Monday, 1 January 2018

Spina Bifida

Congenital defect in the spine leads to spine bifida. This defect of the vertebrae of the the spine of a Child may not be visible at the time of birth and there may be no visible exposure of meninges or neural tissue. And there may be congenital defect only in the lamina of the vertebrae of the spine without any involvement of underlying spinal cord. This is known as spine bifida occulta. But in spine bifida aperta there is a visible or open defect in the spine. There may be congenital defect in vertebrae arches with cystic distension of meninges which is filled with CSF and is known as Meninges. But , in second type of spine bifida aperta which is known as Myelomeningocele, there is congenital defect in vertebral arches with cystic dilatation of meninges and neural tissue.     

Sunday, 3 December 2017

Arachnoid cysts, Ependymal cysts, Benign intracranial developmental cysts

Intracranial Benign Developmental Cysts
Arahnoid cysts and Ependymal cysts
It is very common observation in brain imaging to find small cysts inside the brain. These cystic areas resemble and look like areas of the brain with normal cerebrospinal fluid. Such incidental finding increase anxiety in the person in whom brain imaging was usually  done for some other purpose. Such cysts are usually arachnoid cysts or ependymal cysts.
Arachnoid Cysts
Arachnoid cyst is a benign intracranial developmental cyst which is between two split layers of arachnoid and it usually contains clear colurless CSF.
So, arachnoid cyst is a cyst containing CSF and it forms due to splitting of the archnoid membrane. These are benign congenital malformation.
It is usually an incidental finding.
They are commonly seen in Sylvian fissure, cerebellopontine angle, supracollicular area, vermian area, sellar and suprasellar area, etc. This may appear at any age from infancy and adolescence to adults.
Arachnoid cyst may remain asymptomatic throughout life, only to be diagnosed incidentally by a neuroimaging study. Imaging often shows remodelling of bone, and imaging characteristics exactly mimic CSF on CT and MRI in most cases.
Symptoms and signs of arachnoid cyst depend on its size and location inside the brain and spinal cord.
Recommendation for incidentally discovered arachnoid cyst in adults: a single follow up imaging study in 6-8 months is usually adequate to rule-out any increase in size. Subsequent studies only if concerning symptoms develop.

Sylvian fissure archnoid cyst may present with headache, seizures, dysarthria (speech problem),  focal bulge in temporal region, exophthalmos, papilloedema, and hemiparesis.  X-ray skull or CT scan may show evidence of expansion of the middle cranial fossa, elevation of the lesser wing of the sphenoid, forward protrusion of the greater wing the sphenoid bone and outward expansion and thinning of the temporal bone. But expansion of skull in relation to arachnoid cyst is not an indication for surgery , but mass effect, displacement of midline structures and presence of obsructive hydrocephalus are indications for surgical intervention for middle fossa arachnoid cysts.
On CT, arachnoid cyst appear as low density, smooth bordered lesions having attenuation values similar to that of CSF. The cyst wall has well-defined margins and does not enhance after intravenous injection of contrast agent.
MRI is better at demonstrating multiplanar relationship and characteristics of the lesion on T1, T2, FLAIR, Diffusion weighted images and contrast, MTR ( Magnetization transfer ratio), MRS ( MR spectroscopy), MRA ( MR angiography)study. It helps in differentiating arachnoid cyst from epidermoid, dermoid, lipoma, ependymal cysts, tumors like low grade glioma & metastasis, old hemorrhage, cavernoma, hydatid cyst, hemangioma, and infective granulomas.
On T1 weighted image arachnoid cyst appears hypointense and on T2 weighted image it appears hyperintense like CSF. On T1 weighted MRI ,  lipomas will appear hyperintense as fat appears hyperintense on both T1 and T2 weighted images.
The high protein content of a nonhemorrhagic tumour cyst will cause the cyst to appearslightly hyperintense to CSF on proton density images. The associated peritumoural oedema of cystic astrocytoma will look hyperintense on FLAIR image of MRI.
Ependymal cysts and epidermoid tumors appear isointense or slightly hyperintense to CSF on proton-density images. Epidermoid tumors are more likely to be lobulated, have less distinct margins, and encase rather than displace neighbouring structures. Diffusion-weighted imaging reflects the amount of Brownian motion of proteins which is greater in cystic than in solid lesions.
Sylvian fissure is the most common site for intracranial arachnoid cysts. Sylvian fissure arachnoid cyst may be of three types. It may be a small lenticular lesion at the anterior pole of the middle cranial fossa without any mass effect (Type 1) or quadrangular in shape reflecting a completely open insula (Type II) .  Type III sylvian fissure arachnoid cyst presents as large rounded area with significant compression of the brain. Displacement of the midline structures in type III cysts is an indication for surgical decompression.
Treatment of archnoid cyst
Adults with asymptomatic arachnoid cyst should be treated conservatively, even for large cysts without symptoms and signs or with only a complaint of headache. Only arachchnoid cysts which cause a mass effect or neurological deficit should be treated surgically.
In children, decompression of sylvian fissure archnoid cyst is more likely to lead to decreased parenchymal compression, cyst collapse, and subsequent resolution if intracranial hypertension and neurological deficits.
Ventriculoperitoneal shunting
Cystoperitoneal shunting
Cyst fenestration
Cyst excision
Skull may be very thin and may be even eggshell-like, so care must be taken in placing burrhole during surgery. The dura is bluish because of presence a large pool of fluid underneath. The exposed cyst wall may be clear and transparent; in some  areas  a web of milky thickening may be noted as a result of collagen reinforcement. The forntal lobe appears widely separated from the temporal lobe because of the failure of opercula to develop. So, the insula and branches of middle cerebral artery may be completely exposed after excision of the sylvian fissure arachnoid cyst. When the outer wall of the cyst is excised, clear CSF escapes. Long bridging veins may be observed either on the surface of the cyst or within the cyst. Bridging veins that traverse the cavity of the cyst do not have much support. Rupture of such unsupported veins account for high incidence of subdural hematoma associated with these cysts.
Fenestration of deep wall of cyst creates a communication between the sylvian fissure cyst and the chiasmatic cistern.
A significant number of middle cranial fossa arachnoid cysts are associated with bleeding hematomas which are usually venous in nature and result from tearing of bridging veins within or external to the cyst.  It may precipitate symptoms in a previously asymptomatic patient.
Arachnoid cyst in sella turcica
Sella turcica arachnoid cyst may be intrasellar or suprasellar. Suprasellar cysts are by far the more common. It may present with hydrocephalus, visual impairment, endocrine dysfunction ( hypopituitarism, stunted growth, etc), gait disturbance. A curious head nodding motion described as the “ bobble-head doll syndrome” has been described in suprasellar arachnoid cyst. The nodding or bobbing consists of irregular involuntary head motions in the anteroposterior direction occurring two to three times per second.The motion is reminiscent of that seen in dolls with a weighted head resting on a coiled spring; hence the name of this syndrome. Some degree of mental retardation is associated with this syndrome.
Treatment of suprasellar sella turcica arachnoid cysts are ;endoscopic ventriculostomy with concomitant fenestration of lamina terminalis, subfrontal cyst excision with communication to the basal cisterns, and transcallosal or transventricular cyst excision with concomitant cystoperitoneal shunting.
Treatment of intrasellar sella turcica arachnoid cysts is trans-sphenoidal approach with packing of sella with fat or fascia or muscle tissue.
Arachnoid cysts in Interhemispheric Fissure
Two types of arachnoid cysts occur near the midline in the supratentorial space.
1.       Interhemisheric cysts with associated partial or complete corpus callosal agenesis.It straddles the falx and extends equally on either side, compressing the medial surface of both hemispheres. A coronal MRI shows a “ bat-wing” appearance of the lateral horns and dorsal displacement of the third ventricle.
2.       Parasagittal cysts are usually not associated with agenesis of the corpus callosum. The cyst is strictly unilateral and is sharply limited by falx in the midline, thus it tends to be wedge shaped. There is a marked bulging of the frontal and parietal bones in the parasagittal area. The superior sagittal sinus and falx cerebri are considerably off the midline.
Cerebral convexity arachnoid cyst
In infants, it may present with progressive asymmetrical enlargement of head. MRI findings may mimic subdural hygroma, but without an enhancing membrane
In adults, the lesion may present with seizures, headache , papilloedemaand progressive contralateral hemiparesis.  Skull films  may show erosion of the inner table of the skull. CT scan shows biconvex or semicircular area of lucency over the convexity without an enhancing membrane. Surgical therapy consists of excision of the outer membrane of the cyst.
Quadrigeminal cistern arachnoid cysts
These cysts behave like pineal masses and present with hydrocephalus and Parinaud’s syndrome. Therapy consists of excision of the cyst wallthrough an occipital transtenorial approach, with or without insertion of cystoperitoneal shunt.  
Cerebellopontne angle arachnoid cysts
Clinical presentation of arachnoid cyst in CP angle may mimic that of an acoustic neuroma.
Posterior fossa arachnoid cysts
Posterior fossa arachnoid cysts may present in the midline near the fourth ventricle or the cistrna magna, or paramedian area opposite the cerebellar hemisphere. X-ray skull may show a focal expansion of the occipital bone. Diffrential diagnosis of midline posterior fossa arachnoid cyst include mega cistern magna, Dandy-Walker malformation, epidermoid cyst, cystic glioma and hemangioblastoma.
Clival region arachnoid cysts
The clival region is uncommon site for intracranial arachnoid cyst. Although termed clival , the cyst may extend into the interpeduncular cistern or the cerebellopontine angle. The cyst displaces the midbrain and pons dorsally along with basilar artery.The cranial nerves are stretched , elongated , and draped around the cyst.
Other rare locations of arachnoid cysts are  intraventricular, diploic space, etc.

