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Intraoperative ultrasound imaging in neurosurgery
Book Reviews
Clinical Neurophysiology of the Vestibular
System.
By Robert W. Baloh and Vincente Honrubia. $65.00. Philadelphia: F.A. Davis, 1990. This book, in its expanded second edition, will be of value to any physician who treats patients for dizziness. It is a comprehensive and concise text that is written at a level appropriate for neurologists and neurosurgeons, as well as otologists and neuro-otologists. Primary care physicians might find portions of the text overwhelming but nevertheless informing. The book is divided into three parts. It contains a wealth of charts, tables, photographs, and algorithms. The text is very concise but readable. The schematic drawings and diagrams supplement the text effectively. The first part of the book covers the vestibular system, giving an overview of the basic vestibular function followed by an in-depth discussion of the anatomy and physiology of both the peripheral and central vestibular systems. The second part of the book involves the evaluation of the dizzy patient. This is directed more toward the clinical evaluation of the dizzy patient, with emphasis on the important aspects of the history as it relates to the evaluation of these patients. Included are illustrative cases as well as examination techniques. Explanations are given of the diagnostic testing available, including basic electronystagmography as well as a chapter devoted to rotational and other newer diagnostic tests. The third part of the book deals with the diagnosis and management of more common neuro-otologic disorders. This is a completely new section unique to the second edition. Again, the authors have made good use of algorithms, tables, and drawings to present this material clearly. Dr. Baloh and Dr. Honrubia have done a remarkable job on improving an already classic text. The second edition presents a stronger clinical emphasis than the first edition; however, it maintains a very thorough, new view of the basic science involved. I recommend it strongly to all neurologists, neurosurgeons, neuro-otologists, or other physicians who might be called upon to evaluate a patient complaining of dizziness. Because of its comprehensive text, it can serve as an independent reference without becoming overwhelming. At the same time, it presents an extensive bibliography for further sttidy if the reader so desires. J O H N S. MAY, M.D. Winston-Salem, North Carolina
Microsurgery o f the T e m p o r o - M e d i a l Region. By Rezio R. Renella. Vienna: Springer, 1989. The advent of microsurgery has led to interest in surgery of the medial temporal lobe without resection of the entire anterior
Surg Neurol 1991;35:250-2
251
temporal lobe. Although most of these procedures are performed for epilepsy, these microsurgical techniques are useful in the resection of tumors and vascular malformations in the medial temporal lobe. Dr. Renella has drawn on his extensive work in the microsurgical laboratory and with epilepsy surgery to provide a concise yet informative monograph regarding surgery of the medial temporal region. There is an excellent chapter about the anatomy of the region, which includes a thorough discussion of the anatomy of the anterior choroidal artery. Clinical aspects of medial temporal lesions, including the protean manifestations of complex partial seizures, are covered in another chapter. Chapters on neuroimaging and functional testing discuss modern techniques for the evaluation of these lesions. Approximately one third of the book is devoted to microsurgical techniques that provide access to the temporo-medial region. The retroinsular transventricular and interhemispheric transatrial approaches are discussed in detail. The anatomical and surgical descriptions in this work are excellent. Although there are some high-quality color plates of microsurgical anatomy, the detailed descriptions in the text would have been enhanced by more figures, particularly for the surgical techniques. For example, the retroinsular transventricular approach is described in a steplike manner, but there are few accompanying illustrations. This book is quite readable and benefits from having a single author. It will be of great benefit to those surgeons who perform surgery for epilepsy and would be of interest to any neurosurgeon with a particular interest in microsurgical anatomy; however, its value to the general neurosurgeon is somewhat limited. K. STUART LEE, M.D. Greenville, North Carolina
I n t r a o p e r a t i v e U l t r a s o u n d I m a g i n g in Neurosurgery. C o m p a r i s o n with C T and MRI. By Ludwig M. Auer and Vera Van Velthoven. 173 pages. $98.00. N e w York: Springer, 1990. Portable intraoperative real time ultrasound imaging became available nearly a decade ago. This imaging modality has evolved into routine dally application and is widely used in neurosurgery. Once the initial hurdle of being able to recognize routine anatomy is crossed, a steep learning curve ensues, and the applications in the operating room are enormous. This book draws on the wealth of clinical experience by the authors, Auer and Van Velthoven, in over 500 intracranial operations. The book is simply organized, with an introduction to imaging techniques and normal anatomy followed by an atlas of sequential case demonstrations. The first 20 pages deal with technical aspects of real time ultrasonography and the variety of equipment available. There is an invaluable
252
Surg Neurol 1991;35:250-2
description of intracranial landmarks for the identification of normal anatomy in the various planes of view. This is elegantly supplemented by simple drawings and comparison with MRI and CT scans. Following the introductions are case by case examples of intracranial tumors and other pertinent pathology. The technical reproductions of ultrasound pictures are excellent. There are good correlations with CT and MRI. Unfortunately, descriptions of various interventional procedures, such as tumor biopsy, are not well elaborated upon. There is a conspicuous absence of any examples of intra-
Book Reviews
spinal pathology. Real time ultrasonography is equally as important to neurosurgeons in this setting. Intraoperative anatomical delineation of problems such as syringomyelia, intramedullary tumors, and vascular malformation are invaluable. The book is readable and the illustrations are excellent. This book should be reviewed by all neurosurgeons and ultrasonographers who would like to begin or gain more experience in the use of this valuable technique. STEPHEN M. PAPADOPOULOS, M.D. Ann Arbor, Michigan
Clinical Neurophysiology of the Vestibular
System.
