By H. Krayenbühl, J. Brihaye, F. Loew, V. Logue, S. Mingrino, B. Pertuiset, L. Symon, H. Troupp, M. G. Yasargil

As an addition to the eu postgraduate education process for younger neurosurgeons we started to submit in 1974 this sequence dedicated to Advances and Technical criteria in Neurosurgery which used to be later backed through the Euro­ pean organization of Neurosurgical Societies. the truth that the English language is easily as a way to turning into the overseas medium at ecu clinical meetings is a brilliant asset by way of mutual knowing. for that reason we've got determined to put up all contributions in English, whatever the local language of the authors. All contributions are submitted to the complete editorial board prior to ebook of any quantity. Our sequence isn't meant to compete with the guides of unique medical papers in different neurosurgical journals. Our purpose is, quite, to provide fields of neurosurgery and similar parts during which vital fresh advances were made. The contributions are written by means of experts within the given fields and represent the 1st a part of every one quantity. within the moment a part of each one quantity, we post distinct descriptions of normal operative tactics, offered through skilled clinicians; in those articles the authors describe the thoughts they hire and clarify the benefits, problems and dangers eager about many of the methods. This half is meant basically to help younger neurosurgeons of their postgraduate education. although, we're confident that it'll even be necessary to skilled, totally expert neurosurgeons.

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The site and direction of growth of the tumor may give the indication for the preferred approach. Sub temporal (Posterolateral Approach to the Clivus, Bonnal etal. 1964) The basics of this approach will be discussed under the subtemporal approach to cerebellopontine angle meningiomas . For clivus tumors, a temporal flap with provision for a paramedian suboccipital posterior limb is made, with a craniotomy reaching the lateral sinus and superior margin of the petrous bone. The surgeon must decide whether or not inferiorly draining temporal veins are to be left undisturbed, mobilized, or sacrificed.

This phenomenon appears to derive from the significant vascularity of most meningiomas, and not from blood-brain barrier alterations as is the case for many other intracranial tumors. Thus most isotopes in current use can detect over 90 % of meningiomas, and well over half can be classified as to type of tumor by scan alone. Scanning the posterior fossa presents some particular problems, however, because of the thickness and vascularity of the overlying neck musculature, the overlying venous sinuses and their confluence, activity at the skull base, and difficulty in positioning the patient properly for a posterior view.

1966), and for anomalies of the craniospinal junction (Delandsheer et al. 1977, Derome et al. 1977). A midline incision or flap is made in the mucosa of the pharynx and at times also in the soft palate. The soft tissues are stripped laterally. The posterior aspect of the hard palate may also be removed for better access. The arch of the atlas and odontoid are exposed and removed, and an opening drilled in the clivus. The technique has recently been reviewed (Jomin and Bouasakao 1977). A clear disadvantage of this method is the contaminated field through which one must operate, particularly if the dura must be opened, which would be necessary for a meningioma but usually not for a chordoma.

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