Entre exiliados y nativos: la integración de saberes de españoles y mexicanos para el desarrollo de la neurología en México, 1935-1950 / Between exiled and native doctors: Spanish and Mexican knowledge integrating into the development of neurology in México, 1935-1950

Resumen Entre 1935 y 1950 aconteció la introducción y desarrollo de la neurología en México. Esto se dio por medio de dos vías: el arribo de los neurocientíficos españoles a México tras su exilio provocado por la Guerra Civil; y la presencia de médicos mexicanos que salieron a especializarse en neurocirugía a EEUU. Se discuten algunas posiciones historiográficas que hablan de la importancia de los españoles exiliados en este acontecer, pero que no han expuesto el relevante papel de los nativos en el surgimiento de la neurología mexicana. Se afirma la existencia de un proceso de integración de ambas partes, donde los nativos buscaron satisfacer necesidades asistenciales mientras que los exiliados tuvieron que encontrar y crear espacios dónde insertarse.

Abstract Between 1935 and 1950 the neurology was presented and developed in Mexico. It happened by two ways: the arrival of Spanish neuroscience researchers in Mexico exiled due the Civil War; and the presence of Mexican doctors that had specialized in neurosurgery in the United States. The article discusses historiographic points of view that stress the importance of the Spanish exiled doctors, but neglect the important role of native doctors in the emergence of Mexican neurology. It states that there was an integration process by both parts, where Mexicans tried to satisfy care needs while the Spanish had to find or create working spaces to belong to.

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.

Historical High Complexity Neurosurgery Development of One of the Poorest Brazilian Regions

Human development rates in the Vale do Jequitinhonha, state of Minas Gerais, Brazil, called "Misery Valley," are among the lowest in the country, not to mention the often precarious psychosocial realities that daily contact with these families reveals. The history of neurosurgery at the Neurosurgical Reference Center at the Vale do Jequitinhonha e Mucuri dates from 2004, when the first neurosurgical procedures were performed in the recently organized Section of Neurosurgery. The historical surgical series shows the positive impact of the service. In 2007, the average was 3 neurosurgeries/month. In the last year, 2018, service growth boosted the record to 34.83 neurosurgeries/month. In addition to performing elective surgery, the neurosurgery team supports the emergency team by performing some neurosurgical procedures. The service number of patients operated since the development of the service is nearly 3,000. Neurosurgery at the Santa Casa de Caridade from Diamantina has been made comparable to the best national neurosurgery services.

Professor Fernando Costa ­ A Man Ahead of His Time

This article describes the milestones in the life Brazil's greatest neurosurgeons, Professor Fernando Costa. Born and raised in the city of Pelotas, RS, Professor Fernando was an exemplary doctor. As former director and professor at the Catholic University of Pelotas, School of Medicine, his courage as well as his ethical attitude and transparency were the central traits of this masterful teacher. He will be eternally remembered as a great physician, teacher, father, husband, grandfather and friend.

História da simulação cirúrgica e sua aplicação em Neurocirurgia / History of surgical simulation and its application in Neurosurgery

OBJETIVOS: Neste artigo, os autores abordam a evolução histórica da simulação cirúrgica, tendo como foco a sua aplicação em Neurocirurgia. MÉTODOS: A revisão da literatura foi feita nas bases de dados PubMed/Medline e Scopus, utilizando os termos "history AND simulation"; e "simulation AND neurosurgery". Não houve limite de data de publicação. RESULTADOS: Foram selecionados 30 artigos cujo conteúdo inclui dados de interesse para o objetivo do estudo. A simulação tem sido usada durante séculos de várias formas, incluindo dissecação de cadáveres pelos primeiros médicos (como Galeno) e treinamento militar (como por exemplo nos jogos de guerra). Modelos anatômicos foram criados no século XVIII e seguiram se aperfeiçoando nos séculos seguintes. Já a simulação por realidade virtual foi primeiramente utilizada em 1987, popularizando-se no início da década de 1990. Posteriormente foram criados modelos anatômicos sintéticos que reproduzem cenários cirúrgicos próximos ao real, com grande aplicabilidade atualmente. CONCLUSÕES: A revisão da literatura destacou aspectos evolutivos da simulação e sua aplicação atual em educação médica. As inovações nesse campo foram muito apreciadas por membros da comunidade neurocirúrgica, que reconheceram o vasto potencial da simulação para revolucionar esta especialidade, onde erros intraoperatórios podem ter consequências desastrosas. Esta revisão histórica poderá contribuir para melhor compreensão do relevante papel da simulação e também para sua implementação no currículo médico, especialmente em especialidades de alta complexidade, como a Neurocirurgia.

