Neurosurgery
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Biography Historical Article
Management of spinal disorders and trauma in Avicenna's Canon of medicine.
WE STUDY HISTORY in an attempt to achieve a wide perspective of life and reality. Spinal disorders, particularly spine traumas and their complications, have been one of the most challenging problems throughout the history of medicine and, indeed, throughout the history of humanity. The pioneers and founders of scientific medicine committed much of their lives to understanding these disorders. ⋯ In this book, published in the 11th century, he provided detailed accounts of spinal disorders and strategies for their management. Here, we provide a brief review of Avicenna's most significant points concerning spinal diseases and their treatment from the chapters of the Canon. Although, there are not basic differences from Hippocratic knowledge, this book contains some original contributions.
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Biography Historical Article
Francesco Durante: the history of intracranial meningiomas and beyond.
FRANCESCO DURANTE FROM Letojanni, Sicily, was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. Durante was Chairman of Clinical Surgery at the Royal University of Rome (now University "La Sapienza") for 45 years, participating in the birth of the "Policlinic Umberto I," and was one of the most famous surgeons in the country. ⋯ His contributions are still applicable to medicine today, not only to the neurosurgical community, but also other surgical disciplines, because he developed innovative practices in the fields of oncology, general surgery, and orthopedics in addition to designing special surgical instruments. In commemoration of his legacy, the International Francesco Durante Award is bestowed upon world-renowned surgeons.
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The vulnerability of the brain is considered to be increased after trauma. The present study was undertaken to determine whether intracranial volume insults in the posttraumatic period led to increased metabolic disturbances if intracranial compliance was decreased. ⋯ These results support the hypothesis that decreased intracranial compliance increases the vulnerability of the brain for secondary volume insults even with intracranial pressure at low levels between the insults. This finding has important clinical implications in that it stresses the need to identify patients with low intracranial compliance so that their treatment can be optimized.
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Biography Historical Article
Ulysses and the Sirens by Herbert James Draper (1863-1920).
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Randomized Controlled Trial
Preserving the ligamentum flavum in lumbar discectomy: a new technique that prevents scar tissue formation in the first 6 months postsurgery.
Postoperative fibrosis is one of the most important causes of failed back surgery syndrome after lumbar disc surgery. Numerous natural and synthetic materials have been investigated as means to prevent or reduce postoperative scarring after these operations. Preservation of the ligamentum flavum for this purpose has not been studied in depth. A prospective, randomized, controlled clinical study was conducted. The aim was to present a new technique for preserving the ligamentum flavum during lumbar discectomy, and to evaluate whether this helps prevent or diminish postoperative fibrosis. ⋯ The groups both showed satisfactory clinical outcomes and the improvements were comparable; however, the group with preserved ligamentum flavum showed significantly less local fibrosis at 6 months postoperatively. The authors speculate that this surgical technique provides a physical protective barrier that can reduce or even eliminate fibrosis-related complications after lumbar disc surgery.