Under the Microscope
1 Under the Microscope The Microscope The operating microscope is the neurosurgeon’s most important tool. It illuminates the operative field, magnifies anatomy, and gives constant visual feedback. Skillful dissection depends…
NEUROSURGERY
Vascular Control
4 Vascular Control Contingency Planning A reality of aneurysm surgery is that the technical skill and surgical experience do not eliminate the risk of intraoperative aneurysmal rupture. The dangerous combination…
Intraoperative Rupture
9 Intraoperative Rupture Ever-Present Danger Uncontrolled intraoperative bleeding is one of the most feared complications in neurosurgery. It has been said that uncontrolled bleeding is the one factor above all…
Temporary Clipping
5 Temporary Clipping Final Dissection Temporary clips are used occasionally to control an intraoperative aneurysm rupture, but more often to finish aneurysm dissection and prepare it for permanent clipping. Aneurysm…
Brain Retraction
3 Brain Retraction Retraction Without Retractors Brain retraction is bad. It can raise brain tissue pressure, reduce cerebral perfusion locally, hide critical anatomy, and injure neurovascular structures. However, subarachnoid corridors…
Conclusion
21 Conclusion Technical development does not come from reading a book; it comes from operating. Neurosurgeons develop microsurgical skills through a combination of repetition, technical mistakes, outside learning, and high…
Inspection
7 Inspection Look, Listen, and Feel Clipping an aneurysm can be such a relief that it is tempting to consider the operation over. However, post-clipping inspection is an important part…
Aneurysms of the Basilar Trunk: Far Lateral and Petrosal Approaches
19 Aneurysms of the Basilar Trunk: Far Lateral and Petrosal Approaches Anil Nanda, Haim Ezer, and Prasad Vannemreddy Saccular aneurysms of the basilar artery have remained aloof, because of the…
Microvascular Decompressions for Hemifacial Spasm and Trigeminal Neuralgia
17 Microvascular Decompression for Hemifacial Spasm and Trigeminal Neuralgia Tetsuo Kanno and Iyer Viswanathan The microvascular decompression of cranial nerves has become an accepted surgical technique for the treatment of…
Jugular Bulb Tumors
13 Jugular Bulb Tumors Michael L. Madison and Jon H. Robertson The jugular foramen at the base of the skull is an anatomically complex region. It is divided into two…