                                         Diagrammatic representation of 3 types of Sylvian fissure arachnoid cyts

Diagrammatic representation of probable mechanism of formation of ependymal cyst 

Two types of interhemisheric arachnoid cysts


Ependymal cysts
Ependymal cysts may mimic arachnoid cyst clinically and on imaging studies. They occur much less frequently than arachnoid cysts. They occur in central white matter of the frontal and temoporopatrietal lobes, causing progressive neurological deficits, seizures and features of raised intracranial pressure. The protein content of the cyst fluid is generally greater than that of the CSF; on MRI the cyst will typically appear isointense or slightly hyperintense to CSF on proton density images. The wall is lined by columnar or cuboidal cells with or without cilia. Blepharoplasts may or may not be identifiable , These cysts never communicate with the ventricular system. They are believed to arise by the sequestration of a small segment of the primitive ependymal lining into either the cortical mantle or the perimedullary mesh . treatment consists of drainage of the cyst and excision of its wall.

Neurosurgery, second edition, volume III Editors: Robert H.Wilkins and Setti S.Rengachary, McGraw –Hill, Chapter 374; Intracranial arachnoid and ependymal cysts by Setti S. Rengachary and Jerome D.Kennedy, pages 3709-3728
Handbook of neurosurgery , Mark S Greenberg, 7th edition, Thieme

Wednesday, 20 September 2017

Tuberculosis of Brain and Spine

I have published a book on Tuberculosis of Brain and Spine. This book is intended to apprise the readers about the strategy to diagnose and promptly treat tubercular infections of the brain, spinal cord and vertebral bodies of the spine. I have made an attempt to propose a method to effectively treat this disease in order to avoid morbidity and mortality associated with TB of central nervous system. Many patients of intracranial and spinal TB can be diagnosed and treated without any surgical intervention. I have incorporated sonme cases who were referred to me for neurosurgery, but they were cured completely without any surgery. So, this book is especially useful for the Physicians, Pediatricians, Orthopedicians , Neurologists and Neurosurgeons.

I need feedback of the readers and others who are involved in treating patients of Extrapulmonary Tuberculosis, So that I can further improvise my clinical approach for the better clinical management.

Sunday, 28 May 2017

Colloid Cyst

Colloid cysts are slow growing benign intraventricular tumor of anterior third ventricle. These constitute less than 1% of all intracranial tumors. It constitutes 14% of intraventricular tumors. It is commonest third ventricular tumor.
It is presumed that it originates from roof of third ventricle from rudimentary paraphysis ( evagination in roof of 3rd ventricle during development). It comprises of fibrous epithelial lined cyst filled with either mucoid or gelatinous or dense hyloid substance.
It is commonly seen in between age groups 20 and 40 years. Colloid cyst is usually located in the anterior third ventricle, at the level of foramen of Monro. It may block the cerebrospinal fluid ( CSF) flow causing symmetrical dilatation of both lateral ventricles and obstructive hydrocephalus. It may present insidiously or suddenly. Headache is a common presentation. Intermittent and postural nature of attacks are other common type of presentation. Drop attack due to sudden weakness of lower limbs with headache is also commonly seen in patients with colloid cyst.
Other common symptoms of colloid cyst are diplopia, gait disturbance, vomoting, disturbed mentattion, blurred vision, incontinence, and vertigo or dizziness.
Occurrence of intermittent symptoms is chracteristic of colloid cyst.
CT scan or MRI with contrast is able to detect a rounded lesion in the anterior third ventricle. Most clinicall significant cysts are more than 1.5 centimeter is size. It may show minimal enhancement or no enhancement on CT or MRI. So, the enlargement of both lateral ventricles and sparing of third and fourt ventricle along with a small globular intraventricular lesion at the level of Foramen of Monor should establish the diagnosis of colloid cyst.
Image 1: CT scan of the brain showing axial view of brain with a hyperdense lesion in the anterior third ventricle with enlargemtnt of both lateral ventricles.
                                                       Image 1 source:

Neurosurgery is the definitive treatment. Lumbar Puncture ( LP) is contraindiacted due to risk of herniation. It should be treated surgically as there is risk of acute hydrocephalus and sudden neurological detrioration. Open transcranial surgery or endoscopic neurosurgery are the treatment options. Transcranial surgery may be transcallosal  or transcortical. Endoscopic neurosurgical excisison is the mainstay of treatment.
Trancortical approach involves reaching the third ventricle through right sided middle frontal gyrus. It is feasible when ventricles are enlarged.
Transcallosal approach involves approach to the 3rd ventricle either via the foramen of Monro or by interfornicial approach. This approach can be used even if ventricles are not enlarged. There is risk of venous infarction or fornicial injury in this approach.Injury to the fornisx is associated with memory deficits or behaviour abnormalities.

1. Handbook of Neurosurgery by Mark S Greenberg 7th Deition, Thieme publication

Monday, 5 September 2016

Prescription Audit

Clinical audit is a quality improvement cycle that involves measurement of the effectiveness of care
against agreed and proven standards. The audit cycle includes the assessment of clinical management according to the standards of quality care and interventions then to re-measure the outcome to
make further improvements.
Aim of the audit is to identify & rectify the deficits and then improve. Monitoring , Assessment, Feedback, Discussion, Reassessment are important steps to make any improvement in medical management in healthcare organization.
The mistakes are bound to occur in situations where doctors are treating, reviewing the history, examining the patient as well as documenting the patient care. So, aim should be to improvise the process and not just the fault finding. Moreover, such audit should be done by the medical and para-medical professionals who are the stakeholders in medical management and understand the problems of the patient and doctors. So, medical audit or prescription audit is no way similar to financial audit. In prescription audit the standards should be according the evidence based medical practice. These standards should be achievable in that particular health care system.
The expected standards of an ideal prescription includes:
Prescription must contain the name of the patient , age and gender of the Patient.
Prescription card or note must be dated.
Prescription must be written in a legible manner where the dose, frequency and duration of treatment is clearly mentioned.
Each prescription must be signed by the doctor and doctors identity is clear.

The most common task done by doctors is the writing of prescription. This prescription bears the details of all the drugs including the instructions and name and signature of the physician. If not written appropriately it may loss to the patient including medication errors and adverse drug events
The doctors bears the legal responsibility for prescribing ethically and appropriately.

Prescription audit helps :
1. To prevent the practice of prescribing expensive, unnecessary , irrational and non-essential medicines by the physicians
2. To curtail the practice of writing costly branded drugs when the equally effective cheaper and generic drugs are available
3. To identify shortcomings in prescription writing
4. To reduce omissions in prescription writing by continuous evaluation and feedback to the doctors
5. To measure the extent to which information recorded on Out-Patient Card or In-Patient case file record sheet conforms to the guidelines for prescribing drugs.  Prescription audit measures the compliance with standards set by the health care organization.
6. To articulate measures to improve prescription practices of the doctors.
7.To understand the pattern currently being followed by the doctors and include the drugs in hospital formulary.

The prescription audit improves the prescribing practice in any hospital. Audit is a valuable tool for monitoring compliance to prescribing and administration standards and for encouraging continued improvement in clinical practice.
Physicians, nursing professionals and pharmacists have an important role in continuous evaluation, feedback and improving the quality of health care.
Prescription audit is an important mechanism to improve the quality of healthcare and makes medical care affordable to everyone.

Monday, 4 July 2016

M.Ch. Neurosurgery entrance examination in India

M.Ch. Neurosurgery is the superspeciality course for post doctoral training in General Neurosurgery in India. Many renowned academic medical institutions in India provide training in Neurosurgery.
M.Ch Neurosurgery makes life easy for the surgery post graduates who want to pursue further after passing M.S.Examination in General Surgery.
Obtaining M.Ch. Neurosurgery cuts lot of competition among large number of post graduates. Moreover, it is a new begining and an opportunity to focus your surgical career.
During Master in Surgery you gain experience of assisting and operating on different systems of the body. It is good to have a basic knowledge of surgery. But, career in general surgery is albeit challenging. One needs to have some experience after post graduation if he or she wishes to pursue an academic career or get respect among the peers. Further training adds to your competence and provides an opportunity to plan your career as surgeon.
M.Ch Neurosurgery is best way achieve your goal in a standard, well planned, and time bound manner. Once you get through you many problems are over. You become superspecialist and among few elite medical professionals. M.Ch. Neurosurgery training provides you a job for three years, opportunity to master the art of operating over the brain and spine, enhance your academic experience so that you are eligible to become Assistant Professor in Neurosurgery, without any further residency.
The preparation for M.Ch. Neurosurgery is easy but requires planning, perseverance and patience. Read all aspects of neurosurgery with interest: Neuroanatomy, Neurophysiology, Clinical neurological examination, Neuroradiology and neurosurgical conditions like Neuro-trauma, Neurooncology, Pediatric Neurosurgery, Vascular Neurosurgery, etc. One should join a center as a senior resident doctor in Neurosurgery  Department of any hospital where you will be able to learn basics of neurosurgery. This will help you get out of your previous love of general surgery.
You cannot become a Neurosurgeon by still boasting of being a good general surgeon during your post graduate training. Forget your past achievements, preparation for neurosurgery is entirely a new begining. 

Dare to be novice. 
Be hungry to learn more. 
Be grateful to your new colleagues especially the Neursurgery OT, ICU & ward Nursing staffs, OT & ICU technitians, Neuroanesthetists and seniors in the Neurosurgery department. Be open to listen to the patients and their relatives. Every event in Neurosurgery ward or OPD or OT will teach you something. Everyday adds to your experience and now you a superspecialist just by joining a hospital as a resident doctor. Everyday you are creating your impression and this the last and final opportunity for you.

