By L. I. Malis (auth.), Prof. Franco Pluchino M.D., Prof. Giovanni Broggi M.D. (eds.)
Technological advancements in neurosurgery are disussed. using surgical lasers, ultrasound aspirators, bipolar coagulator and operative microscopes for surgical procedure of deep-seated neoplasms and vascular malformations is mentioned. Intraoperative tracking, chronotherapy, persistent neurostimulation and stereotactic interstitial irradiation are coated and symptoms for interventional neuroradiology are reviewed.
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This experience has led to the following conclusions: 1. Holocord widening occurs in 60% of cases, and is diagnostic of a cystic astrocytoma. 2. Despite the absence of a surgical plane of dissection, these neoplasms may be removed from "inside out" until a glia-tumor interface is recognized. 3. Radical tumor excision is compatible with partial or total recovery of neurological function. 4. The success of surgery is directly related to the pre-operative neurological status of the patient. Paralysis or near paralysis was never improved, while mild to moderate pre-operative neurological dysfunction often recovered.
1). History of Photoradiation Therapy The first application of hematoporphyrin derivative (HpD) to the management of brain tumors took place in the 1950's at John Hopkins. At that time, a series of experiments were performed to evaluate HpD fluorescence in the detection of brain tumors at the time of surgery. These experiments demonstrated that detectable levels of HpD would concentrate in brain tumors and that HpD was effectively exluded by an intact blood-brain barrier. The first studies that suggested that photoactivation of HpD might be cytoxic to brain tumors were performed in 1975.
Long term results. J Neurosurg 42: 443-451 Michelsen WJ (1979) Natural history and pathophysiology of arteriovenous malformations. Clin Neurosurg 26: 307-313 Morello G, Borghi GP (1973) Cerebral angiomas. A report ofthe 154 personal cases and a comparison between the results of surgical excision and conservative management. Acta Neurochir 28: 135-155 Pool JL, Potts DG (1965) Aneurysms and arteriovenous anomalies of the brain. Diagnosis and treatment. New York, Harper and Row 1965, pp 463 Stein BM (1979) Arteriovenous malformations of the brain and spinal cord.