A Historical Perspective of Lateral Canthotomy and Its Adoption as an Emergency Medicine Procedure.

BACKGROUND: The treatment of orbital compartment syndrome has a rich history rooted in surgery and emergency medicine. It is a rare but acute and vision-threatening condition that most commonly occurs secondary to facial trauma or as a postoperative complication, and was first recognized in 1950. Surgical techniques and medical management were developed and refined soon afterwards to eventually become the modern-day treatment, lateral canthotomy, and inferior cantholysis. OBJECTIVE: This article details the history of orbital compartment syndrome and the evolution of its treatment to the present day. DISCUSSION: Given the time-sensitive nature and acuity of orbital compartment syndrome, lateral canthotomy was adopted by emergency physicians who could perform it more quickly at the bedside. CONCLUSIONS: Lateral canthotomy is a procedure adopted by emergency physicians from the surgical literature. The history of its adoption is a representative example of how emergency medicine evolves as a field.

Surgical Treatment of Migraine Headache: Back to the Future.

Understanding the history and evolution of ideas is key to developing an understanding of complex phenomena and is the foundation for surgical innovation. This historical review on migraine surgery takes us back to the beginnings of interventional management for migraine centuries ago, and reflects on present practices to highlight how far we have come. From Al-Zahrawi and Ambroise Paré to Bahman Guyuron, two common themes of the past and present have emerged in the treatment of migraine headache. Extracranial treatment of both nerves and vessels is being performed and analyzed, with no consensus among current practitioners as to which structure is involved. Knowledge of past theories and new insights will help guide our efforts in the future. One thing is clear: Where we are going, there are no roads. At least not yet.

The 25th anniversary of the retrograde suction decompression technique (Dallas technique) for the surgical management of paraclinoid aneurysms: historical background, systematic review, and pooled analysis of the literature.

OBJECTIVE: Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection. An endovascular modification was introduced in 1991 (endovascular RSD) but no studies have compared the 2 RSD variations. METHODS: The authors performed a systematic review of MEDLINE/PubMed and Web of Science and identified all studies from 1990-2016 in which either Dallas RSD or endovascular RSD was used for treatment of paraclinoid aneurysms. A pooled analysis of the data was completed to identify important demographic and treatment-specific variables. The primary outcome measure was defined as successful aneurysm obliteration. Secondary outcome variables were divided into overall and RSD-specific morbidity and mortality rates. RESULTS: Twenty-six RSD studies met the inclusion criteria (525 patients, 78.9% female). The mean patient age was 53.5 years. Most aneurysms were unruptured (56.6%) and giant (49%). The most common presentations were subarachnoid hemorrhage (43.6%) and vision changes (25.3%). The aneurysm obliteration rate was 95%. The mean temporary occlusion time was 12.7 minutes. Transient or permanent morbidity was seen in 19.9% of the patients. The RSD-specific complication rate was low (1.3%). The overall mortality rate was 4.2%, with 2 deaths (0.4%) attributable to the RSD technique itself. Good or fair outcome were reported in 90.7% of the patients.Aneurysm obliteration rates were similar in the 2 subgroups (Dallas RSD 94.3%, endovascular RSD 96.3%, p = 0.33). Despite a higher frequency of complex (giant or ruptured) aneurysms, Dallas RSD was associated with lower RSD-related morbidity (0.6% vs 2.9%, p = 0.03), compared with the endovascular RSD subgroup. There was a trend toward higher mortality in the endovascular RSD subgroup (6.4% vs 3.1%, p = 0.08). The proportion of patients with poor neurological outcome at last follow-up was significantly higher in the endovascular RSD group (15.4% vs 7.2%, p < 0.01). CONCLUSIONS: The treatment of paraclinoid ICA aneurysms using the RSD technique is associated with high aneurysm obliteration rates, good long-term neurological outcome, and low RSD-related morbidity and mortality. Review of the RSD literature showed no evidence of a higher complication rate associated with the Dallas technique compared with similar endovascular methods. On a subgroup analysis of Dallas RSD and endovascular RSD, both groups achieved similar obliteration rates, but a lower RSD-related morbidity was seen in the Dallas technique subgroup. Twenty-five years after its initial publication, RSD remains a useful neurosurgical technique for the management of large and giant paraclinoid aneurysms.

Compressive Neuropathy of the Ulnar Nerve: A Perspective on History and Current Controversies.

The untoward effects resulting from compression of the ulnar nerve have been recognized for almost 2 centuries. Initial treatment of cubital tunnel syndrome focused on complete transection of the nerve at the level of the elbow, resulting in initial alleviation of pain but significant functional morbidity. A number of subsequent techniques have been described including in situ decompression, subcutaneous transposition, submuscular transposition, and most recently, endoscopic release. This manuscript focuses on the historical aspects of each of these treatments and our current understanding of their efficacy.

