Hydrocephalus and the First Report of an External Ventriculostomy: The Contributions of Fabrici d'Acquapendente in the Italian Renaissance.

In our historical study, we are unveiling one of the very first surgical treatments of hydrocephalus originally scripted in Latin by Fabrici d'Acquapendente and then transcribed into the French language by Chez Pierre Ravaud. During the European Renaissance, Italian pioneering surgeon Fabricid'Acquapendente illustrated the technique performed at that time. Fabrici described the drainage of fluid for hydrocephalus using the insertion of a cannula. The cannula was kept in place for several days and the fluid was drained slowly and in regulated controlled amounts. Layers of bandage drapes were applied to prevent the leakage of fluid escaping from the wound. Unfortunately, we are missing some significant information regarding the surgical techniques as these were not documented by Fabrici. Although skull trephination was relatively well known, it is unsure whether at the time the cannula was inserted deep within the ventricles. Drainage of the fluid may have still occurred from the extracranial space. Moreover, we are unaware of how long the cannula was kept in place. Nonetheless, Fabrici d'Acquapendente may be considered among the first in Italy and possibly in Europe to lay down the foundations for external ventricular drainage system for hydrocephalus.