By Robert W. Baloh and Vincente Honrubia. $65.00. Philadelphia: F.A. Davis, 1990. This book, in its expanded second edition, will be of value to any physician who treats patients for dizziness. It is a comprehensive and concise text that is written at a level appropriate for neurologists and neurosurgeons, as well as otologists and neuro-otologists. Primary care physicians might find portions of the text overwhelming but nevertheless informing. The book is divided into three parts. It contains a wealth of charts, tables, photographs, and algorithms. The text is very concise but readable. The schematic drawings and diagrams supplement the text effectively. The first part of the book covers the vestibular system, giving an overview of the basic vestibular function followed by an in-depth discussion of the anatomy and physiology of both the peripheral and central vestibular systems. The second part of the book involves the evaluation of the dizzy patient. This is directed more toward the clinical evaluation of the dizzy patient, with emphasis on the important aspects of the history as it relates to the evaluation of these patients. Included are illustrative cases as well as examination techniques. Explanations are given of the diagnostic testing available, including basic electronystagmography as well as a chapter devoted to rotational and other newer diagnostic tests. The third part of the book deals with the diagnosis and management of more common neuro-otologic disorders. This is a completely new section unique to the second edition. Again, the authors have made good use of algorithms, tables, and drawings to present this material clearly. Dr. Baloh and Dr. Honrubia have done a remarkable job on improving an already classic text. The second edition presents a stronger clinical emphasis than the first edition; however, it maintains a very thorough, new view of the basic science involved. I recommend it strongly to all neurologists, neurosurgeons, neuro-otologists, or other physicians who might be called upon to evaluate a patient complaining of dizziness. Because of its comprehensive text, it can serve as an independent reference without becoming overwhelming. At the same time, it presents an extensive bibliography for further sttidy if the reader so desires. J O H N S. MAY, M.D. Winston-Salem, North Carolina
Microsurgery o f the T e m p o r o - M e d i a l Region. By Rezio R. Renella. Vienna: Springer, 1989. The advent of microsurgery has led to interest in surgery of the medial temporal lobe without resection of the entire anterior
Surg Neurol 1991;35:250-2
251
temporal lobe. Although most of these procedures are performed for epilepsy, these microsurgical techniques are useful in the resection of tumors and vascular malformations in the medial temporal lobe. Dr. Renella has drawn on his extensive work in the microsurgical laboratory and with epilepsy surgery to provide a concise yet informative monograph regarding surgery of the medial temporal region. There is an excellent chapter about the anatomy of the region, which includes a thorough discussion of the anatomy of the anterior choroidal artery. Clinical aspects of medial temporal lesions, including the protean manifestations of complex partial seizures, are covered in another chapter. Chapters on neuroimaging and functional testing discuss modern techniques for the evaluation of these lesions. Approximately one third of the book is devoted to microsurgical techniques that provide access to the temporo-medial region. The retroinsular transventricular and interhemispheric transatrial approaches are discussed in detail. The anatomical and surgical descriptions in this work are excellent. Although there are some high-quality color plates of microsurgical anatomy, the detailed descriptions in the text would have been enhanced by more figures, particularly for the surgical techniques. For example, the retroinsular transventricular approach is described in a steplike manner, but there are few accompanying illustrations. This book is quite readable and benefits from having a single author. It will be of great benefit to those surgeons who perform surgery for epilepsy and would be of interest to any neurosurgeon with a particular interest in microsurgical anatomy; however, its value to the general neurosurgeon is somewhat limited. K. STUART LEE, M.D. Greenville, North Carolina
I n t r a o p e r a t i v e U l t r a s o u n d I m a g i n g in Neurosurgery. C o m p a r i s o n with C T and MRI. By Ludwig M. Auer and Vera Van Velthoven. 173 pages. $98.00. N e w York: Springer, 1990. Portable intraoperative real time ultrasound imaging became available nearly a decade ago. This imaging modality has evolved into routine dally application and is widely used in neurosurgery. Once the initial hurdle of being able to recognize routine anatomy is crossed, a steep learning curve ensues, and the applications in the operating room are enormous. This book draws on the wealth of clinical experience by the authors, Auer and Van Velthoven, in over 500 intracranial operations. The book is simply organized, with an introduction to imaging techniques and normal anatomy followed by an atlas of sequential case demonstrations. The first 20 pages deal with technical aspects of real time ultrasonography and the variety of equipment available. There is an invaluable
252
Surg Neurol 1991;35:250-2
description of intracranial landmarks for the identification of normal anatomy in the various planes of view. This is elegantly supplemented by simple drawings and comparison with MRI and CT scans. Following the introductions are case by case examples of intracranial tumors and other pertinent pathology. The technical reproductions of ultrasound pictures are excellent. There are good correlations with CT and MRI. Unfortunately, descriptions of various interventional procedures, such as tumor biopsy, are not well elaborated upon. There is a conspicuous absence of any examples of intra-
Book Reviews
spinal pathology. Real time ultrasonography is equally as important to neurosurgeons in this setting. Intraoperative anatomical delineation of problems such as syringomyelia, intramedullary tumors, and vascular malformation are invaluable. The book is readable and the illustrations are excellent. This book should be reviewed by all neurosurgeons and ultrasonographers who would like to begin or gain more experience in the use of this valuable technique. STEPHEN M. PAPADOPOULOS, M.D. Ann Arbor, Michigan