Concezio Di Rocco – författare

It is estimated that the fU,nctionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters successfully bring to the attention of physicians within developing specialties what is occurring, but generally only in dem­ onstration form without providing historical perspective, pathoanatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years. Over this period, neurosurgeons have obtained special training in pediatric neurosurgery, and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all as­ pects of surgically treatable diseases of the child's nervous system.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub­ specialization" are occurring at approximately an equal rate. Historically, estab­ lished journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters success­ fully bring to the attention of physicians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, pathoanatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years. Over this period, neurosurgeons have obtained special train­ ing in pediatric neurosurgery, and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's nervous system.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub­ specialization" are occurring at approximately an equal rate. Historically, estab­ lished journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops, and newsletters success­ fully bring to the attention of physicians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, pathoanatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years. Over this period, neurosurgeons have obtained special train­ ing in pediatric neurosurgery, and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's nervous system.

This book offers an update on several basic and clinical problems in neurosurgery compiled by internationally recognized experts.  This multi-thematic volume  will touch on a variety of topics: from  the role of women neurosurgeons in the last hundred year of the specialty history, to the pathogenesis of spinal dysraphism, to the convection-enhanced delivery of intracerebral antineoplastic drugs in children, through a review of methods and applications. The intraoperative cerebral blood flow monitoring in neurosurgery will be also discussed, offering again a comprehensive review of contemporary technologies and emerging perspectives.  As for the  technical standards, the book will describe the multimodality approach to cerebral gliomas, the management of thalamic tumors, the intracavitary treatment of craniopharyngiomas, the long term results of spasticity treatments,  the surgical treatment of  spinal vascular malformations, the management of idiopathic and refractory syringomyelia, offering at the same time an update of peripheral nerve surgery. All the chapters have to be considered an advance in the relative fields,  in cerebral pathophysiology and in clinical management.  Approaching the issue of technical standards  in the everyday clinical practice of neurosurgery,  this book is of great interest for neurosurgeons, neurologists and orthopaedists.

This book offers an update on several basic and clinical problems in neurosurgery compiled by internationally recognized experts.  This multi-thematic volume  will touch on a variety of topics: from  the role of women neurosurgeons in the last hundred year of the specialty history, to the pathogenesis of spinal dysraphism, to the convection-enhanced delivery of intracerebral antineoplastic drugs in children, through a review of methods and applications. The intraoperative cerebral blood flow monitoring in neurosurgery will be also discussed, offering again a comprehensive review of contemporary technologies and emerging perspectives.  As for the  technical standards, the book will describe the multimodality approach to cerebral gliomas, the management of thalamic tumors, the intracavitary treatment of craniopharyngiomas, the long term results of spasticity treatments,  the surgical treatment of  spinal vascular malformations, the management of idiopathic and refractory syringomyelia, offering at the same time an update of peripheral nerve surgery. All the chapters have to be considered an advance in the relative fields,  in cerebral pathophysiology and in clinical management.  Approaching the issue of technical standards  in the everyday clinical practice of neurosurgery,  this book is of great interest for neurosurgeons, neurologists and orthopaedists.

The book provides an update of several pathological conditions of the CNS that require neurosurgical treatment.The different chapters, written by the most eminent international scientists and clinicians in the field of neuroscience, offer a critical assessment of the relevant nosographic entities that are the subject of current scientific debate.The first chapter critically analyses the new WHO classification of brain tumours, while the second chapter is specifically devoted to intracranial tumours in the first years of life. The technical aspects of neuro-oncological surgery are addressed by two chapters dealing with the suprasellar approach to infratentorial tumours and how to decrease the risk of a specific complication of the surgical management of these tumours in the paediatric population, namely post-operative speech impairment. Hypothalamic tumours with their associated epilepsy and intracranial schwannomas complete the technical surgical section on intracranial tumours. An interesting chapter presents the latest advances in clinical prediction in neurosurgery.Spinal problems are discussed in two chapters, the first considering evolving concepts on craniovertebral and spinal instability and the second Chiari malformations.The management of intracranial arachnoid cysts is still a matter of controversy, as demonstrated in a specific chapter of the book.  Another chapter deals with subdural haematomas in both adults and children.Hydrocephalus is treated in two chapters devoted to two post-inflammatory or post-infectious complications leading to specific and difficult-to-treat abnormalities in the CSF circulation.The final chapter of the book illustrates the rationale behind midface advancement in craniosynostosis.As with the previous volume in the series, the present volume represents an important contribution to the advancement of neurosurgical specialties.

