Neuroanatomy Guidance to Successful Neurosurgical Interventions: The Torch of Neurosurgical Excellence

Foreword
Preface 1
Preface 2
Contents
Contributors
Part I: General
	1: Phylogenetic Evolution of the Human Central Nervous System
		1.1	 Introduction
		1.2	 Background: The Brain Evolution Story
		1.3	 An Evolutionary Perspective
		1.4	 Embryology of the Human CNS
		1.5	 Evolution of the Telencephalon: What Makes Us Humans
		1.6	 Brain Species Differences
			1.6.1	 Brain Size
			1.6.2	 Number of Neurons
			1.6.3	 Complexity of Neural Circuits
		1.7	 Anatomy Highlights
		1.8	 Blanket of Neurons: Sulcogyral Patterns
		1.9	 Cerebral Substance: White Matter Networks
			1.9.1	 Shape of the Fibers
		1.10	 Surgical Perspective and Future Directions
		1.11	Surgical Pearls
		1.12	 Conclusion
		References
	2: Brain Plasticity and Neurosurgery
		2.1	 Introduction
		2.2	 History and Background
		2.3	 Anatomy Highlights
		2.4	 Dynamic Nature of the Human Brain: A Lifelong Journey of Adaptation and Learning
		2.5	 Network Models of Functional Neuroplasticity
		2.6	 Neuroplasticity and Neurosurgery: A Multifaceted Phenomenon with Clinical Implications
			2.6.1	 Short and Mid-Term Manifestations of Brain Plasticity
			2.6.2	 Manifestations of Brain Plasticity in the Long Term
		2.7	Surgical Pearls
		2.8	 Discussion
		2.9	 Conclusion
		References
	3: History of Neurosurgical Anatomy
		3.1	 Introduction
		3.2	 Anatomical Highlights
		3.3	 Early Studies of Human Neuro-Anatomy
		3.4	 Impact of Religious and Cultural Beliefs on Anatomy Studies
		3.5	 Advancements During the Renaissance Era and the Enlightenment
		3.6	 Advancements During the Nineteenth Century
		3.7	 Advancements in the Twentieth and Twenty-first Century
		3.8	 Surgical Pearls
		3.9	 Discussion
		3.10	 Conclusion
		References
	4: Neurosurgery Theatres, Facilities, and Instruments
		4.1	 Introduction
		4.2	 History
		4.3	 Rationale for Neurosurgical Theatre Design
		4.4	 Types of Neurosurgical Theatres
		4.5	 Design of the Neurosurgical Theatre
			4.5.1	 General Principles of Theatre Design
			4.5.2	 Specific Operation Room Planning Principles
		4.6	 Hybrid Neurosurgical Theatre Concepts
		4.7	 Neurosurgical Equipment and Instrumentation
		4.8	 Microscopes and Exoscopes
		4.9	 Endoscopes
		4.10	 Ultrasonography
		4.11	 Neuronavigation
		4.12	 Instruments
		4.13	 3D Printing for Neurosurgery
		4.14	Surgical Pearls
		4.15	 Conclusion
		References
Part II: Vascular
	5: A Practical Guide to Cerebrovascular Anatomy
		5.1	 Introduction
		5.2	 Anatomy Highlights
		5.3	 Technical Aspects of Cerebral Angiography
		5.4	 Origins of the Cerebral Arterial Supply
		5.5	 Internal Carotid Artery in the Skull Base and Intracranial Space
		5.6	 Arterial Branches in the Supratentorial Space
		5.7	Surgical Pearls
		5.8	 Discussion
		5.9	 Conclusion
		References
	6: Anatomy of the Vertebrobasilar System
		6.1	 Introduction
		6.2	 Anatomy Highlights
		6.3	 History and Background
		6.4	 Basilar Artery
		6.5	 Superior Cerebellar Artery
		6.6	 Anterior Pontomesencephalic Segment of the SCA
		6.7	 Lateral Pontomesencephalic Segment of the SCA
		6.8	 Midbrain Cerebellar Segment of the SCA
		6.9	 Cortical Segment of the SCA
		6.10	 Anterior Inferior Cerebellar Artery (AICA)
		6.11	 Posteroinferior Cerebellar Artery (PICA)
		6.12	 Anterior Spinal Artery
		6.13	 Surgical Pearls
		6.14	 Discussion
		6.15	 Conclusion
		References
	7: Advances in the Surgical Management of Cerebral Aneurysms
		7.1	 Introduction
		7.2	 Background
		7.3	 Anatomy Highlights
		7.4	 Surgical Intervention
			7.4.1	 Case 1
			7.4.2	 Case 2
			7.4.3	 Case 3
		7.5	 Surgical Pearls
		7.6	 Discussion
		7.7	 Conclusion
		References
	8: Clipology, the Art of Aneurysm Clipping
		8.1	 Introduction
		8.2	 Background
		8.3	 Anatomy Highlights
		8.4	 Surgical Intervention
		8.5	 Surgical Technique
		8.6	 Surgical Pearls
		8.7	 Discussion
		8.8	 Conclusion
		References
	9: Orbital-Meningeal Band Anatomy and Application for Exposure of Proximal Carotid Artery
		9.1	 Introduction
		9.2	 History/Background
		9.3	 Anatomy Highlights
		9.4	 Approach/Surgical Intervention
			9.4.1	 Case 1 (Fig. 9.2)
			9.4.2	 Case 2 (Fig. 9.3)
			9.4.3	 Case 3 (Fig. 9.4)
		9.5	Surgical Pearls
		9.6	 Discussion
		9.7	 Conclusion
		References
	10: Surgical Approaches to Cerebral Aneurysms
		10.1	 Introduction
		10.2	 Anatomy Highlights
		10.3	 Intervention
			10.3.1	 Approaches Encountering the Anterior and Middle Fossa
				10.3.1.1	 Pterional Approach and Its Extensions
				10.3.1.2	 Anterior Clinoidectomy
				10.3.1.3	 Transcavernous and Subtemporal Approach
			10.3.2	 Approaches Through the Posterior Fossa
				10.3.2.1	 Far Lateral Approach
				10.3.2.2	 Telovelar (Transcerebellomedullary Fissure) Approach
		10.4	 Surgical Pearls
		10.5	 Discussion
		10.6	 Conclusion
