Marc Sindou

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbiihl. Thus were established the principles of European co­ operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. 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 publi­ cation 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.

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.

The book, in its second edition, is devoted to the neurosurgical management of spasticity and focal dystonia. Starting with a chapter on the anatomical and physiological bases of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen therapy (ITB), Botulinum toxin therapy and Surgery. The large spectrum of scales for assessing hypertonia, spasticity, dystonia, contracture and joint/bone deformities, as well as the scoring systems for quantifying functional abilities are critically reviewed. Beyond ITB, the neurosurgical options covered include the microsurgical procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord, and their intra-operative monitoring. In this second edition, the orthopedic surgical interventions available will take a large place, either as alternative solutions , or even better as important complements after spasticity be solved by the neurosurgical treatments. Based on surgical experience collected with more than a thousand and eight-hundred patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaborations with other surgical disciplines like orthopedic surgery and neuro-urology are outlined.

This book is focused on trigeminal neuralgias and their management, a field in which, during the two past decades, there were numerous advances in comprehension of mechanisms of the disease and diagnosis with imaging, as well as in medical therapies and in surgical treatment. The authors are well-known specialists for this treatment and summarize their long experience in this comprehensive and practical book. They are experts not only on the surgical treatment of trigeminal neuralgia with the micro-vascular decompression procedure but also with the lesioning procedures. In this pictorial guide, readers can find the pathways for diagnosis, and practical guidelines to help decision-making among the most appropriate treatments, tailored on to every patient’s need. Neurologists, neurosurgeons, and dentists, but also ENT specialists, ophthalmologists, and maxillofacial specialists, would find an invaluable support in this book devoted to a rather frequent problem to deal with.

The book, in its second edition, is devoted to the neurosurgical management of spasticity and focal dystonia. Starting with a chapter on the anatomical and physiological bases of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen therapy (ITB), Botulinum toxin therapy and Surgery. The large spectrum of scales for assessing hypertonia, spasticity, dystonia, contracture and joint/bone deformities, as well as the scoring systems for quantifying functional abilities are critically reviewed. Beyond ITB, the neurosurgical options covered include the microsurgical procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord, and their intra-operative monitoring. In this second edition, the orthopedic surgical interventions available will take a large place, either as alternative solutions , or even better as important complements after spasticity be solved by the neurosurgical treatments. Based on surgical experience collected with more than a thousand and eight-hundred patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaborations with other surgical disciplines like orthopedic surgery and neuro-urology are outlined.

The book is devoted to the neurosurgical management of spasticity. Starting with a chapter on the anatomical and physiological foundations of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen Therapy (ITB), botulinum toxin therapy and surgery. Beyond ITB, the neurosurgical options covered include procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord. Based on surgical experience collected with more than a thousand patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaboration with other surgical disciplines like orthopedic surgery and neuro-urology are also outlined.

The book is devoted to the neurosurgical management of spasticity. Starting with a chapter on the anatomical and physiological foundations of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen Therapy (ITB), botulinum toxin therapy and surgery. Beyond ITB, the neurosurgical options covered include procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord. Based on surgical experience collected with more than a thousand patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaboration with other surgical disciplines like orthopedic surgery and neuro-urology are also outlined.