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