Main description:

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.

Contents:

A. Advances.- Neurobiology of Epileptogenesis in the Temporal Lobe.- Reorganisation of Neuronal Circuitries Underlying Epileptogenesis in the Hippocampus.- Anatomy.- Neuronal Loss.- Neurogenesis.- Gliosis.- Axonal Plasticity.- Dendritic Plasticity.- Reorganisation of Neuronal Circuitries in the Amygdala.- Anatomy.- Neuronal Loss.- Reorganisation of Neuronal Circuitries in the Entorinal Cortex.- Anatomy.- Neuronal Loss and Sprouting.- Conclusions.- Acknowledgements.- References.- Diffuse Axonal Injury after Head Trauma. A Review.- Fundamental Structure and Function of the Central Nervous System Axon.- The Axonal Membrane (Axolemma).- Microtubules and Neurofilaments. The Neuronal Cytoskeleton.- Axonal Transport and its Mechanisms.- Calcium and Calcium-Dependent Breakdown of Neurofilaments.- Physiopathology of Head Injury. Diffuse Versus Focal Injuries.- Post-Traumatic Cellular Events and the Concept of Traumatic Penumbra.- Classical Definition of Traumatic Diffuse Axonal Injury.- Biomechanics of Diffuse Axonal Injury.- Characteristics of Mechanical Loading.- The Centripetal Theory of Ommaya.- The Centripetal Theory and the Concept of Primary Brainstem Injury.- The Reticular Formation and the Primary Brainstem Damage Saga.- Clinical and Experimental Validation of the Centripetal Theory.- The Neuropathological Spectrum of DAI.- Focal Lesions Observed in the Brain in DAI.- Pathogenesis of the Corpus Callosum Hemorrhages.- Neuropathological Grading of DAI.- Axonal Retraction Balls, Microglial Stars and Wallerian Degeneration.- Axonal Retraction Balls.- Microglial Clusters (Microglial Stars).- Wallerian Degeneration.- Experimental Models of DAI.- Marmarou's Rodent Model of DAI.- Changing Concepts in Diffuse Axonal Injury. Is DAI Always a Primary Lesion?.- Experimental Evidence of Secondary Axotomy in Closed Head Injuries.- Pathogenesis of Diffuse Axonal Injury.- Stage I: Axonal Membrane Injury and Alterations in Ionic Fluxes.- Stage II: Reversible Cytoskeletal Damage.- Stage III: Secondary Axotomy.- Stage IV: Primary Axotomy.- Mechanoporation, Calcium Influx and Cytoskeletal Abnormalities.- Is Diffuse Axonal Injury a Universal Finding after Severe Head Injury?.- Clinico-Radiological Diagnosis of Diffuse Axonal Injury.- Cranial Fractures in Patients with Diffuse Axonal Injury.- CT Scan Findings.- The Role of MRI in the Study of Postraumatic DAI.- Diffuse Axonal Injury in Minor Head Injuries.- Late Consequences of DAI.- Specific Therapies that may be Effective Against DAI.- Magnesium-the Magic Bullet?.- Neuroprotective Effects of Hypothermia.- Cyclosporin-A and its Effect on DAI.- Hope for the Future.- Acknowledgments.- References.- Multi-Modal Monitoring of Acute Brain Injury.- Abstract.- Aspects of Cerebral Pathophysiology.- Relationships Between ICP, CPP and Cerebral Blood Flow.- Transcranial Doppler Ultrasonography for Assessing Autoregulation.- Static Test of Autoregulation.- TCD Reactivity of Changes in Arterial Carbon PaCO2.- Dynamic Test of Autoregulation.- Transient Hyperaemic Response Test.- Continuous analysis of TCD Using Respiratory Waves.- Continuous analysis of TCD Flow Velocity Waveform.- Non-Invasive Assessment of Brain Perfusion.- Computer Support for Data Analysis.- Continuous EEG monitoring.- Aspects of Cerebral Oxygenation-Brain Gas Analysis.- Jugular Bulb Oximetry.- Normal Values and Ischaemic Thresholds.- Arteriovenous Difference in Oxygen Content.- Factors which Influence SjvO2.- Arterial Oxygen Content.- Cerebral Blood Flow and Perfusion Pressure.- Cerebral Metabolic Rate.- Clinical Use of SjvO2.- Brain Tissue Oxygen Probes.- Normal Values for PtiO2.- Ischaemic Thresholds of PtiO2.- Factors that Influence PtiO2.- Hypoxia.- Cerebral Perfusion Pressure.- Hypocapnia.- Cerebral Blood Flow.- Cerebral Metabolic Rate.- Hyperoxia.- Probe Depth.- Aspects of Cerebral Metabolism-Microdialysis.- Methodology.- Microdialysis Pumps.- Microdialysis Catheters.- Chemical Analysis.- Catheter Fixation.- Clinical Applications.- Conclusion.- Acknowledgements.- References.- B. Technical Standards.- Endoscopic Endonasal Transsphenoidal Surgery.- History.- Pre-Operative Study.- Indications.- Surgical Technique.- Nasal Phase.- Natural Ostium Enlargement.- Preparation of the Sphenoid Sinus and Opening of the Sella.- Tumor Removal.- Clinical Material.- Discussion.- Acknowledgments.- References.- Extracranial Vertebral Artery Anatomy and Surgery.- Surgical Anatomy.- Surgical Exposure.- Anterolateral Approach (ALA).- First Segment.- Second Segment.- Third Segment.- Posterolateral Approach (PLA).- Indications of VA Surgical Exposure.- Intrinsic Lesions.- Extrinsic Lesions.- Intermittent Compression.- Permanent Compression.- Improvement of Exposure.- Anterior Part of the Spinal Canal.- Foramen Magnum.- Jugulare Foramen Tumors - Juxtacondylar Approach.- Personal Experience.- Conclusion.- References.- Neurosurgical Management of Pineal Tumours.- Incidence of Pineal Tumours.- Surgical Strategy with Consideration of Postsurgical Adjuvant Therapies.- Surgical Anatomy.- Selection of Approaches.- Surgical Approaches.- Instrumentation.- Occipital Transtentorial Approach.- Infratentorial Supracerebellar Approach.- Complications.- Conclusion.- Acknowledgment.- References.