Al-Zahrawi (936-1013 AD): On the Surgical Treatment of Neurological Disorders by the Father of Operative Surgery.

BACKGROUND: Medical knowledge during the medieval ages flourished under the influence of great scholars of the Islamic Golden age such as Ibn Sina (Latinized as Avicenna), Abu Bakr al-Razi (Rhazes), and Abu al-Qasim Khalaf ibn al-Abbas al-Zahrawi, known as Albucasis. Much has been written on al-Zahrawi's innovation in various disciplines of medicine and surgery. In this article, we focus for on the contributions of al-Zahrawi toward the treatment of neurological disorders in the surgical chapters of his medical encyclopedia, Kitab al-Tasrif (The Method of Medicine). METHODS: Excerpts from a modern copy of volume 30 of al-Zahrawi's Kitab al-Tasrif were reviewed and translated by the primary author from Arabic to English, to further provide specific details regarding his neurosurgical knowledge. In addition, a literature search was performed using PubMed and Google Scholar to review prior reports on al-Zahrawi's neurosurgical instructions. RESULTS: In addition to what is described in the literature of al-Zahrawi's teachings in cranial and spine surgery, we provide insight into his diagnosis and management of cranial and spinal trauma, the devices he used, and prognostication of various traumatic injuries. CONCLUSIONS: Al-Zahrawi was a renowned physician during the Islamic Golden age who made significant contributions to the diagnosis and treatment of neurological conditions, particularly cranial and spinal cord injuries. He developed innovative surgical techniques for trephination and spinal traction, which are still used in modern neurosurgery. His insights make him worthy of recognition as an important figure in the history of neurological surgery.

The transition from cranial surgery to neurosurgery in East London, 1760-1960.

The emergence of neurosurgery from the practice of cranial surgery between the eighteenth and the twentieth centuries in London, UK, is well documented, including the role of Sir Victor Horsley, the first neurosurgical appointee at the National Hospital Queen Square in 1886. The process of this transition elsewhere in London and the subsequent foundation of other neurosurgical units are less well described. In East London, the status of St. Bartholomew's Hospital (Barts) as the oldest London hospital still active on its original site and its comprehensive archives allow an unusually long history of surgical practice in the specialty to be studied. Using these archives and other primary and secondary sources, this article describes the transition of cranial surgery in East London from the general surgeons, limited to the treatment of brain and skull injury, to the specialized discipline of neurosurgery. We discuss the culmination of this process in the foundation of three neurosurgical units at London Hospital, Whitechapel, by Sir Hugh B. Cairns from 1927; at Barts Hospital, Smithfield, by John E. A. O'Connell from 1937; and at Oldchurch Hospital, Romford, by Leslie C. Oliver from 1945. Two modern neurosurgical units, in Whitechapel and Romford, have taken forward the work begun by this group.

The Mayo, Cushing, and Osler Influence on A. L. Rhoton: A Historical Vignette of the Interconnectedness Between Highly Influential Neurosurgery Leaders over 100 Years.

The careers of the Mayo brothers, Harvey Cushing, and Sir William Osler greatly shaped medical and surgical practice in the late 19th century and early 20th century and created a legacy to influence decades of physicians to follow. Additionally, these individuals were instrumental in the founding of neurosurgery as a distinct surgical specialty. Alongside these great men, Dr. Albert L. Rhoton Jr., revolutionized neurosurgical practice through his study of neuroanatomy and development of microsurgical technique in the second half of the 20th century. This review of the interactions and relationships between the Mayo brothers, Cushing, and Osler and their influences on Rhoton highlights the 100-year-long interconnectedness shared between these giants in the history of neurosurgery.

Art and Neurosurgery: The Importance of Medical Illustration.

Art in neurosurgery has been a critical part of the discipline for centuries. Numerous cultures, such as ancient India, China, and Egypt, and more contemporary scientists, such as Leonardo da Vinci, Max Brödel, and Norman Dott, have significantly contributed to medical illustration. Today, advancements in three-dimensional technology have allowed for the creation of detailed neuroanatomy models for surgical planning and education. Medical illustrations are also used for research and outcome documentation as they help visualize anatomy and surgical procedures. Its use in education, surgical planning, and navigation remains integral to the advancement of neurosurgery. This review demonstrates the invaluable contribution of art in neurosurgery and how it has enabled continuous progress in the field.

[Pavel I. Emdin: Biography without blank spots]. / Pavel Iosifovich Emdin Biografiya neirokhirurga bez belykh pyaten.

