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 Leonides 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.

CONCLUSION

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.