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Book Endonasal Endoscopic Surgery of Skull Base Tumors  An Interdisciplinary Approach

Download or read book Endonasal Endoscopic Surgery of Skull Base Tumors An Interdisciplinary Approach written by Wolfgang Draf and published by Thieme. This book was released on 2021-04-14 with total page 868 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive, multidisciplinary perspective on endonasal endoscopic skull base surgery This book presents a complete step-by-step guide to endonasal endoscopic skull base surgery, written by prominent interdisciplinary specialists and reflecting important recent developments in the field. Combining the fundamentals of skull base anatomy and pathology with current diagnostic and interventional imaging techniques, Endonasal Endoscopic Surgery of Skull Base Tumors provides a solid clinical foundation for anyone working in this challenging and evolving specialty. Special features: State-of-the-art contributions from international experts in endonasal endoscopic skull base surgery A 360 degree panoramic assessment of skull base pathologies Description of basic and advanced endoscopic procedures based on the endonasal corridor system Current tumor-specific strategies, including indications and preoperative work-up, endoscopic surgical techniques, sequel and potential complications, postoperative care, outcomes, and pearls and pitfalls Clear and consistent interdisciplinary guidelines for managing the internal carotid artery in skull base surgery, allowing the removal of previously inoperable tumors Surgical outcomes from two of the leading international skull base centers, one in Fulda, Germany (formerly headed by Professor Draf), and one joint program at the University of Brescia and University of Varese, Italy Complete with 500 full-color photographs, anatomic illustrations, flowcharts and tables, Endonasal Endoscopic Surgery of Skull Base Tumors offers a practical management approach and sets a new standard in the field. It is invaluable for all otolaryngologists, head and neck surgeons, neurosurgeons, neuroradiologists, and pathologists who routinely make diagnostic and therapeutic decisions with regard to skull base lesions. It is also an essential text and reference for those who are learning how to perform endonasal endoscopic skull base surgery in a multidisciplinary environment.

Book Endonasal Endoscopic Surgery of Skull Base Tumors  An Interdisciplinary Approach

Download or read book Endonasal Endoscopic Surgery of Skull Base Tumors An Interdisciplinary Approach written by Wolfgang Draf and published by Thieme. This book was released on 2015-04-15 with total page 868 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents a complete step-by-step guide to endonasal endoscopic skull base surgery, written by prominent interdisciplinary specialists and reflecting important recent developments in the field. Combining the fundamentals of skull base anatomy and pathology with current diagnostic and interventional imaging techniques, Endonasal Endoscopic Surgery of Skull Base Tumors provides a solid clinical foundation for anyone working in this challenging and evolving specialty. Special features: State-of-the-art contributions from international experts in endonasal endoscopic skull base surgery A 360 panoramic assessment of skull base pathologies Description of basic and advanced endoscopic procedures based on the endonasal corridor system Current tumor-specific strategies, including indications and preoperative work-up, endoscopic surgical techniques, sequel and potential complications, postoperative care, outcomes, and pearls and pitfalls Clear and consistent interdisciplinary guidelines for managing the internal carotid artery in skull base surgery, allowing the removal of previously inoperable tumors Surgical outcomes from two of the leading international skull base centers, one in Fulda, Germany (formerly headed by Professor Draf), and one joint program at the University of Brescia and University of Varese, Italy Complete with 500 full-color photographs, anatomic illustrations, flowcharts and tables, Endonasal Endoscopic Surgery of Skull Base Tumors offers a practical management approach and sets a new standard in the field. It is invaluable for all otolaryngologists, head and neck surgeons, neurosurgeons, neuroradiologists, and pathologists who routinely make diagnostic and therapeutic decisions with regard to skull base lesions. It is also an essential text and reference for those who are learning how to perform endonasal endoscopic skull base surgery in a multidisciplinary environment.