The authors present the career of Professor Pavel I. Emdin as one of the pioneers of Russian neurosurgery. Archive documents, biography and scientific articles are analyzed. The merit of Pavel I. Emdin as an organizer of national health care is «armament¼ of neuropathologists with surgical methods of treatment. He created the first in Russia Department of Nervous Diseases with clinics of neurology and neurosurgery at the Don University in Rostov-on-Don. He created the Rostov school of neurosurgeons, whose representatives continued the work of their teacher in various regions of the Soviet Union. Professor Pavel I. Emdin is a bright figure in the galaxy of Russian and Soviet neuropathologists and neurosurgeons with outstanding organizational and professional qualities regarding development of neurosurgery in our country.

Women in Neurosurgery: Turkey's Yildiz Yalçinlar.

BACKGROUND: Severalreports have been published on the history of pioneering women pursuing neurosurgery. Women in Turkey started receiving neurosurgery specialty training later than men, as was the case in other parts of the world. However, compared to other countries, Turkey saw the admission of women in neurosurgery sooner, with Aysima Altinok who obtained her specialization in 1959. Nevertheless, Yildiz Yalçinlar, one of the pioneers, remains relatively unknown. METHODS & RESULTS: In this paper, we witness Yildiz Yalçinlar's journey, from her graduation from Ankara Medical Faculty in 1954 and her subsequent specialization in general surgery to her arrival in Igdir as a young surgeon in the early 1960s, where she faced cultural challenges. We explored her transition into neurosurgery, becoming the second neurosurgeon in Turkey in 1965. We examine her complex career progression from receiving her specialization in neurosurgery to her academic journey toward becoming a department chief and her role as one of the founding members of the Turkish Neurosurgery Association. CONCLUSIONS: In Turkey, the number of women practicing as neurosurgeons has increased consistently. Despite this upward trend, the representation of women in the field of neurosurgery remains disproportionately low. We hope that Yildiz Yalçinlar's achievements, which began in the early 60s, will encourage women today and contribute to the continuing growth of neurosurgery.

The evolution of pediatric neurosurgery: reflection of personal experience of the last half-century.

OBJECTIVES: In the past 50 years, pediatric neurosurgery has made tremendous strides, and gained its own identity as a distinct subspecialty. I have personally observed this progress and evolution in pediatric neurosurgery in multiple dimensions, which are described based upon my own experience and reflection. METHODS: The development and evolutions of multiple domains of pediatric neurosurgery, including neuroimaging, hydrocephalus, pediatric brain tumor, spinal dysraphism, craniosynostosis, vascular malformation, functional neurosurgery and spinal disorders were reviewed and commented on based upon my own experience and reflection. RESULTS: The field of pediatric neurosurgery has grown in all aspects of diagnosis and therapy owing to the introduction of computers, innovative techniques and technologies and new discoveries of scientific data including molecular investigations. CONCLUSION: A minimally invasive approach and molecular target therapy are a current trend. The past half century's clinical experience and advances in biomedical knowledge and techniques provide foundation for further improvement in the care of children of the next generation. Prospective artificial intelligence will likely promote further advances in pediatric neurosurgery.

Clarence Sumner Greene, Sr. (1901-1957): The First Board-Certified Black Neurosurgeon in the United States.

BACKGROUND: This historical account reviews the life and lasting impact of Dr. Clarence Sumner Greene Sr. in neurosurgery. The article covers his early childhood, adulthood, and late-adulthood years to provide insights into his achievements and the lasting impact. METHODS: The writing of this project was sparked by the discovery of original scientific and bibliographical information about Greene Sr. The article thoroughly reviews Greene's upbringing, achievements, and the significance of his work on modern medicine. RESULTS: Clarence Sumner Greene, Sr. paved for African American physicians within neurosurgery and other medical specialties. While living through the segregation and progressive eras, Greene pursued his medical education at Howard University College of Medicine from 1932 to 1936 and graduated at the age of 34. He completed his general residency training at Howard and went on to become an assistant professor of surgery at Howard University School of Medicine in 1943. Five years later, Dr. Wilder G. Penfield offered Greene the chance to train under him in a 2-year neurosurgery residency program at the Montreal Neurological Institute of McGill University from 1947 to 1949. Greene returned to Howard in 1949, eventually becoming the Chief of Neurosurgery and overhauling neurosurgical care by introducing advanced surgical and diagnostic procedures until his unfortunate death in 1957. CONCLUSIONS: Our article provides glimpses into the life of Dr. Greene Sr. and his marked impact on neurosurgery. His significant contributions to the field of medicine and ability to strive through racial barriers and social injustice provide guidance, support, and encouragement to aspiring physicians from all backgrounds.

