Abstract:

Swedish neurosurgeon Lars Leksell, frustrated by the invasiveness of existing surgical tools and the morbidity some neurosurgical patients endured, created the field of stereotactic radiosurgery in 1951. He subsequently pioneered the development of the dedicated multi-source Cobalt 60 Gamma Knife®. During the 27 year interval from its first clinical use in 1967 to its latest application in 1994, single fraction, closed skull irradiation of deep intracranial targets has been performed in more than 20,000patients worldwide. The goals of radiosurgery are obliteration or prevention of further growth of the target coupled with reduced patient risk in comparison to more invasive procedures.

Authors:

Richard K. Spence, M.D., Umur Atabek, M.D., Cooper Hospital/UMC, Robert Wood Johnson Medical School at Camden, NJ

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Abstract:

The aim of human brain grafting is to deliver adequate amounts of endocrine or neural tissue to neurodegenerated areas of the diseased or lesioned brain for functional recovery. The many options available make brain grafting and other neural grafting procedures potentially applicable for the treatment of varied alterations of the central nervous system, such as Parkinson's disease (PD), Huntington's disease (HD), Alzheimer's disease, epilepsy, amyotrophic lateral sclerosis, spinal cord lesions, assorted traumatic lesions to the central nervous system, stroke, etc.

Authors:

Ignacio Madrazo, M.D., D.Sc., Hugo Castrejon, M.D., Centro Medico National Siglo XXI, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico, Rebecca E. Franco-Bourland, Ph.D., Instituto Nacional de la Nutricion Salvador Zubiran, Mexico, D.F., Mexico

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Abstract:

Ever since surgery was introduced for the treatment of neurological diseases, miniaturized approaches have been considered and developed in order to limit trauma of vital and delicate structures of the central n~rvous system. Thus, the application of stereotactic techniques and endoscopy date back to the beginning of this century. Stereotactic neurosurgery started with the goal of reaching target areas in the brain through a burrhole and then to guide (by the aid of landmarks on the bony skull and its radiographic image) small instruments such as needles and biopsy forceps. Moreover, ventriculograms with contrast material were used as guides to calculate coordinates for a 3-dimensional guiding-system within the brain. Coordinates for the brain's interior structures had to be taken from a theoretical average human brain as shown in a stereotactic brain atlas.

Authors:

Prof. Ludwig M. Auer, M.D., Professor of Neurosurgery Saarland University Medical School Homburg, Germany

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