		References
	11: Carotid-Ophthalmic Artery Aneurysms
		11.1	 Introduction
		11.2	 Background
		11.3	 Anatomy Highlights
		11.4	 Surgical Intervention
		11.5	 Surgical Pearls
		11.6	 Discussion
		11.7	 Conclusions
		References
	12: Surgical Treatment of MCA Aneurysms
		12.1	 Introduction
		12.2	 Anatomy Highlights
		12.3	 Characteristics and Classification Systems of MCA Aneurysms
		12.4	 Preoperative Considerations
			12.4.1	 Surgical Technique
		12.5	 Specific Situations
			12.5.1	 Calcifications and Partial Thrombosis
			12.5.2	 Large and Giant Aneurysms
			12.5.3	 Fusiform Aneurysms
			12.5.4	 Dissecting Aneurysms
			12.5.5	 Pseudoaneurysms
			12.5.6	 Bypasses
		12.6	 Role of Endovascular Techniques
		12.7	 Complications and Their Avoidance
		12.8	 Outcome
		12.9	 Surgical Pearls
		12.10	 Conclusion
		References
	13: Microsurgery of Giant Intracranial Aneurysm
		13.1	 Introduction
		13.2	 Anatomical Highlights
		13.3	 Technical Nuances for Specific Aneurysm Subtypes
			13.3.1	 Anterior Circulation Aneurysms
				13.3.1.1	 Anterior Cerebral Artery (ACA)
				13.3.1.2	 Middle Cerebral Artery (MCA) Aneurysms
				13.3.1.3	 Internal Carotid Artery (ICA) aneurysms
			13.3.2	 Posterior Circulation Aneurysms
		13.4	 Microsurgical Strategy
			13.4.1	 Surgical Management
			13.4.2	 General Intraoperative Measures During Aneurysm Surgery
		13.5	 Surgical Pearls
		13.6	 Discussion
		13.7	 Conclusion
		References
	14: Surgical Nuances for Giant Cerebral Aneurysms
		14.1	 Introduction
		14.2	 History/Background
		14.3	 Anatomical Highlights
		14.4	 Approach/Surgical Intervention
			14.4.1	 General Concept of Approach and Direct Surgical Intervention
			14.4.2	 Giant ICA Aneurysms
				14.4.2.1	 High-Flow Bypass Using RA Graft/Saphenous Vein Graft
				14.4.2.2	 Suction Decompression for ICA Aneurysms
			14.4.3	 Giant MCA Aneurysms
			14.4.4	 Giant ACA Aneurysms
			14.4.5	 Giant Posterior Circulation Aneurysms
		14.5	 Representative Cases
			14.5.1	 Case 1: Giant MCA Aneurysm
				14.5.1.1	 History and Imaging Studies
				14.5.1.2	 Strategy
				14.5.1.3	 Surgical Procedures
			14.5.2	 Case 2: Giant ACA Aneurysm, the Importance of Various Bypass Techniques
				14.5.2.1	 History and Imaging Studies
				14.5.2.2	 Strategy
				14.5.2.3	 Surgical Procedures
			14.5.3	 Case 3: A Giant ICA Aneurysm
				14.5.3.1	 History and Imaging Studies
				14.5.3.2	 Strategy
				14.5.3.3	 Surgical Procedures
		14.6	 Surgical Pearls
		14.7	 Discussion
		14.8	 Conclusion
		References
	15: Microsurgical Treatment of Complex Aneurysms in the Current Endovascular Era
		15.1	 Introduction
		15.2	 Anatomy Highlights
		15.3	 Approach and Surgical Intervention
		15.4	 Representative Cases
		15.5	 Surgical Pearls
		15.6	 Discussion
		15.7	 Conclusions
		References
	16: Advanced Micro-Neurosurgery in Treating Basilar Aneurysms
		16.1	 Introduction
		16.2	 History/Background
		16.3	 Anatomy Highlights
			16.3.1	 Basilar Artery
			16.3.2	 Perforators
			16.3.3	 Oculomotor Nerve
		16.4	 Approach/Surgical intervention
		16.5	Surgical Pearls
		16.6	 Discussion
		16.7	 Conclusion
		References
	17: Surgical Trajectories for Clipping of Different PICA Aneurysms
		17.1	 Introduction
		17.2	 Anatomical Highlights
		17.3	 Relevant Vascular Anatomy
			17.3.1	 PICA Vessel Segments
			17.3.2	 Classification of Different PICA Aneurysms
				17.3.2.1	 Morphological Classification
				17.3.2.2	 Haemodynamic Classification
				17.3.2.3	 Classification by Location
		17.4	 Intervention
			17.4.1	 Relationship of the VA/PICA Segments and “3D Visualization” at the Region of the Cranio-Cervical Junction, Foramen Magnum and Posterior Fossa
				17.4.1.1	 Geometric Anatomical Considerations of the Far Lateral Approach
		17.5	 Factors to Be Considered for Selection of Safe Exposure and Trajectories for Clipping of PICA Aneurysms
			17.5.1	 Optimal Exposure/Visualisation of the “Neck” (+++)
			17.5.2	 Proximal and Distal Control (++)
			17.5.3	 Size (±)
			17.5.4	 Proximity of Cranial Nerves (+)
			17.5.5	 Tortuosity/Off Midline VBJ (++)
			17.5.6	 Cranio-Caudal Location (+++)
			17.5.7	 Anatomical Concepts for Tailored Approaches and Surgical Exposure for PICA Aneurysms
				17.5.7.1	 Dilemmas When Choosing the Best Exposure and Approaches for PICA Aneurysms
				17.5.7.2	 Influence of the Location of the PICA Take-Off From VA on the Selection of Approach and Trajectory
				17.5.7.3	 Influence of the Location of the Aneurysm on the PICA Segments on the Selection of Approach and Trajectory
		17.6	 Nuances of the Surgical Approaches Gaining Access to PICA Aneurysms at the CCJ
			17.6.1	 Midline Suboccipital Approach
			17.6.2	 Far Lateral Approach
			17.6.3	 Is There a Rationale for Occipital Condyle Resection to Gain Access Through the Far Lateral Approach to Its Anterior Location for Clipping of PICA Aneurysms?
