Historical review: The golden age of the Golgi method in human neuropathology.

Golgi methods were used to study human neuropathology in the 1970s, 1980s, and 1990s of the last century. Although a relatively small number of laboratories applied these methods, their impact was crucial by increasing knowledge about: (1) the morphology, orientation, and localization of neurons in human cerebral and cerebellar malformations and ganglionic tumors, and (2) the presence of abnormal structures including large and thin spines (spine dysgenesis) in several disorders linked to mental retardation, focal enlargements of the axon hillock and dendrites (meganeurites) in neuronal storage diseases, growth cone-like appendages in Alzheimer disease, as well as abnormal structures in other dementias. Although there were initial concerns about their reliability, reduced dendritic branches and dendritic spines were identified as common alterations in mental retardation, dementia, and other pathological conditions. Similar observations in appropriate experimental models have supported many abnormalities that were first identified using Golgi methods in human material. Moreover, electron microscopy, immunohistochemistry, fluorescent tracers, and combined methods have proven the accuracy of pioneering observations uniquely visualized as 3D images of fully stained individual neurons. Although Golgi methods had their golden age many years ago, these methods may still be useful complementary tools in human neuropathology.

On the classification of cerebral tumors: A tribute to Leonid Smirnov.

The corresponding member of the Academy of Medical Sciences of the USSR Professor Leonid Iosifovich Smirnov (1889 - 1955) authored several dozen publications on neuropathology of infections, schizophrenia, cerebral injuries, and brain tumors. Based on his study of pathology of gunshot head injuries during World War II he suggested a doctrine of traumatic on traumatic brain disease. He was the author of the first Russian classification of cerebral tumors and had an impact on the development of neurooncology in the former USSR. The aim of this paper is to show the early development of modern neuropathology at the example of a leading Soviet neuropathologist in the first half of the 20th century and his relevance for modern classification of CNS tumors.

[P.E. Flechsig's contribution to a Russian-German scientific exchange in the fields of neuropathology and psychiatry]. / Vklad P.É. Fleksiga v rossiisko-nemetskoe nauchnoe sotrudnichestvo v oblasti nevrologii i psikhiatrii.

The University of Leipzig has played an important role in the Russian-German scientific exchange in the fields of psychiatry and neurology in the 19th century. An outstanding but almost forgotten protagonist of that exchange was the psychiatrist and neurologist Paul Flechsig, who enjoyed worldwide recognition for his neuroanatomical works. Famous Russian neurologists and psychiatrists as Vladimir Bekhterev, Liverij Osipovich Darkshevich, Vladimir Chizh not only learned from Flechsig's experience, but also undertook independent research, which gave them impulses for furthering their carriers in Russia.

Professor Henry Urich 1916-2015: A London neuropathologist and his Polish heritage.

This is the story of a tumultuous life, lived with enthusiasm and considerable academic success, despite destruction of his cultural heritage in Poland, and loss of his family, by the cruelty of the invading Soviet and Nazi armies in 1939. As a newly qualified doctor from the Polish Medical School at the University of Edinburgh, he was parachuted into Arnhem with the Polish airborne forces, survived, educated himself in British ways and habits, and rapidly succeeded in the medical hierarchy to become an esteemed neuropathologist not only at The London Hospital, but internationally. His central European background provided him with the linguistic and multicultural skills to excel in this highly specialised area of medical science. He was one of the last of the classically trained neuropathologists.

A half century of change in diagnostic neuropathology: from the giants of yore to current brain tumor classification.

The first issue of Human Pathology contains a laudatory review of one of the most treasured books in the history of neuropathology: Neurological Clinicopathological Conferences of the Massachusetts General Hospital, a collection of neurological cases that appeared first in the New England Journal of Medicine in the 1940s, 1950s, and 1960s. Each patient history is discussed by well-known neurologists, neurosurgeons, and neuropathologists. Review of these cases provides a framework to explore diagnostic shifts that have occurred over the past half century. Importantly, while the discussants of these cases were great diagnosticians, they were somewhat limited by the methods available to them at the time; subsequent novel technologies provided opportunities for new insights that were made by the next generation of experts. Today's pathologists (whether neuropathologists or any other pathology subspecialists) are similarly skilled at diagnosis, although their diagnoses are now more often made on biopsies (rather than autopsies) and informed by pre-operative imaging studies as well as post-operative molecular analyses. In turn, one would conclude that, even in the face of future technological changes brought about by disruptive innovations like artificial intelligence and deep molecular analyses, a need will continue for the expertise of pathologists and other clinical diagnosticians.

Neuropathology in Pitié-Salpêtrière hospital: Past, present and prospect.

