[Why the name "Erasmus" for an hospital ?] / Pourquoi le nom d'"Erasme" pour un hôpital ?

Why the name "Erasmus" for an hospital ? Apart for local circumstances, there are far more obvious reasons for this choice. Erasmus was in close contact with the medical world. Indeed, he suffered all his life from more or less severe diseases and had therefore frequent contacts with doctors. Also, the ideas he was defending stood for the principle of free inquiry before its time. For these various reasons giving the name « Erasmus ¼ to the university clinics of the Free University of Brussels (ULB) was a judicious choise.

Pourquoi avoir donné le nom d'"Erasme" à un hôpital ? A côté de circonstances locales, il est des raisons bien plus évidentes pour ce choix. Erasme avait des relations étroites avec le monde médical. Il souffrit de maladies plus ou moins sévères au long de son existence et de ce fait, eut de fréquents contacts avec les médecins. Enfin, les idées qu'il défendait représentaient un libre examen avant la lettre. Ces diverses raisons rendirent judicieux le choix de son nom pour l'hôpital académique de l'Université libre de Bruxelles.

[Short history of cranial trauma in western country (part 2)]. / Bref historique du traitement des traumatismes crâniens en Occident (partie 2).

The treatment of cranial traumatism has been the subject of numerous publications since the " corpus hippocraticum ". Following this period, the school of Alexandria will only be known thanks to Celsus. After him, Galen will determine the therapeutic attitude in accordance with the hippocratic theory. This theory will have an influence for more than 1.500 years. A better knowledge of anatomy will shake the galenic system for the first time at the Renaissance. The decisive progress will arise in the XIX century, with the emergence of experimental medicine, Pasteur's discoveries, and the greater knowledge of nervous system function.

Le traitement des traumatismes crâniens a fait l'objet de nombreuses publications depuis les travaux d'Hippocrate. L'école d'Alexandrie, qui y fit suite, est connue grâce à Celsus. Galien, après lui, devait fixer une attitude thérapeutique voisine de celle d'Hippocrate. Celle-ci va garder une influence sur le monde médical pour plus de 1.500 ans. C'est la meilleure connaissance de l'anatomie qui, à la Renaissance, va ébranler les conceptions galéniques. Les progrès thérapeutiques déterminants se situent cependant au XIXe siècle par l'apparition de la médecine expérimentale, les découvertes de Pasteur ainsi que la meilleure compréhension du fonctionnement du système nerveux central.

[Short history of cranial trauma in western country (part 1)]. / Bref historique du traitement des traumatismes crâniens en Occident (partie 1).

The treatment of cranial traumatism has been the subject of numerous publications since the " corpus hippocraticum ". Following this period, the school of Alexandria will only be known thanks to Celsus. After him, Galen will determine the therapeutic attitude in accordance with the hippocratic theory. This theory will have an influence for more than 1.500 years. A better knowledge of anatomy will shake the galenic system for the first time at the Renaissance. The decisive progress will arise in the XIX century, with the emergence of experimental medicine, Pasteur's discoveries, and the greater knowledge of nervous system function.

Le traitement des traumatismes crâniens a fait l'objet de nombreuses publications depuis les travaux d'Hippocrate. L'école d'Alexandrie, qui y fit suite, est connue grâce à Celsus. Galien, après lui, devait fixer une attitude thérapeutique voisine de celle d'Hippocrate. Celle-ci va garder une influence sur le monde médical pour plus de 1.500 ans. C'est la meilleure connaissance de l'anatomie qui, à la Renaissance, va ébranler les conceptions galéniques. Les progrès thérapeutiques déterminants se situent cependant au XIXe siècle par l'apparition de la médecine expérimentale, les découvertes de Pasteur ainsi que la meilleure compréhension du fonctionnement du système nerveux central.

[The Belgian and French medicine and the "Ordres" facing the "jewish question" during the Second World War]. / La médecine belge et française et les Ordres face à la "question juive" durant la Deuxieme Guerre mondiale.

The attitude of the medical community and the "Ordres" to the "jewish question" differs in Belgium and France. This difference originates before the Second World War. Xenophobia and antisemitism were stronger in France. In addition, the Belgian capitulation of May 1940 and the armistice of June 22 in France do not represent the same situation. In France, a legal government, under the direction of Marshal Pétain, took a series of xenophobic measures of which the Jews were the first victims. In Belgium, in the absence of any government, the General Secretaries in Ministries were the ones who had to apply the antijewish measures dictated by the German occupant. By law, they could not legislate on the political level. The "Ordre", of French physicians was created in late 1940 by the Vichy government. In Belgium, the "Ordre " had existed since 1938 but had been unable to meet in the absence of implement decrees. An "Ordre bis" was created in late 1941, the legality of which was questioned by many lawyers and physicians. The French "Ordre" was to apply the antijewish measures by taking responsibility for the selection of Jewish physicians entitled to practice. In Belgium, the "Ordre" frowned upon by the physicians, played no official role in this regard. It simply applied the antijewish measures dictated by the Germans without protesting. After the conflict, the leaders of the "Ordres" had a different fate in both countries. In France, they escaped sentences. In Belgium, they were heavily condemned.