			17.6.4	 Vertebral Artery and Exposure of the Cranio-Cervical Junction If Required
		17.7	 Surgical Pearls
		17.8	 Discussion
		17.9	 Conclusions
		References
	18: Anatomy, Characteristics, and Management of Pediatric Aneurysms
		18.1	 Introduction
		18.2	 History and Background
		18.3	 Anatomical Highlights
		18.4	 Clinical Presentation
		18.5	 Imagistic Diagnosis
		18.6	 Management of Pediatric Intracranial Aneurysms
			18.6.1	 Surgical Treatment
			18.6.2	 Endovascular Treatment
			18.6.3	 Conservative Treatment
		18.7	 Surgical Pearls
		18.8	 Discussions
		18.9	 Conclusions
		References
	19: Endoscopic Techniques Applied to Neurovascular Pathology
		19.1	 Introduction
		19.2	 History/Background
		19.3	 Endoscope-Assisted Microneurosurgery for Intracranial Aneurysms
			19.3.1	 Operative Technique
			19.3.2	 Anatomic Highlights
		19.4	 Endoscope-Controlled Microneurosurgery for Intracranial Aneurysm Clipping (Keyhole/Endoscopic Port)
		19.5	 Endoscopic Endonasal Approaches for Aneurysm Clipping (Fig. 19.1)
			19.5.1	 Extended Endonasal Transplanum-Transtuberculum Approach (EETTA) for Anterior Circulation Aneurysms
			19.5.2	 Endoscopic Endonasal Transclival Approach (EETA) for Posterior Circulation Aneurysms (Fig. 19.3)
		19.6	 Endoscopic Endonasal Approaches for Brainstem Cavernous Malformations (BSCM)
		19.7	 Surgical Pearls
			19.7.1	 Endoscope-Assisted Microneurosurgery for Intracranial Aneurysms
			19.7.2	 Endoscope-Controlled Microneurosurgery for Intracranial Aneurysm Clipping (Keyhole/Endoscopic Port)
			19.7.3	 Endoscopic Endonasal Approaches for Brainstem Cavernous Malformations (BSCM)
		19.8	 Discussion
		19.9	 Conclusion
		References
	20: Surgery for Brain Arteriovenous Malformations
		20.1	 Introduction
		20.2	 Background and AVM Anatomy Highlights
			20.2.1	 Diagnostic Procedures
		20.3	 AVM Treatment
		20.4	 Surgery
		20.5	 Surgical Pearls
		20.6	 Discussion
			20.6.1	 Timing of Surgery
			20.6.2	 Endovascular Treatment
			20.6.3	 Radiosurgical Treatment
			20.6.4	 Other Treatment Combinations
		20.7	 Conclusion
		References
	21: Arteriovenous Malformation Involving the Broca’s Area and Precentral Gyrus
		21.1	 Introduction
		21.2	 Anatomy Highlights
		21.3	 Diagnosis of Arteriovenous Malformations in Broca’s Area
			21.3.1	 Clinical Evaluation
				21.3.1.1	 Neuroimaging
			21.3.2	 Surgical Intervention
				21.3.2.1	 Treatment of Arteriovenous Malformations in Broca’s Area
		21.4	 Surgical Pearls
		21.5	 Discussion
		21.6	 Conclusion
		References
	22: Surgical Strategy for Brainstem Cavernomas: Nexus of Anatomy, Pathology, and Ergonomics
		22.1	 Introduction
		22.2	 History/Background
		22.3	 Anatomy Highlights
		22.4	 Approach/Surgical Intervention (Including Representative Own Cases)
			22.4.1	 Brainstem Entry Zones
			22.4.2	 Midbrain Entry Zones
			22.4.3	 Ventral Entry Zones
				22.4.3.1	 InterpeduncularZone (IPZ)
				22.4.3.2	 Anterior Mesencephalic Zone (AMZ) aka Perioculomotor Zone
			22.4.4	 Lateral Entry Zones
				22.4.4.1	 Lateral Mesencephalic Sulcus (LMS)
			22.4.5	 Dorsal Entry Zones
				22.4.5.1	 Supracollicular Zone (SCZ)
				22.4.5.2	 Infracollicular Zone (ICZ)
				22.4.5.3	 Intercollicular Zone (ICR)
			22.4.6	 Pons Entry Zones
			22.4.7	 Lateral Entry Zones
				22.4.7.1	 Supratrigeminal Zone (STZ)
				22.4.7.2	 Peritrigeminal Zone (PTZ)
				22.4.7.3	 Lateral Pontine Zone (LPZ) aka Middle Cerebellar Peduncle Zone
			22.4.8	 Dorsal Entry Zones
				22.4.8.1	 Median Sulcus Zone (MS)
				22.4.8.2	 Suprafacial Collicular Zone (SFZ)
				22.4.8.3	 Infrafacial Collicular Zone (IFZ)
			22.4.9	 Medulla Entry Zones
			22.4.10 Lateral Entry Zones
				22.4.10.1	 Olivary Zone (OZ)
				22.4.10.2	 Anterolateral Sulcus (ALS)
				22.4.10.3	 Lateral Medullary Zone (LMZ)
			22.4.11 Dorsal Entry Zones
				22.4.11.1	 Posterior Median Sulcus (PMS)
				22.4.11.2	 Posterior Intermediate Sulcus (PIS)
				22.4.11.3	 Posterior Lateral Sulcus (PLS)
		22.5	 Surgical Pearls
		22.6	 Discussion
			22.6.1	 Common Pitfalls
		22.7	 Conclusion
		References
	23: Surgical Revascularization Strategies for Vertebral Artery Disease
		23.1	 Introduction
		23.2	 History
		23.3	 Anatomy Highlights
			23.3.1	 Vertebral Artery Anatomy
			23.3.2	 Preoperative Assessment
		23.4	 Surgical Approach
			23.4.1	 Approach by Segment
			23.4.2	 Patient Positioning
			23.4.3	 Donor (Inflow) Selection
			23.4.4	 Vertebral Artery (V1) Transposition Technique
			23.4.5	 Vertebral Artery (V3) Bypass with Interposition Graft Technique
		23.5	 Surgical Pearls
		23.6	 Conclusion
		References
	24: Bypass Surgery in Moyamoya Disease and Ischemia
		24.1	 Introduction
		24.2	 History
		24.3	 Background
			24.3.1	 Bypass for Cerebral Ischemia
			24.3.2	 Bypass for Moyamoya Disease
			24.3.3	 Preoperative Imaging
			24.3.4	 Types of Anastomoses
			24.3.5	 Modeling the Bypass
		24.4	 Anatomy Highlights
		24.5	 Approach/Surgical Intervention
			24.5.1	 Patient Positioning
			24.5.2	 Incision Planning
			24.5.3	 Harvesting the Superficial Temporal Artery
			24.5.4	 Craniotomy
			24.5.5	 Harvesting the Recipients
			24.5.6	 Preparing for the Anastomosis
			24.5.7	 Anastomosis
			24.5.8	 Anastomosis Techniques
			24.5.9	 Flow Measurements/Analysis
			24.5.10	 Closure
			24.5.11	 Postoperative Considerations
		24.6	 Surgical Pearls
		24.7	 Discussion
			24.7.1	 Alternate Options: Choice of Conduit
		24.8	 Conclusion
		References
	25: 3D DSA-Guided Keyhole STA-MCA Bypass in Moyamoya Vasculopathy
		25.1	Anatomical Highlights
		25.2	 Introduction
		25.3	 Surgical Strategy
			25.3.1	 Preoperative Preparation