Decompression of Odontogenic Cystic Lesions: Past, Present, and Future.

Tumors and cystic lesions of the jawbones have been described since the late 1600s and it took another 200 years for classification systems to appear in the medical, surgical, and dental literatures. In the late 1800s, Carl Partsch introduced cystostomy, a method by which the cyst is converted into a pouch by suturing its lining to the mucosa of the oral cavity. The purpose of this article is to analyze the history, present, and future of cystic conditions of the jaws and decompression, a modality of treatment that during the past few years has regained the attention of oral and maxillofacial surgeons and pathologists owing to its relative simplicity and effectiveness compared with other conservative options.

Challenges in early operative approaches to intramedullary spinal cord tumors: Harvey Cushing's perspective.

Although Harvey Cushing was mostly known for his contributions to brain tumor surgery, he was also a pioneer in the development of spinal cord surgery. This lesser known facet of Cushing's career can provide a fresh and unique perspective into how the founders of neurosurgery surmounted early challenges in the field. The authors bring to light and examine for the first time Cushing's unpublished writing "Technique of Laminectomy" along with his first 3 documented intramedullary spinal cord tumor (IMSCT) cases at the Johns Hopkins Hospital. The authors draw lessons from the challenges in pathological classification, preoperative diagnosis, tumor localization, and surgical technique of that time. Although Cushing's attempts at exploration and resection of IMSCT as described here were of limited success, his ability to adapt his clinical and surgical technique to the challenges of the time, as well as develop skills to successfully manipulate the spinal cord during these exploratory procedures without the patients incurring neurological damage, postoperative infection, or complications, is a testament to his determination to advance the field and his meticulous operative technique. In spite of the limitations imposed on the pioneer neurosurgeons, Harvey Cushing and his contemporaries persevered through many of the challenges and built an essential part of neurosurgery's common story.

The historical evolution of the management of spinal cord injury.

The history of spinal cord injury (SCI) is long and fascinating. From Ancient Egypt to the current day, SCI has gradually shifted from being seen as an inevitably fatal condition, to one most amenable to treatment, albeit not yet cure. Several controversies have paved the path of this condition's history, from the question of whether to treat, to the optimal timing of surgical intervention, to the potential of recent novel therapies. This article traces the major developments in the management of SCI, in addition to many broader historical developments relating to SCI.

The first posterior fossa decompression for Chiari malformation: the contributions of Cornelis Joachimus van Houweninge Graftdijk and a review of the infancy of "Chiari decompression".

Over the past several decades, our understanding of the pathophysiology of hindbrain hernias has markedly increased. Additionally, with the advent of MRI, diagnosis of these entities is common. Although the history of the discovery of what are now known as the Chiari malformations is well known, publications regarding the historical surgical treatment of these is, to our knowledge, not extant. Many have attributed the first successful patient series to Gardner in the 1950s. However, and unknown to many, the first description of a hindbrain decompression was in 1930 by the Dutchman Cornelis Joachimus van Houweninge Graftdijk. This neurosurgeon also added to our understanding the pathophysiology of hindbrain herniation and its relationship to raised intracranial pressure. The present paper reviews the contributions of this early pioneer of neurosurgery.

"Groans less, seems more comfortable:" Harvey Cushing's redefinition of success in the operative treatment of pediatric intracranial lesions.

BACKGROUND: Challenges to diagnosing and localizing intracranial lesions in pediatric patients were immense during the advent of neurosurgery. For patients with suspected intracranial tumors, but with negative findings on operation, there were few options. The role of palliative surgical interventions, from decompressive craniectomies to lumbar and ventricular punctures, is not well-represented in the literature during this early stage. OBJECTIVE: To review Harvey Cushing's original surgical files and analyze his use of decompressive procedures in pediatric patients with suspected intracranial tumors, with negative findings during operative interventions. METHODS: Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912. Patients, ≤18 years old, presenting with suspected intracranial tumors, undergoing surgical intervention by Cushing, without discovery of intracranial pathology, were selected for further analysis. RESULTS: Of the 23 pediatric patients selected, 17 were male. The mean age was 10.6 years. Cushing used three main operative approaches: infratentorial/suboccipital, subtemporal, and hemisphere flaps. Post-operative condition was improved in 13 and unchanged in three patients. Seven patients died during their inpatient stay. The mean time to follow-up was 34.79 months; the mean time to death was 11.9 months. CONCLUSIONS: These examples illustrate Cushing's commitment to improving quality of life in patients, offering decompressive procedures, including craniectomies as well as cerebrospinal fluid drainage in the operating room and at the bedside, when attempts at localizing and resecting of suspected tumors were unsuccessful.

Emergency suboccipital decompression for respiratory arrest during supratentorial surgery: the untold story of a surgeon's courage in times of despair.

