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 Drawings and scripts were selected from those tion of the operative routes and their alternatives which were produced by the author in the last for well-defined anatomical target areas alone. This three years to help educate young neurosurgeons viewpoint becomes more and more important, be in Freiburg and in other clinics. cause today there is no anatomical structure of the This programm for education may be managed in 2 brain which cannot be approached with a minimal steps: risk for surviving the operation. But more and more - Learning techniques for performing of trepana the risk for neurologicalor psychological postopera tions from opening of the skin onto dura incision tive complications will rise if the anatomical and (step 1) neurophysiological knowledge is insufficient. These - Learning of techniques for routine operations viewpoints are most important in operations at the (e. g. , for extirpation of gliomas of cerebral lobes) cranial base and operations transcrossing midline (step 2) structures of the brain. An intensive anatomical - Learning of techniques for operative approach es training helps to understand MRI before opera in problematic areas of the cranial and cerebral tion. Often the modern MRI demonstrates more base and of the midline, especially for the often anatomical details than the unexperienced neurosur performed operations, e. g. for basal meningeo geon has understood.

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 book adds in chapter 1 and 2 the MIN-key techniques Laser and sealing, completing the 3 MIN-key techniques of the first volume. In chapter 3 the evolution of anatomy to a key-concept of MIN is described, presenting theory and reality of anatomical perspectives that can be used by the MIN-surgeon directly in the OR. Anatomy must be elaborated according to Gestalt-Theory to become a Key of MIN. Still anatomy is the "House of Medicine”, giving a mental place to all knowledge, theories and biological functions. The "surgical simulation concept" of chapter 4 as trainings environment follows, also as a key-concept of MIN. In this chapter we draw the line from Gestalt-Anatomy to a Surgical Simulation Application in Pathological Anatomy exemplified in aneurysm cases. Chapter 5 presents the best preservation technique of anatomical perishable matter, forming durable, dry and odorless specimen of unknown precision and beauty. The scientific value of this unique technique and the benefit for MIN are shown by many examples.With the Plastination gallery of chapter 6 the best head-plastinates and sheet-plastinates of head and brain complete the volume. Many of the specimen have been shown around the globe in the famous exhibitions “body worlds“ (Prof. Dr. G. v. Hagens/Inventor of Plastination).

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

An illustrated atlas of anatomical aspects important for combinations of microsurgical and endoscopic approaches. The basis for Professor Seeger’s renowned drawings has been anatomical preparations, cadaver dissections and intraoperative pictures. The correct proportions are derived by measuring the distances of anatomical landmarks of cranial preparations and from CT and MR Images. A concise text supports the understanding of the anatomical figures. Numerous common anatomical variants are demonstrated with reference to their impact for the surgical technique.

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.

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.