Vascular neurosurgery

By Pablo A. Rubino


Dario Lipovich

Responsable Comex

About the book:

Vascular Neurosurgery offers the essential microsurgical techniques to mastering the art of cerebrovascular neurosurgery. The book stems from of Dr. Pablo Rubino’s experience and knowledge in the field of microsurgical anatomy and cerebrovascular surgery, with more than 1000 cases solved and the creation of a new microsurgical school. This book is also a tribute to his mentor, Dr. Evandro de Oliveira, one of the most influential neurosurgeons in modern neurosurgery. The content is organized in seven parts: Introduction to Cerebrovascular Surgery, Approaches, Aneurysms, Cerebral Arteriovenous Malformations, Cavernomas, Cerebral Revascularization, and Internal Carotid Artery Disease.
Main features:
Different well-known neurosurgeons trained in Rhoton Jr. and Evandro de Oliveira’s Microsurgery Laboratories contributed to the book. The book offers essential knowledge for readers to design an appropriate plan for surgical treatment of cerebrovascular and spinal vascular disease in a practical and efficient way. The book includes more than 600 high-quality images and an appendix with 33 surgery videos. Vascular Neurosurgery is intended for training or experienced neurosurgeons seeking to broaden their knowledge of cerebrovascular surgery.



It is with great pleasure and honor that I write the prologue to this book of outstanding quality entitled Vascular Neurosurgery. In this book, Dr. Pablo A. Rubino shares his expertise and his most treasured lessons learned over twelve years of working in vascular neurosurgery, at Tertiary Care Hospital El Cruce Buenos Aires, Argentina. During my career, I had an intense relationship and affinity with neurosurgery in Argentina. I have actively collaborated in several courses and conferences. In addition to making many friends, I had the honor of training more than 500 Argentina neurosurgeons who attended my Microsurgery Laboratory at Hospital Beneficência Portuguesa in São Paulo, Brazil over the course of forty years. I think Argentina is a breeding ground for neurosurgeons at the highest level.
I have had the honor of following Pablo’s distinguished career since 2003, when he joined the Microsurgery Laboratory as a fellow to continue his training in microsurgical anatomy of the brain and its uses in microneurosurgery. Given his brilliant performance as a fellow, Pablo was invited to continue his education at the University of Florida Anatomy Lab in the United States, under the supervision of our teacher Albert L. Rhoton Jr.
I can assure beyond a shadow of a doubt that Pablo is currently one of the best vascular neurosurgeons in the world and that his success is due to some qualities I have observed in him throughout the years: determination, passion for neurosurgery, exceptional surgical techniques, kindness towards other people —residents, colleagues or friends—, and integrity.
Pablo has undoubtedly surpassed his teachers and I am sure he will continue pushing his own limits in the future. He is a role model for younger neurosurgeons and I am very proud of him. This book will certainly mark a milestone for neurosurgery in Argentina and the world.

Evandro De Oliveira
January 2021, São Paulo, Brazil

Ever since I started working as a neurosurgeon, I’ve been strongly influenced by a major figure in worldwide neurosurgery who has had a strong impact on Argentine neurosurgery: Dr. de Oliveira, perhaps inadvertently, made the greatest contribution to the development and growth of neurosurgery in Argentina even though he is a Brazilian national. Dr. de Olivera taught a whole new generation of neurosurgeons the significance of an in-depth knowledge of surgical anatomy and a good training in microsurgical techniques when treating cerebrovascular disease.
With the courses he gave in his laboratory in São Paulo, as well as his lectures, surgery videos, scientific publications, and live surgeries, Dr. de Oliveira changed our understanding of microsurgery. His philosophy stems from the study of two great authors, Dr. Albert. L. Rhoton Jr. and Dr. M. Gazi Yaşargil, who revolutionized modern neurosurgery worldwide by studying brain anatomy in-depth, applying that knowledge, and introducing the surgical microscope.
Standing on the shoulders of these two neurosurgery giants, Dr. de Oliveira had the ability to transmit their “recipe” in the operating room, putting it at the service not only of patients, but also of hundreds of disciples, so they might, in turn, provide their patients with better care. This formula is no mystery and I think we could sum it up in four essential pillars on which a vascular neurosurgeon should rely:
Talent: I am certain that some degree of talent is required. I think we all have a hidden talent and it is our duty to tap into it and make it grow to its full potential.
Tenacity: It means to never give up. Mistakes are bound to happen. We need to acknowledge and analyze them in order to learn and keep trying.
Courage: It is essential to perform cerebrovascular surgery, one of the most challenging fields in our discipline in which both a patient’s life and their ability to function are in our hands.
Passion: The spice of life. Passion for microsurgery, passion for patient care, passion for learning, for improving, and for passing on our knowledge to future generations.
If we rely on these four pillars, we will be ready to take the right path in the fascinating and challenging world of cerebrovascular microsurgery.
This book is a tribute to Dr. Evandro de Oliveira. It is a tribute to everything we have learned from him and to the deep influence he has had in our careers. In this book, we seek to express our surgical philosophy built on the foundation of our achievements, failures, and lessons learned after treating more than 1,000 cases of cerebrovascular disease. These cases were treated at public and private institutions in Latin America (particularly in Argentina), with all the advantages and disadvantages our healthcare system entails.
We have written this book so that neurosurgeons interested in vascular disease may benefit from our work and be prepared to make better decisions when it comes to patient care. Therefore, instead of writing a large textbook, we created an effective and efficient book that equips readers with the necessary knowledge to treat a specific vascular disease.
The book may be read in two different ways: either from beginning to end, starting with general and essential aspects of neurosurgery and ending with specific microsurgical techniques, or by reading each chapter separately to extract the necessary information to treat specific pathologies. We have also included an appendix with surgical videos that readers may find helpful.
Throughout this project, I have asked different neurosurgeons, both from Argentina and from other countries, to share all the knowledge we have gathered over all these years. These neurosurgeons learned with me and I also learned from them, neurosurgeons who are or have been part of Dr. de Oliveira’s school. This is the result of a great collaborative effort of which I am proud and for which I am grateful.
We think there is no original work similar to this in Spanish and we hope that readers will find the necessary knowledge and information to safely navigate the brain and effectively treat patients’ pathologies.

Pablo A. Rubino

Translated by Natasha Besoky / Laura Estefanía