Emanuel Olatunde Alaba Olanrewaju Odeku (1927-1974): First African Neurosurgeon Trained in the United States and Establisher of the National and West African Postgraduate Medical Colleges.

BACKGROUND: In this comprehensive historical account, the authors delve into the remarkable trajectory of Dr. Latunde E. Odeku, a pioneering figure in neurosurgery. METHODS: The inspiration for this project was ignited by the discovery of the original scientific and bibliographic materials of Latunde Odeku, a renowned Nigerian neurosurgeon and the first African neurosurgeon in history. Following a thorough review of the literature and information available on Dr. Odeku, we have compiled a comprehensive and detailed analysis of his life, work, and legacy. RESULTS: This paper begins by introducing his childhood and early education in Nigeria, highlights his journey through medical school and residency in the United States, and follows his career and role in establishing the first neurosurgical unit in West Africa. We celebrate the life and legacy of Latunde Odeku, a trailblazing neurosurgeon whose contribution has inspired generations of medical professionals in Africa and around the world. CONCLUSIONS: This article sheds light on the remarkable life and achievements of Dr. Odeku and his trailblazing work for generations of doctors and researchers.

Great Hospitals: The History of Neurosurgery at the University of Vermont Medical Center-A Macroscopic Examination of Microscope-Savvy Pioneers.

The University of Vermont's (UVM) Division of Neurosurgery is enshrined in a rich history of innovation and academic prowess, which have significantly contributed to making neurosurgery the field it is today. From humble beginnings, the department was started by one Raymond Madiford Peardon "Pete" Donaghy on a parenthetically watertight research budget amounting to $25 and shared space in a Quonset hut. Passion and commitment to progress, as well as an innate openness to collaboration, propelled Pete Donaghy, his colleagues, pupils, and successors to establish an exemplary center for treatment of neurosurgical disease, with multiple revolutionary accomplishments along the way. These accomplishments include the birth and promotion of microneurosurgery, the performance of the first extracranial to intracranial bypass, and the education of other neurosurgical giants. The New England Skull Base Course, held annually in UVM's "R.M. Peardon Donaghy Microvascular and Skull Base Laboratory," is a 3-day cadaver-based teaching course for neurosurgery and ear nose and throat residents throughout New England. The course bears testament to Donaghy's everlasting influence on the UVM Division of Neurosurgery and continues to positively affect the education of countless trainees. The purpose of this historical perspective is to outline the events and accomplishments that define the UVM Division of Neurosurgery's many contributions to the field at large and the ongoing efforts to honor Donaghy's example through maintaining a culture of humility, hard work, and commitment to neurosurgical innovation and education.

The New England Neurosurgical Society: growth and evolution over 70 years.

The New England Neurosurgical Society (NENS) was founded in 1951 under the leadership of its first President (Dr. William Beecher Scoville) and Secretary-Treasurer (Dr. Henry Thomas Ballantine). The purpose of creating the NENS was to unite local neurosurgeons in the New England area; it was one of the first regional neurosurgical societies in America. Although regional neurosurgical societies are important supplements to national organizations, they have often been overshadowed in the available literature. Now in its 70th year, the NENS continues to serve as a platform to represent the needs of New England neurosurgeons, foster connections and networks with colleagues, and provide research and educational opportunities for trainees. Additionally, regional societies enable discussion of issues uniquely relevant to the region, improve referral patterns, and allow for easier attendance with geographic proximity. In this paper, the authors describe the history of the NENS and provide a roadmap for its future. The first section portrays the founders who led the first meetings and establishment of the NENS. The second section describes the early years of the NENS and profiles key leaders. The third section discusses subsequent neurosurgeons who steered the NENS and partnerships with other societies. In the fourth section, the modern era of the NENS and its current activities are highlighted.

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.

Neurosurgery at Pearl Harbor: Ralph Cloward's legacy.

