In the previous volume, "Differential Approaches in - if approach is hindered through such variants, or - if the lesion itself has a close relationship to impor- Microsurgery of the Brain", the particularly prob lematical operations in the depth of the brain around tant vessels, for example, if arteries penetrate or the brainstem were covered. Even more than in other are just adjacent to a meningioma. operations on the brain, it was important here to decide before the operation which from several pos On the basis of this method, it was obvious to first sible approaches would be chosen. Therefore in this present the description of the veins and then to con present volume, it was obvious to try to describe sider the arteries and not to choose the direction of microsurgical operations of the brain primarily under the blood flow in the image analysis, as is usually the aspect of preoperative planning. This is done by done. Only then can one judge which problems might presenting the usual daily preliminary discussions be encountered. Certainly only a part of the suspected which have taken place in the Freiburg Clinic for the problems will show up during the operation. How last ten years. On the day before surgery, these ever, in view of the great number of possible difficul discussions are always carried out according to the ties, one should also be prepared for rare complica same principle: tions.

A description of cerebral veins under operative versely, where there are large arterial vessel stems (at the base of the brain) the veins somewhat lose their technical aspects is practically a description of opera significance. They become important again in the tive approaches and their obstruction by cerebral region of the basal Dura, the Tentorium, and the Falx veins. It is this which constitutes the major difference but (with the exception of the region of the Sinus between arteries and veins. The arteries of the brain originate from only four large vessel stems, which cavernosus) away from the large arterial stems. This justifies writing a microneurosurgical textbook exclu bridge the CSF space and then run along the surface sively under the aspect of the cerebral veins. of the brain or inside the brain. Arterial vessels hardly interfere with operative approaches, even in the deep That we know so much about cerebral veins is due CSF spaces such as the Sylvian fissure, the Tentorium primarily to the work of neuroradiologists. It is not fissure, and the ventricle system. Veins, on the other the objective of the present volume to provide a hand, can appear in almost every location of the brain compreherisive and comparative survey of the large as so-called bridging veins. They are extremely vari number of individual results of attempts at establish able and can bloc~ the approach to deep CSF spaces ing vein types.

This detailed atlas illustrates the anatomical structures of the upper basal cisterns, their topography and relationship to other intra- and extradural structures. The author expands his well-established efforts to convey his outstanding neuroanatomical knowledge to the basal cisterns. His famous anatomical drawings are based upon anatomical preparations, cadaver dissections and intraoperative pictures, in order to point out important aspects concerning microsurgical and endoscopic approaches to these parts of the brain.

"The authors have definitely achieved their goal of providing a reference that is easy for both the expert surgeon and the neurosurgeon in training to consult in daily clinical practice ."-Child's Nervous System This important work - featuring complete information on all cranial approaches and techniques, and more than 2000 four-color photographs- marks a new level of achievement in neurosurgery publishing. Superbly conceived and designed, CRANIAL MICROSURGERY leads the neurosurgeon through each procedure in step-by-step detail, and brings together complete coverage of both surgical anatomy and real operative cases. This synthesis of anatomical information and extensive case-based data (including diagnostic histories, radiographic images, and intraoperative photographs) sets the book apart from other works in the field, and will be helpful to neurosurgeons at all levels.

Preoperative Magnetic Resonance Imaging allows now a better analysis of the relationship between intracranial tumors and the surrounding brain tissue. Even very small deepseated tumors can be identified during the operation by intraoperative ultrasound. These technological advances have had a great influence on indications, planning strategies and microsurgical techniques. The author shows the functional anatomy of the brain with the eye and the mind of a microsurgeon and demonstrates well known topographical relationships under the aspect of an utmost gentle operative approach.

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.

The differentiation of the temporal lobe into a lateral neocortical and a medial allocortical region is supported by developmental, anatomical and clinical evidence. Although this view of a dual temporal lobe is generally accepted by neurosurgeons dealing with functional surgery, it still receives little attention by those approaching structural abnormalities located or extending into the medio-basal region. Consequently, the characterization of the temporo-medial area as a distinct surgical region is still lacking. The major object of this study is to analyse the medial part of the temporal lobe as a distinct surgical region and to integrate the microsurgical and physiological aspects into a concept applicable to the several types of temporo-medial lesion. The study includes five sections. The first section is devoted to the morphological aspects; the second and the third sections present a simplified clinical approach to temporo-medial lesions and analyse the ancillary investigations which are indispensable for characterizing their structural and functional features. The fourth section deals with the surgical aspects of temporo-medial lesions, and especially with the selection of the optimal approach in regard to the location of a given process, and to the extent of the functional changes. The last section is devoted to commentaries concerning the neuropathological aspects and the outcome of surgery in the temporo-medial region.