On the Initiation of World Neurosurgery

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ful experience as Editor of Neurosurgery, and his strong dedication to gather neurosurgeons and neuroscientists from all origins and of various opinions, has logically been chosen as the Editorin-Chief of the publication. Perhaps WORLD NEUROSURGERY should concentrate predominantly on education and news from neurosurgical societies and be a real international forum and link between the members of the world neurosurgical community. 1878-8750/$ - see front matter © 2010 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2010.03.008

Robert F. Spetzler, M.D. Director, Barrow Neurological Institute (BNI) Phoenix, Arizona J.N. Harber Chair of Neurological Surgery at BNI Chairman and President, Barrow Neurosurgical Associates Professor of Surgery, Section of Neurosurgery, University of Arizona College of Medicine, Tucson, Arizona, USA

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t the start of a new decade, the year 2010 is a perfect time to inaugurate a fresh new journal. As a Continental Editor, I am pleased to welcome readers to WORLD NEUROSURGERY, which will be devoted to all aspects of neurosurgery around the globe. Editor-in-Chief Michael Apuzzo, M.D., brings his formidable energy, creativity, and editorial acumen to the task of building this new journal, which promises to offer a dynamic and flexible format that will help practitioners integrate ideas from colleagues around the world into their practice of neurosurgery. As technological and clinical advances accelerate, the practice of neurosurgery is poised to change dramatically. WORLD NEUROSURGERY will provide an excellent venue to help neurosurgeons to think globally and to act locally, as the popular saying urges, in response to this escalating rate of change. As underscored by the devastating earthquake in Haiti, however, sometimes neurosurgeons also need to think globally and to act globally. Furthermore, global interactions need not be restricted to relief efforts during a time of crisis. For thousands of individuals around the world who suffer from common afflictions such as stroke, hydrocephalus, hematomas, or traumatic brain or spinal cord injuries, neurosurgical care can be a vital but unattainable service. A journal that can help neurosurgeons find ways to help each other by defining needs and entertaining innovative solutions to global neurosurgical problems can be invaluable in such an effort. For example, my institution is pursuing a health initiative in Tanzania where there are only three fully trained Tanzanian neurosurgeons for a population of about 39 million people. By helping to provide equipment and rotating personnel to treat patients and to train caregivers there, we hope to help bring basic neurosurgical care to thousands who are now deprived of desperately needed care. In return, our rotating neurosurgeons will learn valuable lessons that will likely inform their practice over the course of their careers. Telemedicine, now tantalizingly close to being practical and effective in guiding treatment remotely, is another promising venue for extending neurosurgical care to underserved regions of the world. As digital communications extend our reach and further awareness of our interdepen-

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dence, we may find that to act locally is also to act globally and vice versa. WORLD NEUROSURGERY offers an outstanding opportunity to share such programs, to explore just such collaborations, and to advance the discipline as a whole. A journal that can be a voice that will help shape the future of neurosurgery is welcome indeed. Consequently, I urge neurosurgeons to support WORLD NEUROSURGERY. By taking advantage of this international forum to share our unique clinical experiences or groundbreaking research, we can hope to improve the treatment and care of neurosurgical patients around the world. 1878-8750/$ - see front matter © 2010 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2010.02.033

M. Gazi Yasargil, M.D. Professor, Department of Neurosurgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA Professor and Chairman Emeritus, University of Zurich, Switzerland

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ORLD NEUROSURGERY offers a forum for those involved in neurosurgery (including entire subspecialties), neurosciences, neurotechnology, neuroradiology, neurophilosophy, and related fields, to convey their professional experiences, unfold their research programs, and express their opinions in a constructive, sincere dialogue. Under the skilled editorialship of Micheal Apuzzo, who has a clear perception of this enterprise, the journal will capture the essential elements of developments in these areas. Sincere, candid views may be expressed in its pages, encouraging refreshing, lively and stimulating discussion. WORLD NEUROSURGERY will establish a favorable platform to support professional dialogue, to interconnect with colleagues, and to promote interdisciplinary exchange, building strong global connections in our endeavor to reach common goals. This is an extraordinary opportunity to reflect on the past, and to concentrate our combined powers on designing, adapting, and creating for our future, and translating our research findings to improve the health of our patients. 1878-8750/$ - see front matter © 2010 Published by Elsevier Inc. DOI: 10.1016/j.wneu.2010.03.039

Jizong Zhao, M.D. President, Chinese Neurosurgical Society Professor and Chairman, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

