Introduction

CHAPTER 71 Introduction



Andres M. Lozano, Ron L. Alterman


As we complete work on this edition of Youmans, the field of stereotactic and functional neurosurgery is experiencing an unprecedented period of renaissance and growth. Advances in neuroscience and functional neuroimaging, improved understanding of the pathophysiologies of movement and neuropsychiatric disorders, innovations in medical devices, and an expanding armamentarium of minimally invasive, neuromodulatory, and biologic modifying techniques are all driving a strong innovation pipeline of novel concepts and clinical applications. Disorders that were long ago in the realm of neurosurgeons but had largely escaped our grasp are being repatriated, and disorders that were once considered to be well outside neurosurgery’s purview are now within our sights.


Neurosurgeons were at the forefront of treatment of Parkinson’s disease in the 1950s and 1960s but gave way to neurologists when the introduction of levodopa seemed to provide a lifelong cure. Similarly, psychiatric disorders were treated with neurosurgery in the 1930s, 1940s, and 1950s until the introduction of chlorpromazine and the indiscriminate use of frontal lobotomy by some practitioners (many of whom were not neurosurgeons) created a public backlash that forced all but a few neurosurgeons to abandon further development of this field. In the 1980s and 1990s, armed with better science and technology and the understanding that the limits of contemporary medical therapy had been reached, neurosurgeons revisited the treatment of Parkinson’s disease, tremor, and dystonia to the enormous benefit of thousands. Likewise, as we now learn the limits of even the most sophisticated medical therapies for psychiatric illness, interest in surgical intervention for obsessive-compulsive disorder, depression, and addiction is on the rise.


In the chapters that follow, today’s leaders in stereotactic and functional neurosurgery provide an up-to-date and comprehensive view of our rapidly developing field. The interested reader will find that we are continuing to make significant inroads in the treatment of movement disorders as we begin our exploration of the treatment of psychiatric illnesses, epilepsy, and pain. It will also be clear that deep brain stimulation will soon be accompanied by techniques such as intraparenchymal drug infusions, gene therapy, and brain-machine interfaces to alter the course of biologic processes, modulate aberrant neurological activity, or harness brain power for various purposes. In short, we are just beginning to learn how to work with our patients’ brains to improve their lives. The possibilities are limitless.


Related posts:

Molecular Biology Primer for Neurosurgeons Auditory Language Mapping Default ThumbnailPregnancy and the Vascular Lesion Epidemiology of Traumatic Brain Injury Positioning in Peripheral Nerve Surgery Genetics of Cerebral Cavernous Malformations

Stay updated, free articles. Join our Telegram channel
Tags:
Aug 7, 2016 | Posted by in NEUROSURGERY | Comments Off on Introduction

Full access? Get Clinical Tree
Get Clinical Tree app for offline access