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May 16, 1990

Neurological Surgery

JAMA. 1990;263(19):2658-2659. doi:10.1001/jama.1990.03440190114060

Neurosurgery has rapidly evolved into a very high-tech specialty. Neuroimaging modalities and neurophysiological monitoring techniques have eliminated a significant amount of postulation and have provided a sound basis for sophisticated preoperative planning.

A small nonprioritized sampling of some of these technological advances would include the following: (1) transcranial Doppler ultrasonography, used in the diagnosis and treatment of a variety of conditions where assessment of intracranial arterial blood flow is important, (2) single-photon emission computed tomography, useful in the evaluation of cerebral hemodynamics, cerebral perfusion, and brain tumor permeability, (3) positron emission tomography, which quantitates metabolic activity and finds new applications every year, and (4) three-dimensional computed tomography, which enhances preoperative planning in cases of craniofacial reconstruction, and recently, in addition to computer software that readily permits mixing of different tissue-density signals, has provided three-dimensional visualization of complex skull base lesions and their relationship to bone and large vessels.1 Magnetic