S. Wende – författare

This book represents the second, fully revised edition of the original volume published in 1982. Experience in neuroradiology has confirmed the outstanding value of computed tomography (CT) for the diagnosis of space-occupying lesions within the skull and orbit. It might be assumed, then, that the second edition of this book would simply represent a numerically expanded continua­ tion of the popular first edition. That is not the case, however. Advances in imaging techniques have promp­ ted the creation of a new book whose expanded title reflects its more comprehen­ sive nature. The added illustrations, the revised text, and the expanded circle of editors and contributors document this. Since publication of the first edition, a new modality, magnetic resonance imaging (MRI), has become an established neuroradiologic study. We felt it was essential to include this new modality in our book and explore its capabilities as an adjunct or alternative to CT scanning. Because of the high acquisition costs of MRI and the still small number of MR units currently in operation, we have relied in part on images furnished by other institutions and private practitioners, to whom we are indebted. Many problems relating to MR, both in terms of equipment and image interpretation, have yet to be resolved. There is no denying that we still have much to learn.

This book represents the second, fully revised edition of the original volume published in 1982. Experience in neuroradiology has confirmed the outstanding value of computed tomography (CT) for the diagnosis of space-occupying lesions within the skull and orbit. It might be assumed, then, that the second edition of this book would simply represent a numerically expanded continua­ tion of the popular first edition. That is not the case, however. Advances in imaging techniques have promp­ ted the creation of a new book whose expanded title reflects its more comprehen­ sive nature. The added illustrations, the revised text, and the expanded circle of editors and contributors document this. Since publication of the first edition, a new modality, magnetic resonance imaging (MRI), has become an established neuroradiologic study. We felt it was essential to include this new modality in our book and explore its capabilities as an adjunct or alternative to CT scanning. Because of the high acquisition costs of MRI and the still small number of MR units currently in operation, we have relied in part on images furnished by other institutions and private practitioners, to whom we are indebted. Many problems relating to MR, both in terms of equipment and image interpretation, have yet to be resolved. There is no denying that we still have much to learn.

Contents: Intracranial Pressure and Mass Displacements of the Intracranial Contents. - Special Neuropathology - Morphology and Biology of the Space-Occupying and Atrophic Processes with Their Related Neuroradiological Changes of Diagnostic Significance. - Cerebral Angiography. - Pneumoencephalography. - Myelography. - Spinal Angiography. - Discography. - Ossovenography and Epidural Venography. - References. - Subject Index.

The current book represents a distillation of the experience gained in diagnosis of intracranial tumors with computed X-ray tomography at the University Hos­ pitals of Berlin, Mainz, and Miinchen. To what purpose? Standard radiological techniques such as pneumoencephalography with lumbar puncture and cerebral arteriography with puncture of the common carotid artery are invasive proce­ dures which entail a certain amount of risk as well as discomfort for the patient. Furthermore, diagnoses made with these procedures rely primarily on indirect signs of an intracranial space-occupying lesion - such as displacement of the air-filled ventricles or of normal cerebral vessels. Only a few types of tumor are demonstrated directly with these techniques. In contrast, computed tomography demonstrates the pathology directly in almost all cases, and this with a minimum of risk and discomfort. In addition, normal intracranial structures are demonstrated, so that the tumor''s effect on its surroundings can be evaluated. Today, almost a decade after HOUNSFIELD''S revolutionary invention, diagno­ sis of brain tumors without computed tomography is almost unthinkable, if not in fact irresponsible.

The current book represents a distillation of the experience gained in diagnosis of intracranial tumors with computed X-ray tomography at the University Hos­ pitals of Berlin, Mainz, and Miinchen. To what purpose? Standard radiological techniques such as pneumoencephalography with lumbar puncture and cerebral arteriography with puncture of the common carotid artery are invasive proce­ dures which entail a certain amount of risk as well as discomfort for the patient. Furthermore, diagnoses made with these procedures rely primarily on indirect signs of an intracranial space-occupying lesion - such as displacement of the air-filled ventricles or of normal cerebral vessels. Only a few types of tumor are demonstrated directly with these techniques. In contrast, computed tomography demonstrates the pathology directly in almost all cases, and this with a minimum of risk and discomfort. In addition, normal intracranial structures are demonstrated, so that the tumor's effect on its surroundings can be evaluated. Today, almost a decade after HOUNSFIELD'S revolutionary invention, diagno­ sis of brain tumors without computed tomography is almost unthinkable, if not in fact irresponsible.

Die erste Auflage dieses Buches hat sich einen Platz bei den Ärzten erworben, die das neuroradiologisch gewonnene Bild bei Hirnkrankheiten nicht nur mit seinen Abweichungen erfassen und beschreiben, sondern auch seine Genese verstehen wollten. Diese Form der Darstellung hatte im In-und Ausland viele Freunde gefunden und zahlreiche Schemata sind inzwischen in Lehr-und Hand­ bücher übernommen worden. Jedoch ist die erste Auflage im Laufe der Zeit durch die rasche Weiterentwicklung der Neuroradiologie überholt. Die Verfas­ ser, die noch selbst als Kliniker neuroradiologisch gearbeitet hatten, mußten dieser Entwicklung Rechnung tragen. Es wurden zwei hauptberuflich arbeitende Neuroradiologen zur Erweiterung und Überarbeitung der Themen hinzuge­ beten. Einige Kapitel, wie die Hirnpunktion und der Farbversuch, haben in­ zwischen ihre Bedeutung verloren und wurden fortgelassen. Die Szintigraphie, die Hirndurchblutungsmessung und die in der Entwicklung begriffene Computer­ Tomographie wurden nicht abgehandelt, da sie außerhalb des hier gesteckten Rahmens der neuroradiologischen Diagnostik liegen. Trotz mancher Anregun­ gen wurde auch weiter bewußt auf die Besprechung des Nativbildes von Schädel und Wirbelsäule verzichtet, sie hätten den Rahmen dieser Bearbeitung gesprengt. Andererseits mußte die Myelographie und die neu entstandene radiologische Pathologie der cerebrovaskulären Störungen mitberücksichtigt werden. Die übrigen Kapitel wurden dem heutigen Stand angepaßt. Die Bilder wurden großenteils erneuert. Doch hat sich an der Grundlinie der Darstellung nichts geändert. Das Buch soll auch in seiner vorliegenden Form eine Einführung in die Besonderheiten der neuroradiologischen Diagnostik intrakranialer und spinaler Erkrankungen sein, die dieErgebnisse auch dem Kliniker verständlich machen können.