Françoise LAPIERRE, Bernadette STILHART, The First Two Female Big Bosses in French Neurosurgery.

We believe it is crucial to discuss the roles of women in medicine, specifically in surgery and neurosurgery. Despite society's progress towards gender equality in surgery and neurosurgery, these fields remain predominantly male. Recognizing and supporting these talented women allows them to bring attention to their contributions in their respective fields. Two notable French neurosurgeons, Françoise Lapierre, and Bernadette Stilhart have played significant roles in their field for several decades. Françoise Lapierre, the second head of neurosurgery at Poitiers since its creation, was one of the first female heads of neurosurgery in France. In addition to her departmental role, she has also conducted training missions in the Far East, specifically in Vietnam and Cambodia. She also served as the editor-in-chief of the journal Neurochirurgie for several years. Bernadette Stilhart, with a career spanning almost 50 years, has trained multiple generations of neurosurgeons from France and around the world. She has also been the head of one of France's oldest neurosurgery departments in Colmar, Alsace for 20 years.

Contributions of Laurent Princeteau to trigeminal neuralgia and middle fossa anatomy: more than a mere tubercle.

The contributions of Laurent Princeteau (1858-1932) to anatomy and to the establishment of neurosurgery have largely gone unrecognized, perhaps because he was educated and practiced in a French city other than Paris at a time when Paris was one of the chief centers of medicine in Europe. After completing a thesis describing an iliac artery anomaly and obtaining the distinguished agrégé teaching degree, Princeteau began his surgical career at the University of Bordeaux. Within 10 years, he became chef de clinique and one of busiest surgeons in Saint-André Hospital, as well as head of the anatomy institute and professor of anatomy at the dental school. In 1891, he achieved the rank of surgeon. In the field of general anatomy, he was recognized for novel cadaveric preparations and vascular perfusion techniques. In the neurosciences, he made important contributions to the anatomy of the trigeminal nerve and trigeminal neuralgia. In 1898, Princeteau supervised a thesis that addressed contemporary surgical approaches to the trigeminal complex. In the course of this effort, he identified a bony prominence near the petrous apex (the retrogasserian tubercle) that helped to locate the gasserian ganglion. The surgical significance of the retrogasserian tubercle was quickly acknowledged in the European neurosurgical community and was noted in French textbooks of anatomy. Thierry de Martel, a founding member of the French neurosurgical school, named the tubercle after Princeteau. To the rest of the world, however, it remained almost unknown.

An early case of successful peripheral nerve repair in 1880: Francis L. Parker, MD.

The modern technique of epineural suture repair, along with a detailed reporting of functional restoration, came from Carl Hueter in 1873. While there is extensive information on peripheral nerve surgery throughout recorded history leading up to the 1800s, little early American scientific literature is available. While Schwann, Nissl, and Waller were publishing their work on nerve anatomy and physiology, Francis LeJau Parker was born. The South Carolina native would go on to describe one of the first American cases of peripheral nerve repair with the restoration of function. Francis Parker was born in 1836 in Abbeville, South Carolina. He gained local notoriety as one of the first American surgeons to suture a severed nerve, resulting in restored function. The case dates back to 1880, when a patient presented to his clinic with severing of the posterior interosseous nerve. The details of this case come from the archives of the South Carolina Medical Association. The authors reviewed these records in detail and provide a case description of nerve repair not previously reported in the modern literature. The history, neurological examination, and details of the case provide insight into the adroit surgical skills of Dr. Parker.

[To the origins of surgery for acoustic neuromas]. / K istokam khirurgii nevrinom slukhovogo nerva.

Acoustic neuroma is one of the most common tumors of the posterior cranial fossa. Its removal is always a challenge for the neurosurgeon and the patient. The history of surgery for acoustic neuromas is inextricably linked with the history of neurosurgery in general. The modern surgical community must know history and be able to use it. Only then will the development of surgery lead to the preservation of the quality of life of patients. In the history of surgery for acoustic neuromas, the stages of its development are clearly visible from the description of the clinical picture through the study of the anatomy of the cerebellopontine angle to modern microsurgical removal.