			25.3.2	 Intraoperative Strategy
		25.4	 Results
		25.5	 Surgical Pearls
		25.6	 Discussion
		25.7	 Conclusion
		References
	26: The Art and the Logic of Flow-Guided Bypass for Aneurysms
		26.1	 Introduction
		26.2	 History
		26.3	 Anatomy Highlights
			26.3.1	 Preoperative Assessment
		26.4	 Surgical Intervention
			26.4.1	 Preparation
			26.4.2	 Intraoperative Blood Flow Measurement
			26.4.3	 Operative Nuances
			26.4.4	 Cut Flow
			26.4.5	 Bypass Technique
		26.5	 Additional Tips and Tricks
			26.5.1	 Cut Flow Index
			26.5.2	 Closing
			26.5.3	 Postoperative management
		26.6	 Surgical Pearls
		26.7	 Conclusion
		References
	27: Carotid Endarterectomy
		27.1	 Introduction
		27.2	 Symptomatology
		27.3	 Timing
		27.4	 Diagnostic Procedures
		27.5	 Endarterectomy Technique
			27.5.1 Shunt
			27.5.2 Patch
			27.5.3 Eversion Technique
			27.5.4 Kink
			27.5.5 Pseudoocclusion
			27.5.6 Carotid Occlusion
			27.5.7 Carotid Stump
			27.5.8 Carotid Dissection
			27.5.9 Pseudoaneurysms
			27.5.10 Other Non-Atherosclerotic Conditions Causing Cerebral Ischaemia
		27.6	 Complications and Their Avoidance
		27.7	 Treatment Outcome and CAS Indications
		27.8	 Surgical Pearls
		27.9	 Conclusion
		References
Part III: Skull Base Tumors
	28: Orbit Tumors: Anatomy and Surgical Approaches
		28.1	 Introduction
		28.2	 History/Background
		28.3	Anatomical Highlights
			28.3.1	 The Orbit Chamber
			28.3.2	 The Pyramidal Concept: Surgical Routes to the Orbit Based on the Anatomy
		28.4	 Surgical Interventions
		28.5	Surgical Pearls
		28.6	 Conclusion
		References
	29: Anatomy of and Surgical Approaches to the Orbit for Neurosurgeons
		29.1	 Introduction
		29.2	 History and Background
		29.3	 Anatomy Highlights
		29.4	 Approaches
			29.4.1	 Transorbital Lateral Orbitotomy
			29.4.2	 Transorbital Modified Lateral Orbitotomy
			29.4.3	 Transorbital Transconjunctival Approach
			29.4.4	 Transcranial Frontotemporal Approaches
			29.4.5	 Endoscopic Endonasal Approach
		29.5	 Surgical Pearls
		29.6	 Discussion
		29.7	 Conclusion
		References
	30: Olfactory Groove Meningiomas
		30.1	 Introduction
		30.2	 Background
			30.2.1	 Tumour Grading
		30.3	 Anatomy Highlights
			30.3.1	 Gross Anatomy of the Olfactory Groove
			30.3.2	 Radiological Anatomy of Olfactory Groove Meningiomas
		30.4	 Surgical Treatment of Olfactory Groove Meningiomas
			30.4.1	 Approaches
				30.4.1.1	 Unilateral: Frontal to Lateral Frontal to Modified Pterional
					Incision
				30.4.1.2	 Bilateral: Bicoronal Subfrontal (‘Bifrontal’)
				30.4.1.3	 Extended Endoscopic Endonasal Approach
			30.4.2	 Other Approaches
		30.5	 Surgical Pearls
		30.6	 Discussion
		30.7	 Conclusions
		References
	31: Tailored Microsurgical Approach to Tuberculum Sella Meningioma
		31.1	 Introduction
		31.2	 History and Background
		31.3	 Anatomical Highlights: (Fig. 31.1)
		31.4	 Surgical Intervention
		31.5	 Trans-eyebrow Approach
		31.6	 Fronto-Orbito-Zygomatic Approach and Variant
		31.7	 Endonasal Endoscopic Extended Transsphenoidal Surgery
		31.8	 Surgical Pearls
		31.9	 Discussion
		31.10	 Conclusion
		References
	32: Management of Parasagittal Meningiomas
		32.1	 Introduction
		32.2	 History and Background
		32.3	 Anatomical Highlights
			32.3.1	 Arterial Vascularization of the Tumor
			32.3.2	 Clinical Presentation
			32.3.3	 Pathology
			32.3.4	 Radiological Diagnosis
		32.4	 Surgical Intervention
			32.4.1	 Position
			32.4.2	 Scalp Incision
			32.4.3	 Bone Flap
			32.4.4	 Dural Opening
			32.4.5	 Tumor Removal
			32.4.6	 SSS Invasion
			32.4.7	 Prognosis
		32.5	 Surgical Pearls
		32.6	 Closure
		32.7	 Discussion
		32.8	 Conclusion
		References
	33: Evolution and Revolution in Pituitary Medicine and Surgery
		33.1	 Evolution and Revolution
		33.2	 Anatomical Highlights for Transsphenoidal Surgery
		33.3	 History/Background
			33.3.1	 Ancient Egyptian Transnasal Sphenoethmoidal Approach
			33.3.2	 Endoscopic Techniques and Phillip Bozzini
			33.3.3	 Max Nitze and the Improved Endoscope
			33.3.4	 Knowledge of Pituitary Disease and Pierre Marie and Minkowski
			33.3.5	 Sir Victor Horsley, Pioneer of Pituitary Surgery
			33.3.6	 Davide Giordano and Francesco Durante, Pioneers of Endonasal Surgery
			33.3.7	 Alfred Hirschmann and ENTs Applying Endoscope to Nasal Cavity
		33.4	 Approach/Surgical Interventions
			33.4.1	 Schloffer’s Transsphenoidal Approach
			33.4.2	 Theodor Kocher and the Submucosal Dissection Approach
			33.4.3	 Oscar Hirsch and the Endonasal Approach
			33.4.4	 Pituitary Milestones: Halstead, Hirsch, and Cushing’s Innovations
		33.5	 Medical Treatments
			33.5.1	 Bromocriptine, Cabergoline, Octreotide, Pegvisomant, and Pasireotide
			33.5.2	 Development of Functional Endoscopic Sinus Surgery
			33.5.3	 Limits of the Microscope and Advantages of Endoscopy
			33.5.4	 Endoscopic Techniques in the Spotlight
			33.5.5	 Advancements in Endoscopic Techniques for Anterior Skull Base Lesions and Overcoming Limitations
			33.5.6	 The Nasoseptal Flap Technique
		33.6	 Medical Advances and Hormone Discoveries
		33.7	 Technological and Imaging Advances
			33.7.1	 Norman Dott’s Lighted Nasal Speculum
			33.7.2	 Gerard Guiot’s Intraoperative Fluoroscopy
			33.7.3	 Jules Hardy with the Introduction of the Surgical Microscope and Selective Adenomectomy
			33.7.4	 Hopkins-Storz Endoscope
			33.7.5	 Advances in CT and MR Imaging
		33.8	 Molecular Biology and Pathological Diagnosis
		33.9	 Surgical Pearls
		33.10	 Discussion
		33.11	 Conclusion
		References
	34: Functional Anatomy for Transsphenoidal Approach
		34.1	 Introduction/History
		34.2	 Anatomy Highlights