The book provides an update of several pathological conditions of the CNS that require neurosurgical treatment.The different chapters, written by the most eminent international scientists and clinicians in the field of neuroscience, offer a critical assessment of the relevant nosographic entities that are the subject of current scientific debate.The first chapter critically analyses the new WHO classification of brain tumours, while the second chapter is specifically devoted to intracranial tumours in the first years of life. The technical aspects of neuro-oncological surgery are addressed by two chapters dealing with the suprasellar approach to infratentorial tumours and how to decrease the risk of a specific complication of the surgical management of these tumours in the paediatric population, namely post-operative speech impairment. Hypothalamic tumours with their associated epilepsy and intracranial schwannomas complete the technical surgical section on intracranial tumours. An interesting chapter presents the latest advances in clinical prediction in neurosurgery.Spinal problems are discussed in two chapters, the first considering evolving concepts on craniovertebral and spinal instability and the second Chiari malformations.The management of intracranial arachnoid cysts is still a matter of controversy, as demonstrated in a specific chapter of the book.  Another chapter deals with subdural haematomas in both adults and children.Hydrocephalus is treated in two chapters devoted to two post-inflammatory or post-infectious complications leading to specific and difficult-to-treat abnormalities in the CSF circulation.The final chapter of the book illustrates the rationale behind midface advancement in craniosynostosis.As with the previous volume in the series, the present volume represents an important contribution to the advancement of neurosurgical specialties.

The technical aspects and technological advances in the surgical management of cerebral midline tumors will be covered by several chapters focusing of the optic pathways’ tumors, third ventricle tumors, mesencephalon and pineal body tumors.

The technical aspects and technological advances in the surgical management of cerebral midline tumors will be covered by several chapters focusing of the optic pathways’ tumors, third ventricle tumors, mesencephalon and pineal body tumors.

The main topics covered are cerebral tumors, epilepsy and vascular malformations, congenital and acquired spine anomalies. The first chapter is devoted to the genetic of the Moya-Moya disease, a cerebral vascular disease quite common in Asia that is not yet sufficiently known.

The main topics covered are cerebral tumors, epilepsy and vascular malformations, congenital and acquired spine anomalies. The first chapter is devoted to the genetic of the Moya-Moya disease, a cerebral vascular disease quite common in Asia that is not yet sufficiently known.

In this book, internationally recognised experts provide an update on some important basic and technical aspects of neurosurgery. Intracranial tumours are the main focus of the book with chapters dealing with ependymomas, a tumour that still offers difficulties of interpretation in terms of both pathological features and management modalities, intraventricular tumours, which require particular attention in the choice of treatment modalities, and tumours considered typically paediatric that may still present in adulthood although with different aspects. Technical approaches to difficult anatomical areas are discussed in three chapters, dealing with the orbit, the craniocervical junction and the brainstem, respectively. Two rather didactic chapters, dealing with the minimally invasive technique for the spine and the clipping of cerebral aneurysms, are intended to contribute to the training of young neurosurgeons by illustrating the surgical steps in detail. The contribution of ultrasound to neurosurgery is illustrated in two chapters that should arouse great interest. The so-called Chiari malformations is approached in a chapter emphasising the role of cranio-cerebral disproportion in their pathogenesis. Finally, a chapter devoted to the ethical attitude that should characterise the daily practice of the neurosurgeon completes the book.Like the previous volumes in the series, this one represents an important contribution to the advancement of neurosurgical specialities.

In this book, internationally recognised experts provide an update on some important basic and technical aspects of neurosurgery. Intracranial tumours are the main focus of the book with chapters dealing with ependymomas, a tumour that still offers difficulties of interpretation in terms of both pathological features and management modalities, intraventricular tumours, which require particular attention in the choice of treatment modalities, and tumours considered typically paediatric that may still present in adulthood although with different aspects. Technical approaches to difficult anatomical areas are discussed in three chapters, dealing with the orbit, the craniocervical junction and the brainstem, respectively. Two rather didactic chapters, dealing with the minimally invasive technique for the spine and the clipping of cerebral aneurysms, are intended to contribute to the training of young neurosurgeons by illustrating the surgical steps in detail. The contribution of ultrasound to neurosurgery is illustrated in two chapters that should arouse great interest. The so-called Chiari malformations is approached in a chapter emphasising the role of cranio-cerebral disproportion in their pathogenesis. Finally, a chapter devoted to the ethical attitude that should characterise the daily practice of the neurosurgeon completes the book.Like the previous volumes in the series, this one represents an important contribution to the advancement of neurosurgical specialities.