[The three lifes of Doctor Joseph-Ignace Guillotin (1738-1814)]. / Les trois vies du Docteur Joseph-Ignace Guillotin (1738-1814).

The life of Joseph-Ignace Guillotin can be divided into three periods. The first part of his life consists of his training and his settling as a medical consultant and influential freemason from 1738 to 1788. The second part primarily consists of his political role for a short period during the Revolution (from 1788 to 1791). It was during that time that he proposed a change in the functioning of the General States, a penal Code reform, and the reorganization of the teaching and medical exercice. Finally, during the third period of his life, he focused on promoting vaccination against smallpox and founded with others the present-day Academy of Medicine of Paris.

[Publicity, ethics and medical deontology]. / Publicité, éthique et déontologie médicale.

Compatibility between publicity and deontology is an old problem. Since a few months, TV shows, press interviews or newspapers have aroused interest. Some judgements from the European Court and the National Council of the medical Order and lawmakers were expressed. An "inventory of fixtures" seems to be now necessary.

[A Belgian medical board during World War II or the bad outcome of the law concerning the "Board of Medical Doctors " from 1938 (first part)]. / Un "Ordre des Médecins" de guerre (novembre 1941-septembre 1944) ou i'aboutissement dévoyé de la loi sur l'Ordre de 1938 (Première partie).

The medical profession regulation has always been a delicate subject to deal with. The need for one arose as early as the 17th century. Multiple attempts to create such a regulation occurred during the 19th and the 20th century, which led to the 1938 "Board of Medical Doctors" law. This law could not be applied then because of the Second World War. After the Belgian capitulation of May 28th 1940, the Germans and some members of professional or political movements wished to create a Medical Board that was totally different from the one proposed by the 1938 law. The background to this "33 Months Board" is analysed in this paper along with its functioning during the conflict. Among others this is based on the file dealing with the 1947 trial of this so called "Medical Board".

[A century of intracranial aneurysm treatment: from carotid ligation to endovascular procedures]. / De la ligature de carotide aux techniques endovasculaires ou un siècle de traitement des anévrismes intracrâniens. Historique du traitement des anévrismes.

Intracranial aneurysm treatment began in the 20th century. Treatment remained anecdotal for a long time because these lesions could not be visualized. This was the period of hunterian ligation of the carotid and trapping. After the discovery of the carotid angiography at the end of the 1920s, a new direct clipping approach started. Other techniques were used, such as wrapping and coating. Finally, in the 1980s, endovascular procedures appeared and are now in constant progress. The advantages, problems and improvements of these treatments are briefly reviewed.

[A short history of the knowledge of the CSF circulation and the treatment of hydrocephalus]. / Petite histoire de la circulation du LCR et du traitement de l'hydrocéphalie.

A short history of the knowledge of the CSF circulation is presented. The treatment of hydrocephalus is dependant of this knowledge and it is only in the second half of the XXth century that effective therapeutics with a variety of shunts will be developed.

[Paul Martin (1891-1968), pioneer of the neurosurgery in Belgium and cofounder member of the review "Neurochirurgie"]. / Paul Martin (1891-1968), un des fondateurs de la revue "Neurochirurgie"

As the first chief of an independent neurosurgical unit founded in Belgium in 1948, Paul Martin is to be regarded as the promoter of this specialty in Belgium. After graduation from the ULB. medical school, he was one of the first Belgian doctors to stay for two years (1920-22) in United States in the surgical departments of Halsted and Cushing. He returned to the Peter Bent Brigham Hospital in 1929 for one year as chief of the laboratory of experimental surgery. His career will be impressed by the development of various techniques to localize an intracranial mass such as the ventriculography, encephalography, electroencephalography and later angiography, myelography and iodoventriculography. The introduction of the electrocoagulation was also one of the major advances in surgical technique during his lifetime. In 1955, he was one of the founders of "Neurochirurgie", the official journal of the "Société de neurochirurgie de langue française".

[Historical outline of subarachnoid hemorrhage of aneurysmal origin]. / Aperçu historique de l'hémorragie sous-arachnoïdienne sur rupture anévrismale.

Subarachnoid hemorrhage (SAH) from aneurysmal origin was regarded for long time as a stroke like others vascular attacks. The specific identity of SAH is only recognized anatomically in the XVIIIth century and clinically in the XIXth century. The aneurysmal etiology and the treatment become regular only in the second half of the XXth century.

[A brief history and a few remarks about classifications of aneurysmal subarachnoid hemorrhages and scales of follow-up]. / Petite histoire et quelques réflexions à propos des échelles de grades des hémorragies sous-arachnoïdiennes d'origine anévrismale et des échelles de suivi.