Start with Neuro-anatomy. Learn to know about brain, spinal cord, cranial nerves, skull, spine. Proceed to learn about Neurophysiology like bood supply of brain, CSF formation, etc. 
Neurology learning begins with neurological examination. 
Neuro-radiology is interesting and includes acquanting yourself about the indications and interpretations of X-Ray images, CT scans, MRI, Angiography, PET CT, PET MRI, etc. It is nothing new to you has you might have seen such investigations during your medical graduation or during postgraduate training. Mastering Neuroradiology requires your interest and focus to see minute details and needs your sustained interest & fascination of looking towards such images. You may be surprised to see the pictures of neural structures which you might have thought that such structures are theoretical. A good MRI brain image will show yu the Fornix, Mamillary body, Pituitary talk, superior and inferior collculi. Substantia nigra in the midbrain is very well seen in MRI. So, create your interest in seeing neural structures. 
Any text book of Neurosurgery would provide you a bird eye view of all neurosurgical diseases and their management.
Illustrated Neurology & Neurosurgery by Lindsay Ian Bone is a good book to begin neurosurgery M.Ch preparation. Read each line with interest. Most of the questions of M.Ch. neurosurgery entrance examination can be answered by reading this book. Never underestimate the value of this book.
Clinical Neuroanatomy by Stephen G.Waxman ( 27th edition) by McGraw Hill education, Lange, international edition is another book which I would like to recommend to every aspirant who is preparing for M.Ch neurosurgery. Even this book should be read comprehensively.
Remember that all these books are assets for you as these books will also guide you through out your neurosurgical career.
Start appearing for M.Ch. Neurosurgery entrance examination of reputed institutions like All India Institute of Medical Sciences (AIIMS), Delhi, Govind Ballabh Pant Hospital ( G.B.Pant Hospital, University of Delhi) now G.B.Pant Post Graduate Institute Medical Institute, (GIPMER), Delhi,  Shree Chitra Institute, Trivendrum, P.G.I Chandigarh, NIMHANS Bangalore, Sanjay Gandhi Post Graduate Institute (SGPGI) Lucknow, Uttar Pradesh, Christian Medical College ( CMC ), Vellore and many other institutes who conduct M.Ch Neurosurgery entrance examinations. from any institute is of worth pursuing if it is recognized by Medical Council of India. One should not be scared of failing the M.Ch entrance examinations. It will provide you an opportunity to know what is expected from you.

One textbook of Neurosurgery will be required to have an overall concept of Neurosurgery. Ramamurthi & Tandon's Manual of Neurosurgery authored by PN Tandon, R Ramamurthi & PK JainN of Jaypee Publication provides a good concept of every aspect of neurosurgery. Similarly, Handbook of Neurosurgery by Mark S. Greenberg ( 7th Edition) of Thieme publication is an essential companion for all the neurosurgical aspirants & trainees.
Although, it seems very tedious to learn all aspects of neurosurgery theoretically and master the art of neurosurgery also. But, this is possible because this journey of becoming neurosurgeon is very interesting and self motivating. Everyday you add something to your neurosurgical experience. All notes & books will be your companion.

Just to give you an idea about the common questions which are usually asked in entrance exams, I am mentioning some facts for your revision:

Quincke , in 1891, first reported the measurement of intracranial pressure ( ICP) through the lumbar puncture ( LP). So, if question is asked who performed L.P. for the first time? Answer is Quincke.

Quckenstedt established the normal range of normal ICP and demonstrated the effect of changes in ICP with respiration.

Lundberg, in 1960, published his work on the continuous recording of ICP  using indwelling intraventricular catheter and described 3 waveforms: A,B,C.

Cranium is like a rigid sphere & 3 main components inside are brain, blood & CSF occupying 1400 mL, 75 mL & 75 mL of space, respectively. Therefore , any change in the volume of the brain causes reciprocal change in the volume of either blood or CSF.This is the basis of the modified Monro-Kellie doctrine introduced into neurosurgery by Cushing.

Each day in your neurosurgical practice will make you stronger, wiser & confident.

Some commonly asked questions in M.Ch. entrance examinations are mentioned below:

1. Commonest cause of spontaneous intracerebral hematoma in adults?                            


2. Commonest site of spontaneous intracerebral hematoma in adults due to hypertension?

Basal ganglia

3. Commonest cause of subarachnoid haemorrhage (SAH)?                                               
             Trauma ( Head Injury)

4. Commonest cause of spontaneous subarachnoid haemorrhage ( SAH) in adults?           
                               Rupture of intracranial aneurysm

5. Maximum incidence of rebeed or re-haemorrhage following aneurysm ruture is
   A. within 24 hour
  B. within 1 week
    C. within 2 weeks
D. First month

The patient who survives the initial haemorrhage of an intracranial aneurysm is at significant risk of 2nd haemorrhage from the aneurysm.
If left untreated, at least 4 percent of patients will experience haemorrhage within the first 24 hour and 19 percent will have re haemorrhage within 2 weeks following the initial haemorrhage. The second haemorrhage has 50 percent. In the first 28 days ( if untreated patient) approximately 30% of patients would re-bleed , of these 70% die.  In the following few months the risk gradually falls off but it never drops below 3.5 per year.

6. Commonest brain tumor?                                                                                                
    Brain metastases are the most common brain tumor.

7. On CT scan of brain , Hounsfield units for fat is about                                                   

Hounsfield unit on CT scan indicates the nature of the structure inside the skull, and relative density of the tissue as compared to brain. On CT scan , Hounsfield unit of water is treated as 0 and it looks black on CT scan.
CSF density is about  +10 to +16. It also looks black as compared to brain tissue.
Fat is about -90. It is more black as compared to CSF.
Hounsfield unit of Bone is approximately more than +300 to +1000. 
Metals look very white on CT scan and a metallic foreign body looks hyperdense +3000. Example is gun shot bullet injury in the brain tissue.
So, about 5 structures look black ( Hypodense ) as compared to brain tissue like Fat, CSF, Air, Pus.

8. Commonest primary brain tumor                                                                                   

9. Length of the spinal cord?                                                                                              

           45 centimetre

10. Commonest site of intracranial aneurysm                                                                        

Anterior communicating artery

11. Commonest type of pituitary tumor?                                                                 


12. What is the size of pituitary Microadenoma                                                    

Less than 1 centimeter 

13.  What is the size of pituitary Macroadenoma                                                     

Size of the pituitary tumor more than 1 cm

14. Positive end expiratory pressure ( PEEP) ventilation is beneficial in of the following situations
A. Head Injury
B. Adult Respiratory Distress Syndrome
B. Both of the above
C. None of the above

Answer is B. In fact PEEP is contraindicated in head injury because it decreases venous return and increases intracranial pressure. Positive end expiratory pressure means pressure in the alveoli at the end of the expiration. It helps to open up the collapsed alveoli in edematous lung of ARDS, and in turn, increases the gaseous exchange at the level of alveoli.

15. Who is regarded as "Father of Modern Neurosurgery"
Harvey Cushing

16. Who invented Bone Wax for stopping bleed from the diploic spaces of skull bones
Victor Horsley

17. Which of the following is the second branch of intracranial part of Internal carotid Artery ( ICA)
      A. Anterior cerebal artery
B. Ophthalmic artery
                                      C. Posterior Communicating artery ( P Com)
             D. Anterior Choroidal artery

Answer is Posterior communicating artery

18. What is the location of Basilar artery to Pons                                                          
                         A. It lies anterior to Pons
     B. Posterior
C. Lateral
D. None

Answer is A, i.e., it lies just anterior to the Pons.

19. Triad of Normal Pressure Hydrocephalus?                                                              

                                                  Gait Apraxia ( Gait Ataxia or gait disturbance) : Difficulty in walking without any weakness of the limbs



Urinary incontinence


As Neurosurgeon you get lot of respect not because of you are special but because of your consistent endeavour to improve yourself for improving quality of life of many patients who will benefit from your expertize.




Saturday, 18 June 2016

Eponyms in Neuroscience : Great Neuroscientists, their contribution & Eponyms (Neurological structures, reflexes or diseases named after them)

Legends of neurosciences

Many scientists and philosphers have contributed to present day understanding of brain and mind. Their contribution is immense and difficult to summarise. Many names are repeated whenever we read about specific structures or functions of the brain, spinal cord and other neural tissues.

These neuroscientists could be regarded as great leaders and pioneers of Neurosciences. They took the initial steps of the epic journey of exploring brain which is the most enigmatic and wonderful structure in this universe.

Identity and recognition of achievers and leaders are not restricted to some group or society or region or country , but infact, they inspire us all. Their work affects life of all human beings irrespective of any boundary.

Scottish Neuroscientists & Eponyms

Argyl Robertson Pupil is named after Argyl Robertson, a Scottish Ophthalmlogist. It denotes a condition in which pupillary constriction is seen in accommodation f the eyes but not in response to light.

Bell's Palsy is named after Sir Charles Bell, a Scottish Anatomist, Clinical neurologist and Surgeon. Bell's Palsy is facial paralysis of the lower motor neuron type. Bell-Magendie Law , is also associated with his name ( Dorsal roots are sensory, ventral roots are motor).

