Results.- Transplantation of Other Dopamine Cells.- Brain Cell/Tissue Transplantation in Other Diseases.- Discussion and Perspectives.- Functional Interactions Between Grafts and Host Brain: Fetal Mesencephalic Versus Adrenal Tissue Grafts.- Methodological Aspects on Fetal Brain Tissue Grafting.- Will Transplantation be a Future Neurosurgical Routine in the Treatment of Parkinson’s Disease?.- Future Transplantation Therapy in Other Neurologic Disorders.- General Conclusions.- References.- Editorial Comment.- The Normal and Pathological Physiology of Brain Water.- Summary.- Brain Water, its Origin and Significance.- Normal Brain Water Content: Effect of Maturation.- Measurement of Brain Water Content.- Gravimetry.- Determination of Tissue Specific Weight.- Computed Tomography.- Proton Magnetic Resonance.- Intracranial Fluid Compartments.- Intercompartmental Exchanges.- Fluid Volume: The Coupling of Water to the Prevailing Electrolytes NaCI: Regulation of Systemic Fluid Volume.- Blood-Brain Exchanges: The Blood-Brain Barrier and the Blood-CSF Barrier.- Pathology: Breakdown of the Blood-Brain Barrier and Vasogenic Brain Oedema.- The Blood-CSF Barrier.- The Cerebral Extracellular Space.- Methods to Study Extracellular Space.- The Structure and Functional Significance of Cerebral Extracellular Space.- The Extracellular Matrix.- The Cerebrospinal Fluid.- Factors Determining Normal CSF Formation.- Choroidal CSF Formation.- The Mechanism of CSF Secretion by the Choroid Plexus.- Extrachoroidal CSF Formation.- CSF Absorption.- Morphological Aspects of CSF Absorption.- Alternative CSF Absorption Pathways.- The Flow of CSF.- The Cerebral Intracellular Space.- The Measurement of Intracellular Space.- The Maintenance of Cell Volume.- The Abnormal Accumulation of Brain Water.- Brain Oedema.- Pathogenesis of Brain Oedema.- Vasogenic Brain Oedema.- Cytotoxic Brain Oedema.- Osmotic Brain Oedema.- Hydrostatic Brain Oedema.- Brain Oedema in the Clinical Context.- Peritumoural Brain Oedema.- Ischaemic Brain Oedema.- Traumatic Brain Oedema.- Hydrocephalus.- Cystic Lesions.- Ex vacuo Type Cysts.- Cysts with Fluid Secreting Walls and CSF-Like Content.- Cysts Associated with Gliomas and Other Tumours.- Acknowledgement.- References.- B. Technical Standards.- Transfacial Approaches to the Skull Base.- Transfacial Approaches to the Clivus.- Anatomy of the Clivus.- Functional Anatomy.- Surgical Pathology.- Developmental.- Metabolic Causes.- Trauma.- Inflammatory Conditions.- Tumours.- Vascular Lesions.- Clinical Presentations.- Investigations.- 1. Plain x-Rays.- 2. Angiography.- 3. Computerised Tomography (CT).- 4. Magnetic Resonance Imaging.- 5. Evoked Potentials.- General Operative Considerations.- 1. Preoperative Preparation.- 2. General Anaesthesia.- 3. Control of Intracranial Pressure.- 4. Prophylactic Antibiotics.- 5. Corticosteroids: Replacement.- 6. Positioning.- 7. Blood Pressure Control.- 8. Post-Operative Nutrition.- 9. Dural Closure.- 10. Extubation.- Surgical Approaches.- Transfacial Approach.- Facial Translocation.- Midfacial Degloving.- Transsphenoidal Approach.- Transethmoidal Approach.- The Transantral Transsphenoidal Approach.- Le Fort Maxillotomy.- Complications.- Comparison with Other Methods.- Conclusions.- Acknowledgements.- References5.- Presigmoid Approaches to Skull Base Lesions.- The Transpctrosal Approaches.- Extended Retrolabyrinthine Approach.- Translabyrinthine Approach.- Transcochlear Approach.- The Combination Approaches.- Combined Supra- and Infratentorial Approach.- Far Lateral-Combined Supra- and Infratentorial (Combined- Combined) Approach.- The Orbitozygomatic-Combined Supra- and Infratentorial Approach.- Current Indications for Transpetrosal Approaches.- References.- Anterior Approaches to Non-Traumatic Lesions of the Thoracic Spine.- Surgical Anatomy.- Anterior Surgical Approaches.- Thoracotomy.- Toraco-Abdominal Approach.- Transsternal Approach.- Other Surgical Approaches.- Transpedicular Approach.- Posterolateral Thoracotomy.- Herniated Thoracic Disc.- Surgical Treatment.- Tumours.- Surgical Treatment.- Infections.- Surgical Technique.- Stabilization Techniques.- Operative Complications.- Conclusions.- Acknowledgements.- References.- The Far Lateral Approach to Lumbar Disc Herniations.- Clinical Presentation.- Anatomical Review.- Paravertebral Muscles and Fasciae.- The Lumbar Arteries and Veins.- Lumbar Spinal Nerves and Their Relationship to the LIPC.- Indication for Operative Treatment.- Preoperative Evaluation.- Surgical Technique.- Selection of Approach.- Positioning.- Prophylaxis of Infection.- Operative Technique of Transmuscular Approach.- Operative Technique of Paramuscular Approach.- Ten Steps of the Transmuscular Approach.- Discussion.- Outcome.- Acknowledgement.- References.