1965

1965

1964-1966

In 1965 Parkinson 1) was the first to realize an anatomical study and to propose a surgical approach to the cavernous sinus (CS). Despite the development of the microsurgical technique in the seventies, it was thought that microneurosurgery was reaching its furthest limits in the approach of lesions in and around the CS. The extremely high risk of damaging nervous structures, as well as causing uncontrollable haemorrhage or postoperative CSF leak seemed to be an unavoidable and insuperable obstacle. Thanks to the anatomical work of Vinko Dolenc and his surgical experiences, a rational surgical approach was eventually developed and the different relations between the lesion and the neurovascular structures were defined. In Dolenc's book preface, Yasargyl states that “there is no doubt that this type of microsurgical anatomical study is a new step in the 100 year history of neurosurgery” 2).


Salomón Hakim first identified the Idiopathic normal pressure hydrocephalus in 1957 at the Hospital San Juan de Dios in Bogotá, Colombia. Even after decades of international focus and thousands of publications on his disorder, Hakim's story remains largely untold.

Professor Hakim first published his thesis in 1964 and 6 case reports of NPH in The New England Journal of Medicine and the Journal of the Neurological Sciences in 1965. Hakim rose to the forefront of academic medicine as he described a newfound ability to reverse symptoms of “neurodegeneration” that had long been considered irreversible. 3).

Hakim and Adams in 1965 published varying combinations or degrees of each of the elements of the classic clinical triad of NPH 4).


The modern rigid endoscope was invented by Karl Storz in 1965 when he combined the optical rod system of Hopkins and used fiberoptics to carry illumination down to the tip of the endoscope 5).


1)
Parkinson D. A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg. 1965;23:474–483.
2)
Dolenc V.V., Yasargil M. Springer-Verlag; Wien: 1989. Anatomy and surgery of the cavernous sinus.
3)
Wallenstein MB, McKhann GM 2nd. Salomón Hakim and the discovery of normal-pressure hydrocephalus. Neurosurgery. 2010 Jul;67(1):155-9; discussion 159. doi: 10.1227/01.neu.0000370058.12120.0e. PMID: 20568668.
4)
Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965 Jul-Aug;2(4):307-27. PubMed PMID: 5889177.
5)
Linder TE, Simmen D, Stool SE. Revolutionary inventions in the 20th century. The history of endoscopy. Arch Otolaryngol Head Neck Surg. 1997 Nov;123(11):1161–1163.
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