Charles Bell (12 November 1774 – 28 April 1842) was born & grew up in Edinburgh. Received his medical degree in 1798 from Edinburgh University, He conducted his surgical training as assistant to his elder brother John Bell.
He and his brother were artistically gifted, and together they taught anatomy and illustrated and published two volumes of A System of Dissection Explaining the Anatomy of the Human Body. Bell's career was characterized by the accumulation of quite extraordinary honors and achievements - and by acrimonious disputes unusual even by the standards of medicine during the Regency.
Shortly after his graduation Bell was admitted to the Royal College of Surgeons in Edinburgh, where he operated and taught anatomy. He and his brother published two additional volumes of their anatomical treatise in 1802 and 1804.
Some aspects of his success, however, led to the jealous opposition of local physicians, and he was barred from practice at the Edinburgh Royal Infirmary. He then moved to London in 1804, where he set up a private surgery and school of anatomy. From 1812 to 1825, together with his brother, Bell ran the Great Windmill Street School of Anatomy, which had been founded by the anatomist William Hunter. He also served as a military surgeon, making elaborate recordings of neurological injuries at the Royal Hospital Haslar and famously documenting his experiences at Waterloo in 1815, where the anatomist Robert Knox commented very negatively on Bell's surgical abilities; (the mortality rate of amputations carried out by Bell ran at about 90%). Bell was instrumental in the creation of the Middlesex Hospital Medical School, and became, in 1824, the first professor of Anatomy and Surgery of the College of Surgeons in London. In 1829, the Windmill Street School of Anatomy was incorporated into the new King's College London. Bell was invited to be its first professor of physiology, but resigned shortly afterwards. Wishing to return to Scotland, he accepted in 1836 the position of Professor of Surgery at the University of Edinburgh.
He was made a Knight of the Royal Guelphic Order in 1833.
Charles Bell was a prolific author. Shortly after arriving in London, he set his sights on the Chair of Anatomy at the Royal Academy, and, in furtherance of this career goal, he published Essays on The Anatomy of Expression in Painting (1806), later re-published as Essays on The Anatomy and Philosophy of Expression in 1824. In this work, Bell followed the principles of natural theology, asserting the existence of a uniquely human system of facial muscles in the service of a human species with a unique relationship to the Creator. After the failure of his application (Sir Thomas Lawrence, later President of the Royal Academy, described Bell as "lacking in temper, modesty and judgement"), Bell turned his attentions to the nervous system.
Bell published detailed studies of the nervous system in 1811, in his privately circulated book An Idea of a New Anatomy of the Brain. He described his experiments with animals and later emphasized how he was the first to distinguish between sensory and motor nerves. This essay is considered by many to be the founding stone of clinical neurology. However, Bell's original essay of 1811 did not actually contain a clear description of motor and sensory nerve roots as Bell later claimed, and he seems to have issued subsequent incorrectly dated revisions with subtle textual alterations.
Bell's studies on emotional expression played a catalytic role in the development of Darwin's considerations of the origins of human emotional life; and Darwin very much agreed with Bell's emphasis on the expressive role of the muscles of respiration. Darwin detailed these opinions in his The Expression of the Emotions in Man and Animals (1872), written with the active collaboration of the psychiatrist James Crichton-Browne. Bell was one of the first physicians to combine the scientific study of neuroanatomy with clinical practice. In 1821, he described in the trajectory of the facial nerve and a disease, Bell's Palsy which led to the unilateral paralysis of facial muscles, in one of the classics of neurology, a paper delivered to the Royal Society entitled On the Nerves: Giving an Account of some Experiments on Their Structure an Functions, Which Lead to a New Arrangement of the System.
Bell also combined his many artistic, scientific, literary and teaching talents in a number of wax preparations and detailed anatomical and surgical illustrations, paintings and engravings in his several books on these subjects, such as in his book Illustrations of the Great Operations of Surgery: Trepan, Hernia, Amputation, Aneurism, and Lithotomy (1821). He wrote also the first treatise on notions of anatomy and physiology of facial expression for painters and illustrators, titled Essays on the Anatomy of Expression in Painting (1806). In 1833 he published the fourth Bridgewater Treatise, The Hand: Its Mechanism and Vital Endowments as Evincing Design.

A number of discoveries received his name:

Foramen of Monro is named after a Scottish Anatomist, Alexander Monro.
Interventricular foramen between the lateral and third ventricle is known as Foramen of Monro.

Bohemian Physiologist

Purkinje, Johannes Evangelista, a Bohemian Physiologist.
Purkinje cells of the cerebellar cortex and Purkinje fibres in the heart

Swedish Neuroanatomist

Rexed, Bror was Swedish  Neuroanatomist.
Grey matter of the spinal cord into the laminae of Rexed

American Neuroscientists & Eponyms

Harvey Williams Cushing (April 8, 1869 – October 7, 1939)  is often called the "father of modern neurosurgery." He was the founder of American neurosurgery.

He studied medicine at Harvard Medical School at received degree in 1895. He did residency in surgery under the guidance of  famous surgeon , William  Halsted at John Hopkins Hospital, Baltimore. Cushing learned meticulous surgical technique from his mentor. As was standard then, Cushing spent time in Europe ; he worked in the laboratories of Theodore Kocher in Bern, where he investigated the physiology of CSF. He described Cushing reflex, relationship between blood pressure and intracranial pressure.

While traveling through Europe , he met several important surgical personalities , including Victor Horsley.  

The specialty of neurosurgery was born at Johns Hopkins. In 1900, Harvey Cushing completed his surgical training. After the European grand tour and a year in Kocher's laboratory in Bern where he studied the effects of head injury, Cushing returned to the surgical faculty. In the ensuing 12 years, he founded the specialty of neurosurgery and established the characteristics of the field which endure to this day.
By the time Cushing accepted the Harvard Chair of surgery in 1912, his work at Johns Hopkins had established him as the outstanding young surgeon in the United States. Cushing brought Halsted's meticulous surgical technique to the new field and added Osler's careful clinical observation and his own penchant for accurate documentation. His clinical contributions are legendary: the use of x-rays in surgical practice, physiological saline for irrigation during surgery, understanding the pituitary's function, founding the clinical specialty of endocrinology, the anesthesia record, the use of blood pressure measurement in surgical practice, and the physiological consequences of increased intracranial pressure.

One of the principal inducements for Cushing to stay in Baltimore upon completion of his residency was his appointment as Director of the Hunterian Laboratory. Our concept of the clinician/scientist in medicine largely derives from Cushing's vision of the Hunterian as a place for young physicians to learn to do research. One of the earliest products of the Hunterian experience was Walter Dandy.

He described endocrine syndrome due to basophilic adenoma of pituitary gland ( Cushing disease).

With Percival Bailey in 1926, Cushing introduced the first rational approach to the classification of brain tumors.

At age of 32 , he became associate professor of surgery at John Hopkins Hospital and was in full charge of cases of surgery of the central nervous system.

He made (with Kocher) a study of ICP and (with Sherrington) contributed much to the localization of the cerebral centers.

In 1911, he was appointed surgeon-in-chief at Peter Bent Brigham Hospital in Boston. He became a professor of surgery at the Harvard Medical School starting in 1912. From 1933 to 1937, when he retired, he worked at Yale University School of Medicine.

In the beginning of the 20th century he developed many of the basic surgical techniques for operating on the brain. This established him as one of the foremost leaders and experts in the field. Under his influence neurosurgery became a new and autonomous surgical discipline.

He considerably improved the survival of patients after difficult brain operations for intracranial tumors. He used x-rays to diagnose brain tumors. He used electrical stimuli for study of the human sensory cortex. He had operated more than 2000 cases brain tumors.
Cushing was also awarded the Pulitzer Prize of biography in 1926 for a book recounting the life of one of the fathers of modern medicine, Sir William Osler.

He developed many surgical instruments that are still in use today, most notably the Cushing forceps, He also developed a surgical magnet while working with the Harvard Medical Unit in France during World War I to extract bullets from the heads of wounded soldiers.

Sources: Wikipedia
               Y. Neurological surgery  ( H.R. Winn ) Elsevier Saunders

Kluver, Heinrich
American Psychologist
Name associated with Kluver-Bucy Syndrome

Bucy, Paul Clancy
American Neurosurgeon & Neuropathlogist
Kluver-Bucy syndrome is caused by extensive bilateral lesions of the temporal lobes.
                                                                         (Source: Congress of Neurological Surgeons)

Paul Bucy (November 13, 1904 – September 22, 1992) was an American neurosurgeon and neuropathologist. He is known both for his part in describing the Klüver–Bucy syndrome, his academic life as a teacher in the neurosciences, and for his founding in 1972 and editing Surgical Neurology – An International Journal of Neurosurgery and Neuroscience" from 1972 to 1987.

Bucy grew up and was educated in Iowa. He received his bachelor`s degree, a master`s in neuropathology and his doctorate from the University of Iowa. He interned and trained at Ford Hospital in Detroit. He was an assistant to neurosurgeon Percival Bailey (1892–1973) at the University of Chicago. In the early 1930s he traveled to Europe, and studied with Gordon Morgan Holmes (1876–1965) in London and Otfrid Foerster (1874–1941) in Breslau. In 1941, he became Professor of Neurology and Neurological Surgery at the University of Illinois in Chicago, where he spent 13 years. During World War II he was a medical consultant to the U.S. Army.

From 1954 to 1972, he was Professor of Neurosurgery and taught neurosurgical residents at Northwestern University and at Chicago Memorial Hospital. During his long career, Bucy wrote more than 400 papers and books on neurological and neurosurgical subjects. He trained 65 neurosurgeons who went on to practicing neurosurgery worldwide. Bucy served as publisher for 13 years on the Journal of Neurosurgery. In 1972. after moving to Tryon, North Carolina, he was appointed Clinical Professor of Neurology and Neurological surgery at Bowman Gray School of Medicine in Winston-Salem. That same year (1972) Bucy became Founding Editor of Surgical Neurology, a new neurosurgical journal, which he edited until 1987 along with Robert J. White.

He was past president of the American Neurological Association, The Society of Neurological Surgeons and The World Federation of Neurosurgical Societies.

Paul Bucy is remembered for his work with experimental psychologist Heinrich Klüver  involving the eponymous Klüver-Bucy syndrome, defined as a behavioral disorder caused by malfunction of the left and right medial temporal lobes of the brain. The two men were able to clinically reproduce this disorder in rhesus monkeys by performing bilateral temporal lobectomies. He will also be remembered, along with Percival Bailey, for performing important research of brain tumors, in particular oligodendrogliomas and meningiomas.