Ralph B. Cloward (1908-2000) was the sole neurosurgeon present during the Japanese attack on Pearl Harbor on December 7, 1941. Cloward operated on 42 patients in a span of 4 days during the attacks and was awarded a commendation signed by President Franklin D. Roosevelt in 1945 for his wartime efforts. During the attacks, he primarily treated depressed skull fractures and penetrating shrapnel wounds, but he also treated peripheral nerve and spine injuries in the aftermath. His techniques included innovative advancements such as tantalum cranioplasty plates, electromagnets for intracranial metallic fragment removal, and the application of sulfonamide antibiotic powder within cranial wounds, which had been introduced by military medics for gangrene prevention in 1939 and described for penetrating cranial wounds in 1940. Despite the severity of injuries encountered, only 2 soldiers died in the course of Cloward's interventions. As the sole neurosurgeon in the Pacific Theater until 1944, he remained in Honolulu through World War II's duration and gained immense operative experience through his wartime service. Here, the authors review the history of Cloward's remarkable efforts, techniques, injury patterns treated, and legacy.

Evolution of spinal cord injury treatment in military neurosurgery.

During the mid-1900s, military medicine made historical advancements in the diagnosis, stabilization, and treatment of spinal cord injuries (SCIs). In particular, World War II was an inflection point for clinical practice related to SCIs because of the vast number of devastating injuries to soldiers seen during World War I (WWI). The unprecedented rate of SCI along with growth in the field served as a catalyst for surgical and interdisciplinary advancements through the increased exposure to this challenging pathology. Initially, a tragic fate was assumed for soldiers with SCIs in WWI resulting in a very conservative approach strategy given a multitude of factors. However, soldiers with similar injuries 20 years later saw improved outcomes with more aggressive management interventions by specialists in spine trauma, who applied measures such as spinal traction, arthrodesis, and internal fixation, and with the significant developments in the complex rehabilitation of these patients. This article describes the historical shift in the management of SCIs through the two world wars. These historical lessons of SCI and the fundamental advances in their neurosurgical intervention have molded not only military but also modern civilian treatment of SCI.

Neurosurgery during the Greco-Italian War (World War II): the management of war-related head injuries at the Italian field hospital of Sinanaj in Albania.

During the Greco-Italian War (World War II [WWII], 1940-1941), an Italian field hospital was set up in Sinanaj, Albania. The hospital's military surgeons carefully collected information about the characteristics and management of patients with war-related injuries. In 1942, they published a detailed report, with a section dedicated to the management of war-related head injuries. The aim of this report is to analyze that section, to describe the characteristics and neurosurgical management of war-related head injuries, and to depict the status of war neurosurgery in the Royal Italian Army during WWII. The analysis revealed that, during the Greco-Italian War (November 1940-April 1941), 149 patients with war-related head injuries were admitted to the Sinanaj hospital, and 48 patients underwent surgery. Head injuries were caused by bomb fragments in 126 patients, bullets in 5 patients, and other causes (falls from height, vehicle accidents, or rock fragments) in 18 patients. Six patients (12.5%) died after surgery. Before surgery, patients underwent resuscitation with blood transfusions and fluid. Preoperatively, a plain head radiograph was usually acquired to locate metallic and bone fragments. The surgical technique consisted of craniotomy or craniectomy, aggressive debridement of metallic and bone fragments, and watertight dural closure. Surgical drainage, overall aseptic technique, serial spinal taps, and perioperative antibiotics were used to prevent infections. The surgical aims and technique used by the Italian surgeons for the management of head injuries were similar to those of the Allied surgeons during WWII. Operative mortality was also comparable. Although the surgical technique for war-related head injuries has evolved since WWII, many aspects of the technique used by the Italian and Allied surgeons during WWII are still in the standard of care today.

A history of neurosurgical capabilities in the United States Pacific Command: from World War II to present.

Neurosurgery has benefited from innovations as a result of military conflict. The volume and complexity of injuries sustained on the battlefield require medical teams to triage, innovate, and practice beyond their capabilities in order to treat wartime injuries. The neurosurgeons who practiced in the Pacific Command (PACOM) during World War II, the Korean War, and the War in Vietnam built upon field operating room knowledge and influenced the logistics of treating battle-injured patients in far-forward environments. Modern-day battles are held on new terrain, and the military neurosurgeon must adapt. War in the PACOM uniquely presented significant obstacles due to geographic isolation, ultimately accelerating the growth and adaptability of military neurosurgery and medical evacuation. The advancements in infrastructure and resource mobilization made during PACOM conflicts continue to inform modern-day practices and provide insight for future conflicts. In this historical article, the authors review the development and evolution of neurosurgical care, forward surgical teams, and mobile field hospitals with surgical capabilities through US conflicts in the PACOM.