OBJECTIVES: In this article, the authors address the historical evolution of surgical simulation, focusing on its application in Neurosurgery. METHODS: Literature search was done in the PubMed/Medline and Scopus databases, using the terms "history AND simulation"; and "simulation AND neurosurgery". There was no limit for the publication date. RESULTS: We selected 30 articles whose contents included data of interest for the objective of the study. Simulation has been used for centuries in a variety of ways, including the dissection of corpses by the early physicians (such as Galeno) and military training (for example in war games). Anatomical models were created in the eighteenth century and continued to improve in the following centuries. Virtual reality simulation was first used in 1987 and became popular in the early 1990s. Subsequently, synthetic anatomical models were created that reproduce surgical scenarios close to the real one, with great applicability today. CONCLUSIONS: This literature review highlighted evolutionary aspects of simulation and its current application in medical education. Innovations in this field were highly appreciated by members of the neurosurgical community who recognized the vast potential of simulation to revolutionize this specialty, where intraoperative errors can have disastrous consequences. This historical review may contribute to a better understanding of the relevant role of simulation and for its implementation in the medical curriculum, especially in high complexity specialties such as Neurosurgery.

Gracias instituto Asenjo / Thank you instituto asenjo

El objeto de este artículo es que agradecer a la Sociedad Neurológica de Chile la influencia que ha tenido en Antioquia y Colombia formando nuestros lideres en neurocirugía, especialmente por haber formado al Doctor Ernesto Bustamante, fundador del Servicio de Neurocirugía de la Universidad de Antioquia que cumple 65 años de existencia. Sin embargo, este no fue el único Neurocirujano de Colombia que recibió su entrenamiento en Chile, también lo fueron los Doctores Ernesto Arango Tamayo, Alejandro Jiménez Arango, Raúl Piedrahita, Carlos Pardo, Bernardo Soto, Hans Carmona, Alveiro Morales y muchos otros cuyo nombre desconozco. Sea esta la oportunidad para retomar y fortalecer los lazos académicos entre nuestras sociedades científicas. Gracias Instituto Asenjo.

The main purpose of this article is to recognize the great influence of the Chilean neurosurgical society in the history and development of Colombian neurosurgery. Two pioneers in Colombian neurosurgery: Dr. Alejandro Arango and Ernesto Bustamante were trained by Dr. Alfonso Asenjo in earlier years of the Institute. Dr. Ernesto Bustamante was the founder of the First Neurosurgical and Neurogical service in Colombia, at the Hospital Universitario San Vicente de Paul (Universidad de Antioquia) that is now celebrating 66 years of existence with more tan 50 Neurologist and 70 neurosurgeons formed. The influence of the Chilean neurosurgery has continued since then and many neurosurgeons had visited Chile in order to improve their knowledge. This is an oportunity to strenght the academic link between our cientific societies. Thanks Instituto Asenjo.

Historical distribution of central nervous system tumors in the Mexican National Institute of Neurology and Neurosurgery / Distribución histórica de neoplasias del sistema nervioso central en el Instituto Nacional de Neurología y Neurocirugía de México

Abstract Objective: To determine the frequency of central nervous system (CNS) tumors in the first fifty years of the National Institute of Neurology and Neurosurgery of Mexico Manuel Velasco Suárez (Instituto Nacional de Neurología y Neurocirugía de México, INNN) from 1965 to 2014. Materials and methods: A total of 16 116 institutional records of CNS tumors were analyzed. The frequency and distribution of CNS tumors were evaluated by tumor type, patient age and patient gender. The annual relationship between CNS tumors and surgical discharges (SD) over the last 20 years was estimated. Results: The frequencies of most CNS tumors were consistent with those found worldwide, and the most common tumors were neuroepithelial tumors (33%), particularly astrocytic tumors (67%); meningeal tumors (26%); and pituitary tumors (20%). The incidence of pituitary tumors in these data was twice as high as that reported in other regions of the world, and the relationship between CNS tumors and SD was consistent over time (0.22-0.39). Conclusion: This study summarizes the largest sample of CNS tumor cases analyzed in Mexico and provides an important reference of the frequency of this tumor type in the country. This work will serve as a basis for conducting studies evaluating factors associated with the presence of CNS tumors and for identifying adequate public health interventions.