Book Endoscopic Endonasal Skull Base Surgery  An Issue of Neurosurgery Clinics of North America

Download or read book Endoscopic Endonasal Skull Base Surgery An Issue of Neurosurgery Clinics of North America written by Daniel M. Prevedello and published by Elsevier Health Sciences. This book was released on 2015-07-13 with total page 185 pages. Available in PDF, EPUB and Kindle. Book excerpt: Because the base of the skull has proven to be one of the most challenging regions of the body to access, treatment options were once limited for patients with tumors or lesions in this area. However, with recent advancements and breakthroughs in treatment, patients with skull base tumors now have an array of surgical options that can help them return to leading a normal and active life. The Endoscopic Endonasal Approach (EEA) is an innovative surgical technique used to remove brain tumors and lesions-some as large as softballs-all through the nose.

Book Endoscopic Approaches to the Skull Base

Download or read book Endoscopic Approaches to the Skull Base written by Amin B. Kassam and published by Karger Medical and Scientific Publishers. This book was released on 2012 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Reviews the role of endoscopic endonasal techniques During the last decade the endoscopic endonasal approach (EEA) to the skull base has become a very powerful method to add to the array of neurosurgical technologies. This volume provides a broad overview of the role of transnasal approaches in a wide spectrum of skull base diseases. It starts with a historical perspective of the evolution from the microscope to the endoscope in endonasal surgery and then explores in depth the principles and techniques of the various methods. Discussed are topics based on anatomical boundaries: pituitary fossa to the suprasellar space to the cavernous sinus, clivus and the anterior cranial fossa. Access to the infratemporal and posterior fossae via both the endoscopic endonasal and the retrosigmoid approaches are reviewed. In addition, the critical topic of reconstruction following 'minimally invasive' skull base surgery and finally the learning curve and complications associated with the applications of these new and exciting approaches are discussed. This volume will provide the latest knowledge to help neurosurgeons, otolaryngologists, head and neck surgeons as well as craniofacial surgeons understand the applications and practice of this important technique.

Book Techniques and Key Points for Endoscopic Cranial Base Reconstruction

Download or read book Techniques and Key Points for Endoscopic Cranial Base Reconstruction written by Carlos D. Pinheiro-Neto and published by Thieme. This book was released on 2021-10-11 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: The quintessential guide to endoscopic skull base reconstruction from multidisciplinary experts Due to close collaboration between otorhinolaryngologists and neurosurgeons, endoscopic endonasal brain surgery has become part of the surgical armamentarium for successful treatment of various cranial base pathologies. Today, it is considered the gold standard surgical technique for many types of skull base tumors. Techniques and Key Points for Endoscopic Cranial Base Reconstruction by pioneering otorhinolaryngologist Carlos D. Pinheiro-Neto and neurosurgeon Maria Peris-Celda, co-editor of Thieme's acclaimed Rhoton's Atlas of Head, Neck, and Brain, encompasses the most important endoscopic cranial base reconstruction techniques performed in the last two decades. The book features contributions from an impressive group of additional experts in this field. Comprised of 26 reader-friendly chapters divided into seven sections, the book starts with discussion of general principles of endoscopic cranial base reconstruction. Sections II through VI provide step-by-step descriptions of reconstructive approaches utilizing diverse flaps including nasoseptal, intranasal, extranasal, and free grafts, followed by free flaps. The final section details management of seven challenging cases that enrich practical clinical experience, from free flap reconstruction to recalcitrant cerebrospinal fluid leak. Key Highlights Decision-making rationales and pearls regarding selection of the most efficacious reconstructive techniques. Consistently formatted chapters feature a succinct review of anatomical concepts integral to each procedure, detailed descriptions for each surgical step, and alternative options. High-quality and meticulous anatomical dissections performed at the editors' anatomy laboratory and beautiful illustrations depict the flow of operations essential to understanding surgical nuances. Nineteen narrated videos visually demonstrate techniques and consolidate learning. This must-have, comprehensive resource will help skull base surgeons master the latest techniques, avoid complications, and achieve improved outcomes for their patients.

