Management of Subarachnoid Hemorrhage in Two Important Italian Political Leaders: A Paradigm of Ethical and Technological Evolution of Neurosurgery During the Past Half-Century.

For a curious and extraordinary coincidence, 5 of the 7 most relevant leaders of the Italian Communist Party (Partito Comunista Italiano, which was established in 1921, has been the biggest Communist Party in Western Countries) suffered a cerebral stroke. Cerebrovascular diseases afflicted also Stalin and Lenin, and a number of Presidents of the United States. We present the stories of 2 important Italian political leaders who shared both the leadership role of the major left Italian Party and the dramatic experience of a subarachnoid hemorrhage. Retracing their medical incidents, separated by 50 years of history, we show how a fatal medical disease has become neurosurgical and successfully cured thanks to the advances of neurosurgery, neuroradiology, and hospital organization. A neurologic disease that was disgraceful 50 years ago has lost any disquieting and embarrassing significance in the present time to the light of evolution of vascular neurosurgery.

Endoscopic anatomic features of the triangular recess.

OBJECTIVE: To describe the morphological and topographic features of the triangular recess (TR) in the anterior wall of the third ventricle and the pathological conditions that allow its observation during ventricular endoscopic neuronavigation. METHODS: A systematic review of records and operative videotapes for 145 patients who underwent endoscopic third ventriculostomy was performed. RESULTS: The TR could be recognized in five cases of hydrocephalus, each caused by a different underlying pathological condition. The approach was precoronal in four cases and suboccipital in one. The morphological and topographic features of the TR and adjacent structures varied among the different cases. CONCLUSION: Although it is seldom reported in neuroanatomy handbooks and is not readily accessible under normal conditions, the TR is a characteristic structure of the third ventricle, which might become apparent in several conditions that produce hydrocephalus. Neurosurgeons who perform neuroendoscopy should be aware of this structure and of the situations that cause its deformation and allow its observation during endoscopic neuronavigation.