The story of dexamethasone and how it became one of the most widely used drugs in neurosurgery.

Dexamethasone, a long-acting potent glucocorticoid, is one of the most widely used medications in neurosurgery. In this paper, the authors recount the history of dexamethasone's rise in neurosurgery and discuss its use in brain tumors in the context of emerging neuro-oncological immunotherapies. In 1958, Glen E. Arth synthesized a 16-alpha-methylated analog of cortisone (dexamethasone) for treatment of rheumatoid arthritis. Joseph Galicich, a neurosurgery resident at the time, applied the rheumatological drug to neurosurgery. He gave doses to patients who had undergone craniotomy for tumor removal and saw their paresis improve, midline shift resolve, and mortality rates decrease. He advocated for clinical trials and the drug became a mainstay in neurosurgery. As neuro-oncological treatments evolve to include immunotherapy, the immunosuppressive effects of dexamethasone are becoming an unwanted effect. The question then becomes: how does one treat the patient's symptoms if the only drug that has been used throughout history may become a detriment to their oncological treatment? Since its discovery, dexamethasone has maintained an impressive staying power in the field, acting as a standard drug for cerebral edema for more than 60 years. However, with the advent of immunotherapy, research is warranted to evaluate ways of treating symptomatic edema in the context of modern neuro-oncological therapies.

Meges of Sidon: The "Most Learned" of Surgery's Founding Fathers.

This paper aims to bring back to life an underrated, even forgotten surgeon of the late first century B.C.E., Meges of Sidon. He was an experienced surgeon of his time and was considered the most erudite Roman surgeon before Galen. He belonged to the Alexandria School of Medicine and later migrated to Rome to practice. Although most of his work did not survive, he was mentioned by notable ancient figures, such as Celsus and Galen. He excelled in various surgical specialties, not limited to neurosurgery, orthopedics, ophthalmology, and urology. Galen cited Meges in his surgical book on head injuries and cranial procedures. Meges was known to have invented a "double-edged" blade that he used to remove stones from the neck of the bladder. His treatment of anal fistulas was a reference through the Middle Ages. Celsus, a Roman encyclopedist of the first century, would later erroneously receive credit for ancient surgical innovations, such as the nonslipping cranial drill and the treatment of depressed skull fractures, even though he was not a surgeon. However, as Celsus was going over the history of surgery, he described Meges as the "most learned" of its prominent figures. Meges' neurosurgic techniques and teachings are deduced from Celsus, who shortly succeeded him, did not practice surgery, and acknowledged him as his primary source on surgical topics.

Artery of Uchimura: origin and evolution of identification of the vascular supply to the hippocampus.

In 1928, neuroscientist Yushi Uchimura (1897-1980) published a landmark study detailing the hippocampal vasculature. Working in Walther Spielmeyer's Munich laboratory (1925-1927), Uchimura sought evidence for a vascular theory of Ammon's horn sclerosis (AHS). He described an artery supplying the vulnerable sector of the hippocampus, where pathognomonic changes of AHS were noted, and characterized the artery as particularly susceptible to circulatory disturbances. Discovery of this artery led to new concepts and new terminology pertaining to the hippocampus. In addition to having a distinguished career in psychiatry and academia (including a position as University of Tokyo dean), Uchimura was, before attending medical school, one of Japan's best baseball pitchers; he was eventually named Nippon Professional Baseball Organization commissioner and inducted into the Japan Baseball Hall of Fame. Uchimura's description of hippocampal vasculature, which is still subject to debate after nearly a century, brought international attention to AHS and epilepsy and showed the hippocampal vasculature to be variable and vulnerable; important considerations for later neurosurgeons in the development of selective mesial temporal surgery. Prominent figures in neurosurgery have since developed classification systems for the hippocampal vasculature in which the artery of Uchimura remains central. Perhaps no other brain artery has been the nexus for such intense investigation and debate about its association to structure, function, disease, and treatment methodology.

