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The Brain and Regulation of Eye Movement

Advances in Neurosurgery, Volume 4. Lumbar Disc. Adult Hydrocephalus Edited by R. Wullenweber, M. Brock, J. Hamer, M. Klinger, and 0. Spoerri. (Pp. 338; illustrated; DM76, $33.50.) Springer-Verlag: Berlin, Heidelberg, New York. 1977. The German Neurosurgical Society has in recent years published the proceedings of its annual meeting as a Congress monograph. While the brevity of each individual paper is inevitable in such a format, the concentration of the Society on at most two main themes in their Congress ensures a presentation of current German thinking on major neurosurgical topics. In this respect the present volume is no exception. The two themes discussed are the problems of lumbar disc and adult hydrocephalus. The report on no less than six series consisting of more than 1000 cases of lumbar disc disease approached by standard methods, and one collaborative series with over 3500 cases, must be unique in European literature. It is particularly valuable that this body of data is presented in conjunction with two reports of the newly developed and still somewhat controversial microsurgical approach to the lumbar spine. It seems clear that a considerably greater number of cases require to be analysed in relation to this new technique to assure the neurosurgical world at large that as high a proportion of satisfactory results and as low a proportion of recurrences will be available by this technique as with the proven although more traumatic extensive exposures. The series of papers on normal pressure hydrocephalus presents the German view of the universally fairly confused situation regarding the diagnosis and indications for treatment of this condition. It emerges that in Germany, as elsewhere, long-term measurement of intracranial pressure showing some definite abnormality, in conjunction with a suggestive clinical picture and perhaps one of the other tests, such as Metrisamide cisternograms with CT, or the infusion test are employed by most clinics to differentiate those patients who are likely to benefit from shunting from those who are not. There is a further section on free communications, including a group of three or four papers concerned with the effects of dexamethazone on head injuries, which is of considerable current interest. The volume also includes a brief tribute by Helmut Penzholz to the late Wilhelm Umbach, President of the Congress, whose untimely death is mourned throughout the neurosurgical world.