This book presents a comprehensive update on some crucial aspects of brain and spinal tumoral pathology that strongly influence the  current surgical management. It covers a range of topics, from the latest results of molecular diagnosis for tumors still considered unsuitable for surgical excision, to the increasing use of minimally invasive approaches made possible by the wide application of neuroendoscopic techniques.The first three chapters discuss basic research on the potential benefits of new, less invasive and more sophisticated techniques for brain exploration. The following four chapters examine how modern instruments for intraoperative visualization are modifying the traditional paradigm of classical neurosurgery. Two chapters describe he recent understanding of two of the most relevant intracranial tumors that still pose challenges for successful treatment, namely the tumor of the pineal region and ependymomas. Two more chapters are devoted to the management of brain tumors, the first exploring the valuable information that can be derived from biopsy when properly carried out, and the second detailing an innovative therapeutic modality that increases the intratumoral level of antineoplastic agents while minimizing body toxicity and side effects. The book also delves into congenital or acquired malformations of the brain, the skull base, and the cranial vault in three of its remaining chapters. Finally, the last chapter addresses the traumatic pathology of the spine, whose etiology and management have changed significantly in recent years.

Written and edited by leading international authorities in the field, this book provides an in-depth review of knowledge of human hippocampus, and role of the hippocampus in memory, cognition and learning.It includes informative chapters organized into two main groups: (1), fundamental information about the human hippocampus, including history, development, neuroanatomy, neurophysiology, neuropathology, structural and synaptic plasticity, volume, 3D visualition of the human hippocampus and etc.; and (2) role of the hippocampus in memory, cognition and learning, including role of the hippocampus in cognition, time and memory, learning and etc.There are some unique features about this book: cross-references within chapters to highlight connections between development, anatomy, physiology, pathology, and surgery, real-world examples to illustrate key points and practical applications, summaries of the latest research to keep readers informed of cutting-edge developments.Thus, this comprehensive reference book will be an ideal source for neuroscientists at all levels, from graduate students to researchers in specific disciplines studying this region including neurosurgeons, neurologists, neuroradiologists, neuroanatomists and psychiatrists who seek both basic and more advanced information regarding the human hippocampus.

This volume maintains the structure of previous ATSN series volumes, offering a balanced distribution of chapters that cover recent advances in neurosurgery and reviews of major neurosurgical conditions.Key sections of the volume provide a detailed review of tumors, including those of the optic pathways, hypothalamus, and pituitary adenomas. These sections highlight the renewed interest in surgical options for these tumors, emphasizing multi-specialist treatment approaches. The initial chapters focus on the development of instruments and techniques that facilitate minimally invasive  approaches to various regions of the brain and cranio-vertebral junction.The volume also includes a chapter on colloid cysts of the third ventricle, which complements the discussion of surgical approaches for anterior skull base and frontal basal region pathologies. Other chapters are dedicated to cerebral arterial aneurysms and arteriovenous malformations, exploring the advantages of combined therapeutic strategies for safer and more effective management of these complex lesions.The final chapters investigate the benefits of complete excision of spinal lipomas versus partial resections and the more extensive excision of brain tissue harboring a glioblastoma (lobectomy) versus simple resection of the tumor and its infiltration into the surrounding brain parenchyma.Overall, the book is primarily aimed at mature and experienced neurosurgeons, but it is also beneficial for younger practitioners. It emphasizes a continuous reconsideration of well-known diseases in terms of new approaches that combine increased efficacy with decreased risk for the patient.

This book examines how modern diagnostic tools and technological innovations are transforming neurosurgical education and the surgical management of complex neurosurgical diseases. It offers a comprehensive overview of how these advances are reshaping the field, providing both theoretical insight and practical guidance for neurosurgeons and educators.The chapters address a wide spectrum of essential topics. Early sections explore evolving training methodologies, including the use of avatars and electronic simulation models that are redefining how neurosurgeons are taught. The book then analyzes the growing role of cerebrospinal fluid biomarkers in contemporary diagnosis, discussing their current applications and future potential. Three chapters focus on vascular neurosurgery, highlighting the influence of advanced surgical theater designs and modern instrumentation on clinical practice. Additional chapters examine innovative strategies for treating tumors in challenging regions such as the brainstem and pineal area.Functional neurosurgery is also a key area of focus, with discussions on cranial nerve dysfunction and movement disorders associated with spasticity. The volume concludes with a timely exploration of blast-related injuries in war zones—an emerging field that presents both novel challenges and opportunities for neurosurgeons.This book serves as an essential resource for neurosurgeons, medical educators, and researchers seeking to understand the latest advancements in neurosurgical practice. It is equally valuable for students and professionals in related disciplines who wish to deepen their knowledge of current trends in neurosurgical care and training.