Book Transnasal Endoscopic Skull Base and Brain Surgery

Download or read book Transnasal Endoscopic Skull Base and Brain Surgery written by Aldo C. Stamm and published by Thieme. This book was released on 2019-07-19 with total page 1979 pages. Available in PDF, EPUB and Kindle. Book excerpt: Outstanding endoscopic skull base surgical resource presents cutting-edge approaches from multidisciplinary global experts Transnasal endoscopic skull base and brain surgery have undergone major technical advances in recent years. The accumulation of experience and exciting technological innovations – including high-definition cameras, more ergonomic and precise surgical instruments, as well as new hemostatic agents – have enabled safer and more efficacious treatment of lesions affecting highly complex and delicate regions. This fully revised and updated second edition of Transnasal Endoscopic Skull Base and Brain Surgery: Surgical Anatomy and its Applications builds on the acclaimed first edition, focusing on the correlation between endoscopic skull base anatomy and state-of-the-art clinical applications. Among these are the transplanum/transtuberculum, transcribrifom, transclival, and craniocervical junction surgical approaches. Renowned skull base surgeon Aldo Stamm and leading worldwide experts have compiled a comprehensive multidisciplinary textbook with 72 chapters in 14 sections, didactically organized by regions and diseases. Detailed descriptions of sinonasal, orbital, cranial base, and intracranial anatomy, imaging modalities, and in-depth surgical navigation techniques form the foundation of this remarkable book. The content reflects significant knowledge and diverse perspectives from masters in neurosurgery, otorhinolaryngology, head and neck surgery, neuroendocrinology, intensive care, neuro-anesthesiology, and other disciplines. Key Highlights Chapter summaries and highlights facilitate understanding and retention of complex concepts More than 700 beautiful anatomical, operative, and dissection illustrations and photographs enhance understanding of impacted areas 20 accompanying videos provide guidance on endoscopic transnasal approaches in patients with diverse skull base diseases Pearls, pitfalls, and nuances throughout this book provide invaluable insights on achieving optimal outcomes Neurosurgeons, otolaryngologists–head and neck surgeons, and others will greatly benefit from the step-by-step endoscopic procedural guidance and tips in this quintessential skull base surgical reference.

Book Endoscopic Endonasal Transsphenoidal Surgery

Download or read book Endoscopic Endonasal Transsphenoidal Surgery written by Enrico de Divitiis and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Currently, surgical management provides the definitive treatment of choice for most pituitary adenomas, craniopharyngiomas and meningiomas of the sellar region. The elegant minimally invasive transnasal endoscopic approach to the sella turcica and the anterior skull base has added a new dimension of versatility to pituitary surgery and can be adapted to many lesions in the region. In this multi-author book with numerous color illustrations the main aspects of the endonasal endoscopic approach to the skull base are presented, starting with a clear description of the endoscopic anatomy, the panoramic view afforded by the endoscope and the development of effective instruments and adjuncts. After the diagnostic studies, the strictly surgical features are considered in detail. The standard technique is described and particular aspects are treated, including the new extended approaches to the cavernous sinus, spheno-ethmoid planum and clival regions.

Book Sinonasal and Skull Base Malignancies

Download or read book Sinonasal and Skull Base Malignancies written by Nabil F. Saba and published by Springer Nature. This book was released on 2022-04-22 with total page 283 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book reviews the standard surgical, radiotherapeutic, and systemic management of sinonasal and skull base tumors. It provides up-to-date information on epidemiology, diagnostic modalities, molecular biology, staging, treatment complications, principles of supportive care, and current controversies. Sinonasal and skull base tumors display histologic and anatomic heterogeneity, as well as wide variation in clinical behavior. Accordingly, they pose significant diagnostic and treatment challenges. A multidisciplinary approach offers the best chance of a successful outcome. In addition to documenting in detail the currently accepted management approaches, this book sheds light on various promising novel therapeutic strategies. Sinonasal and Skull Base Malignancies is an invaluable reference for all specialists involved in treating these tumors, including otolaryngologists, head and neck surgeons, reconstructive surgeons, medical and radiation oncologists, neuroradiologists, specialized head and neck pathologists, prosthodontists, and speech and swallow therapists.

