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July 15, 1992

Neurological Surgery

Author Affiliations

Duke University Medical Center, Durham, NC

JAMA. 1992;268(3):379-380. doi:10.1001/jama.1992.03490030091040

In their 1990 Contempo issue report, Carson and Brem emphasized that neurological surgery has rapidly evolved into a high-tech specialty.1 They mentioned the development by neuroradiologists and neurosurgeons of the subspecialty of interventional neuroradiology and discussed the endovascular treatment of such lesions as intracranial aneurysms and arteriovenous malformations using balloons, glues, etc. Further refinements in equipment and technique have extended this work, with greater success and fewer complications. These interventionalists are now able to guide their catheters safely into small cerebral arterial branches to perform diagnostic and therapeutic maneuvers that include selective angiography; injection of an agent such as amobarbital to transiently alter the function of a focal brain region to establish the location of certain functions such as speech; injection of a chemotherapeutic drug into the direct arterial supply of a tumor; injection of an agent such as tissue plasminogen activator to lyse intravascular emboli and thrombi; injection