Neurocutaneous diseases are a wide group of conditions that affect the nervous system but appear as lesions of the skin. Some of the more common entities have variable forms of expression that can confuse the diagnosis; for the rare conditions it is difficult to find descriptions in the literature. Recent insights into their cellular, biochemical and molecular genetic bases have shown the essential need for a new nosology and updated genotype-phenotype correlations. The book provides an authoritative source of knowledge about these difficult problems and bridges the gap between clinical recognition and the new molecular medicine. The editors, distinguished clinicians and geneticists, assembled an internationally renowned group of collaborators, many of them the experts who first described a particular disorder or established its present accepted definition. They have written a practical, comprehensive guide to the recognition, investigation and management of more than 60 recognised phakomatoses.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR.KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...72 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR.KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties.Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace.Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...72 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

Pediatric Craniovertebral Junction Diseases

Written and edited by leading international authorities in the field, this book provides an in-depth review of knowledge of complications of CSF shunting, with emphasis on prevention, identification, and management. It covers the full range of shunt-related complications and the various associated adverse consequences that remain common despite significant improvements in imaging techniques and therapeutic methods. The chapters are organized into two parts: complications of extrathecal CSF shunt devices and complications of endoscopy. In addition to providing clinicians and investigators with the most pertinent current evidence, the book looks forward to future areas of hydrocephalus research and to innovative therapeutic philosophies. This comprehensive reference book will be an ideal source for neurosurgeons seeking both basic and more sophisticated information and procedures relating to the complications associated with CSF shunting.

​This dedicated volume in the series Advances and Technical Standards in Neurosurgery (ATSN) provides a comprehensive approach to diseases of the craniovertebral junction (CVJ) and their management based on the multidisciplinary cooperation of neurosurgeons, anatomists, neuroradiologists, and neuroanesthesiologists. The contributing authors represent the most renowned clinical and surgical experts from Europe and beyond. The main topics highlighted are embryology, normal and abnormal development of the CVJ, including the related vessels, modern radiological contributions to diagnosis, genetic and metabolic factors which may impact on the surgical strategies, the opportunities offered by traditional operative techniques, and the recently introduced minimally invasive and endoscopic surgical modalities. Special emphasis is also placed on the evolution of the principles of surgical treatment as matured during the past decade by experiences in the still open field of pediatric neurosurgery.

Written and edited by leading international authorities in the field, this book provides an in-depth review of knowledge of complications of CSF shunting, with emphasis on prevention, identification, and management. It covers the full range of shunt-related complications and the various associated adverse consequences that remain common despite significant improvements in imaging techniques and therapeutic methods. The chapters are organized into two parts: complications of extrathecal CSF shunt devices and complications of endoscopy. In addition to providing clinicians and investigators with the most pertinent current evidence, the book looks forward to future areas of hydrocephalus research and to innovative therapeutic philosophies. This comprehensive reference book will be an ideal source for neurosurgeons seeking both basic and more sophisticated information and procedures relating to the complications associated with CSF shunting.

This book documents the state of the art in pediatric neurosurgery with the intention of providing a comprehensive guide to the management of the full range of pediatric neurosurgical disorders that will aid in the delivery of optimal care.

A better understanding of specific neurosurgical problems will help practicing neurosurgeons provide better medical care for their patients, and will also provide the neurosurgery resident with a reliable European standard for step-by-step management of neurosurgical problems, which will prove useful when preparing for the board examination.

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN,  J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GUÉNOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE,  M. SINDOU).- Child abuse – some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS,  E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

AdvancesJ. Maarrawi, P. Mertens, R. Peyron, L. Garcia-Larrea, M. Sindou: Functional exploration for neuropathic pain. - Z. H. Rappaport: The neuroscientific foundations of free will. - A. Hejcl, P. Jendelova, E. Sykova: Experimental reconstruction of the injured spinal cord. - M. Visocchi: Advances in video-assisted anterior surgical approach to the craniovertebral junction. Technical StandardsN. Akalan: Myelomeningocele (Open spina bifida): Surgical management. - M. Stoffel, C. Stüer, F. Ringel, B. Meyer: Treatment of infections of the spine. - I. Massimi, F. Novegno, C. di Rocco: Chiari Type 1 malformation in children.