| Abstrakt: |
There is something so satisfying and practical about having a book that one can carry from place to place, open to and flip back and forth between whatever pages one pleases, that it is hard to imagine a world without stereotactic atlases in print format. The continued use of printed stereotactic atlases to guide functional neurosurgical operations still represents the legacy of nineteenth century neurological localizationalists and their phrenolological forebears – after more than 100 years of advances in neuroimaging and electrophysiological technology. Even apparently simple neurological processes involve the interaction of integrated functional systems that have nuclei in different geographical parts of the central nervous system, and that are connected by complex pathways. Although the concept of discrete anatomic ˵centers″ for specific functions or behaviors is now outmoded, several well-defined intracerebral targets have retained their therapeutic utility since the advent of modern human stereotaxis in the mid-twentieth century. Unlike the pioneers of stereotactic surgery, who depended on the capricious appearance of normally calcified midline landmarks (pineal gland or habenular commissure) to navigate the brain, and unlike their immediate successors, who depended on the positive or negative shadows cast by air- or contrast-filled ventricles on x-ray film, contemporary neurosurgeons work directly from computed tomographic (CT) scans and magnetic resonance images (MRI) of the brain itself. Some – although the list is diminishing as imaging technology improves – important functional stereotactic targets are still indistinguishable from surrounding structures on CT or MRI; they remain invisible, or at least well camouflaged. Functional neurosurgeons solve this dilemma by referring to one of the excellent contemporary or historic stereotactic atlases or to a computerized atlas – the subject of Chapters 26 and 27. [ABSTRACT FROM AUTHOR] |