A modern history of neurosurgery and neurology in India: lessons for the world.

The compendia of medical knowledge of the great ancient Indian physicians Susruta, Caraka, Jivaka, and Vagbhata all attest to the practice of neurosurgery and neurology starting in the 1st millennium bce. Although a period of scientific stagnation ensued between the 12th and 20th centuries ce, Indian medical neurosciences once again flourished after India's independence from British rule in 1947. The pioneers of modern Indian neurosurgery, neurology, and their ancillary fields made numerous scientific and clinical discoveries, advancements, and innovations that proved influential on a global scale. Most importantly, the efforts of Indian neurosurgeons and neurologists were unified at the national level through the Neurological Society of India, which was established in 1951 and enabled an unprecedented degree of collaboration within the aforementioned medical specialties. The growth and success of the Indian model bears several lessons that can be applied to other nations in order to garner better collaboration among neurosurgeons, neurologists, and physicians in related fields. Here, the authors elaborate on the origins, growth, and development of neurosurgery and neurology in India and discuss their current state in order to glean valuable lessons on interdisciplinary collaboration, which forms the basis of the authors' proposal for the continued growth of societies dedicated to medical neurosciences across the world.

Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon.

Introduction: The evolution of neurosurgery coincides with the evolution of visualization and navigation. Augmented reality technologies, with their ability to bring digital information into the real environment, have the potential to provide a new, revolutionary perspective to the neurosurgeon. Research question: To provide an overview on the historical and technical aspects of visualization and navigation in neurosurgery, and to provide a systematic review on augmented reality (AR) applications in neurosurgery. Material and methods: We provided an overview on the main historical milestones and technical features of visualization and navigation tools in neurosurgery. We systematically searched PubMed and Scopus databases for AR applications in neurosurgery and specifically discussed their relationship with current visualization and navigation systems, as well as main limitations. Results: The evolution of visualization in neurosurgery is embodied by four magnification systems: surgical loupes, endoscope, surgical microscope and more recently the exoscope, each presenting independent features in terms of magnification capabilities, eye-hand coordination and the possibility to implement additional functions. In regard to navigation, two independent systems have been developed: the frame-based and the frame-less systems. The most frequent application setting for AR is brain surgery (71.6%), specifically neuro-oncology (36.2%) and microscope-based (29.2%), even though in the majority of cases AR applications presented their own visualization supports (66%). Discussion and conclusions: The evolution of visualization and navigation in neurosurgery allowed for the development of more precise instruments; the development and clinical validation of AR applications, have the potential to be the next breakthrough, making surgeries safer, as well as improving surgical experience and reducing costs.

Management of injuries on the 16th-century battlefield: Ambroise Paré's contributions to neurosurgery and functional recovery.

During the 1536 siege of Turin in northern Italy, a young French barber-surgeon abandoned the conventional treatment of battle-inflicted wounds, launching a revolution in military medicine and surgical techniques. Ambroise Paré (1510-1590) was born into a working-class Huguenot family in Laval, France, during an era when surgery was not considered a respectable profession. He rose from humble origins as a barber-surgeon, a low-ranked occupation in the French medical hierarchy, to become a royal surgeon (chirurgien ordinaire du Roi) serving 4 consecutive French monarchs. His innovative ideas and surgical practice were a response to the environment created by new military technology on 16th-century European battlefields. Gunpowder weapons caused unfamiliar, complicated injuries that challenged Paré to develop new techniques and surgical instruments. Although Paré's contributions to the treatment of wounds and functional prosthetics are documented, a deeper appreciation of his role in military neurosurgery is needed. This paper examines archives, primary texts, and written accounts by Paré that reveal specific patient cases highlighting his innovative contributions to neurotrauma and neurosurgery during demanding and harrowing circumstances, on and off the battlefield, in 16th-century France. Notably, trepanation indications increased because of battlefield head injuries, and Paré frequently described this technique and improved the design of the trepan tool. His contribution to neurologically related topics is extensive; there are more chapters devoted to the nervous system than to any other organ system in his compendium, Oeuvres. Regarding anatomical knowledge as fundamentally important and admiring the contemporary contributions of Andreas Vesalius, Paré reproduced many images from Vesalius' works at his own great expense. The manner in which Paré's participation in military expeditions enabled collaboration with multidisciplinary artisans on devices, including surgical tools and prosthetics, to restore neurologically associated functionality is also discussed. Deeply religious, in a life filled with adventure, and serving in often horrendous conditions during a time when Galenic dogma still dominated medical practice, Paré developed a reputation for logic, empiricism, technology, and careful treatment. "I have [had] the opportunity to praise God, for what he called me to do in medical operation, which is commonly called surgery, which could not be bought with gold or silver, but by only virtue and great experimentation."

