Main description:

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 European 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 post graduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons.

Contents:

A. Advances.- Is There any Future for Robots in Neurosurgery?.- I. Introduction.- II. Robotics in Medicine and Neurosurgery: History and General Principles.- II.1. History of the Robotics Concept in Medicine.- II.2. General Principles of a Neurosurgical Robotized Set-up.- A. Stereotactic Frames.- B. X-ray Systems.- III. State of the Art of Medical Robotics.- III.1. Robots in Neurosurgery.- A. Stereotactic Robots.- A.1. The K woh-Young (Long Beach) System.- A.2. The Grenoble Stereotactic Robot System.- 1. Description of the System.- 2. Data Acquisition.- a) Calibration.- b) Projective Neuroradiology.- c) CT-scan.- d) MRI.- 3. General Procedure.- 4. Clinical Applications.- a) Tumour Biopsies (141 cases).- b) Stereo-electro-encephalographic (SEEG) Investigations of Epileptic Patients (14 cases).- c) Brachytherapy (5 cases).- d) Midline Stereotactic Neurosurgery.- e) Operative Complications.- 5. Perspectives.- a) Short Term Perspectives.- b) Middle Term Perspectives.- A.3. The Lausanne System.- B. Stereotactically Guided Open-field Surgical Robots.- B.1. The Mayo Clinic System.- B.2. The Grenoble-Paris-Rennes Robotized Microscope.- C. Positioning Robots.- C.1. The "Neuronavigator".- C.2. The Retractor Robot.- III.2. Robots in Other Medical Fields.- A. Ophthalmology.- B. Robot Assisted Nursing Care.- IV. Future Applications and Science-fiction.- IV.1. Open Surgery.- IV.2 Flexible Robots.- IV.3 Sensor Guided Robots.- V. Discussion and Conclusion.- References.- Aspects of the Medical Management in Aneurysmal Subarachnoid Hemorrhage.- Prevention of Rebleeding.- I. Drug Administration.- II. Results of the Treatment.- III. Complication s of the Treatment.- IV. Conclusion.- Prevention and Treatment of Cardiac Arrhythmias.- I. Incidence.- II. Description.- III. Etiology.- IV. Prevention or Treatment.- Prevention and Treatment of Hyponatremia.- I. Signs and Symptoms.- II. Etiology.- III. Treatment.- Prevention of Seizures and Epilepsy.- I. Early Seizures.- II. Late Epilepsy.- Prevention of Cerebral Arterial Vasospasm.- I. Correction of Hypovolemia.- II. Calcium Antagonists.- A. Pharmacology.- B. Nimodipine.- 1. Uncontrolled Prospective Studies.- a) Uncontrolled Single Centre Studies.- b) Uncontrolled Multicentre Studies.- 2. Placebo-Controlled Randomized Studies.- a) Controlled Single Centre Studies.- b) Controlled Multicentre Studies.- 3. Discussion.- C. Nicardipine.- D. Other Calcium Antagonists.- 1. Diltiazem.- 2. Flunarizine.- III. Other Drugs.- A. Nizofenone.- B. Reserpine + Kanamycin.- C. Anti -Thromboxane A2 Synthetase.- D. Heparin.- E. Dipyridamole.- F. Ticlopidine.- Treatment of Symptomatic Vasospasm.- I. Hypervolemia and Hypertension.- A. Hypervolemia.- B. Hypertensive Hypervolemia.- 1. Vasopressive Drugs.- 2. Hypervolemia and Dopamine.- 3. Hypertensive Hypervolemia.- 4. Hypertension + Hypervolemia + Hemodilution.- II. Vasoactive Drugs.- A. Isoproterenol + Lidocaine.- B. Isoproterenol + Aminophylline.- C. Aminophylline + Nitroprusside + Dopamine.- D. Nimodipine.- III. Naloxone.- IV. Barbiturates.- V. Steroids.- A. Hydrocortisone in Large Doses.- B. Dexamethasone, Betamethasone, Methylprednisolone.- Conclusions.- References.- B. Technical Standards.- Unilateral Partial Hemilaminectomy for the Removal of Extra- and Intramedullary Tumours and AVMS..- Osteoplastic Laminectomy.- Unilateral (Partial) Hemilaminectomy.- Clinical Material.- Operative Technique.- Discussion.- References.- Organization of the Primary Transportation of Head Injuries and Other Emergencies in the Federal Republic of Germany.- Advancesin Drug Delivery Systems and Applications in Neurosurgery..- 1. Implantable Drug Delivery Systems.- 1.1 Access Ports.- 1.2 Implantable Pumps.- 1.2.1 Pulsatile Pumps.- 1.2.2 Continuous Flow Pumps.- 1.2.3 Programmable Pumps.- 2. Implantation Techniques.- 2.1 Catheter Placement.- 2.2 Implantation of a Drug Administration System.- 3. Current Clinical Applications.- 3.1 Intrathecal Spinal and/or Intra-cerebro-ventricular Morphine in Intractable Cancer Pain.- 3.1.1 Neurobiological Basis.- 3.1.2 Selection Criteria.- 3.1.3 Intrathecal Administration of Opiates via the Lumbar Route.- Patients.- Implantation Technique.- Results.- Side Effects of Morphine.- Discussion.- 3.1.4 Intra-(cerebral)-ventricular Morphinotherapy.- Patients.- Administration Technique and Morphine Titration.- Results.- Discussion.- 3.1.5 Conclusion - Perspectives.- 3.2 Iritrathecal Baclofen for Control of Severe Spasticity.- 3.2.1 Neurochemical and Pharmacokinetic Basis.- 3.2.2 Patient Selection Criteria.- 3.2.3 Implantation for Chronic Intrathecal Administration, Titration and Out-patient Follow-up.- 3.2.4 Clinical Results.- 3.2.4.1 Administration ofa Single Intrathecal Bolus of Baclofen.- 3.2.4.2 Results After Chronic Administration.- 3.2.4.3 Complications.- Infections and Neurological Complications.- Pharmacological Complications.- Acquired Tolerance.- 3.2.5 Discussion.- 3.2.5.1 Inter-individual Differences in Dose.- 3.2.5.2. Influence of Etiology on Functional Improvement.- 3.2.5.3 Pharmacological Complications and Risks.- 3.2.5.4 Alternatives to Intrathecal Baclofen.- 3.2.6 Conclusion.- 4. Other Clinical Applications and Perspectives.- 4.1 Intracarotid and Direct Intratumoural Chemotherapy for Malignant Glioma.- 4.1.1 The Rationale.- 4.1.2 Local or Regional Intracarotid Chemotherapy.- 4.1.3 Direct Intra-tumoural Chemotherapy.- 4.2 Intraventricular Cholinergic Drug Infusion for Alzheimer's Disease.- 4.3 Intrathecal Infusion of TRH in Amyotrophic Lateral Sclerosis.- 4.4 Perspectives.- Conclusion.- References.