Book Advances in Endoscopic Surgery

Download or read book Advances in Endoscopic Surgery written by Cornel Iancu and published by IntechOpen. This book was released on 2011-11-25 with total page 458 pages. Available in PDF, EPUB and Kindle. Book excerpt: Surgeons from various domains have become fascinated by endoscopy with its very low complications rates, high diagnostic yields and the possibility to perform a large variety of therapeutic procedures. Therefore during the last 30 years, the number and diversity of surgical endoscopic procedures has advanced with many new methods for both diagnoses and treatment, and these achievements are presented in this book. Contributing to the development of endoscopic surgery from all over the world, this is a modern, educational, and engrossing publication precisely presenting the most recent development in the field. New technologies are described in detail and all aspects of both standard and advanced endoscopic maneuvers applied in gastroenterology, urogynecology, otorhinolaryngology, pediatrics and neurology are presented. The intended audience for this book includes surgeons from various specialities, radiologists, internists, and subspecialists.

Book Endoscopic Pituitary Surgery

Download or read book Endoscopic Pituitary Surgery written by Theodore H. Schwartz and published by Thieme. This book was released on 2011-11-23 with total page 737 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive guide on current clinical management options for pituitary tumors -- including state-of-the-art endoscopic techniques Thieme congratulates Theodore H. Schwartz on being chosen by New York magazine for its prestigious ‘Best Doctors 2015' list. Offering the unique dual perspective of neurosurgeons and otolaryngologists, Endoscopic Pituitary Surgery: Endocrine, Neuro-Ophthalmologic and Surgical Management describes both cutting-edge endoscopic techniques and tried-and-true decision-making methodologies that lead to the most successful outcomes. From choosing the right surgical or non-surgical approach for individual patients, to managing complex endocrine and neuro-ophthalmologic issues, this is the first major reference in the field in nearly a decade, making it the go-to guide for all interdisciplinary specialists who treat pituitary tumors. Special Features: Step-by-step descriptions of the newest endoscopic pituitary and skull base procedures, ensuring that specialists have full mastery of techniques for different tumor types in this surgically challenging area The clinical wisdom and perspectives of the masters of pituitary surgery, who share insights on patient selection, endoscopic versus open procedures, medical management, and much more Operative pearls from both neurosurgeons and otolaryngologists Compelling discussions of the pros and cons of various procedures (e.g., the utility of intraoperative MRI in pituitary surgery cases) Inclusion of detail-revealing 3D endoscopic images (complete with 3D glasses) Rationale for a collaborative neurosurgery--otolaryngology team approach to developing and implementing the most innovative endoscopic and skull base techniques Enhanced by hundreds of images, decision-making algorithms, and clinical pearls from experts on each tumor type, Endoscopic Pituitary Surgery is a comprehensive guide representing the current palette of available treatment options. It is indispensable for residents in training as well as for practicing neurosurgeons and otolaryngologists who are making the transition to the newest minimally invasive endoscopic procedures in the treatment of pituitary lesions.

Book Endoscopic Pituitary and Skull Base Surgery

Download or read book Endoscopic Pituitary and Skull Base Surgery written by Paolo Cappabianca and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Anterior Skull Base Tumors

    Book Details:
  • Author : P. Nicolai
  • Publisher : Karger Medical and Scientific Publishers
  • Release : 2020-07-30
  • ISBN : 3318066702
  • Pages : 266 pages

Download or read book Anterior Skull Base Tumors written by P. Nicolai and published by Karger Medical and Scientific Publishers. This book was released on 2020-07-30 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, interest in the management of anterior skull base tumors has been fostered by the introduction and subsequent rapid expansion of indications of transnasal endoscopic techniques. In parallel, extraordinary progress has been made in all the other disciplines which are involved in the complex process of managing anterior skull base tumors, leading to substantial improvements in diagnosis and treatment. The anterior skull base can be involved in a large variety of tumors of a varying nature and histology, which in the majority of cases originate from adjacent anatomic sites. In fact, primary lesions of the anterior skull base mainly include osteoma and other tumors originating from bone and cartilage. Tumors involving the anterior skull base have their origin prevalently in the sinonasal tract, but lesions developing on the intracranial site, such as meningiomas, may also extend caudally to encroach upon this area. All these lesions are rare, which means that the pertinent literature does not include prospective studies or treatment guidelines based on a high level of evidence. In view of the extreme histological variability of lesions involving the anterior skull base, much emphasis has been placed on addressing the different nuances of treatment in relation to histology, especially for malignant tumors. The chapters focusing on surgery provide divergent views on selection criteria for a specific surgical technique, which is the aim of this publication.