International Women in Neurosurgery.

The history of women in neurosurgery worldwide has been characterized by adversity and hardships in a male-dominated field, where resilient, tenacious, and ingenious women have nevertheless left their mark. The first women in neurosurgery appeared in Europe at the end of the 1920s, and since then have emerged in all continents in the world. Women neurosurgeons all over the globe have advanced the field in numerous directions, introducing neurosurgical subspecialties to their countries, making scientific and technical advances, and dedicating themselves to humanitarian causes, to name a few. The past 30 years, in particular, have been a period of increasing involvement and responsibility for women in neurosurgery. We must now focus on continual system improvements that will promote a diverse and talented workforce, building a welcoming environment for all aspiring neurosurgeons, in order to advance the specialty in the service of neurosurgical patients.

A comparative history of psychosurgery.

The term "psychosurgery" reflecting neurosurgical treatment of mental disorders, was coined by a Portuguese neurologist Egas Moniz (1874-1955), who, in 1935, suggested a procedure named prefrontal leucotomy (or lobotomy) aimed to divide white matter tracts connecting prefrontal cortex and thalamus. Starting from 1936, this technique and its subsequent modification (transorbital lobotomy) was zealously promoted by a neurologist Walter Freeman (1895-1972) and a neurosurgeon James Watts (1904-1994) at George Washington University, who in 1942 summarized their experience in a monograph, which publication resulted in a tremendous worldwide interest in psychosurgical interventions. The present review describes comparative development of prefrontal leucotomy followed by stereotactic ablation and neurostimulation in three different geographical regions: USA, USSR/Russia, and Far East (China and Japan), where psychosurgery followed nearly similar courses, progressing from the initial enthusiasm and high clinical caseloads to nearly complete disregard. The opposition to neurosurgical interventions for mental disorders around the world was led by different groups and for varying reasons, but, unfortunately, always with political considerations mixed in. Today, with vast advancements in neuroimaging, stereotactic neurosurgical techniques, and physiological knowledge, psychiatric neurosurgery can be performed with much greater precision and safety.

Dr. Djunga: First Congolese Neurosurgeon.

Antoine Shako Hiango Omokanda Djunga was the pioneer of neurosurgery in the Democratic Republic of Congo (DRC), a country located in Central Africa. He was born in 1938 in Sankuru, a province of the DRC. He graduated from the Free University of Brussels medical school and later trained there in neurosurgery. Thereafter, he completed a fellowship at Bellevue Hospital in New York. As a neurosurgeon, he worked at the Kinshasa University Clinic of Lovanium School of Medicine in the DRC, where he introduced neurosurgery and advocated for the construction of the first dedicated neurosurgical operating room. His leadership helped ensure sustainability in the field in the DRC. He died at the age of 48, leaving a void in neurosurgery and an unfulfilled mission of advocating for the construction of an independent neurosurgery hospital in the DRC.

Phanor L. Perot Jr.: South Carolina's father of academic neurosurgery.

