History, 20th Century ; Humans ; Neurosurgery ; history ; Singapore

History, 20th Century ; History, 21st Century ; Neurosurgery ; history ; Singapore

History, 20th Century ; History, 21st Century ; Humans ; Minimally Invasive Surgical Procedures ; history ; trends ; Neurosurgery ; history ; trends

No Abstract Available.
United States ; Surgery/education/*history ; Physiology/history ; Neurosurgery/history ; Humans ; History, 20th Century ; History, 19th Century ; Blood Pressure Determination/history ; Bacteriology/history ; Animals ; Anesthesia/history

History, 19th Century ; History, 20th Century ; Humans ; Neurosurgery ; history ; Philately ; United States

China ; History, 20th Century ; History, 21st Century ; Neurosurgery ; history ; methods ; trends

It is not an easy task to imagine what will happen to cerebrovascular surgery in the twenty-first century, considering the tremendous developments that have occurred during the past decades. This review paper is attempted to address the present and future of cerebrovascular surgery on the basis of author's experience of cerebrovascular diseases during the past 30 years. Cerebrovascular surgery has been recognized as a subspecialty of neurosurgery that requires utmost technical challenge and precision in all of medicine. Cerebrovascular surgery has achieved much that we can proud of. However, as forward-thinking cerebrovascular surgeons, our concern isn't with past glories. They would tackle questions of natural history, scientific assessment of therapy, outcomes sciences, and molecular basis of cerebrovascular disease. They would remain at the forefront of research in stroke and brain protection, and would succeed at the integration of endovascular, radiosurgical, and pharmacological tools into a truly multidisciplinary armamentarium.
Aneurysm ; Brain ; Cerebral Hemorrhage ; Natural History ; Neurosurgery ; Stroke ; Vascular Malformations

No abstract in English.
History, 19th Century ; History, 20th Century ; Humans ; Neuralgia/history/surgery ; Neurophysiology/*history ; Neurosurgery/*history ; Therapeutic Human Experimentation/ethics/*history ; United States

Many approaches are being used for exposure of the anterior cranial base regions, ranging from extracranial to intracranial, such as transsphenoidal approach. This intracranial approach, developed in the beginning of the twentieth century, has recently become one of the most commonly used approaches after many incremental improvements. This thesis aims at examining the development of the approach and those who contributed to this procedure. The author also contemplate problems which may occur in the historical analysis. From the nineteenth century, advances have been made in anesthesiology, sterilization, cerebral localization and knowledge of anatomical and physiologic aspects of the skull base. The development of new knowledge and technique has helped to overcome obstacles, making surgery of the skull base through extracranial approach both technically feasible and therapeutically effective. To avoid serious postoperative complications after the extracranial approach, transsphenoidal approach had been developed in the beginning of the twentieth century. Transsphenoidal approach had been widely used right after its introduction. But it had not been used popularly since late 1920s in the United States. In early 1960s, this technique, spread from Europe, has regained popularity and become one of the most widely-used approaches. In the history of the transsphenoidal approach, it has been thought that the effort of Harvey Cushing and Oskar Hirsch, the endeavor of Cushing's scholars, several new attempts of otolaryngologists played an important role. However, comparing to great appreciation of neurosurgeons, especially Harvey Cushing on their significant contribution to the further development of this technique, the role of other pioneering doctors have been underestimated in previous historical studies on the transsphenoidal approach. It was because dynamical relationships among several specialties had influence on the historical analysis. This cases shows that historical analysis is influenced not only by past figures but also by current situations.
English Abstract ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; History of Medicine, 21st Cent. ; Neurosurgery/*history ; Skull Base/*surgery ; Surgery/*history

BACKGROUND: The purpose of this study was 1) to review the length of an adequate period of conservative treatment and the appropriate surgical indications for herniated lumbar disc(HLD), 2) to collate the scientific evidences on surgeries for HLD, and 3) to collect expert opinions on HLD. METHODS: We searched for articles in PubMed, the Cochrane Library and KoreaMed up to 1 October 2008, and these articles were concerned with the natural history of HDL, systemic reviews of HDL and expert opinions on HLD. We also searched for meta-analyses and randomized or quasi-randomized controlled trials(RCTs or QRCTs) of surgery for HLD. We performed a meta-analysis using the Cochrane method. The survey consisting of 21 questions was delivered to all the members of the Korean Spinal Neurosurgery Society(KSNS) via E-mail. RESULTS: A total of 59 articles were included in this study. There were 16 articles concerning the period of conservative management and the surgical indications. Among the 33 articles on surgery for HLD, there were 4 meta-analyses, 27 RCTs, and 2 QRCTs. Among the 938 members of the KSNS, 72 responded to the survey. A minimum of 1 to 3 months of conservative management was the most preferred answer(58%), followed by a conservative management period of less than 1 month(33%). Percutaneous endoscopic discectomy was more preferred by the hospitals that specialized in spinetreatment than by the university hospitals(p<0.05). CONCLUSION: Conservative management for a minimum of 2 weeks to 3 months is recommended for patients with tolerable pain only. The patients with neurological compromise or intolerable pain should be considered for surgery. There is strong evidence on the relative effectiveness of surgical discectomy versus chemonucleolysis versus placebo. There is no scientific evidence on the effectiveness of any other form of minimally invasive procedure.
Diskectomy ; Electronic Mail ; Evidence-Based Medicine ; Expert Testimony ; Humans ; Intervertebral Disc Chemolysis ; Natural History ; Neurosurgery