Full Description
Various textbooks on stereotactic neurosurgery have been published during the last few years (Riechert 1980, Schaltenbrand and Walker 1982, Spiegel 1982), all of them dealing with functional stereo tactics as the major subject in the field. Diagnostic and therapeutic stereotactic interventions are only briefly described, whereas localization techniques are not yet mentioned. Since 1980, however, an increasing number of reports has been published on CT guided and computer monitored stereotactic performances which enable the surgeon to combine diagnostic and therapeutic efforts in one session. With recent progress in scanning techniques, including high resolution CT, NMR, and PET imaging of the brain, it has become possible to study and localize any brain area of interest. With the concomitant advances in computer technology, 3-dimensional reconstruction of deep seated lesions in stereotactic space is possible and the way is open for combined surgery with stereotactic precision and computer guided open resection. This type of open surgery in stereotactic space is already being developed in some centers with the aid of microsurgical, fiberoptic, and laser beam instrumentation. With these advances stereotactic techniques will rapidly become in tegrated into clinical neurosurgery. Stereotactics has become a metho dology which enables the surgeon to attack deep seated and subcortical small tumors. Neurosurgeons may abandon therapeutic nihilism, still frequently seen in glioma treatment, in the near future when stereotactic resection will be feasible and remaining tumor cells may be killed by adjuvant treatment modalities still in development.
Contents
1: Introduction.- I. Stereotaxy in Experimental Brain Research.- II. Stereotaxy in Man.- III. Stereotactic Methodology.- IV. Integration of Stereotactics in Clinical Neurosurgery.- 2: Stereotactic Principles.- I. Development.- II. Definition.- III. Stereotactic Atlasses.- IV. Invisible and Visible Targets.- V. Preparation of the Stereotactic Intervention.- 3: Expanding Field of Stereotactic Surgery.- I. Functional Stereotactics.- II. Mass Lesions Stereotactics.- III. Localizing Stereotactics and Open Surgery.- 4: Modern Instrumentation.- I. Introduction.- II. CT Guided Stereotactic Apparatus; Technical Aspects.- III. CT Guided Stereotactic Surgery.- 5: Indications for Stereotactic Interventions.- I. Indications for Functional Stereotactic Interventions.- II. Indications for Diagnostic Stereotactic Interventions.- III. Indications for Therapeutic Stereotactic Interventions.- IV. Indications for Localizing Stereotactic Interventions.- 6: Contraindications for Stereotactic Interventions.-I. Contraindications for Functional Stereotactic Interventions.- II. Contraindications for Diagnostic Stereotactic Interventions.- III. Contraindications for Therapeutic Stereotactic Interventions.- IV. Contraindications for Localizing and Interventional Stereotactics.- 7: Stereotactic Techniques.- I. Leksell's Apparatus.- II. Preparation of the Patient.- III. The Positioning of the Patient.- 8: Pitfalls.- I. Technical Problems.- II. Pitfalls by Underlying Pathology.- 9: Functional Stereotactics.- I. Extrapyramidal and Cerebellar Tremor.- II. Intractable Pain Syndromes.- III. Brainstem Stereotactic Surgery in Cancer Pain.- 10: Mass Lesions Stereotactics.- I. Discussion of Deep Seated Tumors According to Growth Pattern.- II. Presentation of Our Own Material and Discussion of Other Reports.- 11: Stereotactic Localization with Subsequent Lesion Treatment.- I. Introduction.- II. Colloid Cysts of the Third Ventricle.- III. Primary Deep Seated Hematomas.- IV. Deep Seated Small ArteriovenousMalformations.- V. Stereotactic Aiming and Open Surgery in Stereotactic Space for Small and Deep Seated Tumors.- 12: Illustrative Cases.- 13: Integration of Stereotactics in Clinical Neurosurgery.- I. Introduction.- II. The Computer in Neurosurgery.- 14: Future Possibilities.- I. Introduction of Magnetic Resonance Imaging.- II. Future Applications of Stereotactics in Functional Disorders.- III. Future Applications of Stereotactics in Mass Lesions.- IV. Conclusion.- References.