		34.3	 Approach and Surgical Intervention/Representative Cases
		34.4	 Surgical Pearls
		34.5	 Discussion
		34.6	 Conclusions
		References
	35: Approach to Giant Pituitary Adenomas
		35.1	 Introduction
		35.2	 History/Background
		35.3	 Anatomy Highlights
		35.4	 Approach/Surgical Intervention
			35.4.1	 Case 1
			35.4.2	 Case 2
			35.4.3	 Case 3
		35.5	 Surgical Pearls
		35.6	 Discussion
		35.7	 Conclusion
		References
	36: Endoscopic Approach of Complex Pituitary Tumors with Involvement of Cavernous Sinus
		36.1	 Introduction
		36.2	 History and Background
		36.3	 Anatomy Highlights
		36.4	 Approach (Surgical Intervention)
		36.5	 Surgical Pearls
		36.6	 Discussion
		36.7	 Conclusion
		References
	37: Surgical Anatomy of the Intracavernous Carotid Artery
		37.1	 Introduction
		37.2	 Anatomy Highlights
		37.3	 History and Background
		37.4	 Branches of the Cavernous Internal Carotid Artery
			37.4.1	 The Lacerum Segment
			37.4.2	 Cavernous Segment
			37.4.3	 Venous Spaces of the Cavernous Sinus
			37.4.4	 Clinoid Segment
		37.5	 Surgical Pearls
		37.6	 Conclusion
		References
	38: Surgical Anatomy of the Cavernous Sinus and Refinement of Its Surgery
		38.1	 Introduction
		38.2	 History and Background
		38.3	 Anatomical Highlights
			38.3.1	 The Four Walls of the Cavernous Sinus
			38.3.2	 The Osseous Anatomy of the Cavernous Sinus
				38.3.2.1	 The Anterior, Middle, and Posterior Clinoid Processes
			38.3.3	 Arterial Anatomy
			38.3.4	 Venous Anatomy
			38.3.5	 Nerves
		38.4	 Surgical Relevance and Surgical Strategies
		38.5	 Surgical Cases
		38.6	 Surgical Pearls
		38.7	 Discussion
		38.8	 Conclusion
		References
	39: Surgical Treatment of Craniopharyngiomas
		39.1	 Introduction
		39.2	 Anatomical Highlights
		39.3	 History/Background
			39.3.1	 Pathogenesis
			39.3.2	 Classification
		39.4	 Surgical Approaches
			39.4.1	 Pterional Approach
			39.4.2	 Translamina Terminalis Approach
			39.4.3	 Interhemispheric Approach
			39.4.4	 Trans-Sphenoidal Approach
		39.5	 Surgical Pearls
		39.6	 Discussion
		39.7	 Conclusion
		References
	40: The Endoscopic Endonasal Approach to Suprasellar Craniopharyngioma
		40.1	 Introduction
		40.2	 History and Background
		40.3	 Anatomy Highlights
		40.4	 Approach (Surgical Intervention)
			40.4.1	 Infrachiasmatic/Preinfundibular (i.e. Type I)
			40.4.2	 Transinfundibular (Type II)
			40.4.3	 Infrachiasmatic/Retroinfundibular (Type III)
			40.4.4	 Reconstruction
			40.4.5	 Postoperative Care
			40.4.6	 Case 1
			40.4.7	 Case 2
			40.4.8	 Case 3
		40.5	 Surgical Pearls
		40.6	 Discussion
		40.7	 Conclusion
		References
	41: Anterior Petrosal Approach
		41.1	 Introduction
		41.2	 History and Background
		41.3	 Anatomy Highlights
		41.4	 Preoperative Evaluation of Imaging
		41.5	 Approach/Surgical Intervention
			41.5.1	 Positioning and Setting
			41.5.2	 Soft Tissue Dissection and Craniotomy
			41.5.3	 Kawase Triangle Exposure
			41.5.4	 Anterior Petrosectomy
			41.5.5	 Dura Opening
			41.5.6	 Closure
		41.6	 Surgical Pearls
		41.7	 Risk of Complications
		41.8	 Discussion
		41.9	 Conclusion
		References
	42: Anatomy and Surgical Aspects of Supracerebellar Infratentorial Approach
		42.1	 Introduction
		42.2	 Anatomical Highlights
		42.3	 Positioning and Monitoring of the Patient
		42.4	 Skin Incision
		42.5	 Three Types of Craniotomy and Target Areas
			42.5.1	 Midline SCIT (mSCIT)
			42.5.2	 Paramedian SCIT (pSCIT)
			42.5.3	 Lateral SCIT (lSCIT)
		42.6	 Dural Opening
		42.7	 Approach to the Pineal Region
		42.8	 Surgical Pearls
		42.9	 Discussion
			42.9.1	 Summary of Approaches and Target Lesions
			42.9.2	 Duraplasty and Wound Closure
			42.9.3	 Pitfalls
		42.10	 Conclusion
		References
	43: Neurosurgical Approach to Vestibular Schwannoma
		43.1	 Introduction
		43.2	 Background
		43.3	 Anatomy Highlights
			43.3.1	 Mastoid Anatomy
			43.3.2	 Internal Auditory Canal Landmark in Retrosigmoid Exposure
			43.3.3	 Middle Cranial Fossa and Rhomboid Fossa Anatomy
		43.4	 Approaches
			43.4.1	 Retrosigmoid Approach
			43.4.2	 Translabyrinthine Approach [9]
			43.4.3	 Middle Fossa Approach [11]
		43.5	 Surgical Pearls
			43.5.1	 Retrosigmoid Approach
			43.5.2	 Translabyrinthine Approach
		43.6	 Discussion
		43.7	 Conclusion
		References
	44: Retrosigmoid Microsurgery of Giant Vestibular Schwannoma
		44.1	 Introduction
		44.2	 Anatomy Highlights
		44.3	 Surgical Approach
		44.4	Special Recommendations
		44.5	 Surgical Pearls
		44.6	 Discussion
			44.6.1	 Microsurgical Approaches for Giant Vestibular Schwannomas
			44.6.2	 Facial Nerve Outcome
			44.6.3	 Hearing Preservation
			44.6.4	 Postoperative Complications
			44.6.5	 Alternative Treatment Strategies to Decrease Risks and to Improve the Functional Outcome
		44.7	 Conclusions
		References
	45: Retrosigmoid Approach and Hybrid Use of Endoscopy in CPA Tumors
		45.1	 Introduction
		45.2	 History and Background
		45.3	 Anatomical Highlights (Figs. 45.1 and 45.2)
		45.4	 Approach Selection and Indication
		45.5	 Retrosigmoid Approach (RS)
		45.6	 Special Considerations
		45.7	 Surgical Pearls
		45.8	 Discussion
		45.9	 Conclusion
		References
	46: Neuroanatomy for Neurobionic Hearing Restoration
		46.1	 Introduction
		46.2	 Anatomy Highlights of the Auditory System
		46.3	 Cochlea and Round Window
		46.4	 Cochlear Nuclei
		46.5	 Inferior Colliculus
		46.6	 Approaches and Surgical Technique of Hearing Restoration
			46.6.1	 Cochlear Implant
			46.6.2	 Auditory Brainstem Implant (ABI)
			46.6.3	 Auditory Midbrain Implant (AMI)
		46.7	 Surgical Pearls
		46.8	 Discussion
		46.9	 Conclusion
		References