Buerger, Leo
American Physician and Urologist
Chronic inflammatory disease of the peripheral nerves

Huntington, George Summer
American General Medical Practioner
Huntington's Chorea resulting from neuronal degeneration in the corpus striatum

Lantermann, A.J.
Americal Anatomist
Incisures of Schmidt-Lantermann in myelin sheaths

Meyer, Adolph
American Psychiatrist
The fibers of the geniculocalcarine tract that loop forward in the temporal lobe constitute Meyer' loop

Papez, John Wenceslas
American Anatomist
Circuitry of Limbic System

Renshaw, Birdsey
American Neurophysiologist
interneurons in the spinal cord are called Renshaw cells

Schmidt, Henry D
American Anatomist & Pathologist
Incisures of Schmidt-Lantermann in myelin sheaths

English Neuroscientists & Eponyms

Clarke, Jacob Augustus Lockhard was English Anatomist & Clinical Neurologist
Nucleus Dorsalis ( thoracicus ) of the spinal cord

Sherrington, Sir Charles Scott was English Neurophysiologist
Relexes: decerebrate rigidity, reciprocal innervation and the snapse

Waller, Augustus Volney was Enlish Pysician & Physiologist
Degenerative changes in the distal portion of a sectioned peripheral nerve , known as wallerian degeneration

Weber, Sir Hermann David was English Physician
Midbrain lesion causing hemiparesis and ocular paralysis

Willis, Thomas was English Physician
Arterial circle of Willis

Wilson, Samuel Alexander Kinnier was British Clinical Neurologist
Wilson's disease ( hepatolenticular degeneration)

Czech Neuroscientist & Eponym

Chiari, Hans was a Czech Physician
Arnold- Chiari malformation

Danish Neuroscientists & Eponyms
Hirschsprung, Harald was a Danish Physician
Congenital aganglionic megacolon

Greek Neuroscientists & Eponyms

Herophilus was a Greek Physician
Honfluence of the dural venous sinuses at the internal occipital protuberance is known as Torcular Herophili

French Neuroscientists & Eponyms


Babinski, Joseph Francois Felix (17 November 1857 – 29 October 1932) was a French neurologist of Polish descent. He is best known for his 1896 description of the Babinski sign, a pathological plantar reflex indicative of corticospinal tract damage.

Babinsnki reflex is the upward turning of the great toe and spreading of the other toes on strking the outer and lateral aspect of the sole, indicating a upper motor neuron lesion of the spinal cord.

Babinski received his medical degree from the University of Paris in 1884. He came early to Professor Charcot at Paris' Salpêtrière Hospital and became his favorite student.
Charcot's 1893 death left Babinski without support, and he subsequently never participated in qualifying academic competitions. Free of teaching duties, while working at the Hôpital de la Pitié he was left with ample time to devote himself to clinical neurology. He was a masterful clinician, minimally dependent on neuropathological examinations and laboratory tests.
Babinski also took an interest in the pathogenesis of hysteria and was the first to present acceptable differential-diagnostic criteria for separating hysteria from organic diseases, and coined the concept of pithiatism.
In 1896, at a meeting of the Société de Biologie, Babiński, in a 26-line presentation, delivered the first report on the "phenomène des orteils", i.e., that while the normal reflex of the sole of the foot is a plantar reflex of the toes, an injury to the pyramidal tract will show an isolated dorsal flexion of the great toe—"Babinski's sign."
He was professor of neurology at the University of Paris.
Babinski wrote over 200 papers on nervous disorders. With Jules Froment he published Hysteropithiatisme en Neurologie de Guerre (1917), which was translated into English in 1918 by Sir H. Rolleston.


Balliarger, Jules Gabriel Francois was French Psychiatrist

Bands of Balliarger in the cerebral cortex


Broca, Pierre Paul was a French Pathologist and anthropologist.

Motor speech area is known as Broca's area.

Pierre Paul Broca (28 June 1824 – 9 July 1880) was a French physician, anatomist and anthropologist. He is best known for his research on Broca's area, a region of the frontal lobe that has been named after him. Broca's Area is involved with language. His work revealed that the brains of patients suffering from aphasia contained lesions in a particular part of the cortex, in the left frontal region. This was the first anatomical proof of the localization of brain function. Broca's work also contributed to the development of physical anthropology, advancing the science of anthropometry.

In 1848, Broca founded a society of free-thinkers, sympathetic to Charles Darwin's theories. Broca was fascinated by the concept of evolution.

In 1853, Broca became professor agrégé, and was appointed surgeon of the hospital. He was elected to the chair of external pathology at the Faculty of Medicine in 1867, and one year later professor of clinical surgery. In 1868, he was elected a member of the Académie de medicine, and appointed the Chair of clinical surgery. He served in this capacity until his death.

In parallel with his medical career, Broca pursued his interest in anthropology. In 1859, he founded the Society of Anthropology of Paris. He served as the secretary of the society from 1862. In 1872, he founded the journal Revue d'anthropologie, and in 1876, the Institute of Anthropology.

Near the end of his life, Paul Broca was elected a lifetime member of the French Senate. He was also a member of the Académie française and held honorary degrees from many learned institutions, both in France and abroad.

Broca's early scientific works dealt with the histology of cartilage and bone, but he also studied cancer pathology, the treatment of aneurysms, and infant mortality. One of his major concerns was the comparative anatomy of the brain. As a neuroanatomist he made important contributions to the understanding of the limbic system and rhinencephalon. Olfaction was for him a sign of animality. He wrote extensively on biological evolution, then known as transformism in France (the term was also adopted in English at the time but is today used little in either language).

One of Broca's major areas of expertise was the comparative anatomy of the brain. His research on the localization of speech led to entirely new research into the lateralization of brain function.

Broca is celebrated for his discovery of the speech production center of the brain located in the ventroposterior region of the frontal lobes (now known as Broca's area). He arrived at this discovery by studying the brains of aphasic patients (persons with speech and language disorders resulting from brain injuries).

This area of study began for Broca with the dispute between the proponents of cerebral localization – whose views derived from the phrenology of Franz Joseph Gall (1758–1828) – and their opponents led by Pierre Flourens (1794–1867) – who claimed that, by careful ablation of various brain regions, he had disproved Gall's hypotheses. However, Gall's former student, Jean-Baptiste Bouillaud (1796–1881), kept the localization of function hypothesis alive (especially with regards to a "language center"), although he rejected much of the rest of phrenological thinking. Bouillaud challenged professionals of the time to disprove him by finding a case of frontal lobe damage unaccompanied by a disorder of speech. His son-in-law, Ernest Aubertin (1825–1893), began seeking out cases to either support or disprove the theory, and he found several in support of it.

In 1861, Broca heard of a patient, named Leborgne, in the Bicêtre Hospital who had a 21-year progressive loss of speech and paralysis but not a loss of comprehension nor mental function. He was nicknamed "Tan" due to his inability to clearly speak any words other than "tan".

When Leborgne died just a few days later, Broca performed an autopsy. He determined that, as predicted, Leborgne did in fact have a lesion in the frontal lobe of the left cerebral hemisphere. From a comparative progression of Leborgne's loss of speech and motor movement, the area of the brain important for speech production was determined to lie within the third convolution of the left frontal lobe, next to the lateral sulcus. For the next two years, Broca went on to find autopsy evidence from 12 more cases in support of the localization of articulated language.

Today the brains of many of Broca's aphasic patients are still preserved in the Musée Dupuytren, and his collection of casts in the Musée d'Anatomie Delmas-Orfila-Rouvière. Broca presented his study on Leborgne in 1861 in the Bulletin of the Société Anatomique.

Patients with damage to Broca's area and/or to neighboring regions of the left inferior frontal lobe are often categorized clinically as having Expressive aphasia (also known as Broca's aphasia). This type of aphasia, which often involves impairments in speech output, can be contrasted with Receptive aphasia, (also known as Wernicke's aphasia), named for Karl Wernicke, which is characterized by damage to more posterior regions of the left temporal lobe, and is often characterized by impairments in language comprehension.

Broca published around 223 papers on general anthropology, physical anthropology, ethnology, and other branches of this field. He founded the Société d'Anthropologie de Paris in 1859, the Revue d'Anthropologie in 1872, and the School of Anthropology in Paris in 1876.
He also invented more than 20 measuring instruments for the use in craniology, and helped standardize measuring procedures.


Charcot, Jean Martin was a French Neuroogist

Lenticulostriate branch of the middle cerebral artery


Foville , Achille-Louis-Francois was a French Physician

Paramedian pontine syndrome of Raymond-Foville


Gubler, Adolphe-Marie was aFrench Physician

Ventral pontine syndrome of Millard-Gubler


Magendie, Francois was a French Physiologist

Bell-Magendie Law

Median aperture of the fourth ventricle ( Foramen of Magendie)


Millard, Auguste Louis Jules was a French Physician

Ventral pontine syndrome of Millard-Gubler


Parinaud, Henri was a French Ophthalmologist

Paralysis of upward gaze due to a lesion of the midbrain commonly due to pressure from a space occupying lesion of the Pineal region


Ranvier, Louis-Antoine was a French histologist

Nodes of Ranvier in the myelin sheaths


Raymond, Fulgence was a French Neurologist

Paramedian pontine syndrome of Raymond-Foville


Robin, Charles Phillipe was a French Anatomist

Perivascular spaces of the brain (Virchow-Robin spaces)


Sylvius, Jacobus was a French Anatomist

Cerebral aqueduct of Sylvius ( in midbrain)


Trolard, Paulin was a French Anatomist

Greater anastomotic vein of Trolard

Germany's contribution to neuroscience : Great Neuroscientists from Germany & Eponyms ( structures, reflexes or diseases named after Germans)




















Dr. Aloysius "Alois" Alzheimer ( 14 June-19 December, 1915) was a German psychiatrist and neuropathologist.

Dr Alois Alzheimer is credited with identifying the first published case of presenile dementia.

