Charles G. diPierro

One century after the description of the "sign": Joseph Babinski and his contribution to neurosurgery.

One hundred years ago, in 1896, Joseph Babinski published a preliminary report on réflexe cutané plantaire (cutaneous plantar reflex), which became widely known as the Babinski sign. However, Babinski did not view the description of the sign as his major achievement. Instead, he considered his greatest contribution to medicine to be his having ... indiqué la voie à Martel et à Vincent (pointed the way to Thierry de Martel and Clovis Vincent, founders of French neurosurgery). Several of Babinskis manuscripts deal with neurosurgical problems. In 1900, 1 year before Alfred Fröhlichs description, Babinski gave the first account of the adiposogenital syndrome and its relation to pituitary-hypothalamic disorder. Many other original contributions ensued. These include a report on the relief of papilledema by surgical decompression in 1901, the successful removal (in collaboration with de Martel) of an intracranial meningioma in 1909, the description (again with de Martel) of a cerebellopontine angle tumor treated by surgical excision with good result in 1925, and several manuscripts concerning diagnosis and treatment of compressive spinal cord lesions. Babinskis dream to establish a department of neurosurgery became a reality shortly after his death. The Hôpital de la Pitie in Paris, where Babinski did most of his work, established the first French department of neurosurgery chaired by Babinskis pupil, Vincent.

Cerebral ischemia-reperfusion injury: a novel therapeutic approach with TAK-218.

The goal of the present study was to evaluate the potential neuroprotective effect of TAK-218 in an in vivo rat focal cerebral ischemia/reperfusion model. TAK-218 is a novel compound with multiple antiischemic properties, including suppression of aberrant dopamine release, modulation of sodium channels, and inhibition of lipid peroxidation. The study was a blinded, randomized, placebo-controlled study of TAK-218 in a three-vessel focal ischemic rat model. A total of 22 rats were randomly assigned to the treatment or placebo group. Animals were injected intrapertoneally with either a 2 mg/kg dose of drug or saline at 2 hours after reperfusion. Infarction volume was measured with use of 2,3,5-triphenyltetrazolium chloride. Total adjusted infarction volume in treated animals decreased by 10%. With use of a statistical analysis requiring 80% power with a 20% reduction desired effect, there was no statistically significant difference in the end-point of infarction volume between drug and placebo treatment groups. In light of the proven efficacy of thrombolytic therapy for acute stroke, it is now desirable to test neuroprotective agents during the 3-hour therapeutic window after ischemia. Further research is necessary to discern if a therapeutic agent with multiple antiischemic properties may provide a more robust neuroprotective effect than an agent with a single neuroprotective action.