Salomón Hakim, MD (1922–2011): A honeymoon with Neurosurgery

2021 ◽  
pp. 096777202110540
Author(s):  
Daniel Jaramillo-Velásquez ◽  
Fernando Hakim ◽  
Andreas K Demetriades
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Medical Literature ◽  
Medical Physics ◽  
Fluid Pressure ◽  
Normal Pressure ◽  
Empirical Knowledge ◽  
Cranial Cavity ◽  
The Social ◽  
Programmable Valve

Salomón Hakim (1922–2011) was a Colombian neurosurgeon and brain scientist This biography examines the social and cultural background through which he emerged as an inquisitive and multi-dimensional surgeon-scientist, and his lifelong contributions to the specialty of neurosurgery. With empirical knowledge in applied medical physics, electronics, electricity and chemistry, he understood the paradoxical phenomenon of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. This ultimately led Hakim to describe in exquisite detail the physics of the cranial cavity and brain hydrodynamics. His name is intertwined with the identification of the entity of a syndrome which had not previously been addressed in the medical literature: Normal Pressure Hydrocephalus (Hakim's syndrome). Additionally, he designed and built various models of valved shunting devices to treat the condition (eg the Hakim programmable valve). Through his selflessness and cogent work, Hakim left a legacy and intellectual heritage that has allowed many colleagues worldwide to save thousands of lives who would be otherwise condemned to oblivion.

Normal pressure hydrocephalus. Influences on cerebral hemodynamic and cerebrospinal fluid pressure-chemical autoregulation

1984 ◽  
Vol 21 (2) ◽  
pp. 195-203 ◽  
Author(s):  
John S. Meyer ◽  
Hisao Tachibana ◽  
Jeffrey P. Hardenberg ◽  
Richard E. Dowell ◽  
Yasuhisa Kitagawa ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Fluid Pressure ◽  
Normal Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Cerebral Hemodynamic ◽  
Pressure Chemical

scholarly journals Normal-Pressure Hydrocephalus: Is There a Genetic Predisposition?

2011 ◽  
Vol 38 (2) ◽  
pp. 274-281 ◽  
Author(s):  
M. D. Cusimano ◽  
D. Rewilak ◽  
D. T. Stuss ◽  
J. C. Barrera-Martinez ◽  
F. Salehi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Urinary Incontinence ◽  
Cognitive Impairment ◽  
Environmental Factors ◽  
Natural History ◽  
Normal Pressure Hydrocephalus ◽  
Genetic Predisposition ◽  
Fluid Pressure ◽  
Cerebral Atrophy ◽  
Normal Pressure

Background:Normal-pressure hydrocephalus (NPH) is characterized by gait disturbance, cognitive impairment, with or without urinary incontinence, enlarged ventricles with or without cerebral atrophy and normal cerebrospinal fluid pressure.Methods:We report two sisters with NPH who lived together their entire lives and whose natural history might provide insights into genetic and environmental mechanisms underlying this disorder. Both patients were in their early seventies, single, had similar daily habits and hypertension. No other family members had NPH.Results:They both underwent shunt placement and showed improvement documented by history and neuropsychological assessment. Both showed a delayed deterioration due to vasculopathy. Both patients were homozygous for the apolipoprotein E (ApoE) e3 allele on chromosome 19. No environmental factors that might have influenced the development of NPH were identified.Conclusion:Our report of two sisters with NPH may indicate the presence of genetic predisposition and further studies involving genetics and environmental factors are necessary to elucidate their role in the pathogenesis of NPH.

scholarly journals Chronic subdural hematoma treatment with adjustment of programmable valve in idiopathic normal pressure hydrocephalus patient: a case report

2014 ◽  
Vol 33 (02) ◽  
pp. 139-141
Author(s):  
Matheus Fernandes de Oliveira ◽  
Rodolfo Casimiro Reis ◽  
Fernando Campos Gomes Pinto ◽  
José Marcus Rotta
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Benign Condition ◽  
Programmable Valve ◽  
Programmable Valves ◽  
Normal Pressure Hydrocephalus Patient

AbstractChronic subdural hematoma (CSDH) is a common entity in daily neurosurgical practice. It is considered a benign condition. Idiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, dementia and/or urinary incontinence added to dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure. We describe an experience of a conservative treatment of subdural hematoma based in the physiopathology and ability to control the pressure in programmable valves. The adjustment of programmable valves in the treatment of INPH allow us the therapeutic control of hydrocephalus and an important tool to manage complications, especially overshunting and undershunting.

scholarly journals Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients

2013 ◽  
Vol 71 (4) ◽  
pp. 229-236 ◽  
Author(s):  
Matheus Fernandes de Oliveira ◽  
Felippe Saad ◽  
Rodolfo Casimiro Reis ◽  
José Marcus Rotta ◽  
Fernando Campos Gomes Pinto
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Standard Treatment ◽  
Fluid Pressure ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Test Results ◽  
Shunt Surgery ◽  
Tap Test ◽  
Programmable Valve ◽  
Programmable Valves

Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, dementia and /or urinary incontinence, dilation of the ventricular system and normal opening cerebrospinal fluid pressure. Shunt surgery is the standard treatment of iNHP. Diversions with programmable valves are recommended, once drainage pressure can be changed. However, well-defined protocols still lack guiding the steps to attain proper pressure for each patient. Methods: In our study, we reported the experience of shunting 24 patients with iNPH using Strata® (Medtronic) valve, following a protocol based on a positive Tap Test. Results: We observed clinical improvement in 20 patients and stability/worsening in 4 patients. Complications occurred in five patients, including one death. The results display improvement, and complications occurred at a lower rate than reported in other studies. Conclusions: The Strata® valve used in the proposed protocol represents an efficient and safe tool in the treatment of iNPH.

scholarly journals Reversal of Normal Pressure Hydrocephalus Symptoms by Subdural Collections

2002 ◽  
Vol 29 (2) ◽  
pp. 171-174 ◽  
Author(s):  
C. M. Fisher
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Trauma ◽  
Normal Pressure Hydrocephalus ◽  
Direct Evidence ◽  
Fluid Pressure ◽  
Normal Pressure ◽  
The Other ◽  
Intraventricular Pressure ◽  
Ventricular Size ◽  
Insight Into

Abstract:Background:The pathogenesis of symptoms in normal pressure hydrocephalus (NPH) is unclear. One theory is that in the presence of enlarged lateral ventricles, the ventricular fluid exerts increased force on the ventricular walls, the cerebrospinal fluid pressure remaining normal. This is in accordance with Pascal’s principle of F = PxA. It has not been possible to obtain direct evidence for this view.Method:The opportunity to gain insight into the matter arose when it was observed that two patients with symptomatic NPH were relieved of their symptoms when they developed bilateral subdural collections, one after head trauma, the other after ventriculo-peritoneal shunting for NPH.Result:In each case, concomitant with the subdural collections and the reversal of symptoms, the ventricular system became smaller. In the first patient, symptoms returned when the subdural collections were resorbed. In the second patient, symptoms returned when the subdural collections became excessive.Conclusion:Although documentation was less thorough than desired, it was concluded that relief of symptoms was related to the decrease in the ventricular size rather than lowering of the intraventricular pressure, thus providing evidence for operation of the principle F = PxA as the mechanism of symptoms in NPH.

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