Resumen Objetivo: Determinar la frecuencia de neoplasias del sistema nervioso central (NSNC) en los primeros 50 años del Instituto Nacional de Neurología y Neurocirugía de México (INNN). Material y métodos: Se analizaron 16 116 registros institucionales de las NSNC, atendidas en el INNN de 1965 a 2014; se estimó su frecuencia y distribución por tipo de neoplasia, edad y género, y se determinó la relación anual de NSNC y egresos quirúrgicos (EQ) en un período de 20 años. Resultados: Las frecuencias de la mayoría de NSNC fueron consistentes con las encontradas a nivel mundial. Las más frecuentes fueron las neuroepiteliales (33%), entre las cuales destacaron las astrocíticas (67%); meníngeas (26%), e hipofisiarias (20%). El número de neoplasias hipofisiarias en esta serie fue dos veces mayor al reportado en otras regiones del mundo y la relación NSNC/EQ fue similar a través del tiempo (0.22-0.39). Conclusión: Ésta es la mayor serie de casos de NSNC analizados en México y proporciona un referente importante sobre la frecuencia de este tipo de neoplasias en el país. Este trabajo servirá de base para llevar a cabo estudios de los factores asociados a la presencia de NSNC e identificar intervenciones de salud pública adecuadas.

Neurocirurgia e filosofia no século XIX: como o pensamento da época influenciou o desenvolvimento da neurocirurgia moderna / Neurosurgery and Philosophy in the 19th Century: How Modern Neurosurgery Development Relates to Past Thinking

O século XIX foi um período marcado por profundas mudanças sociais, políticas e econômicas que refletiram diretamente no desenvolvimento científico. Neste artigo, tenta-se estabelecer relação entre as linhas filosóficas deste período e o surgimento da neurocirurgia moderna.

The 19th century was a period with important social, politic and economic changes that strongly supported scientific development. In this paper, I tried to establish relationship between philosophical theories of this period and beginning of modern neurosurgery.

Aportes de Giovanni Battista Morgagni al desarrollo de la neurocirugía / Giovanni Battista Morgagni contributions tothe development of neurosurgery

Introducción: El estudio de la anatomía humana se convirtió en el eje principal del desarrollo en la medicina de los siglos XVI y XVII. Sin embargo, fue el gran anatomista italiano Giovanni Battista Morgagni que con su obra marco el inicio de la anatomía patológica moderna, así como el punto de partida de la base científica anatomoclínica de muchas especialidades donde se encuentra la neurocirugía. Conclusiones: El estudio de la Anatomía patológica sirvió de base para el conocimiento y desarrollo en la neurocirugía moderna.

Introduction: The study of human anatomy became the main axis of development in medicine from the XVI and XVII centuries. However, it was the great Italian anatomist Giovanni Battista Morgagni with his work marked the beginning of modern pathological anatomy, as well as the starting point of the scientific basis of many specialties anatomic where neurosurgery. Conclusions: The study of pathology was the basis for knowledge and development in modern neurosurgery.

The history of neurosurgery at the University of Sao Paulo / A historia da neurocirurgia na Universidade de Sao Paulo

The history of neurosurgery at University of São Paulo comes from 1918, since its origins under the Department of Neurology from Chair of Psychiatric Clinic and Nervous Diseases. Professor Enjolras Vampré was the great inspiration for such medical specialty in the State of Sao Paulo. In 1929, the first neurosurgical procedures were performed in the recently (at time) organized Section of Neurosurgery. The official inauguration of the Division of Functional Neurosurgery occurred at June 1977, with the presence of worldwide well-known neuroscientists. The division suffered a deep streamlining under the leadership of Professor Raul Marino Jr., between the decades of 1990 and 2000. At this time, it was structured with the sections of neurological surgery, functional neurosurgery and neurosurgical emergency. Since 2008, Professor Manoel Jacobsen Teixeira is the Chairman of the Division and has provided the Division with the best available technological resources, performing more than 3,000 surgeries a year and training professionals who will, certainly, be some of the future leaders of brazilian neurosurgery.

