Advances and Technical Standards in Neurosurgery, Volume 33
Advances and Technical Standards in Neurosurgery is a periodical of the European Association of Neurosurgical Societies. It is intended for postgraduate education of young neurosurgeons. Its founders have been Bernard Pertuiset, Fritz Loew and Hugo Krayenbuhl. The goal of this periodical is to acquaint the neurosurgical community with the latest achievements in neurosurgery and adjacent specialties and to present detailed description of conventional neurosurgical interventions, written by experienced clinicians.
Volume 33 is devoted to general problems of neurosurgery and specific aspects of surgical anatomy and technique.
The opening article of the section Advances has been written by H. Duffau from the Montpelier University hospital and is entitled Brain Plasticity and Tumors. Plasticity is brain ability to change during the process of ontogenesis and training or under conditions of its damage. The first part of the article reviews pathophysiologic mechanisms of plasticity, typical of different levels of functional organization. Reorganization patterns can differ depending on a tempo of brain lesion. The best functional compensation is watched in slow-growing tumors. The second part includes the analysis of relationships between a tumor growth and a change of the brain, carried out with applying both noninvasive imaging modalities and invasive methods of electrophysiologic functional mapping. Finally, new views on brain plasticity and their effect on surgical tactics are analyzed. An individual capacity for CNS reorganization should be estimated and taken into consideration during planning an intervention for tumor removal, and elaborating a rehabilitation program, as it helps to preserve life quality.
Tumor Biology and Current Treatment of Scull-Base Chordomas is the second article of the section, written by M.N. Pamir and K. Ozduman from the Istanbul University. It deals with diagnosis, differentiation and surgical treatment of skull base chordomas in detail. The article is well-illustrated. Preoperative differential diagnosis of tumor types and an effect of peculiar biology of neoplasm on its recurrence are discussed. The article has a systemic character and, thus, may be considered to be a manual on this problem of neurooncology.
The Influence of Genetics on Intracranial Aneurysm Formation and Rupture: Current Knowledge and Its Possible Impact on Future Treatment has been written by B. Krischek and M. Tatagiba from the Tubingen University (Germany). It is devoted to a genotype effect on appearance and rupture of intracranial aneurysms and describes problems of genetic analysis, carried out with the purpose of revealing gene alleles, which predetermine these phenomena. The acquired knowledge can serve the basis for future development of screening and gene therapy modalities.
The section Technical Standards begins with the article, written by Italian neurosurgeons from Naples and entitled Extended Endoscopic Endonasal Approach to the Midline Skull Base: The Involving Role of Transsphenoidal Surgery. Development of endoscopic transnasal transsphenoidal approach, used earlier only in surgical treatment of intrasellar pathology, has resulted in its application for reaching a skull base. Visualization of supra-, retro- and parasellar regions, absence of brain traction make it possible to treat different pathologic processes of the skull base, having been an object of intracranial interventions some time ago. The article contains a review of endoscopic anatomy of the midline skull base; description of operation stages, aimed at opening of different compartments, dangerous anatomic landmarks and methods of reconstruction of dura and bone structures. The authors consider their own experience of using extended interventions for treatment of 33 cases with sellar tumors, which proves efficacy and relative safety of this approach.
Management of Brachial Plexus Injuries has been written by G. Blaauw et al. from Netherlands. Its peculiar feature is a detailed overview of generic traction trauma of the brachial plexus in newborns, which is considered separately from non-obstetric injuries. The authors analyze anatomy, a clinical picture and diagnosis of such injuries in detail and present treatment algorithms with a special emphasis on early surgical management.
Surgical Anatomy of the Jugular Foramen by P.-H. Roche et al. from the Universities of Marseilles and Angers (France) describes surgical anatomy with taking into account topographic peculiarities of main microsurgical approaches to this region. One can get acquainted with classical topographic anatomy of the foramen and peripetrous structures. Besides, it is considered from the point of view of main surgical approaches with a detailed and step-by-step comment on preparation technique.
Summarizing the aforesaid, it should be noted, that volume 33 of Advances and Technical Standards in Neurosurgery contains rather interesting information on urgent problems of up-to-date neurosurgery, useful for those, studying neurosurgery and practicing it. It meets all the goals of educational literature and can be recommended for training neurosurgeons-residents.