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June 19, 1996

Neurological Surgery

Author Affiliations

Duke University Medical Center, Durham, NC

JAMA. 1996;275(23):1825-1826. doi:10.1001/jama.1996.03530470053031

In neurosurgery, the trend continues in the direction of making operations more accurate, with less damage to normal tissues and fewer complications. Several of the techniques that are allowing these improvements were first introduced years ago, but only recently has the associated technology developed sufficiently to give them everyday usefulness. For example, endoscopy of the cerebral ventricular system (ventriculostomy) was first used more than 80 years ago. However, the procedure was not practical for neurosurgeons until endoscopes were miniaturized and made flexible, and video systems, laser techniques, and other instruments were developed for, or adapted to, endoscopy. [See also Plastic Surgery.—Ed.] Similarly, stereotactic brain operations, primarily for the treatment of movement disorders such as Parkinson disease, were introduced about 50 years ago. But the current widespread use of stereotactic techniques in daily neurosurgical practice required the development of computer-based diagnostic and treatment procedures. In a recent review, Kelly1