Priola Stefano M, Raffa Giovanni, Abbritti Rosaria V, Merlo Lucia, Angileri Filippo F, La Torre Domenico, Conti Alfredo, Germanò Antonino, Tomasello Francesco
Neurosurgical Clinic, Department of Neurosciences, University of Messina, Messina, Italy.
Neurosurgical Clinic, Department of Neurosciences, University of Messina, Messina, Italy.
World Neurosurg. 2014 Sep-Oct;82(3-4):523-8. doi: 10.1016/j.wneu.2013.07.076. Epub 2013 Jul 26.
The origin of neurosurgery as a modern, successful, and separate branch of surgery could be dated back to the end of the 19th century. The most important development of surgery occurred in Europe, particularly in Italy, where there was a unique environment, allowing brilliant open-minded surgeons to perform, with success, neurosurgical operations. Neurosurgery began at the skull base. In everyday practice, we still pay tribute to early Italian neuroanatomists and pioneer neurosurgeons who represented a starting point in a new, obscure, and still challenging field of medicine and surgery during their times. In this paper, we report at a glance the contributions of Tito Vanzetti from Padua (1809-1888), for his operation on a destructive skull base cyst that had, indeed, an intracranial expansion; of Davide Giordano (1864-1954) from Venice, who described the first transnasal approach to the pituitary gland; and, most importantly, of Francesco Durante from Messina (1844-1934), who was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. They carried out the first detailed reported surgical excision of intracranial lesions at the skull base, diagnosed only through clinical signs; used many of the advances of the 19th century; and conceived and performed new operative strategies and approaches. Their operations were radical enough to allow the patient to survive the surgery and, in the case of Durante, for the first time, to obtain more than 12 years of good survival at a time when a tumor of this type would have been fatal.
神经外科作为现代、成功且独立的外科学分支，其起源可追溯至19世纪末。外科学最重要的发展发生在欧洲，尤其是意大利，那里有着独特的环境，使杰出且思想开放的外科医生得以成功开展神经外科手术。神经外科始于颅底。在日常实践中，我们依然缅怀早期的意大利神经解剖学家和神经外科先驱，在他们所处的时代，神经外科是一个全新、晦涩且仍具挑战性的医学和外科学领域，而他们代表了这个领域的起点。在本文中，我们简要介绍来自帕多瓦的蒂托·万泽蒂（1809 - 1888）的贡献，他曾对一个具有颅内扩展的破坏性颅底囊肿进行手术；来自威尼斯的达维德·乔尔达诺（1864 - 1954），他描述了首例经鼻垂体手术入路；以及最重要的来自墨西拿的弗朗切斯科·杜兰特（1844 - 1934），他是神经外科历史上首位成功切除颅底脑膜瘤的外科医生。他们首次详细报道了仅通过临床体征诊断的颅底颅内病变的手术切除；运用了19世纪的诸多进展；构思并实施了新的手术策略和入路。他们实施的手术足够彻底，使患者得以在术后存活，就杜兰特的病例而言，在当时这种类型的肿瘤通常会致命的情况下，患者首次获得了超过12年的良好生存期。