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irst and foremost, on behalf of the Chinese Neurosurgical Society, I would like to extend my respectful congratulation on the inauguration of the WORLD NEUROSURGERY, which is

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a new member of international journals on neurosurgery. We believe that this new journal will contribute to academic exchange and cooperation around the world in the rapidly growing field of neurosurgery. In addition, as President of the Chinese Neurosurgical Society, I sincerely hope that WORLD NEUROSURGERY would help widen the spectrum of Chinese neurosurgeons and researchers and I do believe that there would be more articles by Chinese investigators presented in front of the worldwide readers through WORLD NEUROSURGERY. At the beginning of a brand-new decade, China is at the all-around developing stage. In the past three decades, China’s economy has been growing at an accelerated speed. Thanks to this, the development of science and technology has made some important achievements in the world’s biggest developing country, neurosurgery included. At present, in mainland China, there are thousands of active neurosurgeons practicing their clinical and basic research, covering almost all the fields related to neurosurgery. In recent years, although many modalities have been introduced, cerebrovascular diseases are still an important aspect for every practicing neurosurgeon. In the past five decades, neurosurgery, particularly minimally invasive neurosurgery and surgical treatment of patients with giant intracranial aneurysms, have progressed significantly in China. Xu et al. (1) introduced their experience in surgical management of large and giant intracavernous and paraclinoid aneurysms. Qi et al. (2) reported on the clinical characteristics and surgical treatment of patients with giant intracranial aneurysms. Both issues are fascinating and informative regarding this ongoing hot topic, which is still a challenge for neurosurgeons worldwide. These investigators have published extensive volumes on neurosurgery in China, which are worthy of reading. In addition to the method or maneuver in clipping aneurysms, they detail the complications that should be avoided. Ocular motor palsy is a common postoperative complication. Yang et al. (3) has reported on nerve recovery. Endovascular intervention has been practiced in China for several decades. At present the most advanced devices are available to clinicians. However, the costs and benefits have become controversial issues. Wang et al. (4) compared the clinical outcomes of traditional conservative therapy and conservative plus endovascular therapy in elderly patients with symptomatic vertebrobasilar stenosis. Although there have been acceptable failure rates, stereotactic radiotherapy has been considered an alternative therapy for arteriovenous malformations. Liu et al. (5) reported seven cases of failure after radiosurgery, which demonstrates the significance of long-term follow-up and consideration of the necessity of microsurgical procedures. As the most common type of malignant brain tumor, the overall prognosis of glioma is still poor. In addition, the prognosis of patients diagnosed with grade III gliomas varies significantly. Zhu et al. (6) has reported on the prognostic factors for such patients. Tian et al. of the brain trauma section reported on the risk factors for hospital mortality in patients who have undergone surgical treatment for isolated traumatic acute subdural hematoma. Their report may help clinicians in determining management criteria and improve survival rates. In addition to brain trauma, peripheral nerve injury is common and an important area for neurosurgeons, but most of our Chinese neurosurgeons are not familiar with this

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field. Chen et al. (7) reported on a preliminary positron emission tomography study of brain glucose metabolic changes associated with chronic spontaneous pain due to brachial plexus avulsion. Because computer technology continues to be introduced in almost every field of modern medicine, virtual reality techniques have become a way of better understanding anatomic pathology. Yi et al. (8) reported the experience with virtual reality technique in preoperative planning of skull base surgery. Sometimes innovation does not only mean highly advanced technology, it means some inspiration from daily routine. Hu et al. (9) reported their interesting tip of liquid capsule application after resection of a giant meningioma to avoid the postoperative complication. Functional neurosurgery is also a promising part of neurosurgery, including movement disorder, pain management, and most importantly, epilepsy. Zhang et al. (10) reported on dorsal root entry zone coagulation for treatment of deafferentation pain syndromes. In addition, two rare cases are reported, one is moyamoya disease with arteriovenous malformation (11) and the other is a fracture of a cerebral protection device wire in carotid artery stenting (12). Currently, the Chinese Neurosurgical Society has registered nearly 7000 active neurosurgeons as its members all over China. The conventions involve each specification, such as tumors, cerebral vascular diseases, minimally invasive approaches, functional neurosurgery, and trauma. Today’s Chinese neurosurgeons actively participate in international events. Some neurosurgeons are invited to be reviewers of international journals, such as Neurosurgery, Surgical Neurology, Neurosurgical Review, Child Nervous System, and Journal of Clinical Neuroscience. Participation in international events have helped Chinese neurosurgeons learn about the world and vice versa. Today’s achievements of Chinese neurosurgeons may be of international interest, not only in clinical practice, but also in basic research (13-15). Currently, hundreds of Chinese neurosurgeons have experienced overseas practice or training. We believe that more articles written by Chinese neurosurgeons will be published in international journals in the near future. More importantly, the acceptance of the concept of minimally invasive procedures by neurosurgeons has marked the start of an era of minimally invasive neurosurgery in China. Progress is evident in clinics, basic research, infrastructure, resident training, and multidisciplinary collaboration. In addition to all the achievements by Chinese neurosurgeons and researchers, we still have more to do. We admit that the inadequate level of familiarity of the technical English language and the unfamiliarity with the Western peer reviewing process have made Chinese professionals reluctant to contribute their articles to English language publications. I hope this new journal, at the very beginning, will present itself in a new fashion in front of the worldwide professionals, which is to say, that it meets the international academic standards and at the same time reflects the realistic conditions in China. We live in an information age. Exchange of academic and technical information is more important today than ever before. Our profession has several excellent professional journals and WORLD NEUROSURGERY will add significantly to those already operating. I sincerely wish WORLD NEUROSURGERY a great success! Acknowledgment I am grateful to Taiji Sun, M.D., for his collaboration in this inaugural commentary.