Phanor Leonidas Perot Jr., MD, PhD (1928-2011), was a gifted educator and pioneer of academic neurosurgery in South Carolina. As neurosurgical resident and then as a junior faculty member at the Montreal Neurological Institute, he advanced understandings of both epilepsy and spinal cord injury under Wilder Penfield, William Cone, and Theodore Rasmussen. In 1968, he moved to Charleston to lead neurosurgery. From his time spent with master physicians such as Isidor Ravdin and Wilder Penfield, Perot himself became "the ultimate teacher." His research spanned the fields of epilepsy to torticollis to spinal trauma, focusing the most on the basic pathophysiology of spinal cord damage elucidated through somatosensory evoked potentials. His research was distinguished by generous grant funding. By the time he stepped down as chairman in 1997, the division of neurosurgery had become a department and he had served as president of the American Academy of Neurological Surgery and the Society of Neurological Surgeons. Perot taught prolifically at the bedside, and considered the residency program at the Medical University of South Carolina his greatest achievement. Although Dr. Perot never fully retired, he also enjoyed active hobbies of fly-fishing, traveling, and hunting, until his death on February 2, 2011. He influenced many and earned his role in history as the father of academic neurosurgery in South Carolina.

Ibn Zuhr (Avenzoar) on Head Wounds in Kitab al-Taysir (Liber Teisir).

OBJECTIVE: To present and evaluate the section concerning head wounds in Kitab al-Taysir (Liber Teisir) by Ibn Zuhr (Avenzoar). METHODS: In this study, 4 different versions of Avenzoar's work were analyzed. The first 2 versions are in Arabic and titled Kitab al-Taysir fi al-Mudawat wa al-Tadbir; one was edited by Michel Khouri and printed in Damascus in 1983, and the other was edited by Muhammad b. 'Abd Allah al-Rudani and printed in Rabat in 1991. The third and fourth versions are in Latin; one was translated by Paravicius, edited by Hieronymus Surianus, and printed in Venice in 1530, and the other was a manuscript in Bibliothèque interuniversitaire de santé, MS 5119 in Paris and was translated by John of Capua. RESULTS: The titles of the sections are "Wounds due to iron objects" and "Wounds due to stones" in Arabic and "On head injuries from external factors such as blow" and "On head wounds from iron or stone or wood" in Latin. The chapter written by Avenzoar on head wounds is divided into 2 parts. First, he explained the treatment, and subsequently he described his views and related experiences. CONCLUSIONS: The information provided by Avenzoar on head injuries technically reflects the medical and surgical comprehension of his era. In the section that is the focus of this study, he first provided technical information related to head injuries and then offered his opinions on the controversial and problematic issues in treatment such as phlebotomy. This study revealed that Avenzoar approached the subject differently than his predecessors.

The historical evolution of the fornix and its terminology: a review.

The historical evolution of the fornix has not been sufficiently reviewed in the literature. In this article, we follow this evolution from the first mention of the fornix in animal dissections of the second century AD, to the legalization of cadaver dissection in the 1300 s, to the introduction of neural staining techniques and the microscope in the seventeenth century, to today. We summarize the focus of fornix studies on memory to reveal its relationship with the hippocampus. We then cover the detection of the fornix and its neural connections noninvasively with the advancement of radiological imaging techniques. Finally, we discuss the prominence of the fornix as a target for deep brain stimulation in Alzheimer's disease and post-traumatic brain injury memory disorders.

No woman alone: Dorothy Russell's legacy to neurosurgery.

Dorothy Russell's contributions to neuropathology are pivotal in the evolution of modern neurosurgery. In an era preferential to men in medicine, she entered the second medical school class to include women at the London Hospital Medical College in 1919. In the laboratory of Hubert Turnbull, she met Hugh Cairns, who would become her professional neurosurgeon-neuropathologist partner. In 1929, arriving at McGill's Royal Victoria Hospital in Montreal, where Wilder Penfield and William Cone had just begun a neurosurgical service, Russell elucidated the origin and activity of microglia. Returning to London, Russell continued to work closely with Cairns for many years. Along with J. O. W. Bland, she became the first to culture gliomas and meningiomas. Her work on the effects of and fatality rates associated with head injuries among soldiers during World War II led to the initiation of helmet requirements for motorcyclists. Her textbook, Pathology of the Tumours of the Nervous System, written with Lucien Rubinstein, is considered a landmark text in neurosurgery, neuropathology, and neurooncology. Honored by Penfield and Cone as their first neurosurgery research fellow, Russell was considered a favorite of the Montreal Neurological Institute. Dorothy Russell's extraordinary career elucidating the mysteries of neurosurgical pathology has made an enduring mark on neurosurgery.