In 1901, he observed a 51 year old female patient, Ms Auguste Deter, at the Frankfurt mental asylum. This patient had strange behavioural symptoms including loss of short term memory. Ms Deter died in 1906.  He along with 2 Italian physicians, analysed brain in Krapelin laboratory at Munich. He used the staining techniques of Bielschowsky to identify amyloid and neurofibrillary tangles.

He presented his work & later published his work in 1907. Later, In 1910, his colleague Emil Krapelin named this disease after him in the chapter " Presenile & Senile Dementia" in the 8th Edition of his handbook of psychiatry.

Julius Arnold (August 19, 1835 – February 3, 1915) was a German pathologist. He was the son of anatomist. And he was a student of Rudolf Virchow. He was professor of pathological anatomy and director of the institute of pathology at Heidelberg.

With Austrian pathologist, Hans Chiari, his name is lent to a condition known as Arnold–Chiari malformation, a disorder that takes place when the cerebellar tonsils and the medulla oblongata protrude through the foramen magnum into the spinal canal, without displacing the lower brain stem. Arnold described his pathological findings associated with the disorder from an infant who died shortly after delivery. He published his account of the disorder in an 1894 paper titled "Myelocyste, Transposition von Gewebskeimen und Sympodie". In 1907, two of Dr. Arnold's students coined the eponym of "Arnold–Chiari malformation" in honor of the two scientists.

Leopold Auerbach ( 27 April 1828-30 September 1897)

Leopold Auerbach was a German anatomist and neuropathologist.  He was an associate professor of neuropathology at the University of Breslau.

Auerbach was among the first physicians to diagnose the disease of nervous system using histological staining methods. He is credited with the discovery of Plexus myentericus Auerbachi, or Auerbach's Plexus, a layer of ganglion cells that provide control of movements of the gstro-intestinal tract, also known as ' myenteric plexus".


Korbinian Brodmann (17 November 1868 – 22 August 1918) was a German neurologist who became famous for his definition of the cerebral cortex into 52 distinct regions from their cytoarchitectonic (histological) characteristics, known as Brodmann areas.

He worked also in the Psychiatric Clinic in the University of Jena, with Ludwig Binswanger, and in the Municipal Mental Asylum in Frankfurt, from 1900 to 1901. There, he met Alois Alzheimer, who was influential in his decision to pursue neuroscientific basic research.

Following this, Brodmann started to work in 1901 with Cécile and Oskar Vogt at the private institute "Neurobiologische Zentralstation" in Berlin, and in 1902 in the Neurobiological Laboratory of the University of Berlin. In 1915 he joined the Kaiser-Wilhelm-Institut für Hirnforschung (Institute for Brain Research).

In 1909 he published his original research on cortical cytoarchitectonics in "Vergleichende Lokalisationslehre der Großhirnrinde in ihren Prinzipien dargestellt auf Grund des Zellenbaues" (Comparative Localization Studies in the Brain Cortex, its Fundamentals Represented on the Basis of its Cellular Architecture).

In the following years he worked at the University of Tübingen, as professor & later as physician and chairman of the Anatomical Laboratory at the University Psychiatric Clinic.

The areas he depicted on the brain are now usually referred to as Brodmann areas. Brodmann used a variety of criteria to map the human brain, including attention to gross anatomical features as well as the examination of cortical micro-structures.

Brodmann postulated that these areas with different structures performed different functions, such as the area 41 & 42 are in th temporal lobe and associated with hearing, Areas 44 & 45 constitute the areas for language , area 17 is in occipital lobe and it is assoiated with vision.


Edinger Ludwig was a German anatomist and clinical neurologist

Ludwig Edinger (13 April 1855 – 26 January 1918) was an influential German anatomist and neurologist and co-founder of the University of Frankfurt. In 1914 he was also appointed the first German professor of neurology.

Edinger studied medicine from 1872 to 1877 in Heidelberg and Strasbourg. His studies into neurology began during his time as an assistant physician in Giessen (1877 - 1882). His habilitation was in 1881 about neurological researches. He became a docent for these themes. He worked in Berlin, Leipzig and Paris and opened his own practice for neurology in Frankfurt am Main in 1883.

Edinger died suddenly on January 26, 1918 in Frankfurt of a heart attack. He had instructed that his brain was examined in his institute. The institute continued with the introduction of a foundation set-up by Edinger. The neurological department of the medical faculty of the Goethe University is named after him.

Edinger is credited with coining the terms "gnosis" and "praxis". These terms were later used in psychological descriptions of agnosia and apraxia.[1] Also, he was the first to describe the ventral and dorsal spinocerebellar tracts and to distinguish the paleocerebellum from the neocerebellum.

Virchow was German pathologist
Rudolf Ludwig Carl Virchow (13 October 1821 – 5 September 1902) was a German physician, anthropologist, pathologist, biologist, writer, editor, and politician, known for his advancement of public health. He is known as "the father of modern pathology". He is also known as the founder of social medicine and veterinary pathology.

Although he failed to contain the 1847–1848 typhus epidemic in Upper Silesia, his report laid the foundation for public health in Germany, as well as his political and social activities. From it, he coined a well known aphorism: "Medicine is a social science, and politics is nothing else but medicine on a large scale". He participated in the Revolution of 1848, which led to his expulsion from Charité the next year. He published a newspaper Die medicinische Reform (Medical Reform) during this period to disseminate his social and political ideas. He took the first Chair of Pathological Anatomy at the University of Würzburg in 1849. After five years, Charité invited him back to direct its newly built Institute for Pathology, and simultaneously becoming the first Chair of Pathological Anatomy and Physiology at Berlin University. The campus of Charité is now named Campus Virchow Klinikum. He cofounded the political party Deutsche Fortschrittspartei, by which he was elected to the Prussian House of Representatives, and won a seat in the Reichstag.
A prolific writer, his scientific writings alone exceeded 2,000 in number. Among his books, Cellular Pathology published in 1858 is regarded as the root of modern pathology. This work also popularised the third dictum in cell theory: Omnis cellula e cellula ("All cells come from cells"). He founded journals such as Archiv für pathologische Anatomie und Physiologie und für klinische Medizin (now Virchows Archiv), and Zeitschrift für Ethnologie (Journal of Ethnology). The latter is published by German Anthropological Association and the Berlin Society for Anthropology, Ethnology and Prehistory, the societies of which he also founded.
Virchow was the first to precisely describe and give names of diseases such as leukemia, chordoma, ochronosis, embolism, and thrombosis. He coined scientific terms, chromatin, agenesis, parenchyma, osteoid, amyloid degeneration, and spina bifida. His description of the transmission cycle of a roundworm Trichinella spiralis established the importance of meat inspection, which was started in Berlin. He developed the first systematic method of autopsy involving surgery of all body parts and microscopic examination. A number of medical terms are named after him, including Virchow's node, Virchow–Robin spaces, & Virchow's triad. He was the first to use hair analysis in criminal investigation, and recognised its limitations.
He was elected a foreign member of the Royal Swedish Academy of Sciences, awarded the Copley Medal of the British Royal Society & he was elected to the Prussian Academy of Sciences.

Dieters was a German anatomist.

Otto Friedrich Karl Deiters (November 15, 1834 – December 5, 1863) was a German neuroanatomist. He was born in Bonn, studied at the University of Bonn, and spent most of his professional career in Bonn. He is remembered for his microscopic research of the brain and spinal cord.

Around 1860, Deiters provided the most comprehensive description of a nerve cell. He identified the cells' axon, which he called an "axis cylinder", and its dendrites, which he referred to as protoplasmic processes. He postulated that dendrites must fuse to form a continuous network.

His name is lent to the "nucleus of Deiters", also called the lateral vestibular nucleus, and to "Deiters' cells", structures that are associated with outer hair cells in the cochlea of the inner ear. Deiters died in 1863 from typhoid fever at the age of 29. After his death, his work pertaining to nerve cells of the spinal cord was edited and published by anatomist Max Schultze (1825-1874).

Kayser, Bernhard was German ophthalmologist

Fleischer, Bruno was German ophthalmologist

Kayser–Fleischer rings (KF rings) are dark rings that appear to encircle the iris of the eye. They are due to copper deposition in part of the cornea (Descemet's membrane) as a result of particular liver diseases. They are named after Dr. Bernhard Kayser and Dr. Bruno Fleischer, the German doctors who first described them in 1902 and 1903. Initially thought to be due to the accumulation of silver, they were first demonstrated to contain copper in 1934.
Heubner was German Pediatrician.

Johann Otto Leonhard Heubner (January 21, 1843 – October 17, 1926) was a German internist and pediatrician.

Heubner is considered one of the fathers of pediatric medicine. He also made important contributions to the treatment of infectious and gastrointestinal diseases. He was instrumental in improving infant mortality  and introduced aseptic practices into the hospital environment.

With Max Rubner he investigated energy metabolism in infants, creating the concept of a nutrition quotient. With Eduard Heinrich Henoch he was among the first to use an antitoxin for diphtheria that had been developed by Emil von Behring (1854–1917).

Heubner also made contributions in his research of cerebrospinal meningitis.

He provided an early description of syphilitic endarteritis obliterans, a condition that is sometimes referred to as "Heubner's disease".

His name is also lent to "Heubner's artery", a cerebral artery that typically originates from the junction of the A 1 and A 2 segments of the anterior cerebral artery (ACA).

Krause , Wilhelm Johan Friedrich was German anatomist.

Johann Friedrich Wilhelm Krause (July 12, 1833 – February 4, 1910) was a German anatomist and he was son of anatomist.

Krause is known for the discovery and description of mechanoreceptors that were to become known as "Krause's corpuscles", sometimes referred to as "Krause's end-bulbs". His name is also associated with:

Krause is also remembered for pioneer research in the field of embryology. Among his better known students at Göttingen was bacteriologist Robert Koch (1843-1910).