Pitié and La Salpêtrière, both founded in the17th century, were for long two distinct hospitals until they merged in 1964. The name La Salpêtrière is inherited from the initial purpose of the buildings designed to produce saltpeter for gun powder. But the place was soon transformed into an asylum to shelter the poor and the insane. From the care of this underprivileged population, alienists such as Pinel have paved the way for modern medicine for the mentally ill at the time of the French Revolution. In the second half of the 19th century, Jean-Martin Charcot and his students laid the foundations of modern neurology from the observation of the large population hosted in La Salpêtrière, mostly women with severe chronic diseases. Charcot led clinicopathological studies in almost all the fields of nervous system disorders. His successors (including Raymond, Dejerine, Pierre Marie) maintained the same close relationship between clinical neurology and neuropathology. In parallel with the development of neurosurgery at Pitié hospital, neuropathology first spread through small laboratories attached to clinical departments. The merger of the two hospitals in the early '60s coincided with the creation of a large university hospital in which the care and study of diseases of the nervous system were preponderant. An independent laboratory of neuropathology was created, led by Raymond Escourolle. This period was on the eve of important developments in neuroscience around the world. Today, the Pitié-Salpêtrière neuropathology laboratory still plays a central role between neurology and neurosurgery clinics and major research institutes such as the Brain Institute, callled Institut du Cerveau et de la Moelle (ICM), and the Institute of Myology.

Remembering Robert D. Terry at a Time of Change in the World of Alzheimer's Disease.

Dr. Robert Terry (January 14, 1924-May 20, 2017) studied normal aging and Alzheimer's disease for more than five decades. He was at a visionary neuropathologist who trained generations of researchers in the field of neurodegenerative disorders and was always at the cutting edge of incorporating ever advancing technology into the fields of neuroscience and neuropathology. He was among the first to study plaques and tangles using electron microscopy, described the effects of aluminum on neurons, and collaborated to develop new approaches to study synaptic pathology in the context of cognitive impairment in Alzheimer's disease. Dr. Terry made indelible contributions to our understanding of Alzheimer's disease and dementia. In memory of Bob: veteran, physician-scientist, collaborator, friend, husband, and father.

Historical setting and neuropathology of lathyrism: Insights from the neglected 1944 report by Oliveras de la Riva.

Lathyrism is a central motor system disorder recognized since antiquity resulting from prolonged dietary dependence on the grasspea (Lathyrus sativus). The neuropathology underlying the characteristic spastic paraparesis of lathyrism is sketchy. Described here is a landmark but little-known Spanish-language neuropathological study of two patients with lathyrism of recent onset. Due to erroneous interpretations of Filimonov's influential work in 1926, it was assumed that spastic paraparesis of lathyrism was explained by destruction of Betz's pyramidal cells in the motor cortex. Contrary to present understanding, Betz cells and anterior horn cells were preserved, and pathological findings dominated by myelin loss were largely limited to pyramidal tracts in the lumbar cord. Thickening of the adventitia of capillaries and arterioles, together with proliferation of perivascular astrocytes, was found along the length of the spinal cord. Oliveras de la Riva proposed that the segmental spinal pathology arose because distal regions of elongate pyramidal tract axons are distant from their trophic center in the motor cortex, a view not far from the current distal axonopathy concept of lathyrism. In addition, we review the historical circumstances of Filimonov's work in Russia, a summary of the epidemic of lathyrism in Spain following its Civil War (1936-1939), and some historical aspects of the Cajal Institute in Madrid, where Oliveras de la Riva's work was carried out under the supervision of Fernando de Castro, one of Cajal's favorite students.

The laryngoscope and nineteenth-century British understanding of laryngeal movements.

The source of the human voice is obscured from view. The development of the laryngoscope in the late 1850s provided the potential to see the action of the vocal folds during speaking for the first time. This new instrument materially contributed to the understanding of vocal fold neuroanatomy, neurophysiology, and neuropathology. The laryngoscope led to elaborated understanding of disorders that previously were determined by changes in sound. The objective of this paper is to detail the consequences of this novel visualization of the larynx, and to trace how it aided in the development of understanding of the movements of the vocal folds. This is demonstrated through an examination of the activities and practices of a group of London clinicians in the second half of the nineteenth century.

Comparative Neuropathology (1962): Attending to Neuropathologies Across Multiple Species.

This paper takes as its subject Comparative Neuropathology (1962), arguing that the volume illustrates the interlocking cultures of veterinary medicine, human medicine, and laboratory-based biological sciences after the Second World War. The project amassed cases of domestic, experimental, and wild animals, identified species-specific conditions, and evaluated the vulnerabilities of the nervous system to disease and trauma. The collection of ill ruminants, poisoned cats, and injured dogs built on earlier traditions of comparative medicine, but also reflected the turn to biological principles to explain medical conditions, increased industry and military funding for the biomedical sciences, and changes in veterinary practice. Using Comparative Neuropathology as a lens, this paper probes the actors, affiliations, and frameworks that wrestled with new species of neurological patients, newly exposed vulnerabilities of the nervous system, and the emergence of new neurological sciences, casting new light on the heterogenous landscape of the emergent neurosciences and mid-twentieth-century efforts to entwine human and veterinary medicine.