[Professor Veniamin M. Ugriumov (To the 110th anniversary of birth)]. / Professor Veniamin Mikhailovich Ugryumov. K 110-letiyu so dnya rozhdeniya.

The authors claim four milestones of V.M. Ugriumov's career - time spent twice in Moscow, Saratov, and Leningrad. In Moscow, V.M. Ugriumov evolved as an N.N. Burdenko disciple and later as deputy director of Burdenko Neurosurgical Institute. Ugriumov's life and career in Saratov was the least studied part of his biography, and the authors used archive documents of various origins to investigate and describe them. As a result, the new scope of text and photo files was introduced into the scholarly discourse. It was in Saratov where V.M. Ugriumov designed his original neurosurgery studies, laid the groundwork for the development of Saratov neurosurgery school, and brought his management and teaching talents to light. Later, in Leningrad, Professor V.M. Ugriumov proved to be a remarkable neurosurgeon, physiologist, science, and healthcare manager.

A Study on Head Wounds in Kitab al-'Umda fi Sina'a al-Jiraha by Ibn al-Quff.

The aim of this study is to investigate the knowledge on head wounds contained in the Kitab al-'Umda fi Sina'a al-Jiraha, written by Ibn al-Quff in the thirteenth century. This study was based on a copy of the Kitab al-'Umda fi Sina'a al-Jiraha, printed in 2 volumes in Da'ira al-Ma'arif al-Uthmaniyya in Hyderabad in 1356/1937-38 and reprinted by the Institute for the History of Arabic-Islamic Science at the Johann Wolfgang Goethe University. This printed copy was compared with the manuscript of Istanbul University Rare Works Library, Arabic Manuscripts, A 4749. Relevant chapters were translated from Arabic to English, after which they were thoroughly examined. Obtained knowledge is presented in the Results section and is compared in the Discussion section with other reports of this subject. The first chapter classified head wounds into 6 types: the first 3 types are conservatively treated and the remaining 3 types are surgically treated. This chapter also presents information on how to proceed when there is a head wound-related hemorrhage, which medications should be used, and which are the adequate treatment protocols. The second chapter discusses the symptoms and signs that follow head blow and fall injuries. The characteristics and noteworthy circumstances of skull fractures as well as the surgical treatment methods are included in the fifteenth chapter, which is concluded with surgery-related complications. The present study shows that Ibn al-Quff benefited from his predecessors' knowledge and made some considerable contributions to this subject.

The Proud History of Psychosurgery in the USA.

To understand the development and growth of psychosurgery, the context of psychiatric care in the mid-twentieth-century USA must be considered-for example, overpopulation and understaffing of public institutions, and typical use of psychotherapy, which was generally useless in treating the symptomatology of severe mental illness. Therefore, the introduction of prefrontal lobotomy (and, later, transorbital lobotomy) by Drs. Walter Freeman and James Watts, who modified the technique of leukotomy developed by Nobel Prize laureate Dr. Egas Moniz, was considered revolutionary and quickly gained widespread acceptance by medical community. No other alternative treatment at the time demonstrated comparable efficacy. At its peak, psychosurgery was sometimes applied inappropriately, but records from multiple institutions across the USA demonstrate that these were exceptional cases, whereas, as a rule, selection of surgical candidates was based on very strict criteria, indicating the high professionalism and humanity of medical staff. Although psychosurgery has declined heavily since the 1950s, it is not obsolete and is currently considered a valuable treatment option, realized through various open, stereotactic, or radiosurgical procedures.