By L. I. Malis (auth.), Prof. Franco Pluchino M.D., Prof. Giovanni Broggi M.D. (eds.)

Technological advancements in neurosurgery are disussed. using surgical lasers, ultrasound aspirators, bipolar coagulator and operative microscopes for surgical procedure of deep-seated neoplasms and vascular malformations is mentioned. Intraoperative tracking, chronotherapy, persistent neurostimulation and stereotactic interstitial irradiation are lined and symptoms for interventional neuroradiology are reviewed.

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Increased reflexes and extensor plantar signs, with or without clonus, occurred relatively early in the neurological course. A presenting complaint of bowel and bladder dysfunction was most unusual, and was diagnostic of neoplasm extending into the conus. In general, these symptoms evolved only late in the clinical course if the tumor was rostral to the conus medullaris. Neurodiagnostic Studies Spinal cord astrocytomas may be divided into two general categories: holocord and focal. Holocord Astrocytomas "Holocord" widening occurred in 60% of pediatric patients, and was manifest by expansion of the entire spinal cord from the medulla or cervicomedullary junction to the conus.

I. Current concepts and treatment. Arch N eurol 37: 1-5 Stein BM, Wolpert SM (1980b) Arteriovenous malformations of the brain. II. Current concepts and treatment. Arch Neurol37: 69-75 Troupp H (1976) Arteriovenous malformations of the brain: what are the indications for operation? In: Morley TP (ed) Current controversies in Neurosurgery. Saunders, Philadelphia, pp 210-216 Wilson CB, Dorninque J (1979) Microsurgical treatment of intracrauial vascular malformations. J Neurosurg 51 : 446-454 Wolpert SM, Stein BM (1975) Catheter embolization of intracrauial arteriovenous malformations as an aid to surgical excision.

Epstein Thoracic Tumors Mild scoliosis was the most common early signs of an intramedullary thoracic cord neoplasm. Pain and paraspinal muscle spasm commonly occurred before there were objective signs of neurological dysfunction, and were commonly assumed to be secondary to the evolving scoliosis. Insidious progressive motor weakness in the lower extremities was first manifest by "awkwardness" and, only later, by frequent falls and an obvious limp. Early sensory abnormalities were common although dysesthesias and paresthesias were occasionally present.

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