Lissauer, Heinrich was German clinical neurologist

Heinrich Lissauer (September 12, 1861 – September 21, 1891) was a German neurologist born in Neidenburg (today Nidzica, Poland). He studied at the Universities of Heidelberg, Berlin and Leipzig. He was a neurologist at the psychiatric hospital in Breslau, and was a one-time assistant to Carl Wernicke.

In 1885 he provided a description of the dorso-lateral tract, a bundle of fibers between the apex of the posterior horn and the surface of the spinal marrow, that was to become known as "Lissauer's tract". Another eponymous term associated with Lissauer is "Lissauer's paralysis", a condition that is an apoplectic type of general paresis.

Among his written works was an influential treatise on visual agnosia, being referred to as Seelenblindheit in 19th-century German medicine, a term that roughly translates to "soul blindness". Lissauer died in Hallstatt, Austria on September 21, 1891 at the age of 30.

Luschka, Hubert von was German anatomist

Hubert von Luschka (July 27, 1820 – March 1, 1875), was a German anatomist. He lent his name to several structures, including the foramina of Luschka, Luschka's crypts, Luschka's law, Luschka's joints, and Ducts of Luschka.

His work particularly concerned the need for anatomy to be connected in a practical manner to medicine and surgery. His Anatomie des Menschen in Rücksicht auf das Bedürfnis der praktischen Heilkunde (1862–69; Human Anatomy in Consideration of the Needs of Practical Medicine) aimed to provide such a link. He promoted the use of anatomical information in surgery, for example to manipulate internal organs using long needles before cutting the body open, and was one of the first to conduct detailed research on normal corpses, publishing a series of detailed books covering specific aspects of anatomy, such as the nerves of the hands and the blood vessels of the brain.

, Johan Friedrich was German anatomist

Johann Friedrich Meckel (October 17, 1781 – October 31, 1833), often referred to as Johann Friedrich Meckel, the Younger, was a German anatomist born in Halle. He worked as a professor of anatomy, pathology and zoology at the University of Halle, Germany. In 1829, he was elected a foreign member of the Royal Swedish Academy of Sciences.

He was a pioneer in the science of teratology, in particular the study of birth defects and abnormalities that occur during embryonic development.

The following eponymous terms are named after him:

His grandfather was also named "Johann Friedrich Meckel". In order to avoid confusion, he is often referred to as Johann Friedrich Meckel, the Elder. The elder Meckel was also a professor of anatomy, and he too has anatomical structures named after him.

Nissl, Franz was German Neuropsychiatrist, neuropathologist and medical researcher.

Franz Nissl (9 September 1860– 11 August 1919)

Franz Nissl’s father Theodor taught Latin in a Catholic school and wanted Franz to become a priest. However Franz entered the Ludwig Maximilian University of Munich to study medicine. Later, he specialized in Psychiatry.

One of Nissl's university professors was Bernhard von Gudden. His assistant, Sigbert Josef Maria Ganser suggested that Nissl write an essay on the pathology of the cells of the cortex of the brain. When the medical faculty offered a competition for a prize in neurology in 1884, Nissl undertook the brain-cortex study. He used alcohol as a fixative and developed a staining technique that allowed the demonstration of several new nerve-cell constituents. Nissl won the prize, and wrote his doctoral dissertation on the same topic in 1885.

Professor von Gudden was the judge in Nissl's college-essay competition, and he was so impressed with the study that he offered Nissl an assistantship at the Furstenried castle southwest of Munich, where one of his responsibilities would be to care for the mad Prince Otto. Nissl accepted, and remained in that post from 1885 until 1888. There was a small laboratory at the castle, which enabled Nissl to continue with his neuropathological research. In 1888 Nissl moved to the Institution Blankenheim. In 1889 he went to Frankfurt as second in position under Emil Sioli (1852–1922) at the Städtische Irrenanstalt. There he met neurologist Ludwig Edinger and neuropathologist Karl Weigert, who was developing a neuroglial stain. This work motivated Nissl to study mental and nervous diseases by relating them to observable changes in glial cells, blood elements, blood vessels and brain tissue in general.

In Frankfurt Nissl became acquainted with Alois Alzheimer, and they collaborated over seven years. They became close friends & jointly editing the Histologische und histopathologische Arbeiten über die Grosshirnrinde (1904–1921).

In 1895 Emil Kraepelin invited Nissl to become assistant physician at the University of Heidelberg. By 1904 he was a full professor at that institution, and became director of the Department of Psychiatry when Kraepelin moved to Munich.

The burden of teaching and administration, combined with poor research facilities, forced Nissl to leave many scientific projects unfinished. He also suffered from a kidney disease. During World War I he was charged with administering a large military hospital.

In 1918 Kraepelin again invited Nissl to accept a research position at the Deutsche Forschungsanstalt für Psychiatrie in Munich. After one year at that position, where he performed research alongside Korbinian Brodmann and Walther Spielmeyer, he died in 1919 of kidney disease.

Nissl was possibly the greatest neuropathologist of his day and also a fine clinician who popularised the use of spinal puncture,[4] which had been introduced by Heinrich Quincke.

Nissl also examined the neural connections between the human cortex and thalamic nuclei; he was in the midst of this study at the time of his death.

The Nissl method refers to staining of the cell body, and in particular endoplasmic reticulum. This is done by using various basic dyes (e.g. aniline, thionine, or cresyl violet) to stain the negatively charged RNA blue, and is used to highlight important structural features of neurons. The Nissl substance (rough endoplasmic reticulum) appears dark blue due to the staining of ribosomal RNA, giving the cytoplasm a mottled appearance. Individual granules of extranuclear RNA are named Nissl granules (ribosomes).

Reil, Johan Christian was German physician

Johann Christian Reil (20 February 1759 – 22 November 1813) was a German physician, physiologist, anatomist, and psychiatrist. He coined the term psychiatryPsychiatrie in German–in 1808.
Medical conditions and anatomical features named after him include Reil's finger and the Islands of Reil in the cerebral cortex. In 1809, he was the first to describe the white fibre tract now called the arcuate fasciculus[3] and the locus coeruleus.
In 1795 Reil established the very first journal of psychology in German, the Archiv für die Physiologie. In 1810 he became one of the first university teachers of psychiatry when appointed professor of medicine in Berlin.
From 1802-1805 the poet Goethe visited Reil to discuss scientific matters such as psychiatry and to access his skills as a physician.

Reil used the term 'psychiaterie' in a short-lived journal he set up with J.C. Hoffbauer, Beytrage zur Beforderung einer Curmethode auf psychischem Wege (1808: 169). He argued there should not just be a branch of medicine (psychische Medizin) or of theology or penal practice, but a discipline in its own right with trained practitioners. He also sought to publicize the plight of the insane in the asylums, and to develop a 'psychical' method of treatment, consistent with the moral treatment movement of the times. He was critical of Frenchman Philippe Pinel, however. Reil was mainly theoretical, with little direct clinical experience, by contrast with Pinel. Reil is considered a writer within the German Romantic context and his 1803 work Rhapsodien uber die Anwendung der psychischen Kurmethode auf Geisteszerrüttungen ('Rhapsodies about applying the psychological method of treatment to mental breakdowns') has been called the most important document of Romantic psychiatry

Romberg, Moritz Heirich was German clinical neurologist

Moritz Heinrich Romberg (11 November 1795 – 16 June 1873) was a Jewish physician from Berlin who published his classic textbook in sections between 1840 and 1846. ]Edward Henry Sieveking translated it into English in 1853. His nephew was Eduard Heinrich Henoch, who was known for describing Henoch–Schönlein purpura.

He described what is now universally recognised as "Romberg's sign" in his original account of tabes dorsalis (a disease caused by syphilis damaging the back of the spinal cord).

The unsteadiness with eyes closed (sensory ataxia), relates to loss of sense of position in the legs and feet that are normally compensated for by the patient who uses vision to provide that information. But when the eyes are closed or in the dark, the loss of sense of position causes unsteadiness and sometimes falls, as Romberg described.

He was one of a tiny number of truly innovative neurologists in Europe who in the 1820-50 period introduced order and clinical observation and deduction into what was then an elementary discipline. He is credited with having been "the first clinical neurologist.

According to Pearce, Romberg acquired much of the wisdom and attitudes prevailing in English medicine when in 1820 he translated into German, Andrew Marshall’s (1742–1813) The Morbid Anatomy of the Brain and Charles Bell’s The Nervous System of the Human Body. He revolutionised European neurology, publishing his Lehrbuch der Nervenkrankheiten des Menschen: the first systematic textbook in neurology. Romberg’s contribution to neurology, and his establishing tabes dorsalis as a distinctive disease were of crucial importance. Romberg’s sign, once synonymous with tabes dorsalis, became recognised as common to all proprioceptive disorders of the legs. His several major clinical contributions included: a classic description of achondroplasia (on which he wrote his graduation thesis entitled "Congenital rickets" in 1817), progressive facial hemiatrophy, and an unmistakable description of the pupils in tertiary syphilis before E.J. Remak and Argyll Robertson.

Rosenthal, Friedrich Christian was German anantomist
Friedrich Christian Rosenthal (June 3, 1780 – December 5, 1829) was a German anatomist.

Rosenthal is remembered today for two anatomical terms that contain his name:

Schwann, Thedor was German anatomist
Theodor Schwann (7 December 1810 – 11 January 1882) was a German physiologist. His many contributions to biology include the development of cell theory, the discovery of Schwann cells in the peripheral nervous system, the discovery and study of pepsin, the discovery of the organic nature of yeast, and the invention of the term metabolism.

It was during the four years spent under the influence of Müller at Berlin that Schwann's most valuable work was done. Müller was at this time preparing his great book on physiology, and Schwann assisted him in the experimental work required. Schwann observed animal cells under the microscope, noting their different properties. Schwann found particular interest in the nervous and muscular tissues. He discovered the cells that envelope the nerve fibers, now called Schwann cells in his honor.

