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Neurosurgery o/the Future: Computers and Robots in Clinical Neurosurgical Practice and in Training - a Philosophical Journey into the Future Many present day neurosurgeons believe that they already obtain good results in operative surgery with the benefit of the operating microscope and other aids which have become available in the last three decades and that the introduction of computers and robots to the operating theatre is superfluous. However, it is clear from analogy with the function of the airline pilot, another profession where there are great demands on manual skill and on spatial awareness, that these devices do have much to offer neurosurgery. Classical neurosurgery, in the time of Cushing, Dandy and Scarff, was based on a three dimensional picture of the patient's brain formed in the surgeon's mind and often illustrated in elegant drawings. Such pictures were based on neuroradiological studies by pneumoencephalography, ventriculography or by angiography. Generally these stud ies showed the presence and position of a lesion by displacement of normal brain structures and the picture was built up by interference. This was then converted by the experienced neurosurgeon into a plan for the craniotomy site and the trajectory of the surgical approach. Once the brain was exposed further pre-operative information was obtained by visual inspection and by palpation with the brain needle. These classical forms ofneuroradiology have largely been superseded by computerised tomography and by magnetic resonance imaging.
Surgical Treatments of Parkinson’s Disease.- Controversies in Pallidal Surgery.- Chronic Electrostimulation of Ventroposterolateral Pallidum: Follow-up.- Posteroventral Pallidotomy in Movement Disorders.- Selection Criteria for Unilateral Posteroventral Pallidotomy.- The Effects of Pallidotomy on Parkinson’s Disease: Study Design and Assessment Techniques.- Frameless 3D Volume Registration of MR Data Sets for Stereotactic Pallidotomy.- Unilateral Pallidotomy for Parkinson’s Disease Promptly Improves a Wide Range of Voluntary Activities — Especially Gait and Trunk Movements.- The Side-Effects and Complications of Posteroventral Pallidotomy.- Deep Brain Stimulation and Thalamotomy for Tremor Compared.- Pain.- Treatment of Deafferentation Pain by Chronic Stimulation of the Motor Cortex: Report of a Series of 20 Cases.- Psychosurgery.- Obsessive Compulsive Disorder and the Right Hemisphere: Topographic Analysis of Lesions After Anterior Capsulotomy Performed with Thermocoagulation.- Epilepsy.- Lesionectomy in Epileptogenic Temporal Lobe Lesions: Preoperative Seizure Course and Postoperative Outcome.- Low Grade Glioma in Intractable Epilepsy: Lesionectomy versus Epilepsy Surgery.- Frameless Stereotaxy.- Incorporation of Ultrasonic Imaging in an Optically Coupled Frameless Stereotactic System.- Functional Imaging.- Magnetoencephalography (MEG) in Epilepsy Surgery.- Integration of Functional Brain Mapping in Image-Guided Neurosurgery.- Significant Reduction of Seizure Incidence and Increase of Benzodiazepine Receptor Density after Interstitial Radiosurgery in Low-Grade Gliomas.- Methodology.- Functional Neurosurgery Aided by Use of an Electronic Brain Atlas.- Gene Therapy.- Gene Transfer of Suicide Genes for the Treatment of Malignat Gliomas: Efficacy, Limitations, and Perspectives for a Combined Immunotherapy.- Anti-Angiogenic Gene Therapy of Malignant Glioma.- Gene Therapy in Brain Tumours: Implications of the Size of Glioblastoma on its Curability.- Radiosurgery.- Risk Analysis of LINAC Radiosurgery in Patients with Arteriovenous Malformation (AVM).- Effect of Linac Radiosurgery on Regional Cerebral Blood Flow, Glucose Metabolism and Sodium-Potassium ATP-ase in Skull Base Meningiomas and Metastasis.- Tumours.- Potential Role of in vitro 1H Magnetic Resonance Spectroscopy in the Definition of Malignancy Grading of Human Neuroepithelial Brain Tumours.- Stereotactic Brain Biopsy Guided by Positron Emission Tomography (PET) with [F-18]Fluorodeoxyglucose and [C-11]Methionine.- Glioma Cells Transduced with Selection Transgenes May Not Form Gliomas in vivo and Can Also Inhibit Glioma Formation by Admixed Wild Glioma Cell Lines.- Index of Keywords.