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Gonzalo Moreno Sanchez and Alwyn Louise Burridge

✓The Edwin Smith Papyrus (circa 1650–1550 BC) is a didactic trauma treatise of major interest to neurosurgery, as it deals primarily with cranial and spine injuries. Information regarding the patient's condition is conveyed in the papyrus with sufficient clarity to allow a clinical assessment of each injury. The ancient Egyptian physician/teacher lists the key diagnostic elements in each case, and then pronounces his opinion of the treatment potential in one of three verdicts: 1) “a medical condition I can treat;” 2) “a medical condition I can contend with;” or 3) “a medical condition you will not be able to treat.” The structural organization of the text according to regional injuries of increasing severity permits analysis of sequential cases, and makes it possible to determine which clinical features led the ancient Egyptian physician to give the first or second verdict in the less severe injuries, but the third in the worst cases. Interestingly, the ancient physicians were not deterred from contending with injuries in the presence of basilar skull fractures, traumatic meningismus, skull perforation without overt neurological deficit, drowsiness, limited facial fractures, or closed head injuries without depressed fragments. Factors identified as determinant for the third verdict in head injuries are depressed skull fragments, dura laceration with exposed brain, infected cranial wounds/tetanus, major craniofacial fractures, deep skull–penetrating stab wounds, and aphasia. This study describes three case sequences of head injuries.

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Johannes K. Lang and Herbert Kolenda

, physiology and pathology , in Ancient Egyptian Medicine. Norman : University of Oklahoma Press , 1996 , pp 42 – 63 Nunn JF: Concepts of anatomy, physiology and pathology, in Ancient Egyptian Medicine. Norman: University of Oklahoma Press, 1996, pp 42–63 18. Nunn JF : Surgery, trauma and dangerous animals , in Ancient Egyptian Medicine. Norman : University of Oklahoma Press , 1996 , pp 163 – 190 . Nunn JF: Surgery, trauma and dangerous animals, in Ancient Egyptian Medicine. Norman: University of Oklahoma Press

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Patric Blomstedt

prêtre de Sekhmet dans le corps médical de l'ancienne Égypt . Actes du Vle Congrès International d'Histoire des Sciences Amsterdam , 1951 . 324 – 333 7 Nunn JF : Ancient Egyptian Medicine London , The British Museum Press , 1996 8 Smith GE : The causation of the symmetrical thinning of the parietal bones in ancient Egyptians . J Anat Physiol 41 : 232 – 233 , 1907 9 Yiu Luk S , Fai Shum JS , Wai Chan JK , San Khoo JL : Bilateral thinning of the parietal bones: a case report and review of radiological features . Pan Afr Med J 4 : 7

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Andrew A. Fanous and William T. Couldwell

America) Philadelphia , March 27–28 2007 . 24 , (Abstract) 21 Nicolaeff L : Quelques données au sujet des méthodes d'excérebration par les Égyptiens anciens . Anthropologie 40 : 77 – 92 , 1930 22 Nunn JF : Ancient Egyptian Medicine London , British Museum Press , 1997 23 Oetteking B : Kraniologische studien an Altägyptern Braunschweig , F. Vieweg und Sohn , 1908 24 Peltier L : Fractures: A History and Iconography of Their Treatment San Francisco , Norman Publishing , 1990 25 Pirsig W , Parsche F : Instruments for

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Ali M. Elhadi, Samuel Kalb, Luis Perez-Orribo, Andrew S. Little, Robert F. Spetzler, and Mark C. Preul

eventually formed the knowledge base underlying the success of the neurosurgical specialty of skull base surgery. Ancient Egyptian Medicine Among the most ancient civilizations, the Egyptians became renowned for the practice of medicine combined with what seems to be a lively inquiry into what might be considered the science or philosophy of the day. The caliber of Egyptian medicine is broadly recognized in numerous references in both modern and ancient literature. In The Odyssey Homer wrote that “for there [in Egypt] the earth, the giver of grain, bears the

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Expanding neurosurgery

The 2014 AANS Presidential Address

William T. Couldwell, Vance Mortimer, and Kristin L. Kraus

Matching Program ( http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2011.pdf ) [Accessed September 1, 2014] 48 Nunn JF : Ancient Egyptian Medicine London , British Museum Press , 1997 49 Oakley K , Brooke W , Akester A , Brothwell D : Contributions on trepanning or trephination in ancient and modern times . Man (Lond) 59 : 92 – 96 , 1959 50 Panourias IG , Skiadas PK , Sakas DE , Marketos SG : Hippocrates: a pioneer in the treatment of head injuries . Neurosurgery 57 : 181 – 189 , 2005 51 Poley S , Belsky