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REFERENCES 1. Xu BN, Sun ZH, Jiang JL, et al: Surgical management of large and giant intracavernous and paraclinoid aneurysms. Chin Med J 2008;121:1061-1064. 2. Qi W, Wang S, Zhao YL, Yang HB, Zhao JZ: Clinical characteristics and surgical treatment of patients with giant intracranial aneurysms. Chin Med J 2008; 121:1085-1088. 3. Yang MQ, Wang S, Zhao YL, Zhang D, Zhao JZ: Postoperative recovery from posterior communicating aneurysm complicated by oculomotor palsy. Chin Med J 2008;121:1065-1067. 4. Wang DM, Chen HB, Liu JC, Liu F, Wang LJ, Lu J: Treatment of patients older than 60 years with symptomatic vertebrobasilar artery stenosis. Chin Med J 2008;121:1068-1071. 5. Liu WM, Ye X, Zhao YL, Wang S, Zhao JZ: Clinical and pathological changes in cerebral arteriovenous malformations after stereotactic radiosurgery failure. Chin Med J 2008;121:1076-1079.

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6. Zhu YJ, Zhu XD, Wang SH, Shen F, Shen H, Liu WG: A multivariate analysis of the prognostic factors of grade III gliomas. Chin Med J 2008;121:1072-1075. 7. Chen FY, Tao W, Cheng X, et al: Brain glucose metabolic changes associated with chronic spontaneous pain due to brachial plexus avulsion: A preliminary positron emission tomography study. Chin Med J 2008;121:1096-1100. 8. Yi ZQ, Li L, Mo DP, Zhang JY, Zhang Y, Bao SD: Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality. Chin Med J 2008;121:1134-1136. 9. Hu YH, Wu JL, Shao ED, Wu JL, Ji JW: Extraordinary effects of liquid capsule application after resection of a giant meningioma. Chin Med J 2008;121:11401142. 10. Zhang XH, Li YJ, Hu YS, Tao W, Zheng Z: Dorsal root entry zone coagulation for treatment of deafferentation pain syndromes. Chin Med J 2008;121:10891092. 11. Deng ZH, Wang S, Li Z, Zhao JZ: Unilateral moyamoya disease associated with cerebellar arterio-

venous malformation: One case report. Chin Med J 2008;121:1145-1147. 12. Qu LF, Ritter W, Raithel D: Fracture of a cerebral protection device wire in carotid artery stenting: An unexpected complication. Chin Med J 2008;121: 1148-1149. 13. Zhao JZ, Zhou LF, Zhou DB, Tang J, Zhang D: The status quo of neurosurgery in China. Neurosurgery 2008;62:516-520. 14. Zhu J, Zhou L, XingWu F: Tracking neural stem cells in patients with brain trauma. N Engl J Med 2006; 355:2376-2378. 15. Zhao JZ, Zhou LF, Zhou DB, et al: Computed tomography-guided aspiration versus key-hole craniotomy for spontaneous putaminal haemorrhage: A prospective comparison of minimally invasive procedures. Surgical Neurology 2009;72:21-22. 1878-8750/$ - see front matter © 2010 Published by Elsevier Inc. DOI: 10.1016/j.wneu.2010.02.036

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