History and evolution of surgical treatment for spasticity: a journey from neurotomy to selective dorsal rhizotomy.

The evolution of neurosurgical approaches to spasticity spans centuries, marked by key milestones and innovative practitioners. Probable ancient descriptions of spasmodic conditions were first classified as spasticity in the 19th century through the interventions of Dr. William John Little on patients with cerebral palsy. The late 19th century witnessed pioneering efforts by surgeons such as Dr. Charles Loomis Dana, who explored neurotomies, and Dr. Charles Sherrington, who proposed dorsal rhizotomy to address spasticity. Dorsal rhizotomy rose to prominence under the expertise of Dr. Otfrid Foerster but saw a decline in the 1920s due to emerging alternative procedures and associated complications. The mid-20th century saw a shift toward myelotomy but the revival of dorsal rhizotomy under Dr. Claude Gros' selective approach and Dr. Marc Sindou's dorsal root entry zone (DREZ) lesioning. In the late 1970s, Dr. Victor Fasano introduced functional dorsal rhizotomy, incorporating electrophysiological evaluations. Dr. Warwick Peacock and Dr. Leila Arens further modified selective dorsal rhizotomy, focusing on approaches at the cauda equina level. Later, baclofen delivered intrathecally via an implanted programmable pump emerged as a promising alternative around the late 1980s, pioneered by Richard Penn and Jeffrey Kroin and then led by A. Leland Albright. Moreover, intraventricular baclofen has also been tried in this matter. The evolution of these neurosurgical interventions highlights the dynamic nature of medical progress, with each era building upon and refining the work of significant individuals, ultimately contributing to successful outcomes in the management of spasticity.

Progress in neurosurgery: Contributions of women neurosurgeons in Latin America.

Nearly 75 years after the first woman neurosurgeon was trained in Latin America, the field of neurosurgery is changing and the prominence of women neurosurgeons within the specialty is increasing. By researching the histories of individual physicians and neurosurgeons, as well as neurosurgical departments and societies, we present, for the first time, the history of the women in neurosurgery in Latin America. Women neurosurgeons in the region have made notable progress, inspiring subsequent generations and actively participating in organized neurosurgery, medical leadership outside neurosurgery, academic neurosurgery, and leadership in contemporary society. The establishment of "Women in Neurosurgery" networks and organizations has been important to the success of many of these efforts. This collaborative study, which identifies the known women neurosurgeons in Latin America for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.

Tribute to Theodor Kocher: Far Beyond an Anatomical Reference

We know Kocher's name as an anatomical reference in neurosurgery. In fact, Theodor Kocher was a Swiss general surgeon, and his contributions were such that Kocher was honored in 1909 with the Nobel Prize in Medicine and Physiology, and he was the first surgeon to receive this honor. Kocher participated in the initial scientific phase of medicine, livingwith names that are in history, as well as him; Langenbeck and Virchow, Lucke, Billroth, Horsley, Lister, Halstedt, Pasteur, Osler, Lawson Tait, Verneuil, and a long list and other icons of the time. The present account rescues the many important facets and contributions of the Swiss surgeonTheodor Kocher, and his relationship with several of them. Kocher's memory, surgical instruments and literary production are preserved in a small wing of the University of Bern. The present article highlights how intense Kocher's dedication to the medical field was.

Neurological Functional Surgery in Mexico: From Pre-Columbian Cranial Surgery to Functional Neurosurgery in the 21st Century.

From the predominance of the pre-Columbian cultures to the present, an interest has existed in Mexico in brain structure and function, in both normal and pathological conditions. This interest has resulted in both medical and surgical attempts to treat some neurological conditions. Eighty years ago, with the influence of American and European neurosurgeons, modern Mexican neurosurgery emerged. Since then, it has progressively grown and diversified into several high specialties. At present, functional neurosurgery in Mexico constitutes, similar to that in other countries, a recognized surgical subspecialty that provides valuable information to treat brain dysfunctions such as movement disorders, pain, epilepsy, and other conditions. In the present report, we have briefly described the main historical aspects of the emergence and development of functional neurosurgery in Mexico.