A brief history of the most current scales of aneurysmal subarachnoid hemorrhage and follow-up is presented. Advantages and inaccuracies of these scales are discussed. The World Federation of Neurological Surgeons (WFNS) classification is recommended as the most objective and reliable although some critics exist about its use in particular conditions. The grading of the follow-up is also analyzed. Here, the Glasgow Outcome Scale (GOS) is the most common employed and promoted in a first approach in spite of its briefness. Secondary functional and neuropsychological examination at 6 or 12 months is to be recommended to enable a more accurate evaluation. In conclusion, the WFNS scales for subarachnoid hemorrhage and follow-up is proposed as the best way to allow comparison between work of different centers.

[Paul Martin (1891-1968). Pioneer of the neurosurgery in Belgium]. / Paul Martin (1891-1968). Un des fondateurs de la neurochirurgie en Belgique.

As the first chief of an independent neurosurgical unit founded in Belgium in 1948, Paul Martin is to be regarded as the promoter of this speciality in Belgium. After graduation from the U.L.B. medical school, he was one of the first Belgian doctors to stay for two years (1920-22) in USA in the surgical departments of Halsted and Cushing. He returned to the Peter Bent Brigham Hospital in 1929 for one year as chief of the laboratory of experimental surgery. Through his publications, we try to explain the problems of diagnosis and surgical techniques at that time in comparison with the present day situation. At the beginning, the only test available besides the neurological signs to detect intracranial lesion were plain Xrays of the skull, ophthalmologic examination and cerebrospinal fluid examination. Anaesthesiology was still unsafe and intracranial hypertension was not under control in any way. During his professional career, he witnessed the development of various techniques to localize an intracranial mass such as the ventriculography, encephalography, electroencephalography and later angiography, myelography and iodoventriculography. The introduction of the use of the electrocoagulation was one of the major advances in surgical technique during his lifetime.

[Authorized publicity? Amendment of the Code of Ethics by the National Council of the Order of Physicians on the publicity and three related notices]. / La publicité autorisée? A propos de la modification du Code de Déontologie par le Conseil National de l'Ordre des Médecins sur la publicité et de trois avis qui s'y rapportent.

In the issue of december 2002 of the bulletin of the National Council of Medicine are detailed some amendments about the chapter "PUB and publicity" of the Code of Ethics and two closely related notices. Another notice about neon signs take place in the bulletin of june 2003. Globally, the National Council does not authorize PUB but adopt a more moderate position about publicity in a series of particular situations. This article discuss the new situation and what it is necessary to think about.

Lower clivus and foramen magnum anterolateral meningiomas: surgical strategy.

Lower clivus and anterolateral foramen magnum meningiomas are rare but challenging tumors. Indeed, all access routes to their intradural anterolateral implantation appear unsafe since highly-functional local structures may not be sacrified or even retracted. Anterior and posterior surgical approaches have specific advantages and limitations. Different lateral extensions of the posterior approach have been described. They include a transposition of the vertebral artery, a partial occipital condylectomy and even the exposure and the section of the sigmoid sinus. Such posterolateral approaches offer the optimal access to anterolateral foramen magnum meningiomas and allow a total removal with a minimal morbidity. We report the surgical strategy that we applied for the last 6 anterolateral foramen magnum meningiomas in our department.

Monstrous skull osteomas in a probable Gardner's syndrome: case report.

BACKGROUND: Gardner's syndrome includes a clinical triad of familial polyposis coli, osteomas, and soft tissue tumors. METHODS: We present a very unusual case of probable isolated Gardner's syndrome characterized by extremely voluminous osteomas in the occipital and frontal areas associated with diffuse subcutaneous lipomas and without colic abnormality. RESULTS: The neurosurgical management included resection of the osteomas for cosmetic reasons. After a follow-up period of 5 years, the patient remains free of digestive complaints and the resected osteomas did not recur. CONCLUSIONS: The special clinical presentation of our case of possible Gardner's syndrome is discussed.

[Multiple and de novo aneurysms in Ehlers-Danlos syndrome]. / Anévrismes multiples et "de novo" dans le syndrome d'Ehlers-Danlos.

BACKGROUND AND PURPOSE: In 1964, the first case of "de novo" aneurysm has been reported by Graf and Hamby. The risk of late formation of aneurysm is unknown. Some factors could influence risk: history of hypertension, oral contraceptives, cigarette smoking. We report a rare case of "de novo" aneurysm associated with Ehlers-Danlos syndrome. RESULTS: A 35-year-old female developed a subarachnoid hemorrhage (SAH). Angiography demonstrated 4 aneurysms. Five years before, she presented a SAH. At that time, four vessels angiography demonstrated only one PICA aneurysm. A Ehlers-Danlos syndrome was suspected, which was demonstrated on skin biopsies. CONCLUSION: At our knowledge, this is the first case of "de novo" aneurysm associated with a Ehlers-Danlos syndrome.

The role of the Zairian Health Services in the Rwandan refugee crisis.

In July 1994, a stream of Rwandan refugees entered the southern part of North Kivu Region, Zaire. The public health consequences of this crisis for the host population and health services have not been analysed up to now. The lack of human and financial resources did not prevent Zairian health structures and personnel from taking care of the many refugees settled outside the camps, following their arrival. The public health consequences of the crisis for the local population should be considered an integral part of the disaster.