The odyssey leading to the discovery of herniation syndromes was prolonged due to a lack of early understanding of the underlying pathophysiology. In 1896, Leonard Hill documented transtentorial pressure gradients as the intervening phenomenon involved in uncal herniation. In 1904, James Collier became the first to describe cerebellar tonsillar herniation as a "false localizing sign" often associated with intracranial tumors. During the infancy of neurological surgery, management of increased intracranial pressure and an improved understanding of brain herniation syndromes were of the utmost importance in achieving a safe technique. Harvey Cushing provided seminal contributions in understanding the pathophysiology of increased intracranial pressure and resulting cardiopulmonary effects. Cushing believed that tonsillar herniation was a cause of acute cardiorespiratory compromise in patients with intracranial tumors. In this vignette, we describe the untold story of Cushing's heroic attempt to treat respiratory arrest operatively during supratentorial tumor surgery with an emergency suboccipital craniectomy to relieve the medullary dysfunction that he believed was caused by compression from tonsillar herniation. This case illustrates a surgeon's determination and courage in fighting for his patient's life in the most desperate of times.

A history of carpal tunnel syndrome.

Carpal tunnel syndrome is the commonest entrapment neuropathy seen in clinical practice. The history of its aetiology and diagnosis gives an interesting insight into how the condition has evolved to also become the best understood neuropathy.

Endoscopic orbital and optic nerve decompression.

Endoscopic orbital decompression has become the surgical treatment of choice for many patients with orbital manifestations of Graves' disease, including proptosis and optic neuropathy. The unparalleled visualization provided by endoscopic instrumentation allows for a safe and thorough decompression, particularly when operating along the orbital apex and skull base. Although the benefits of and indications for decompression of the orbit are well established, the role of optic nerve decompression remains controversial.

Glossopharyngeal neuralgia.

Glossopharyngeal neuralgia is a distinctive syndrome, named by Wilfred Harris. Investigation must exclude multiple sclerosis, and local compression, especially by tumours which require treatment. Dandy deserves credit for first indicating vascular compression of cranial nerve roots as a cause of cranial neuralgias, and Jannetta for establishing neurovascular decompression. Vascular compression is a common and treatable cause but does not account for all previously designated idiopathic cases.

The transsphenoidal approach. A historical perspective.

Over the last century, the transsphenoidal approach has evolved into the first-line method of treatment for sellar as well as select groups of parasellar and suprasellar lesions. The journey to its current popularity has been marked by controversy and near abandonment in the late 1920s, followed by its renaissance in the late 1960s. Despite the profound skepticism with which this procedure was viewed, several visionary neurosurgeons persevered through its nadir in popularity, preserving this surgical corridor to the skull base. Advances in medical and surgical techniques, paralleling an improved understanding of pituitary pathophysiology, contributed to its resurgence. The transsphenoidal procedures now performed stem from an array of modifications and refinements accumulated through nearly 100 years of medical and surgical evolution. This era's critical innovations and neurosurgical personalities are the topic of this historical overview.

[History of the surgical treatment of carpal tunnel syndrome]. / Historia operacyjnego leczenia zespolu kanalu nadgarstka.

The paper presents history of surgical treatment of median nerve compression at the wrist. Chronical overview the history surgical techniques is presented. This article to provide information of history surgical treatment of median nerve decompression in Poland.

[History of the surgical treatment of cubital tunnel syndrome]. / Historia operacyjnego leczenia zespolu rowka nerwu lokciowego.

The paper presents history of surgical treatment of ulnar nerve compression at the elbow. Chronological overview the history surgical techniques is presented. This article to provide information of history surgical treatment of ulnar nerve decompression in Poland.

Inauguration of pediatric neurosurgery by Harvey W. Cushing: his contributions to the surgery of posterior fossa tumors in children. Historical vignette.

Development of posterior fossa surgery remains Harvey Cushing's hallmark contribution to pediatric neurosurgery. During the era before Cushing, posterior fossa lesions were considered inoperable, and only osseous decompressive surgery was offered. The evolution of Cushing's surgical expertise from subtemporal decompressions to total extirpation of vascular fourth ventricular tumors, combined with a dramatic decrease in his operative mortality rate, reflects the maturation of modern neurosurgical techniques. A comprehensive review of the medical records of Cushing's pediatric patients treated between 1912 and 1932 revealed that procedures such as lateral ventricular puncture (to decrease cerebellar herniation), transvermian approach to midline tumors, and electrocoagulation were the key factors punctuating the path to his pioneering achievements in posterior fossa surgery. The outcome of such operations was improved by his recognition of the importance of tumor mural nodule in cyst recurrence, as well as elucidation of the histogenesis of pediatric posterior fossa tumors to tailor treatment including radiotherapy.