Baron Larrey at the Dawn of Correlative Neuroanatomy.

In 1820, a young soldier was accidentally injured by a splinter of a fencing sword that penetrated through the right orbit into the brain. Examination by the French military surgeon Baron D.-J.

[Young man with gunshot wound (GSW)--what killed Ernst vom Rath?].

On the morning of November 7, 1938 vom Rath, a diplomat at the German embassy in Paris, was shot by Herschel Grynzspan, a Jewish teenager. Of the 5 shots fired, 2 hit vom Rath, one in the right shoulder and one in the abdomen. He was rushed to Alma Women's Hospital near the embassy, where emergency surgery was undertaken.

The neurologist lipman halpern-author of the oath of the hebrew physician.

Lipman Halpern was born in 1902 into a family of Grand Rabbis who lived in Bialystok from the mid-nineteenth century. Inspired by his son's decision to study medicine, Halpern's father authored a comprehensive and innovative book on medicine according to Rabbinic Law. After completing his initial medical studies in Königsberg, Halpern went on to specialize in neuropsychiatry in Berlin and then in Zurich.

The philosopher's swoon--the concussion of Michel de Montaigne: a historical vignette.

The French philosopher Michel Eyquem de Montaigne (1533-1592) sustained a transient loss of consciousness due to a head injury. Montaigne described his concussion as a "swoon," with astutely illustrative details of the symptoms he experienced, including brief loss of consciousness, with apparent (temporary) confusion, and post-traumatic amnesia. His vivid portrayal of the recovery period lends understanding of the process of conscious awakening after his near-death experience.

Moritz schiff (1823-1896): a physiologist in exile.

Moritz Schiff was one of the pioneers of modern experimental physiology. His involvement in the liberal movement forced him out of Germany, and, because of his adherence to proper physiological research, he had to flee Italy, his first refuge. The number and importance of his contributions are outstanding.

Chapter 4: neurology in the Bible and the Talmud.

The Bible, a major pillar of Western Civilization consists of Hebrew Scriptures, assembled over a millennium and accepted as of divine origin. The Talmud is a compendium of Jewish laws, covering every possible aspect of life, analyzed in depth from 200 BCE to 600 CE, becoming the foundation of Jewish existence. The all-encompassing character of the books provides numerous medical problems and observations that appear in various connotations.

Pituitary apoplexy and CABG: should we change our strategy?

Patients with pituitary adenoma that had coronary artery bypass grafting with cardiopulmonary bypass had pituitary apoplexy develop with neurologic deficits and even death. Four patients with pituitary adenoma underwent coronary artery bypass grafting operations (3 patients had coronary artery bypass grafting on bypass, 1 of them with known pituitary adenoma. All of them had pituitary apoplexy develop with neurologic deficits).

Hyperbaric oxygen pretreatment reduces the incidence of decompression sickness in rats.

We have previously hypothesised that the number of bubbles evolving during decompression from a dive, and therefore the incidence of decompression sickness (DCS), might be reduced by pretreatment with hyperbaric oxygen (HBO). The inert gas in the gas micronuclei would be replaced by oxygen, which would subsequently be consumed by the mitochondria. This has been demonstrated in the transparent prawn.

[Dr. Henry Wigderson--the first neurosurgeon in Eretz-Israel].

The vision of Hadassah Medical Organization and the Hebrew University in Jerusalem was to establish a University Hospital where clinical excellence and high academic level will be the hallmark of its departments. More than seventy years ago, guided by this spirit, the leaders of the two institutions attempted to establish a department of neurosurgery, which, at the time in only a few countries, was making its initial steps as an independent discipline. It was only during World War II that Hadassah could bring over a specialist in neurosurgery who worked for nearly three years in the Hadassah Hospital on Mount Scopus.

Evaluation of the apoptosis-related proteins of the BCL-2 family in the traumatic penumbra area of the rat model of cerebral contusion, treated by hyperbaric oxygen therapy: a quantitative immunohistochemical study.

The growth and progression of traumatic brain injury (TBI) lesions depend significantly on developments in the traumatic penumbra area, perilesional region, where delayed neuronal death occurs. Recent data supports the important role of apoptosis in delayed cell death in TBI. Previously we demonstrated a significant reduction of apoptosis in traumatic penumbra in animals treated by hyperbaric oxygen (HBO).

Effect of electroconvulsive therapy on cortical excitability in patients with major depression: a transcranial magnetic stimulation study.

Objective: The antidepressant action of electro-convulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) may be related to their ability to modulate cortical excitability. The aim of this study was to investigate changes in cortical excitability following ECT in patients with major depression (MD) and to compare therapeutic efficacy of ECT combined with rTMS to that of ECT alone.

Methods: Twenty-two patients with MD were assigned to receive ECT and right prefrontal 1 Hz rTMS (n=12) or ECT with sham rTMS (n=10).

Evidence for cortical hyperexcitability of the affected limb representation area in CRPS: a psychophysical and transcranial magnetic stimulation study.