	47: Anatomy and Variation for Combined Transpetrosal Approach
		47.1	 Introduction
		47.2	 History/Background
		47.3	 Anatomy Highlights
		47.4	 Approach (Surgical Intervention)
			47.4.1	 Patient Positioning, Skin Incision, and Craniotomy
			47.4.2	 Splitting Mastoidotomy and Exposure of the Sigmoid Sinus
			47.4.3	 Dural Dissection and Exposure of the Posteromedial Triangle (Kawase’s Triangle)
			47.4.4	 Petrosectomy
			47.4.5	 Dural Opening and Cutting of the Tentorium
			47.4.6	 Opening of Meckel’s Cave and the Posterior Component of the Cavernous Sinus
			47.4.7	 Observation of Cranial Nerves and Blood Vessels in the Posterior Cranial Fossa
			47.4.8	 Observation of Cranial Nerves and Blood Vessels in the Supratentorial Space
		47.5	 Representative Cases
			47.5.1	 Anterior and Posterior Combined Transpetrosal Approach
			47.5.2	 Anterior and Posterior Combined Transpetrosal Approach with Labyrinthectomy
			47.5.3	 Combined Transpetrosal Approach with Retrosigmoid Approach
			47.5.4	 Combined Presigmoid Approach with Transcondylar Approach
		47.6	 Surgical Pearls
		47.7	 Discussion
		47.8	 Conclusion
		References
	48: Anatomy and Surgical Approaches to Pineal Region Tumors (PRTs)
		48.1	 Introduction
		48.2	 Classification and Clinical Aspects
		48.3	 Anatomical Highlights (Figs. 48.1 and 48.2)
		48.4	 Surgical Approaches
			48.4.1	 Occipital Transtentorial Approach (OTA): (Figs. 48.3 and 48.4)
			48.4.2	 The Midline Supracerebellar-Infratentorial Approach (M-SCITA). (Figs. 48.5 and 48.6)
			48.4.3	 Endoscopic-Assisted Paramedian SCIT Approach (PM-SCITA): (Fig. 48.7)
			48.4.4	 Posterior Interhemispheric Trans-callosal Approach: (PITA)
			48.4.5	 Endoscopic Third Ventriculostomy (ETV) & Biopsy (BX) (Figs. 48.8 and 48.9)
		48.5	 Surgical Pearls
		48.6	 Discussion
		48.7	 Conclusion
		References
	49: Surgical Strategies for Jugular Foramen Tumors
		49.1	 Introduction
		49.2	 History/Background
		49.3	 Anatomy Highlights
		49.4	 Approach/Surgical Intervention
			49.4.1	 Posterolateral Approaches
				49.4.1.1	 Retrosigmoid Approach
				49.4.1.2	 Far Lateral Approach
			49.4.2	 Anterolateral Approaches
				49.4.2.1	 Postauricular Transtemporal Approach
				49.4.2.2	 Preauricular Subtemporal Infratemporal Approach
			49.4.3	 Combined Approach
				49.4.3.1	 Combined Transmastoid Retro- and Infralabyrinthine Transjugular Transcondylar Transtubercular Transcervical Approach
			49.4.4	 Representative Cases
				49.4.4.1	 Case 1
				49.4.4.2	 Case 2
				49.4.4.3	 Case 3
				49.4.4.4	 Case 4
		49.5	 Surgical Pearls
		49.6	 Discussion
		49.7	 Conclusion
		References
	50: Merits of Endoscopic Approach to Clivus Tumors and Challenges
		50.1	 Introduction
		50.2	 History and Background
		50.3	 Anatomy Highlights
		50.4	 Approach (Surgical Intervention)
		50.5	 Surgical Pearls
		50.6	 Discussion
		50.7	 Conclusion
		References
	51: Anatomy and Tailored Surgical Approach to Foramina Magnum Meningioma
		51.1	 Introduction
		51.2	 History
		51.3	 Anatomy Highlights
		51.4	 Approaches
			51.4.1	 Far-Lateral Approach
			51.4.2	 Posterior Midline Approach
			51.4.3	 Anterior Midline Approach (Endoscopic Endonasal Approach)
		51.5	Surgical Pearls
		51.6	 Discussion
		51.7	 Conclusion
		References
	52: Anatomy for Microsurgery of Paragangliomas
		52.1	 Introduction
		52.2	 History
		52.3	 Anatomy Highlights
		52.4	 Clinical Aspects and Intervention
			52.4.1	 Paragangliomas
		52.5	 Approach/Surgical Intervention
			52.5.1	 Positioning and Skin Incision
		52.6	 Dissection of Cervical Neurovascular Structures
			52.6.1	 Mastoidectomy
		52.7	 Venous Structures Management
		52.8	 Closure
		52.9	 Surgical Pearls
		52.10	 Discussion
			52.10.1	 Paragangliomas
		52.11	 Conclusion
		References
Part IV: Ventricular Tumors
	53: Intraventricular Endoscopic Anatomy
		53.1	 Introduction
		53.2	 History and Background
		53.3	 Anatomical Highlights
			53.3.1	 Anatomy of the Lateral Ventricles
			53.3.2	 Anatomy of the Third Ventricle
			53.3.3	 Surgical Technique of Endoscopic Third Ventriculostomy
		53.4	 Surgical Pearls
		53.5	 Discussion
		53.6	 Conclusion
		References
	54: Anatomy and Surgical Approaches to Lateral Ventricle Tumors
		54.1	 Introduction
		54.2	 Anatomical Highlights
			54.2.1	 Detailed Surgical Anatomy of the Lateral Ventricle [30, 31]
		54.3	 Intraventricular Meningioma (IVM)
			54.3.1	 Clinical Features
			54.3.2	 Radiological Features: ( See Figs. 54.1, 54.2 and 54.3 Below)
			54.3.3	 Histology and Pathology
			54.3.4	 Conservative Management of Trigone Meningiomas
			54.3.5	 Open Surgical Approaches and Complication Avoidance for Lesions of the Atrium
		54.4	 Surgical Intervention
			54.4.1	 Overview of Surgical Approaches
			54.4.2	 Anterior Approaches
				54.4.2.1	 Distal Transsylvian Approach for Small IVM
			54.4.3	 Lateral Approaches
				54.4.3.1	 Superior Parietal Lobule Approach (Fig. 54.5)
				54.4.3.2	 Intraparietal Sulcus Approach
				54.4.3.3	 Transtemporal Approach
				54.4.3.4	 Temporoparietal Approach (Fig. 54.7)
				54.4.3.5	 Combined Temporal and Parietal Approach
			54.4.4	 Posterior Approaches
				54.4.4.1	 Parieto-Occipital Approach (Figs. 54.8 and 54.9)
				54.4.4.2	 Occipital Corticotomy or Lobectomy
				54.4.4.3	 Posterior Interhemispheric Parieto-Occipital Precuneal (Para-Splenial) Approach
				54.4.4.4	 Posterior Transcallosal Approach
		54.5	 Intraventricular Subependymoma
			54.5.1	 Epidemiology and Background [65]
			54.5.2	 Radiographic Features [66] (See Figs. 54.8 and 54.9)
				54.5.2.1	 Surgical Decision Making
		54.6	 Surgical Pearls
		54.7	 Discussion