The first central nervous system autopsy in Southern Brazil.

OBJECTIVE: The history of Anatomical Pathology in the state of Paraná, in southern Brazil, is closely linked with the foundation of the Universidade Federal do Paraná (UFPR). This study identified the first central nervous system (CNS) clinical autopsy performed by the Department of Anatomical Pathology of the UFPR. METHODS: This study reviewed the autopsy report archives of the Hospital de Clínicas-UFPR from 1951 onward. The clinical anatomy interpretations of the autopsy report and possible etiologic agents were discussed. RESULT: The first adult clinical autopsy with CNS study was performed on April 23, 1952 on a 45-year-old man with lobar pneumonia with abscesses complicated by bacterial meningitis. CONCLUSION: This case was the first CNS clinical autopsy performed in the state of Paraná and, possibly, in southern Brazil. The death was due to an infectious disease, which was the main cause of death in Brazil in the 1950s.

The first central nervous system autopsy in Southern Brazil / Primeira autópsia do sistema nervoso central no sul do Brasil

ABSTRACT Objective: The history of Anatomical Pathology in the state of Paraná, in southern Brazil, is closely linked with the foundation of the Universidade Federal do Paraná (UFPR). This study identified the first central nervous system (CNS) clinical autopsy performed by the Department of Anatomical Pathology of the UFPR. Methods: This study reviewed the autopsy report archives of the Hospital de Clínicas-UFPR from 1951 onward. The clinical anatomy interpretations of the autopsy report and possible etiologic agents were discussed. Result: The first adult clinical autopsy with CNS study was performed on April 23, 1952 on a 45-year-old man with lobar pneumonia with abscesses complicated by bacterial meningitis. Conclusion: This case was the first CNS clinical autopsy performed in the state of Paraná and, possibly, in southern Brazil. The death was due to an infectious disease, which was the main cause of death in Brazil in the 1950s.

RESUMO Objetivo: A história da Anatomia Patológica no Estado do Paraná, sul do Brasil, está ligada com a fundação da Universidade Federal do Paraná (UFPR). Este estudo identificou a primeira autópsia clínica do sistema nervoso central (SNC) realizada pelo Departamento de Anatomia Patológica da UFPR. Métodos: Foi realizada revisão dos arquivos dos relatórios de autópsia do HC-UFPR, desde 1951. As interpretações anátomo-clínicas do laudo da autópsia e os possíveis agentes etiológicos foram discutidas. Resultado: A primeira autópsia clínica em adulto com estudo do SNC foi realizada em 23 de abril de 1952. Um homem de 45 anos com pneumonia lobar com abscessos pulmonares, complicada com meningite bacteriana. Conclusão: Este caso é a primeira autópsia clínica em adulto com estudo do SNC do estado do Paraná e possivelmente do Sul do Brasil. A causa da morte foi devido a uma doença infecciosa, as principais causas de óbito no Brasil nos anos 50.

The remarkable pioneering contribution of Gaspar Vianna to the study of the neuropathology of Chagas disease / A notável contribuição pioneira de Gaspar Vianna para o estudo da neuropatologia da doença de Chagas

ABSTRACT Gaspar Vianna is considered one of the great names in Medicine and Science in Brazil. Yet, little prominence has been given to his studies in Neuropathology. He was the first to describe, in 1911, the histopathology and pathogenesis of chagasic encephalitis in the acute phase of Chagas disease, as well as the intracellular life cycle of Trypanosoma cruzi. Over 100 years have elapsed and Gaspar Vianna's pioneering study remains an example of a meticulous and still up-to-date description of central nervous system involvement in the acute phase of Chagas disease.

RESUMO Gaspar Vianna é considerado um dos grandes nomes da Medicina e da Ciência no Brasil. Contudo, pouco destaque tem sido dado aos seus estudos em Neuropatologia. Ele foi o primeiro a descrever a histopatologia e a patogênese da encefalite chagásica na fase aguda da doença de Chagas, bem como o ciclo evolutivo intracelular do Trypanosoma cruzi, em 1911. Passados mais de 100 anos, o estudo pioneiro de Gaspar Vianna permanece como exemplo de descrição minuciosa e ainda atual do envolvimento do sistema nervoso central na fase aguda da doença de Chagas.

Abe Baker: Visionary and organizational leader of the American Academy of Neurology.

American neurologist and neuropathologist Abraham Bert (Abe) Baker (1908-1988) was instrumental in founding the American Academy of Neurology and served as a catalyst for the emergence of neurology as a strong, independent medical discipline in the United States in the second half of the twentieth century. Baker served as the first president of the Academy from 1948 to 1951. He was also instrumental in garnering support for the National Institute of Neurological Diseases and Blindness, which was founded in 1950 and later evolved into the National Institute of Neurological Disorders and Stroke. Baker's leadership was also essential in developing continuing medical education for neurologists at a national level and in garnering federal financial support for neurology training programs.