Giovanni Broggi – författare

The proceedings of the 12th Congress of the European Society for Stereotactic and Functional Neurosurgery in Milan contain selected contributions on surgery of Parkinson's disease, pain, psychosurgery, epilepsy, frameless stereotaxy, functional imaging, gene therapy and radiosurgery. The selection reflects the current status and progress in the field. The book is an update of the current methods and controversies and should serve those specialized in the field as a source of information and judgement. The foreword by Jens Haase unifies the views of both stereotactic and general neurosurgeons with great enthusiasm.

Craniopharyngioma represents a major challenge for neurosurgeons, paediatricians, and endocrinologists. This so-called benign tumour is a real threat to quality of life and life itself. This book discusses the various therapeutic strategies and suggests multimodal treatment approaches, including microsurgery, stereotaxis, and alternative treatments. The rationale for choice of therapy is supported by biological, clinical, and neuroradiological data. Therapeutic results of a large series of case studies from all over the world are reported. Finally, guidelines for further development and new topics for research and treatment are offered.

Technological improvements in neurosurgery are disussed. The use of surgical lasers, ultrasound aspirators, bipolar coagulator and operative microscopes for surgery of deep-seated neoplasms and vascular malformations is discussed. Intraoperative monitoring, chronotherapy, chronic neurostimulation and stereotactic interstitial irradiation are covered and indications for interventional neuroradiology are reviewed.

Neurosurgery o/the Future: Computers and Robots in Clinical Neurosurgical Practice and in Training - a Philosophical Journey into the Future Many present day neurosurgeons believe that they already obtain good results in operative surgery with the benefit of the operating microscope and other aids which have become available in the last three decades and that the introduction of computers and robots to the operating theatre is superfluous. However, it is clear from analogy with the function of the airline pilot, another profession where there are great demands on manual skill and on spatial awareness, that these devices do have much to offer neurosurgery. Classical neurosurgery, in the time of Cushing, Dandy and Scarff, was based on a three dimensional picture of the patient's brain formed in the surgeon's mind and often illustrated in elegant drawings. Such pictures were based on neuroradiological studies by pneumoencephalography, ventriculography or by angiography. Generally these stud­ ies showed the presence and position of a lesion by displacement of normal brain structures and the picture was built up by interference. This was then converted by the experienced neurosurgeon into a plan for the craniotomy site and the trajectory of the surgical approach. Once the brain was exposed further pre-operative information was obtained by visual inspection and by palpation with the brain needle. These classical forms ofneuroradiology have largely been superseded by computerised tomography and by magnetic resonance imaging.

The last ten years has witnessed a resurgence of interest in stereotactic surgery although this has been mainly in the field of the comparatively simple stereotactic biopsy of intracranial tumours. There is also evidence of a returning interest in functional neurosurgery other than pain which has always sustained high levels of endeavour. The present work comprises selected papers from a much larger group of interesting and important communications to the European Society for Stereotactic and Functional Neurosurgery. They represent modern views on a wide variety of stereotactic surgical topics from internationally acclaimed experts in this field. The neurosurgeon who has little or no acquaintance with this fruitful sub-specialty will be surprised to find very broad applications of the technique which is gradually replacing many con­ ventional neurosurgical procedures. This is particularly evident in the papers on tumours but there is also a section on the treatment of vascular disease which marks an extension of neurosurgical practice. The Society has always regarded technical advances as important and some of the most recent devel­ opments appear in this book. Finally, an exciting new development of neural transplantation marks the beginning of what may be an important part of neurological surgery in the future.

The book gives the most up-to-date information for the expanding field of stereotactic and functional neurosurgery from European and international experts.