Neurological and architectural sinuosities: the Niemeyer brothers.

In a family of 7 siblings in Rio de Janeiro, Brazil, 2 of the most remarkable national personalities decided to follow different fields at the beginning of the 20th century. Their life's work would, however, intersect in at least 2 respects: the quest for innovation and a passion for sinuosity. The achievements of Paulo and Oscar Niemeyer are landmarks in the history of neurosurgery and architecture in Brazil. Among his many innovations in neurosurgery, Paulo Niemeyer first described the transventricular amygdalohippocampectomy in 1957 and introduced the operating microscope to neurosurgery in Brazil in 1971. His brother Oscar became a world-renowned representative of the modern architecture movement, sculpting graceful curves from concrete.

Glossopharyngeal neuralgia: neurosurgical treatment and differential diagnosis.

The objective of this study was to review the literature on glossopharyngeal neuralgia (GN) and to discuss its differential diagnosis and treatment options. Despite the significant improvement of trigeminal neuralgia with pharmacological treatment, GN has a higher incidence of treatment failure and neurosurgery is necessary for the majority of patients. Functional neurosurgery has a great rate of success for GN, especially techniques such as percutaneous thermal rhizotomy, trigeminal tractotomy and/or nucleotomy. The main problem with GN remains the diagnosis as it is a rare disease with similarities to trigeminal neuralgia, including the same pharmacological treatment. Facial pain specialists should be trained to achieve a better accuracy of diagnosis.

From lateral to mesial: the quest for a surgical cure for temporal lobe epilepsy.

PURPOSE: A gap of more than a hundred years occurred between the first accounts of mesial temporal sclerosis and recognition of its role in the pathogenesis of psychomotor seizures. This paper reviews how the understanding and surgical treatment of temporal lobe epilepsy developed, particularly from the work of Penfield, Jasper, and their associates at the Montreal Neurological Institute (MNI). METHODS: Publications on EEG and surgery for temporal lobe seizures from 1935 to 1953 were reviewed and charts of selected patients operated on at the MNI in the same period were examined. Attention was focused on the evolution of surgical techniques for temporal lobe epilepsy. RESULTS: In the late 1930s, some EEG findings suggested deep-lying disturbances originating in the temporal lobe. However, it took another two decades before the correlation of clinical, neurophysiological, and anatomical findings provided evidence for the involvement of the mesial structures in psychomotor or temporal lobe seizures. From 1949 and onward, Penfield and his associates applied this evidence to extend the surgical resections to include the uncus and the hippocampus. CONCLUSION: The collaborative work of a team led by Penfield and Jasper at the MNI helped to define the role of neurophysiological studies in epilepsy surgery. As a result, the importance of removing the mesial structures in order to obtain better seizure control in patients with temporal lobe epilepsy became firmly established.

Las trepanaciones en sudamérica: medicina y sociedad / Trepanation in South America: medicine and society

Durante la época precolombina en Sudamérica hay una practica muy extendida en los pueblos de los Andes. Tanto los Incas como sus vecinos practicaban ritos de trepanaciones en el cráneo con una gran perfección, llegando a la supervivencia de varias semanas de sus pacientes. Una práctica que se extendió con la medicina de guerra. (AU)

First published record of a neurosurgical procedure on the North American continent, Mexico City, by Pedro Arias de Benavides, 1561: Secretos de Chirurgia, Valladolid, Spain, 1567.

The first published account of a neurosurgical intervention performed on the North American continent is described. The operation took place in Mexico City in 1561. The neurosurgical intervention was performed by a Spanish surgeon, Pedro Arias de Benavides, on a 13-year-old boy who had sustained head trauma that caused an open depressed cranial fracture and exposed the cerebrum. A description of this case was first published in Valladolid, Spain, 6 years after the event, in a book entitled Secretos de Chirurgia ("Secrets of Surgery").