A história da neurocirurgia na Universidade de São Paulo remonta a 1918, quando surge sob o Departamento de Neurologia da cadeira de Clínica Psiquiátrica e Doenças Nervosas. O Professor Enjolras Vampré foi o grande inspirador da especialidade no estado de São Paulo. Em 1929, foram realizadas as primeiras intervenções neurocirúrgicas na então recentemente organizada Seção de Neurocirurgia. A fundação oficial da Divisão de Neurocirurgia Funcional data de junho de 1977 e contou com a participação de diversos cientistas de renome internacional. A Divisão passou por profunda reorganização sob a direção do Professor Raul Marino Jr. entre as décadas de 1990 e 2000, quando foi estruturada com os setores de neurocirurgia geral, neurocirurgia funcional e emergência neurocirúrgica. Desde 2008, o Professor Manoel Jacobsen Teixeira é responsável pela Divisão, que conta com os melhores recursos tecnológicos disponíveis, realizando mais de 3.000 cirurgias por ano e formando profissionais que certamente serão futuros líderes na neurocirurgia brasileira.

Momentos históricos y profesores insignes de la neurocirugía en Camagüey / Historical moments and significant professors of the neurosurgery in Camagüey

Se realizó una investigación cualitativa en el Hospital Universitario Manuel Ascunce Domenech, en Camagüey, durante el año 2011 con el objetivo de describir la historia de la Neurocirugía en la provincia y los momentos más importantes de su desarrollo. Se realizaron entrevistas a personalidades que laboran en el hospital desde su fundación el 14 de enero de 1962, los que aportaron información valiosa para la identificación cronológica de los hechos. Además, se revisaron artículos publicados que ilustraron los principales momentos en el desarrollo de la especialidad. Se pudo determinar que antes del triunfo revolucionario y previo a la inauguración del hospital, la atención neuroquirúrgica especializada en la provincia era muy limitada y los traumatismos craneales eran atendidos fundamentalmente por ortopédicos y cirujanos. En marzo de 1968 se constituyó el servicio provincial de Neurología y Neurocirugía, y a partir de este momento comienza el desarrollo vertiginoso de la especialidad en sus diferentes vertientes: docente, asistencial y científica. Se destacan los resultados alcanzados en la atención al trauma craneoencefálico y a los aneurismas intracraneales así como la introducción de la cirugía estereotáctica para el tratamiento de los tumores malignos del encéfalo. El servicio de Neurocirugía de Camagüey con el decurso de los años se ha consolidado como uno de los polos neuroquirúrgicos de Cuba y como una escuela de neurociencias que ha garantizado la formación de más de treinta especialistas de Neurocirugía para Cuba y el mundo.

Since the foundation of the Neurology Service of the University Hospital Manuel Ascunce Domenech at the end of the decade of the 60, it has kept a sustained development in the different branches of the general neurosurgery, becoming a territorial teaching-assistancial service. The achieved development has been due to the efforts and dedication of its professors staff. Some of them have physically departed but have left their legacy in the new generations of neurosurgeons that continue developing the specialty in the territory. The objective of the current work is highlighting the inestimable work of two eminent Camagüeyan neurosurgeons that marked the development of this specialty out, the professors Enrique Mendoza Rivera and Sergio Vega Basalto. In the same way we mentioned important moments in the advance of our service after its foundation. After 1982 the vascular surgery is potentiated at the expenses of the surgical treatment of the brain aneurisms, the introduction of the computerized axial tomography at the end of the 90s, the application of the stereotactic surgery in the brain tumor treatment and the development of the neurotraumatology, all of them transcendental moments of the Camagüeyan neurosurgery. The results of the medical assistance have been supported by the achievements obtained in the scientific research. The beginning of the endoscopic neurosurgery and the application of the ambulatory surgery for the treatment of the cervical and lumbar disk hernia since 2010 have been the ultimate progress of our service.