		54.8	 Conclusion
		References
	55: Microsurgical Anatomy of Third Ventricle Approaches
		55.1	 Introduction
		55.2	 Anatomical Highlights
		55.3	 History/Background
		55.4	 Microsurgical Anatomy of Third Ventricle Approaches
		55.5	 Anterior Approaches
			55.5.1	 Transylvian Approach
			55.5.2	 Interhemispheric Trans Lamina Terminalis Approach
			55.5.3	 Trancallosal Approach
		55.6	 Transforaminal Approach
		55.7	 Transchoroidal Approach
		55.8	 Interforniceal Approach
		55.9	 Posterior Approaches
			55.9.1	 Infratentorial-Supracerebellar Approach
			55.9.2	 Interhemispheric-Transcallosal Approach
			55.9.3	 Occipital-Transtentorial Approach
		55.10	 Surgical Pearls
		55.11	 Discussion
		55.12	 Conclusions
		References
	56: Endoscopic Resection of Colloid Cysts
		56.1	 Introduction
		56.2	 History and Background
		56.3	 Anatomy Highlights
		56.4	 Approach/Surgical Intervention
			56.4.1	 Preoperative Considerations
			56.4.2	 Surgical Procedure
			56.4.3	 Hemostasis Techniques
		56.5	 Surgical Pearls
		56.6	 Discussion
		56.7	 Conclusion
		References
	57: Endoscopic Transchoroidal Fissure Approach to the Posterior Third Ventricle
		57.1	 Introduction
		57.2	 History/Background
		57.3	 Anatomy Highlights
		57.4	 Approach/Surgical Intervention
		57.5	 Surgical Pearls
		57.6	 Discussion
		57.7	 Conclusion
		References
	58: Anatomy and Telovelar Approach to the Fourth Ventricular Pathology
		58.1	 Introduction
			58.1.1	 History/Background
			58.1.2	 Indications
		58.2	 Anatomy Highlights
		58.3	 Anatomy
		58.4	 Approach/Surgical Intervention
			58.4.1	 Pre-operative Considerations
			58.4.2	 Positioning
			58.4.3	 Surgical Technique
			58.4.4	 Complications
		58.5	 Surgical Pearls
		58.6	 Discussion
		58.7	 Conclusion
		References
	59: Endonasal Endoscopic Skull Base Surgery in Children: Anatomical and Technical Considerations
		59.1	 Introduction
		59.2	 Development of the Skull Base
		59.3	 Radiological Insights into Developmental Anatomy
			59.3.1	 Anatomical Highlights
		59.4	 Surgical Approach
			59.4.1	 Steps of Surgery
		59.5	 Illustrative Cases
		59.6	 Complications
		59.7	 Surgical Pearls
		59.8	 Discussion
		59.9	 Conclusion
		References
Part V: Gliomas
	60: Anatomy and White Matter Dissection for Surgery of Low-grade Gliomas
		60.1	 Introduction
		60.2	 Background
		60.3	 Anatomy Highlights
		60.4	 Association Fibers
			60.4.1	 Short Association Fibers (U Fibers)
			60.4.2	 Superior Longitudinal Fasciculus/Arcuate (SLF/AF) Complex
			60.4.3	 Extreme Capsule
			60.4.4	 Uncinate Fasciculus
			60.4.5	 Fronto-Occipital Fasciculus
			60.4.6	 Cingulum
			60.4.7	 Inferior Longitudinal Fasciculus
			60.4.8	 Fornix
		60.5	 Commissural Fibers
			60.5.1	 Corpus Callosum
			60.5.2	 Anterior Commissure
		60.6	 Hippocampal (Forniceal) Commissure
		60.7	 Projection Fibers
			60.7.1	 Internal Capsule—Corona Radiata
			60.7.2	 Approach
		60.8	 Surgical Pearls
		60.9	 Discussion
		60.10	 Conclusion
		References
	61: Neuroanatomical Landmarks to Approach Insular Tumors
		61.1	 Introduction
		61.2	 History/Background
		61.3	Anatomical Highlights
			61.3.1	 The Telencephalic Flexure
			61.3.2	 The Sylvian Fissure and Opercula
			61.3.3	 Topographic Anatomy of the Insular Surface
			61.3.4	 Arteries of the Insula
			61.3.5	 Subcortical Anatomy
		61.4	Surgical Pearls
		61.5	 Discussion
		61.6	 Conclusion
		References
	62: The Left Inferior Parietal Lobule: Anatomy, Function, and Surgery
		62.1	 Introduction
		62.2	 History and Background
		62.3	 Anatomical Highlights
		62.4	 Gross Anatomy
		62.5	 Cortical Functional Anatomy
			62.5.1	 Superiorly
			62.5.2	 Inferiorly
			62.5.3	 Anteriorly
			62.5.4	 Posteriorly
		62.6	 Subcortical Functional Anatomy
			62.6.1	 Medially (To the Depth)
		62.7	Surgical Pearls
		62.8	 Discussion
		62.9	 Conclusion
		References
	63: White Fibers Anatomy for Approaches to Limbic Tumors
		63.1	 Introduction
		63.2	 History/Background
			63.2.1 The Phylogenetic Evolution of the Limbic System
			63.2.2 An Overview of the Limbic System Embryology
			63.2.3 An Overview of the Limbic System Functions
		63.3	 Anatomical Highlights
			63.3.1 Orbitofrontal Gyri and Olfactory Cortex
			63.3.2 Septal Area
			63.3.3 Cingulate Gyrus
			63.3.4 Isthmus Cinguli
			63.3.5 Parahippocampal Gyrus
			63.3.6 Hippocampal Formation
			63.3.7 Amygdala and Entorhinal Cortex
		63.4	Surgical Pearls
		63.5	 Discussion
			63.5.1 Orbitofrontal and Septal
			63.5.2 Cingulate Tumors
			63.5.3 Isthmic Tumors
			63.5.4 Parahippocampal Tumors
			63.5.5 Hippocampal and Amygdala Tumors
			63.5.6 Diffuse Limbic Tumors
		63.6	 Conclusion
		References
	64: Anatomy and Challenges for Surgical Removal of Brainstem Tumors: The Mesencephalic Region
		64.1	 Introduction
		64.2	 Anatomy Highlights
		64.3	 Mesencephalon. Surface Anatomy. Limits and Divisions
			64.3.1	 Perimesencephalic Cisterns
				64.3.1.1	 Anterior
				64.3.1.2	 Lateral (Parapeduncular)
				64.3.1.3	 Posterior
		64.4	 Intrinsic Anatomy
		64.5	 ‘Safe Entry Zones’
		64.6	 Intervention
		64.7	 Surgical Pearls
		64.8	 Discussion
		64.9	 Conclusion
		References
	65: Neuroanatomy and Surgical Approaches to Paediatric Posterior Fossa Tumours
		65.1	 Introduction of Paediatric Posterior Fossa Tumours
		65.2	 Anatomy Highlights
		65.3	 Surgical Approaches
			65.3.1 Midline Suboccipital Approaches
			65.3.2 Supracerebellar Infratentorial Approach (SCIT)
			65.3.3 Paramedian Approaches to Cerebellum
			65.3.4 Lateral (Upper and Lower) Approaches
			65.3.5 Far-lateral Approach
			65.3.6 Transtentorial Approaches
			65.3.7 Anterior Approaches (Transnasal or Transoral)
