Rostral cingulate gyrus: A putative target for deep brain stimulation in treatment-refractory depression

Surgery for intractable affective illnesses has generated considerable controversy over the last century. Deep brain stimulation (DBS) has revolutionized neurosurgical practice, especially in the field of advanced Parkinson’s disease and, more recently, in selected medical-refractory cases of obsessive-compulsive disorder. In this paper, we propose a discrete area of the rostral. cingulate gyrus as a potential target for DBS in medical-resistant depressive patients. Brodmann’s area 24a has proved to be a vital link in the integration of neural circuits underlying depression, both through proposed neurobiological models and accurate neuroimaging studies. The full reversibility and adjustability of DBS offer the best chance to treat the multidimensional and Life-span profile of depression, so giving hope to a great number of desperate human beings. (c) 2005 Elsevier Ltd. ALL rights reserved

Hydrocephalus according to Byzantine writers

OBJECTIVE: To describe hydrocephalus, the techniques applied for its treatment by Byzantine physicians, and their later influence. METHODS: A study and analysis of the original texts of the Byzantine medical writers, written in Greek, was undertaken. A comparison with current concepts also was made. RESULTS: Three eminent Byzantine physicians: Oribasius (4th century AD), Aetius (6th century AD), and Paul of Aegina (7th century AD) gave the first detailed information regarding hydrocephalus and its conservative and surgical treatment. These physicians, who were trained in Alexandria, quote the concepts of the now-lost works of the celebrated surgeons of the Pneumatic School of Alexandria Leonids and Heliodorus (1st century AD) and its follower Antyllus (2nd century AD). In the types of hydrocephalus they described, we identify the conditions currently known as cephalhematoma and subgaleal hematoma, for which conservative and surgical treatments were provided, and epidural hematoma, which was thought to be incurable. CONCLUSIONS: The term hydrocephalus was coined during the Hellenistic period. The clinical picture of the disease, however, as described by later Byzantine physicians, does not correspond to current concepts. The ideas of the Byzantine physicians were based on the ancient Hippocratic, Hellenistic, and Roman traditions, which influenced Arab medicine and then Western European medicine, thus constituting significant roots of modern neurosurgery

Hippocrates: A pioneer in the treatment of head injuries

HIPPOCRATES’ TREATISE On Wounds in the Head represents an excellent source of information regarding the extent of experience with head injuries in classical antiquity. On the basis of clinical observation, the great physician gives an accurate description of the external appearance and consistency of the cranium. Fractures of the cranium are divided into six main categories, each of which is discussed separately, regarding its mechanism, clinical assessment, and treatment. The medical history and clinical evaluation are considered the most important factors when dealing with cranial trauma. Trepanation, a neurosurgical procedure still in practice today, is presented in detail. As a whole, the treatise, the first written work in medical history dealing exclusively with cranial trauma, reveals that Hippocrates was a pioneer in treating head injuries

Cerebellar ataxia and intrathecal baclofen therapy : Focus on patients´ experiences

Elucidating patients´ experiences of living with chronic progressive hereditary ataxia and the symptomatic treatment with intrathecal baclofen (ITB) is the objective of the current study. A multicenter qualitative study with four patients included due to the rare combination of hereditary ataxia and ITB therapy was designed to elucidate participants' experiences through semi-structured interviews. The transcribed text was analyzed according to content analysis guidelines. Overall we identified living in the present/ taking one day at a time as the main theme covering the following categories: 1) Uncertainty about the future as a consequence of living with a hereditary disease; The disease; 2) Impact on life as a whole, 3) Influence on personal life in terms of feeling forced to terminate employment, 4) Limiting daily activities, and 5) ITB therapy, advantages, and disadvantages. Uncertainty about the future was the category that affected participants' personal life, employment, and daily activities. The participants' experience of receiving ITB therapy was expressed in terms of improved quality of life due to better body position and movement as well as better sleep and pain relief