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Advances and Technical Standards in Neurosurgery

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the Euro- pean Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. 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. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their postgraduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons.
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Table of Contents

A. Advances.- The Overdrained Hydrocephalus. Clinical Manifestations and Management.- I. Introduction.- II. Theoretical Considerations.- III. Clinical Manifestations.- 1. Acute Decompression.- 2. Microcrania, Craniostenosis.- 3. Slit Ventricles.- 4. Intolerance of CSF Pressure Elevation, Shunt Dependency.- 5. Subdural Haematoma.- 6. Low Pressure Headaches.- IV. Management of Overdrainage Symptoms.- V. Prevention of Overdrainage.- 1. The Role of Valvular Closing Pressure in the Origin of Overdrainage.- 2. Specially Designed Valves and Devices for Preventing Post-Shunt Overdrainage.- VI. Future Perspectives.- VII. Conclusions.- References.- Intravascular Occlusion of Saccular Aneurysms of the Cerebral Arteries by Means of a Detachable Balloon Catheter.- I. Introduction.- II. Making and Construction of the Detachable Balloon Catheter.- III. Detachable Balloon Catheter Technique in Saccular Aneurysms of the Cerebral Arteries.- IV. Material and Methods.- V. Indication for Surgery.- VI. Preoperative Care and the Operation.- 1. Preoperative Care.- 2. The Operation.- 2.1. Introduction of Balloon Catheters into the Aneurysm.- 2.2. Temporary and Permanent Occlusion of Aneurysms by Means of the Detachable Balloon Catheter.- 2.3. Complications.- VII. Results of Intravascular Operations for Saccular Aneurysms of the Cerebral Arteries.- Conclusion.- Acknowledgements.- References.- Advances in Computerized Tomography.- 1. Examination Techniques.- 2. Cerebral CT.- 2.1. Differential Diagnosis Concerning Diffuse Hypodense Changes in the Parenchyma.- 2.2. Orbital Processes.- 2.3. Sellar Processes.- 2.4. Processes in the Petrous Portion of the Temporal Bone and the Cerebellopontine Angle Area.- 2.5. Blood-Vessel Malformations.- 3. Body-CT.- 3.1. Spinal Processes.- 3.2. Neurogenic and Myopathie Muscle Atrophy.- References.- B.Technical Standards.- Surgical Approaches to the Tentorial Hiatus.- Pre-operative Management.- General.- Antibiotic Cover.- Anaesthesia.- The Use of c.s.f. Drainage.- The Anterior Temporal Approach.- The Extended Anterior Temporal Approach with Anterior Temporal Lobectomy.- The Subtemporal Approach to the Tentorial Hiatus.- The Combined Supra-and Infratentorial Approach to the Lateral Aspect of the Tentorial Hiatus.- Essential Preliminary Investigations.- Positioning the Patient.- The Incision.- Opening the Dura.- Closure.- The Posterior Tentorial Hiatus.- The Occipital Approach to the Posterior Part of the Tentorial Hiatus - the Preferred Approach to the Pineal Region.- Positioning the Patient.- The Incision.- Closure.- The Subtentorial Approach to the Tentorial Hiatus.- Acknowledgements.- References.- Management of Chronic Subdural Haematomas and Hygromas.- Aetiology and Physiopathology.- Clinical Symptoms.- Diagnostic Procedures.- Treatment.- Conservative Treatment.- Operative Treatment.- Technique of Burr Hole Evacuation.- Peritoneal Drainage of Subdural Hygromas.- Haematoma Capsule Resection by Formal Craniotomy.- Technique of Operative Reduction of Skull Size.- Complications.- Results.- In Children.- In Adults.- Summary.- References.- Subdural Empyema.- Historical.- Cases in Present Study.- Incidence.- Etiology.- Traumatic.- As a Complication of Surgery.- As a Complication of Trauma.- Spontaneous.- As a Complication of Meningitis.- As a Complication of Paranasal Sinusitis.- As a Complication of Ear Disease.- Haematogenous Disease.- Method of Spread.- Presentation.- Diagnosis.- Transmission Computerised Axial Tomography.- Skull Radiographs and Angiography.- Radio-Nuclide Scanning.- Electroencephalography.- Differential Diagnosis.- Pre-Operative Management.- Airway.- Bacteriology and Antibiotics.- Fits.- Radiography and Anaesthesia.- Operations.- Exposure.- Exploratory.- Unilateral.- Bilateral.- Posterior fossa.- Dealing with the Empyema.- Second Craniotomies.- Surgery of Associated Lesions.- Otitic and Sinus Disease.- Osteomyelitis.- Epidural Abscess.- Cranioplasty.- Post-Operative Management.- Complications.- Necropsy Findings.- Mortality.- Morbidity.- Neurological Deficits.- Epilepsy.- Discussion.- Conclusions.- Acknowledgements.- References.- Author Index.

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