		65.4	 Surgical Pearls
		65.5	 Discussion
			65.5.1 Surgery vs. Natural History and Alternative Treatments
			65.5.2 Vascular Principles
			65.5.3 Surgical Adjuncts
			65.5.4 Minimally Invasive and Maximally Safe Approaches
			65.5.5 En Bloc Resection Versus Piecemeal Resection
			65.5.6 Staged Surgery
		65.6	 Conclusion
		References
Part VI: Spinal Tumors and Peripheral Nerves
	66: Spinal Cord Vascularity
		66.1	 Introduction
		66.2	 Anatomical Highlights
		66.3	 History and Background
		66.4	 Vascular Supply of the Spinal Cord
		66.5	 Vascular Supply of the Thoracic Segment of the Spinal Cord
		66.6	 Adamkiewicz Artery
		66.7	 Great Posterior Radiculomedullary Artery
		66.8	 Surgical Pearls
		66.9	 Conclusion
		References
	67: Microsurgical Removal of Spinal Tumors
		67.1	 Introduction
		67.2	 Anatomical Highlights
		67.3	 History/Background
			67.3.1 EMSCTs
			67.3.2 IMSCTs
		67.4	 Surgical Pearls
		67.5	 Discussion
		67.6	 Illustrative Cases
		67.7	 Conclusion
		References
	68: Anatomy of Brachial Plexus and Peripheral Nerves—Surgical Challenges
		68.1	 Introduction
		68.2	Anatomical Highlights
			68.2.1 Upper Extremity
			68.2.2 Lower Extremity
		68.3	 Important Anatomical Variations
		68.4	 Surgical Exposures
			68.4.1 General Principles
			68.4.2 Individual Key Steps—Upper Extremity
			68.4.3 Individual Key Steps—Lower Extremity
		68.5	Surgical Pearls
		References
Part VII: Functional
	69: White Fiber Anatomy Relevant to Epilepsy Surgery
		69.1	 Introduction
			69.1.1 History and Background
		69.2	 Anatomical Highlights
		69.3	 White Fiber Correlates of Temporal Lobectomy and Amygdalohippocampectomy
		69.4	 Approach Via the Temporal Neocortex
			69.4.1 Relevant Surgical Anatomy
			69.4.2 Surgical Technique—Standard Temporal Lobectomy and Amygdalohippocampectomy Through the Middle Temporal Gyrus
			69.4.3 Safe Zone to Enter the Temporal Horn
			69.4.4 Technique of En Bloc Amygdalohippocampectomy and Anterior Temporal Lobectomy
			69.4.5 Alternative Approaches to Enter the Temporal Horn
		69.5	 White Fiber Correlates of Corpus Callosotomy
			69.5.1 Relevant Surgical Anatomy
			69.5.2 Surgical Technique of Callosotomy
		69.6	 White Fiber Correlates of Hemispherectomy and Hemispherotomy
			69.6.1 Relevant Surgical Anatomy
			69.6.2 Surgical Technique of Transylvian Hemispherotomy (Figs. 69.15, 69.16, and 69.17)
			69.6.3 Surgical Technique of Vertical Parasagittal Hemispherotomy
		69.7	 Surgical Pearls
		69.8	 Discussion
		69.9	 Conclusions
		References
	70: Functional Hemispherotomy and Variants for Treatment of Epilepsy
		70.1	 Introduction
		70.2	 History and Background
		70.3	 Vertical Hemispherotomy
		70.4	 Lateral Hemispherotomy Techniques
			70.4.1 Peri-insular Hemispherotomy
			70.4.2 Transsylvian Keyhole Hemispherotomy
		70.5	 Endoscopic Hemispherotomy
		70.6	 Anatomical Highlights
		70.7	 Surgical Pearls
		70.8	 Discussion
		70.9	 Conclusions
		References
	71: Evolution in Surgical Management for Movement Disorders
		71.1	 Introduction
		71.2	 History of Movement Disorder Surgery
			71.2.1 The Prestereotactic Era
			71.2.2 The Stereotactic Era
			71.2.3 The Resurgence of Functional Surgery
		71.3	 Anatomical Highlights (Figs. 71.4, 71.5, 71.6 and 71.7)
		71.4	 Evolution in Movement Disorder Surgery
			71.4.1 Indications
			71.4.2 Imaging (Fig. 71.7)
			71.4.3 Intervention
				71.4.3.1	 DBS Technological Advances (Figs. 71.5 and 71.6)
		71.5	 Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) (Figs. 71.8, 71.9, 71.10 and 71.11)
		71.6	 Surgical Pearls
		71.7	 Discussion
		71.8	 Conclusion
		References
	72: The Role of Endoscopy in MVD for Treatment of Trigeminal Neuralgia and Hemifacial Spasm
		72.1	 Introduction
		72.2	 History and Background
		72.3	 Anatomical Highlights
		72.4	 Surgical Approach
			72.4.1 Indication
			72.4.2	 Anesthesia and Positioning
			72.4.3	 Surgical Steps
				72.4.3.1	 Role of Intraoperative Neuromonitoring
				72.4.3.2	 Closure
				72.4.3.3	 Postoperative Management
		72.5	 Surgical Pearls
		72.6	 Discussion
			72.6.1	 The Role of Endoscopy
			72.6.2	 Predictors for Outcome and Complications
			72.6.3	 Technological and Future Trends
		72.7	 Conclusion
		References
	73: NPH Etiology and Updated CSF Management
		73.1 Introduction
		73.2 Etiology
			73.2.1 Abnormal Cerebrospinal Fluid Dynamics
			73.2.2 Vascular Etiology
			73.2.3 Other Possible Etiologies
		73.3 Clinical Aspects
			73.3.1 Gait Abnormalities
			73.3.2 Neuropsychiatric and Cognitive Issues
			73.3.3 Urinary Symptoms
		73.4 Investigations
			73.4.1 CSF Tap Test
			73.4.2 Lumbar Infusion Test
			73.4.3 Continuous CSF Drainage
			73.4.4 CSF Biochemical Tests
			73.4.5 Radiology
		73.5 Interventions
		73.6 Shunt Systems for iNPH
		73.7 Ventriculoperitoneal Shunt
		73.8 Complications Avoidance in Treating iNPH with VP Shunt
		73.9 Lumboperitoneal Shunt
		73.10 Ventriculoatrial Shunt for iNPH
		73.11 Endoscopic Third Ventriculostomy for NPH
		73.12 Surgical Pearls
		73.13 Discussion
		73.14 Conclusion
		References
Part VIII: Complication in Neurosurgery
	74: Complications in Neurosurgery: Ethics, Morals and Legalities
		74.1	 Introduction
		74.2	 History
		74.3	 Surgical Records
		74.4	 Discussion
			74.4.1 Ethical Issues
			74.4.2 Morals
				74.4.2.1	 The Three Rs: Regret, Redemption and Restitution
			74.4.3 Legal Implications
		74.5	 Conclusion
		References
	75: Anticipation and Management of Complications in Pediatric Neurosurgery
		75.1	 Introduction
		75.2	 Anatomical Highlights
		75.3	Surgical Pearls
		75.4	 Discussion
		75.5	 Conclusion
		References