Functional alterations in noxious, sensory and motor circuits within the central nervous system may play an important role in the pathophysiology of complex regional pain syndrome (CRPS). The aim of the present study was to search for further evidence of hyperexcitability in the hemisphere contralateral to the affected limb in patients with CRPS by employing both psychophysical and transcranial magnetic stimulation (TMS) methods. Twelve patients with CRPS type I, confined to the distal part of a limb (six in an upper-limb and six in a lower-limb), were enrolled in the study.

Antidepressant effects of different schedules of repetitive transcranial magnetic stimulation vs. clomipramine in patients with major depression: relationship to changes in cortical excitability.

The antidepressant effects of repetitive transcranial magnetic stimulation (rTMS) that have been demonstrated in recent studies could be related to its ability to modulate cortical excitability. Yet, the relationship between stimulus location and frequency and treatment outcome has not been established. The aim of the present study was to compare efficacy of rTMS in various configurations and clomipramine treatment in patients with major depression (MD) and to evaluate the relationship between clinical outcome and changes in cortical excitability.

[Indirect traumatic optic neuropathy--problems and challenges in diagnosis and uncertainty in treatment].

Traumatic optic neuropathy is one of the many facets of head injuries and a major cause of devastating permanent visual loss due to head injuries. Indirect traumatic optic neuropathy (ITON) occurs when blunt trauma to the forehead results in a transmission of force through the cranium to the confined portion of the optic nerve within the bony optic canal. The physics of the injuring forces that induced anatomical and histological effects on the optic nerve were thoroughly studied but the recognition of ITON in the acute stage still poses a diagnostic challenge.

The value of motor and somatosensory evoked potentials in evaluation of cervical myelopathy in the presence of peripheral neuropathy.

Study Design: Patterns and rates of motor-evoked potential (MEP) and somatosensory-evoked potential (SEP) abnormalities were evaluated in 9 patients with combined cervical cord compression and diabetic neuropathy and 15 patients with asymptomatic cervical cord compression. The results were compared with those of 8 patients with pure cervical myelopathy and 7 patients with pure diabetic neuropathy.

Objective: To assess the efficacy of MEPs and SEPs in the evaluation of cervical myelopathy in the presence of peripheral neuropathy.

Hyperbaric oxygen therapy for reduction of secondary brain damage in head injury: an animal model of brain contusion.

Cerebral contusions are one the most frequent traumatic lesions and the most common indication for secondary surgical decompression. The purpose of this study was to investigate the physiology of perilesional secondary brain damage and evaluate the value of hyperbaric oxygen therapy (HBOT) in the treatment of these lesions. Five groups of five Sprague-Dawley rats each were submitted to dynamic cortical deformation (DCD) induced by negative pressure applied to the cortex.

Unlocking the brain: attempts to improve mental function of microcephalic retarded children by "craniotomy".

"Is it sufficient glory to don a white apron and swing a carbolized knife and is therein a sufficient indication to let daylight into a deformed cranium and on top of a hopelessly defective brain, and to proclaim success because the victim consented not to die of the assault? Such rash feats of indiscriminate surgery, if continued, moreover in the presence of fourteen deaths in thirty-three cases, are stains on your hands and sins on your souls. No ocean of soap and water will cleanse those hands, no power of corrosive sublimate will disinfect the souls." These passionate words, delivered by Abraham Jacobi, the father of American pediatrics, at the International Congress in Rome in 1893, and later in the article "Non nocere" (42), epitomize the growing antagonism to the attempts by many prominent surgeons to improve the gloomy fate of severely retarded, microcephalic children by "liberating" their brains from their presumed bony chains by "linear craniotomy.

[Gunshot brain injury--Rishon-le-Zion 1913].

Dr. Leon Pochovski (1869-1965), the first fully trained surgeon to settle in Eretz-Israel, was summoned in 1913 from Jaffa to Rishon-le-Zion to treat a patient who sustained a tangential gunshot injury of the brain from a bullet shot at nearly point blank range, in the right occipital region. As the patient's condition deteriorated intracranial bleeding was diagnosed.

[The amputated leg--a tale of scientific curiosity--1792].

In 1792 the young military surgeon Dominique Jean Larrey (later Baron de l'empire) had to amputate a soldier's leg. His scholarly knowledge combined with intellectual curiosity turned a common event into an innovative scientific experiment, after he used the severed leg to affirm in the human being the recent observations made by Galvani on frogs. The possibility of inducing muscular contractions by galvanic current led him to foretell, much ahead of his time, that this mode would facilitate rehabilitation of the paralyzed.

A flask full of jelly: the first in vitro model of concussive head injury--1830.

IN 1830, THE French Military Surgeon Jean-Pierre Gama reported an experiment planned to unravel the mechanical events caused by head injury. His model was a round glass flask with a long neck filled with a gelatinous substance that resembled the consistency of the brain. Thumping the walls of the flask caused the movement of thin wires embedded in the "brain-like" material, thought to represent the spread of forces within the brain.