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Surgical Principles and Operative Results

  • Jean-Francois Hirsch
  • Elizabeth Hoppe-Hirsch
  • Ph. Meyer
Part of the Principles of Pediatric Neurosurgery book series (PRINCPEDIATR)

Abstract

Principles in surgery spring from a very simple, obvious, and patent fact: the aim of the surgical procedure is to cure the patient. To reach this goal requires repeated trial and error over the years. Moreover, principles do not remain true forever, but may change with technological advances. For example, at the turn of the century, it was mandatory to operate as fast as possible because long anesthesia was dangerous; speed in surgery is now meaningless since the duration of the anesthetic procedure is no longer a problem. Unfortunately the reasons behind such principles are often progressively forgotten so that their justification is no longer understood. In other cases they may become invalid, but continue to be applied. To under-stand the present situation a certain knowledge of history is therefore essential. For all these reasons, it may be of some interest to recall what posterior fossa surgery was in the 1950, and what difficulties had to be overcome.

Keywords

Brain Stem Posterior Fossa Fourth Ventricle Cerebellar Hemisphere Posterior Fossa Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Choux M, Lena G. Le médulloblastome. Neurochirurgie. 1982; 28 (suppl l): 9–229.Google Scholar
  2. 2.
    Paterson E. Medulloblastoma: treatment by irradiation of the whole central nervous system. Acta Radiol. 1953; 39: 323–336.PubMedCrossRefGoogle Scholar
  3. 3.
    Guggiari M, Lechat P, Garen-Colanne C. Early detection of patent foramen ovale by two- dimensional contrast echocardiography for pre-vention for paradoxical air embolism. Anesth Analg. 1988; 67: 192–194.PubMedCrossRefGoogle Scholar
  4. 4.
    Geraghty J, Feelry M. Antibiotic prophylaxis in neurosurgery. J Neurosurg. 1984; 60: 724–726.PubMedCrossRefGoogle Scholar
  5. 5.
    Cucchiara RF. Anesthesia for patients with in-creased intracranial pressure. In: ASA Annual Refresher Course Proceedings. 1991: 432.Google Scholar
  6. 6.
    Cucchiara RF, Bawers B. Air embolism in children undergoing sub-occipital craniotomy. Anesthesiology. 1982; 57: 338–340.PubMedCrossRefGoogle Scholar
  7. 7.
    Perkins NAK, Bedford RF. Hemodynamic con-sequences of PEEP in seated neurosurgical patients; implications for parodoxical air embolism. Anesth Analg. 1984; 63: 429–432.PubMedCrossRefGoogle Scholar
  8. 8.
    Meyer Ph, Jayais P, Quenet G, Barrier G. Prevention of venous air embolism in pediatric neurosurgical procedures by using MAST. Anesthesiology. 1990; 73 (Suppl 6): 1100.Google Scholar
  9. 9.
    Cushing H. Experiences with cerebellar medul-loblastomas. A critical review. Acta Pathol Microbiol Scand. 1930; 7: 1–86.CrossRefGoogle Scholar
  10. 10.
    Lampe, Mclntyre. Radiation therapy of medul-loblastomas. Am J Roentgenol. 1954; 71: 659–668.Google Scholar
  11. 11.
    Machado HR, Pariente D, Hirsch E, Sauveg-rain J, Hirsch JF. L’échographie per-opératoire en neurochirurgie pédiatrique. Expérience sur une série de 40 interventions. Neurochirurgie. 1986; 32: 287–295.PubMedGoogle Scholar
  12. 12.
    Mealey J, Hall PV. Medulloblastoma in children: survival and treatment. J Neurosurg. 1977; 46: 56–64.PubMedCrossRefGoogle Scholar
  13. 13.
    Penier D, Daussange J, Rigault P, Hirsch JF. Children’s cervical spine instability after post-erior fossa surgery. Child’s Brain. 1981; 8: 77–78.Google Scholar
  14. 14.
    Hirsch JF, Renier D, Pierre-Kahn A, Ben-veniste L, George B. Les medulloblastomes de l’enfant. Survie et résultats fonctionnels. Neurochirurgie. 1978; 24: 391–397.PubMedGoogle Scholar
  15. 15.
    Hoppe-Hirsch E, Renier D, Lellouch-Tubiana A, Sainte-Rose C, Pierre-Kahn A, Hirsch JF. Medulloblastoma in childhood: progressive intellectual deterioration. Childs Nerv Syst. 1990; 6: 60–65.PubMedCrossRefGoogle Scholar
  16. 16.
    Pierre-Kahn A, Hirsch JF, Roux FX, Sainte- Rose C. Intracranial ependymomas in childhood. Survival and functional results of 47 cases. Childs Brain. 1983; 10: 145–156.PubMedGoogle Scholar
  17. 17.
    Hirsch JF, Sainte-Rose C, Pierre-Kahn A, Pfister A, Hoppe-Hirsch E. Benign astrocytic and oligodendrocytic tumors of the cerebral hemispheres in children. J Neurosurg. 1989; 70: 568–572.PubMedCrossRefGoogle Scholar
  18. 18.
    Hirsch JF. Fautil operer les tumeurs du tronc cerebral de l’enfant? “Les entretiens de Bichat” 1990.Google Scholar
  19. 19.
    Pierre-Kahn A, Perrin A, Hirsch JF. Transpet-rosal, translabyrinthic approach for anteriorly extended pontine tumors. Communication to the Paediatric Neurosurgical Section Meeting of the A.A.N.S., Pebble Beach, California, December 1990.Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Jean-Francois Hirsch
  • Elizabeth Hoppe-Hirsch
  • Ph. Meyer

There are no affiliations available

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