Yves Keravel – författare

The first aneurysms explored by such pioneers of neurosurgery as Cushing and Dandy were the giant intracranial aneurysms. These giant aneurysms present many therapeutic difficulties and, because of their unique anatomical features and size, may present in a multitude of ways. With the advent of specialized imaging techniques such as computed tomography (CT), mag- netic resonance imaging (MRI) and selective angiography, preoperative diag- nosis today is most often accomplished without difficulty. However, com- pletely thrombosed giant aneurysms may mimic other lesions with mass effect (such as basilar meningiomas, chordomas or chondromas) and their true anatomical shapes and relations to other cranial structures can only be ascer- tained by direct operative inspection. Due to their morphological features (thrombosed, nonthrombosed, par- tially thrombosed, fusiform), anatomical variations and difficult locations, giant aneurysms present new challenges for the modern neurosurgeon.Al- though microsurgical techniques have rendered direct surgical treatment of giant intracranial aneurysms safer, elimination of the aneurysm without dis- turbing the hemodynamics continues to be problematic. Some of these lesions have relatively small necks and can therefore be clipped fairly easily. Others have large necks, are fusiform, or contain perforators; how best to treat these lesions is a question still unresolved by presentday neurosurgery.

"Spasticity is one of the commonest sequelae of neurological disease and during the last few years many advances have been made in the treatment of this complaint by functional neurosurgery. This book ... will appeal to neurosurgeons, orthopaedic surgeons and neurologists amongst others.” Annals of the Royal College of Surgeons of England

Idiopathic Hemifacial Spasm constitutes a severe disability both from a cosmetic and psychological point of view and functionally for the daily life. Until recently this peculiar disease had remained enigmatous and was resistant to any kinds of treatments. Over the last two decades important advances have been made in the comprehension of its mechanisms and the efficacy of its treatment. Botulinic toxin revealed to be helpful although its effects are most often transient. Microvascular decompression – suppressing the neuro-vascular conflict almost constantly found at the root exit zone of the facial nerve from the brain stem – has been recognized as the curative treatment of this disease.A wide range of specialists, namely neurologists, ophthalmologists, ENT-surgeons, clinical neurophysiologists, neuroradiologists and of course neurosurgeons are involved in the diagnosis and the management of Hemifacial Spasm and will be interested in this multidisciplinary review of the topic.