Thisbookispublishedintwovolumes. Velum medullare posterior in the area of the 4th Inthisfirstvolume, anattemptismadetogiveyoung ventricle, including the choroidpoint ofthe PICA, neurosurgeons methodical instruction in the dissec canbestudiedexactly. Theseexampleswerechosen tion of formaldehyde-preserved brains. This book, becauseexacttopographicalknowledgeoftheseves however, isnotintendedtobetakenasatextbookon sel-richstructuresisofteninadequate;andwhenusing modernoperativetechniques, increasingly more op anatomy. Conventionalpresentationsoftheanatomy ofthebrainmustpresent, stepbystep, theindividual erationsareperformedinjusttheseparticularareas. systemsoftheorganaccordingto itsdevelopmental These dissections compose the content of the first and functional aspects, e. g. cortex, limbic system, volume. basal ganglia, brainstem, and cerebellum. Because The second volume is intended for experienced duringasingleoperationtheneurosurgeon issome neurosurgeonswhoperformcomplexoperationsdeep times confronted with all the various systems, it is insidethebrain. Someoftheseoperations have be necessarytoperformbraindissectionsfromtheview come standardized, e. g. theopeningofthesylvian point of operative approaches. Therefore, in this fissure withoperations intheareaofthe Insulaand worktheattemptismadetokeepcertainindividual cranial base. Other complex operations are per surfacestructures, e. g. theGyruspraecentralisintact formed seldom eventoday, e. g. approaches to the until the end of the dissection so that the relative 3rdventricle, Velum interpositum, lateralventricle, topographicalpositionsofsurfaceanddeepstructures Cisterna tecti, Lobulus quadrangularis cerebelli, to can be made discernable. For these reasons, it is namejustafew. Beforesuchoperations, itis advis advisabletoviewthesurfacestructuresofthebrainin able(theauthorstilldoessooccasionally)toorientate relationship to the skull, but then to start with re oneself on a formaldehyde-preserved brain. It is movingthebloodvesselsandleptomeningessothatin shownhowonaformaldehyde-preservedbrain, even this waythe skeletonizedorgan is dissected step by thoughitdoesnotprovidetherealconditionsofalive step, because in the preserved vascular system, the brainunderthe operative microscope, the most im structures are only partially recognizable and thus portant topographical relationships can be recog confusing. Forthisdissectiontwoorgansareneeded. nized. Inthe first dissection, thecerebrum andcerebellum Bothvolumesaretheresultofaone-yeardissection are studied. These the young neurosurgeon should course for colleagues meeting twice a week in our havebecomefamiliarduringhisinitialtraininginthe clinic.

Modern diagnostic imaging and operative approaches have witnessed significant improvements in our times. Computerassisted methods are in use in all microsurgical fields. Neuronavigation, novel stereotactic methods, endoscopic procedures, magnetic resonance imaging, ultrasound and the progress in pre- and intraoperative epilepsy diagnostics must be mentioned in particular in this connection. However, the insights of neuroanatomy and neurophysiology have not become obsolete thereby, on the contrary: such knowledge is imperative and a prerequisite for all neurosurgeons, nowadays more than ever before. Otherwise, excellent modern approaches are liable to fall into discredit if microanatomical aspects are neglected. The goal of this book is two-fold: first, to guide the resident towards a fruitful application of anatomical basics in visualizing and operative techniques. Second, to draw attention to as many anatomical norm variants as possible to forestall complications during surgery. Standard methods, such as the pterional approach, often confront the surgeon with a range of anatomical variants.

This didactic book clearly and systematically describes the anatomical-surgical fundamentals of cranial neurosurgery, relating them to norm variants, imaging modalities and interdisciplinary aspects. All illustrations, hand drawn in ink by the first author, are simple and self-explanatory. The book reflects the first author’s lifetime experience as an academic neurosurgeon and teacher, as well as the second author’s theoretical and practical knowledge of neurosurgical subspecialties such as epilepsy surgery. In addition to its core audience in neurosurgery, it provides all connected disciplines, in particular neuroradiology, neurology, neuropathology, ENT surgery, maxillofacial surgery and eye surgery, with unique anatomical insights into the neurosurgeon’s perspective.

First multi-year cumulation covers six years: 1965-70.

Preface matic depiction of the NMR slices in three levels. The Supported by NMR it has become possible to carry out operations in socalled inoperable regions of basal book is completed with selected technical tricks in ganglia, brainstem and problematic areas of the cor problematic operation cases. tex as well as in the areas of limbic system. Special appreciation is due to Prof. Dr. B. Volk, Thus the planning of an operation has become widely Director of the Institute of Neuropathology of the extended. A widening of the knowledge of the ana University of Freiburg, for his advice and help. tomical fundamentals is therefore indispensable and For nearly all MRI-findings I have to thank the should be conveyed by means of this book. colleagues of the Institute of Radiology (Director: The last two volumes "Anatomical Dissections for Prof. Dr. W. Wenz), especially Dr. Dorothea Ott, Use in Neurosurgery Vol. 1 and 2" supply the mor Dr. T. Adam and Dr. B. Wimmer. I also have to phological base for this book. The book itself is a thank Dr. R. Fiirmaier (neuroradiologist in Freiburg) continuation of "Planning Strategies of Intracranial for several MRI- and CT-findings. Microsurgery" . Most of the CTs were made in the stereotactic depart Some very problematic operations were carried out ment (Director: Prof. Dr. F. Mundinger) of our cli by my co-worker, Priv.-Doz. Dr. Eggert, who is now nic. I want to thank in particular Dr. M. Mohadjer.

Preface better recognized, if this overlapping of different In recent years microsurgical strategies have been mostly assisted by magnetic resonance measurements, structures is known. in which many morphological details surrounding the This book is divided in two parts. The general part pathological lesions can be better seen than in CT. So demonstrates comparisons of NMR and anatomical dissections. The special part considers anatomical it seems important to compare NMR (MRI, MR) findings with anatomical dissections of the brain and problems for complicated operations in the depth of skull. In sagittal slices, most important slices close to the brain. Cornu inf., basal ganglia and cisterns, CT reconstruc These special dissections have to regard brain struc tures more than the vessels, which are well known. In tions are not so instructive as NMR. Anatomical coronal transections are used in neuropathology, but some cases brain dissections may be compared with except in CT reconstructions, coronal projections skull dissections. The shifts of brain stuctures by tumors or other space were not considered in neuroradiological findings as occupying lesions are not considered here. They will they are now in NMR. Horizontal slices are well known from CT, but important details, e. g. the area be demonstrated in the next volume with description between Chiasma, quadrigeminal plate, Fornices and of microsurgical operations based on NMR-findings.

The author describes in his unique style the anatomical variants of the brain and skull. This atlas is a continuation of his last work on "Neuronavigation and Neuroanatomy". Most anatomical reference volumes show a large number of common and rare variations. This atlas concentrates on well known and little known variants which are especially important for the clinicians, in particular the neurosurgeons and the radiologists. The variants have been grouped after areas of trepanation. The author presents also a number of so far unknown variants gathered from his personal theoretical and clinical experience of 50 years. Exact knowledge of anatomical variations which the surgeon may encounter helps to plan operations and to avoid unexpected complications. Variants of no clinical relevance, even rather common ones, have not been included.