Neurosurgery
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Biography Historical Article
M. Gazi Yaşargil: Neurosurgery's man of the century.
Dissatisfied with the available macrosurgical techniques and encouraged by colleagues such as Donaghy and Krayenbühl, M. Gazi Yaşargil possessed the ingenuity to take advantage of and further improve emerging technologies such as angiography to develop microsurgery. To enable the advancement of microsurgical techniques, Yaşargil created innovative instrumentation, such as the floating microscope, the self-retaining adjustable retractor, microsurgical instruments, and ergonomic aneurysm clips and appliers. His genius in developing microsurgical techniques for use in cerebrovascular neurosurgery has transformed the outcomes of patients with conditions that were previously inoperable.
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Cushing's New Haven years were limited professionally to the completion of projects that had been previously started. These were the description of basophilism and the completion of the meningioma monograph and A Surgeon's Journal. His early years as a student at Yale led him to subsequent intense involvement in events in the developing Yale University. One little-appreciated aspect was Cushing's involvement in the early history of national health care.
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This article reviews the 1681 edition of The Anatomy of the Brain, by Thomas Willis (1621-1675), which was first published in Latin in 1664. Although description of the circulation at the base of the brain is part of this text, the majority of the book is devoted to functional anatomic features of the brain. ⋯ Extensive comparisons are made between "lower" animals and human subjects, emphasizing the differences in their intellects. This unique document ushered in the era of modern neuroanatomy and laid the groundwork for future neuroanatomic and neurophysiological investigations.
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Accepted management strategies for odontoid fractures include external immobilization and surgical stabilization using anterior or posterior approaches. Displaced Type II fractures and rostral Type III fractures are at high risk for nonunion. Anterior fixation of odontoid fractures with a single cortical lag screw is a relatively new technique that combines rigid internal stabilization with preservation of intrinsic C1-C2 motion. We retrospectively reviewed our series of 26 consecutive patients who underwent odontoid screw fixation, to further define the safety and efficacy of the technique. ⋯ Single-screw anterior odontoid fixation was associated with a relatively low complication rate and a high fusion rate in this study. We think that this should be the preferred treatment method for acute Type II odontoid fractures.