Book Controversies in Skull Base Surgery

Download or read book Controversies in Skull Base Surgery written by Andrew S. Little and published by Thieme Medical Publishers. This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: State-of-the-art approaches and insightful discussions on challenging topics in skull base surgery Advances in endoscopic, microsurgical, radiosurgical, and pharmacotherapeutic strategies have revolutionized the treatment of skull base pathologies. Controversies in Skull Base Surgery, edited by Andrew Little and Michael Mooney and authored by esteemed multidisciplinary contributors, focuses on management strategies and treatment options for a wide range of tumors affecting the skull base, while addressing the most urgent and challenging questions facing skull base surgeons today. Throughout nine sections and 46 chapters, experts describe the treatment of neoplasms such as vestibular schwannoma, meningioma, pituitary adenoma, craniopharyngioma, chordoma, cranial nerve schwannoma, sinonasal malignancies, and others. In many chapters, authors provide instructional case studies and suggestions for future studies to help clarify areas of controversy. This textbook is unique in that it tackles problems typically minimized or ignored by other texts that impact a patient's quality of life and recovery. Key Highlights Reader-friendly tables feature concise summaries, author pearls, and levels of available evidence Pearls and insights on hotly debated issues such as the role of radiosurgery, surgery vs. medical management, radical resection vs. subtotal resection, and proton-beam vs. photon therapy for various pathologic conditions Controversies not frequently discussed in depth, including the use of lumbar drains, postoperative antibiotics, and cerebral revascularization in skull base surgery; multidisciplinary collaboration in endoscopic endonasal surgery; skull base reconstruction techniques; and the future of robotics in skull base surgery This stellar resource will benefit all residents and advanced practice providers who evaluate and treat patients with skull base pathologies, including neurosurgeons, otolaryngologists, and radiation and medical oncologists. This book includes complimentary access to a digital copy on https://medone.thieme.com.

Book Endoscopic Lateral Skull Base Surgery

Download or read book Endoscopic Lateral Skull Base Surgery written by Daniele Marchioni and published by Thieme Medical Publishers. This book was released on 2022-05-18 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: The quintessential state-of-the-art atlas on endoscopic approaches to the lateral skull base The endoscope has become a highly effective tool in the arsenal of ear and skull base surgeons. Endoscopic Lateral Skull Base Surgery: Principles, Anatomy, Approaches by endoscopic surgery masters Daniele Marchioni and Livio Presutti, reflects their development of innovative transcanalar approaches to the lateral cranial base using the external auditory canal as a surgical corridor. This unique atlas is designed to teach and clarify current and emerging endoscopic-assisted surgery approaches to the lateral skull base. The common goal of these cutting-edge procedures is to access and treat tumors located in the lateral cranial base via the most minimally-invasive endoscopic approach possible, thereby bypassing delicate cranial nerves, dural, cerebral, and vascular structures. Throughout 14 chapters, an impressive group of skull base surgeons share firsthand insights and expertise in areas vital to endoscopic skull base surgery. Key Features Featuring contributions from the who's who of global experts who continue to innovate by using the endoscope beyond its traditional use in middle ear surgery Opening chapters cover anatomy, microscopic approaches, endoscopic dissection, instrumentation, OR set-up, and radiologic assessments Procedural chapters detail endoscopic approaches including transtemporal combined, retrosigmoid, and transcanalar techniques such as suprageniculate, transpromontorial, and infracochlear Patient cases, clinical applications, and step-by-step guidance enhance understanding of diverse endoscopic approaches High-quality preoperative, intraoperative, and postoperative illustrations are selected from thousands of surgeries performed by the authors This remarkable book provides the most comprehensive and elucidating information written to date on endoscopic approaches to the lateral skull base, making it essential reading for novice and expert surgeons alike. This print book includes complimentary access to a digital copy on https://medone.thieme.com.

