neurosurgery in greece - the bikinihermes.the-bikini.gr/images/documents/neurosurgery_in... ·...
TRANSCRIPT
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Neurosurgery in Greece
Past - Present - Future
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Neurosurgery in Greece
PERIOD YEARS
Mythology Cosmogony
Ancient 2000 - 330 AC
Byzantine 330 -15th
Modern 1880 - 2015
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Mythology 1st Neurosurgeon Hephaestus
1st Patient Zeus
1st Lesion Athena
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Mythology • Explanation = Parasitic Craniopagus
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Ancient Period 1st Trepanation
• 1900 BC
• Delphi (Kirra)
• Papagrigorakis et
• W Neurosurg 2014
• Male, 35 yrs
• R Parietal 1 cm
• Metal Tool
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Aetiology of Trepanation
• Ritual – Mystical
• Epilepsy/ Psychiatr.
• Headache
• Trauma
• Exostotic Lesions
• Painful areas
• Postmortem
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ANCIENT PHYSICIANS
• HIPPOCRATES • Cos Island • Athens
• Golden Age
• 460 - 377
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HIPPOCRATIC TREPANATION
“Omnia Opera Hippocratis” 1st Greek ed. 1526, Venice • Exploration «μαχαιπα» • Scraping «ξυστηπ» • Trepanation «τπυπανον» • Saw «ππιον» • Probe «μηλη» • Local Cure «καταπλασμα»
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HIPPOCRATES & Neurosurgery
The Hellenic-Hippocratic origins of head, brain & spinal terminology Panourias I, Stranjalis G, Stavrinou L, Sakas DE • J History Neuroscience 2011 • Clinical Anatomy 2012
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First Anatomist Physicians School of Alexandria
• Herophilos
335–280, Chalcedon
• Erasistratus 304 – 250, Cos
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GALEN
• Asia Minor 129 - 200
• 1st Greek ed.
• Venice 1550
• Anatomy
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GALEN and Neurosurgery
• Ventricles - CC • Brainstem - Cranial Nerves • Spine - PNS • Techniques - Tools • Trepanation • Guarding Trepan • Dural Protector “meningophylax” • Nerve suturing
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Ancient Trepanation
• Introduced - Reluctant
• Anatomist - Established - Developed
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BYZANTINE 330 – 1453
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PAUL of AEGINA 625 – 690 & Neurosurgery
• Hydrocephalus in Byzantine writers
Lascaratos et. Neurosurgery 2004
• Neurosurgery in the
Byzantine Empire: Paul of Aegina
Missios et. J Neurosurgery 2014
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PAUL of AEGINA & Neurosurgery
• Epitome (7 books) - 800 years !
• Hydrocephalus/ Trauma (Skull - Spine - Nerves)
• Based on Hippocrates / Galen
• Bridge to Byzantine / Arabic / Western
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Modern Era 1880 - 2015
DEVELOPMENT PERIOD
GEN. SURGERY NEUROLOGY
1880 - 1950
TRAINING 1935 - 1950
NEUROSURGERY 1951 - 2015
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MODERN PERIOD 1877
• Prof. Magginas
• General Surgery
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MODERN PERIOD 1894 • Dr. Apostolides
• 1882-1890
• 3 Trauma ops
• Successful
• Louis & Aretaios
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Profs. Kokkalis & Patrikios Univ. Athens - Evangelismos
1930 - 1945
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Evangelismos Hospital 1884 Surgery - Neurology 1930s
• Publications
• Tumors
• Trauma / Abscess
• Spine
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Training 1940 - 1950
3 Neurosurgeons
NSURGEON HOSPITAL YEAR ESTABLISHED
Griponisiotis Evangelismos 1951
Economos Polyclinic 1953
Taptas Ag. Savvas 1959
Griponisiotis AHEPA 1967
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Prof. Griponisiotis
1st
Neurosurgeon
Evangelismos 1951
1st
Professor
AHEPA 1967
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Journal of Neurosurgery. July 1955
Ossifying Chronic Subdural Hematoma. Report of a Case.
B. Griponisiotis
Neurosurgical Clinic “Evangelismos” Athens, Greece
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Prof. Griponisiotis
Pediatric patient in 1960s readmitted in 2010
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Development of
Departments
PERIOD No DEPTs
1951 - 1985 14
1986 - 2015 26
TOTAL 40
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Neurosurgeons
per Decade
DECADE No NSgeons No Increase
1951 - 1979 23
1970 -1979 60 37
1980 - 1989 121 61
1990 - 1999 251 130
2000 - 2010 391 140
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1966 – D. Economos
22 members
1987 1st Congress Hellenic-British
29 National / Joint
Sessions / CMEs
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International Workshops (EANS)
Microanastomosis / 2014
Microvascular Hands-on / 2014
Skullbase & White Matter / 2015
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PRESENT
• History
• Civilization
• EU
• Globalization
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PRESENT
• General Neurosurgery
• Trauma / ITU
• Oncology / Skullbase
• Radiosurgery
• Spinal
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PRESENT
• Endovascular
• Pediatric
• Functional
• Neuroimaging
• Neuropathology
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PRESENT
• Academic Dpt (7+2)
• Neuroanatomy Labs
• Pubmed
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Hellenic NS Society
Short Survey
Direct or Mail
June 2014
62 %
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Type of Employment
State/Academic 157 Resident 80 Private ? 250
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Departments
Training Centers
Departments 40
Large/Small 8/32
Training 16
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Structure / Function
State or Academic
700 Beds 1- 8 OR / W 3 - 6 Nsgeon / Dpt
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Operations / yr
State or Academic
• Ops 9.000 /yr
• Ops / Dpt 100-800
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FUTURE
• EU Coordination
• Legislative change
• National Board
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National Board
• Training
• Licence
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National Board
Reduction
• NSgeons
• Units
• Training Centers
Organize
• Subspecialty
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Dawn or Sunset ?