A very special thanks goes to both Mrs. M. Traber and Mrs. M. Jent who worked wonders with typing of the manuscript, verification of statistics and literature references, and deciphering illegible handwriting.
Finally I would like to cordially thank Dr. h.c. G. Hauff, owner of Georg Thieme Verlag, and his staff, especially Mr. R. Zeller, for their help, cooperation and patience in the preparation of these volumes.
M. G. Yaşargil
Preface
The operative treatment of vascular malformations using microsurgical techniques began in Zurich in January 1967. During the next 20 years, 414 patients with AVM of the brain and 71 with spinal AVM have been treated surgically. In the same time period 86 patients with cerebral AVM were discharged from our department without operation: In 40 cases the AVMs were operable but the patients refused surgery; in 24 cases the risk of neurological deficits delayed the decision for operative intervention until a later time; in 22 cases (22/500 = 4.4%) the lesion was deemed inoperable.
The present volumes III A–III B are intended to relate and analyze our experience gained in the evaluation of 414 operated and 86 nonoperated patients with intracranial AVMs, to review what has been accomplished before and since the advent of microsurgical techniques and to identify the problems remaining in the treatment of these often difficult lesions. Other operated intracranial vascular lesions such as cavernomas (22 cases) and venous angiomas (5 cases) of the brain are also covered briefly. Interventional neuroradiological and surgical procedures for the treatment of cranial dural, spinal dural and medullary AVMs, and of carotid-cavernous fistulae are not included and will form separate subsequent monographs.
The third volume, part A, contains:
History, embryology, pathological considerations, hemodynamics, Doppler-techniques, neuroradiology, neurosurgical anatomy, microcirculation, anatomy of the calcarine sulcus.
The third volume, part B, contains:
General operative techniques, the specific treatment and results of surgery for AVMs of specific locations like convexial (frontal, temporal, insular, parietal, occipital and cerebellar) and deep central (limbic system, corpus callosum, striocapsulothalamic, meso-diencephalic, vein of Galen, splenial, plexal, pontine), special and general statistics regarding morbidity and mortality, complications, the follow-up of nonoperated cases, and a chapter concerning the cavernous and venous angiomas and finally a chapter on neuroanesthesia technique, as utilized in Zurich.
M. G. Yaşargil
Contents
A Short History of the Diagnosis and Treatment of Cerebral AVMs
Treatment of Extracranial AVM in Earlier and Present Time
The Contributions of Virchow and his Contemporaries
Early Clinical Observations on Intracranial AVMs
Surgical Treatment of Cerebral AVMs (1889–1930)
Neurosurgical Approaches Prior to the Introduction of Angiography (1928)
Neurosurgical Treatment of Intracranial AVM Following the Introduction of Angiography (1930)
Conservative versus Surgical Treatment
Miguel Marin-Padilla
A. Embryogenesis of the Early Vascularization of the Central Nervous System
Perineural Vascular Territory of the CNS Vasculature
Interneural Vascular Territory of the CNS Vasculature
Composition and Organization of the Pial Vascular Plexus
Vascular Perforation of the CNS Surface by Pial Vessels
Vascular Approach and Contact with the CNS Surface
Endothelial Filopodia Perforation of CNS Surface
In Situ Formation of New Intraneural Vessels
Establishment of the VRC and Interneural Vascular Territory
Intraneural Vascular Territory of the CNS Vasculature
B. Vascular Malformation of the Central Nervous System. Embryological Considerations
Capillary Telangiectasias and Cavernous Angiomas