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Benefit from the expertise of world-renowned neurosurgeons, who share their strategies for managing a wide range of cerebral and spinal conditions involving vascular and tumor pathology. Presented in a case format, the book details problems, history, surgical tactics, procedures, and postoperative course, followed by a valuable section of comments from the experts. You will find insights on such complex procedures as clipping of giant intracranial aneurysms, removal of brain stem tumors, bypass surgery with radial artery graft and more. The resulting work is a compilation that explains some of the most difficult clinical problems in the field while enhancing your ability to treat more routine cases. By turning their talents to the toughest cases, Dr. Kobayashi and his colleagues have created a reference that is certain to advance the practice of neurosurgery at every level, with treatments that are more accurate, less invasive, and safe. Table of Contents Foreword Preface Message Lessons in Neurosurgery Microsurgical Anatomy: The Present and Future Current Perspectives in Neurosurgery I. Vascular Lesions Multiple paraclinoid aneusyms Multiple aneurysms treated via frontal interhemispheric approach, Surgical Management of a Challenging Giant Paraclinoid Aneurysm Giant aneurysm of the subclinoidal (anterior genu) ICA treated with aneurysm resection and reconstruction of ICA with venous patch. Giant intracavernous aneurysm and carotid ophthalmic aneurysm. Giant internal carotid artery-superior hypophyseal artery aneurysm. An internal carotid artery giant aneurysm presenting regrowth after neck clipping. Emergency recanalization of the inferior M2 trunk by arteriotomy and retrival of migrated guglielmi detachable coil, and clipping of superior wall aneurysm of proximal internal carotid artery. Large aneurysm of the internal carotid artery obliterated with seven fenestrated clips under intraoperative monitoring of anterior arterial blood flow insufficiency. A case of Giant anterior communicating artery aneurysm complicated by visual deterioration after coiling Giant fusiform aneurysm of the middle cerebral artery. Treatment of difficult MCA aneurysm Subtemporal approach to a basilar bifurcation aneurysm with failed surgery. An extremely high positioned giant basilar top aneurysm operated via intratemporal approach. Backwards projecting, ruptured basilar bifurcation aneurysm combined with hypoplasia of the internal carotid artery Management of A Giant Mid-Basilar Artery Fusiform Aneurysm Basilar trunk aneurysm - retrolabyrinthine approach. Combined endovascular and surgical treatment of large basilar trunk aneurysm in a child. Partially thrombosed giant dissecting aneurysm vertebral artery: Treatment strategies. Collateralization via vasa vasorum: a determinant of therapeutic efficacy of coil embolization of the thrombosed giant aneurysm of the vertebral artery. Contralateral approach for a large thrombosed aneurysm of the vertebral artery Giant anterior cerebellar artery (AICA) aneurysm in a 6-year-old boy treated with hypothermic cardiac arrest Occipital artery: Superior cerebellar artery bypass (Paramedian supracerebellar approach) for Vertebrobasilar TIAs due to a severe Basilar artery Stenosis A case of right carotid endarterectomy and axillar-axillar bypass for symptomatic carotid stenosis with innominate arterial occlusion. A case of carotid artery reconstruction. A large cerebellopontine angle AVM Retrograde venous thrombosis after excision of a cerebral arteriovenous malformation II. Brain Tumors Dominant Hemisphere Insular Tumor Surgical removal of pilocytic astrocytoma from brain stem and thalamus. A large ependymoma with intratumoral hemorrhage in the medulla oblongata Angiomatous acoustic neuroma Total removal of a large vestibular schwannoma with hearing preservation Removal of vestibular schwannoma in the internal auditory canal with the aid of neuroendoscopy. Large trigeminal neurinoma Combined Crnio-orbital Zygomatic and Petrosal Approach for A Giant Retrochiasmatic Craniopharyngioma Optico-condylar transpetrosal approach (an extensive middle fossa approach) for radical removal of a large calcified craniopharyngioma A case of midline suprasellar tumor removed by an extendedd transsphenoidal skull base technique. Total removal of a recurrent craniopharyngioma. Subarachnoid hemorrage with bilateral aneurysms and apoplexy of pituitary adenoma. Giant non-secreting pituitary adenoma. Olfactory neuroblastoma with brain invasion Giant olfactory groove meningioma Supraorbital key-hole craniotomy for frontobasal meningioma. Giant skull base meningioma invading carotid artery Clinoidal meningioma encasing the internal carotid artery Visual improvement in a clinoidal meningioma extending into the optic canal Huge falx meningioma removed by using end-to-end anastomosis of the superficial cortical vein for obtaining a wide operative field Meningioma of the petrous and clival region Radical total resection of giant petrocllival meningioma A large petroclival meningioma with a fibrous capsule Large meningioma of the jugular tubercle and foramen magum Surgical removal of giant meningeal hemangiopericytoma Approach to lesions in and around the cavernous sinus: A formidable challenge Extensive intra-extradural chordoma of the whole clivus Management of An Extensive Recurrent Clivus Chordoma Chordoma Huge chondrosarcoma in the skull base A case of unusual giant and complex bifrontal cavernoma Cerebral peduncle cavernoma with recurrent hemorrhage A case of cavernous hemangioma in the brachium pontis Cavernous angioma in the medulla oblongata with venous malformation III. Spinal Lesions Intramedullary spinal arteriovenous malformation Large intradural-extramedullary cervical spine tumor Spinal meningioma A case of complex chordoma of mid and upper cervical spine in an eleven year old Intra-osseous tumor of the cervical spine Osteolytic tumor of the Th2 vertebral body, causing progressive paraparesis in a 19-year-old C2 over C3 spondylosis in a case with absent posterior elements of axis IV. Miscellaneous Lesions Rasmussens encephalitis causing epilepsy partialis continua. Fibrous dysplasia of the paranasal sinuses and anterior cranial base