Book Chordomas and Chondrosarcomas of the Skull Base and Spine

Download or read book Chordomas and Chondrosarcomas of the Skull Base and Spine written by Griffith R. Harsh IV and published by Academic Press. This book was released on 2017-09-14 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chordomas and Chondrosarcomas of the Skull Base and Spine, Second Edition, is a major reference and guide for neurosurgeons, medical oncologists, neuroscientists, orthopedic surgeons, head and neck surgeons and radiation oncologists that treat patients and research chordomas and chondrosarcomas of the axial skeleton. This book is the unique result of the collaboration of multidisciplinary specialists from a wide variety of fields (neurological sciences, medical oncology, molecular biology, orthopedics and radiation oncology), offering the most relevant information about chordomas and chondrosarcomas of the axial skeleton from each of these fields condensed into one single volume. It contains new medical knowledge and scientific advances regarding the treatment of these types of tumors. Additionally, the book includes chapters written by the Chordoma Foundation and Sarcoma Foundation of America, providing the most valuable information and support for patients and their relatives. Presents an up-to-date, comprehensive resource that details chordomas and chondrosarcomas from a multidisciplinary approach Edited by the leading researchers in brain and skull base tumors Includes chapters written by the Chordoma Foundation and Sarcoma Foundation of America

Book Fundamentals of Neuroanesthesia

Download or read book Fundamentals of Neuroanesthesia written by Keith J. Ruskin and published by Oxford University Press. This book was released on 2013-10 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fundamentals of Neuroanesthesia is a comprehensive guide to neuroanesthesia which focuses neurophysiology, neuroanatomy, and neurosurgical procedures, and then offers practical approaches to the practice of neurosurgical anesthesia.

Book Neuroendoscopic Surgery

    Book Details:
  • Author : Jaime Torres-Corzo
  • Publisher : Thieme
  • Release : 2019-04-04
  • ISBN : 1626231621
  • Pages : 420 pages

Download or read book Neuroendoscopic Surgery written by Jaime Torres-Corzo and published by Thieme. This book was released on 2019-04-04 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neuroendoscopy: State-of-the-art, global subspecialty encompassed in multimedia volume Honorable mention from the 2017 PROSE Awards HONORABLE MENTION for Textbook/Clinical Medicine! The development and refinement of neuroendoscopy has been driven by the persistent desire of neurosurgeons to advance the field and offer less invasive, more efficacious options to patients. This remarkable multimedia book reflects the technological advances achieved in the last two decades in fiber optics, cold light, cameras, and endoscopic instrumentation. Written by an impressive Who's Who of international neurosurgeons, the outstanding text and videos reflect global contributions to neuroendoscopy. Current indications for intracranial and intraventricular endoscopy are described in depth, through detailed chapters, stellar videos, professional animations, and exquisite illustrations. The authors share their clinical expertise on procedures ranging from endoscopic third ventriculostomy to transventricular approach of the fourth ventricle. Cover to cover, this book details the differences, alternatives, advantages, and limitations of the flexible neuroendoscope. This hands-on learning tool will enable neurosurgeons to perform endoscopy of the ventricles and basal cisterns for exploratory purposes and conditions such as hydrocephalus, congenital aqueductal stenosis, tumors, hypothalamic hamartoma, arachnoid cysts, and neurocysticercosis. Additional topics include endoscopic-assisted microvascular decompression and aneurysm surgery, fluorescence, complications, anesthesia, utilization in developing countries, and future trends. Key Features: Comprehensive multimedia reference with online access to 70 superb videos and animations More than 300 meticulously drawn illustrations Beautifully illustrated anatomical chapters that facilitate in-depth understanding of endoscopic anatomy An entire chapter devoted to flexible neuroendoscopy Indications, preoperative preparation, procedure description, intraoperative complications and their management ("risk and rescue: techniques), expert pearls, postoperative management, and outcomes This volume is a must-have resource for neurosurgery and neurology residents, neurosurgeons, pediatric neurosurgeons, and all physicians involved in the care of patients with intracranial and intraventricular disease.