Schwann discovered the striated muscle in the upper esophagus and initiated research into muscle contraction. In 1837 Schwann isolated an enzyme essential to digestion, which he called pepsin.

Schwann became chair of anatomy at the Belgian Catholic University of Leuven in 1839. Here he produced a paper establishing the importance of bile in digestion.

Wallenberg, Adolf was German physician

Adolf Wallenberg (10 November 1862 – 10 April 1949) was a German internist and neurologist.

In order to escape Nazism he emigrated to Great Britain in 1938. He later relocated to the United States in 1943.

While working with Ludwig Edinger he described the avian brain, and also examined the role of the olfactory system in the assessment, recognition, and ingestion of food.

He described the clinical manifestations (1895) and the autopsy findings (1901) in occlusions of the arteria cerebelli posterior inferior (Wallenberg's syndrome).

With Edinger, and later alone, he published the "Jahresberichte über die Leistungen auf dem Gebiete der Anatomie des Zentralnervensystems" (1895–1928). Since 1975 the "Adolf Wallenberg-Preis" has been awarded by the Deutsche Gesellschaft für Neurologie for outstanding contributions made in the field of cerebrovascular disease, cerebral hemorrhage or cerebral metabolism.[5]

Associated eponym , Wallenberg's syndrome is the associated eponym with Wallenberg. Synonyms are dorsolateral medullary syndrome or lateral bulbar syndrome or lateral medullary infarction syndrome or posteroinferior cerebellar artery syndrome. This syndrome is a complex of symptoms caused by occlusion of the posterior inferior cerebellar artery, resulting in sensory and sympathetic disturbances, cerebellar ataxia.

, Karl Friedrich Otto was German anatomist

Westphal's contributions to medical science are many; in 1871 he coined the term "agoraphobia", when he observed that three male patients of his displayed extreme anxiety and feelings of dread when they had to enter certain public areas of the city. He is credited with providing an early diagnosis of "pseudosclerosis", a disease known today as hepatolenticular degeneration. He also demonstrated a relationship between tabes dorsalis (nerve degeneration in the spinal cord) and paralysis in the mentally insane.

Westphal is credited with describing a deep tendon reflex anomaly in tabes dorsalis that later became known as the "Erb–Westphal symptom" (named with neurologist Wilhelm Heinrich Erb (1840–1921). His name is also shared with neurologist Ludwig Edinger (1855–1918) regarding the Edinger–Westphal nucleus, which is an accessory nucleus of the oculomotor nerve (cranial nerve number III; CN III). He was the first physician to provide a clinical description of narcolepsy and cataplexy (1877). 
A large portion of his written work dealt with diseases of the spinal cord and neuropathological issues. He trained a number of prominent neurologists and neuropathologists, including Arnold Pick, Hermann Oppenheim, Karl Fürstner, Carl Moeli and Karl Wernicke. His son, Alexander Karl Otto Westphal (1863–1941) was also a psychiatrist, and is associated with the Westphal-Piltz syndrome (neurotonic pupillary reaction). Westphal, in addition to his multiple contributions to neurology and neuroanatomy, has been credited with introducing rational and non-censorious treatment to psychiatric hospitalization in Germany.

Italian Neuroscientists & Eponyms


Alfonso Giacomo Gaspare Corti (22 June 1822 – 2 October 1876)

Corti, Marchese Alfonso was Italian histologist
Organ of Corti is the sensory epithelium of cochlea
Corti worked in Italy, Vienna, Bern, Würzburg, London, Paris &Utrecht. He worked with many renowned neuroscientists of that period.

Gennari, Francesco was Italian Physician
His name is associated with white line in the visual cortex-"Stria of Gennari"


Golgi, Camillo was Italian Histologist. His name is associated with :

              Type 1 and Type 2 Neurons

              Golgi Tendon Organ

              Golgi Apparatus

Camillo Golgi was born in July 1843 in the village of Corteno, in the province of Brescia (Lombardy), Italy. The village is now named Corteno Golgi in his honour. His father was a physician and district medical officer. Golgi studied at the University of Pavia, where he worked in the experimental pathology laboratory under Giulio Bizzozero, who elucidated the properties of bone marrow. He graduated in 1865. He spent much of his career studying the central nervous system. Tissue staining techniques in the later half of the 19th century were inadequate for studying nervous tissue. While working as chief medical officer in a psychiatric hospital, he experimented with metal impregnation of nervous tissue, using mainly silver (silver staining). He discovered a method of staining nervous tissue that would stain a limited number of cells at random in their entirety. This enabled him to view the paths of nerve cells in the brain for the first time. He called his discovery the "black reaction" (in Italian, reazione nera), which later received his name (Golgi's method or Golgi stain).

In addition to this discovery, Golgi discovered a tendon sensory organ that bears his name (Golgi receptor). He studied the life cycle of Plasmodium and related the timing of tertian and quartan fevers seen in malaria with the life cycle of the organisms now named Plasmodium vivax and Plasmodium malariae, respectively. Using his staining technique, Golgi identified the intracellular reticular apparatus in 1898 which bears his name, the Golgi apparatus.

In renal physiology Golgi is renowned for being the first to show that the distal tubulus of the nephron returns to its originating glomerulus, a finding that he published in 1889.

Golgi, together with Santiago Ramón y Cajal, received the Nobel Prize in Physiology or Medicine in 1906 for his studies of the structure of the nervous system. In 1900 he was named senator by King Umberto I. In 1913 he became foreign member of the Royal Netherlands Academy of Arts and Sciences.

Martinotti, Giovanni was Italian Physician.
Eponym is "Cells of Martinotti " in the cerebral cortex.

Pacini, Filippo was Italian Anatomist & Histologist
The sensory endings known as Pacinian corpuscles

Filippo Pacini (25 May 1812 – 9 July 1883) was an Italian anatomist, posthumously famous for isolating the cholera bacillus Vibrio cholerae in 1854, well before Robert Koch's more widely accepted discoveries 30 years later.

In 1831, during a dissection class, Pacini discovered small sensory organs in the nervous system which can detect pressure and vibrations. He studied them closely from 1833 on, and first discussed them in 1835 at the Società medico-fisica in Florence, but did not publish his research ("Nuovi organi scoperti nel corpo umano") until 1840. Within just a few years, the work was widely known in Europe and the bodies had become known as Pacinian corpuscles.

He served as an assistant to Paolo Savi in Pisa from 1840 to 1843, then began working at the Institute of Human Anatomy. In 1847, Pacini began teaching at the Lyceum in Florence, and then was named chair of General and Topographic Anatomy at the "Istituto di Studi Superiori" at the University of Florence in 1849, where he remained to the end of his career.

The Asiatic cholera pandemic of 1846-63, which swept through Florence in 1845–1846, brought the disease to the center of Pacini's attention. In 1854, he described the disease in a paper called "Microscopical observations and pathological deductions on cholera", but because of the prevailing belief of Italian scientists in the miasma theory of disease, the work was not noted by others until many years after his death, despite additional publications in 1865, 1866, 1871, 1876, and 1880 which identified the cause of the disease's lethality, and even proposed some effective treatments. John Snow, who disproved the miasma theory, and Robert Koch, widely credited with the discovery of the bacillum 30 years later, were unaware of his previous work.

When Koch, a much more widely respected scientist who had previously identified the tuberculosis bacillus, presented his findings to the Cholera Commission of the Imperial Health Office in Berlin in 1884, the commission congratulated him, but also recognized Pacini's previous discovery of the bacterium. In 1965, the international committee on nomenclature adopted the formal name Vibrio cholerae Pacini 1854 to honor his work.

During his career, Pacini also published several studies on the retina of the human eye, the electric organs in electric fishes, the structure of bone, and the mechanics of respiration.

Pacini did not marry, and spent most of the money remaining after his scientific investigations on the long-term care of his two ailing sisters. He died nearly penniless in Florence on July 9, 1883.

Rolando, Luigi was Italian Anatomist.
Central sulcus of the cerebral hemisphere is known as central sulcus of Ronaldo
His name is also associated with substansia gelatinosa of the spinal cord.

Luigi Rolando (16 June 1773, Turin – 20 April 1831, Turin) was an Italian anatomist known for his pioneer research in brain localization of function.

He studied medicine and studied engraving, drawing, anatomical dissection, and conducted microscopic investigations of nerve tissue. From 1804 he was a professor at the University of Sassari, and in 1814 was appointed professor of anatomy at the University of Turin.

As a University of Turin professor, he devoted his life to the study of brain anatomy. A range of neuroanatomical and neurological entities are named after him: the Rolandic vein, the Rolandic artery (central sulcal artery), the pre-Rolandic artery (precentral sulcal artery), the Rolandic operculum (post-central operculum), the Rolandic area (primary motor cortex), the substantia gelatinosa of Rolando, the fissure of Rolando (central sulcus) and Rolandic epilepsy.

Ruffini, Angelo was Italian Anatomist
Sensory endings, known as the end bulbs of Ruffini.

Angelo Ruffini (1864 – 1929) was an Italian histologist and embryologist.

He studied medicine at the University of Bologna, where beginning in 1894 he taught classes in histology. In 1903 he attained the chair of embryology at the University of Siena.

He was the first to describe small encapsulated nerve endings (mechanoreceptors) which were to become known as Ruffini corpuscles. He used a gold chloride stain on his microscope slides in order for to view the tiny corpuscles.

Ruffini was a pioneer in the study of amphibian gastrulation, providing a comprehensive and detailed description on the formation of "bottle cells". He published these findings in a book titled Fisiogenia (1925).

Between 1896 and 1903, Ruffini corresponded regularly with Sir Charles Sherrington. This relationship evolved after Ruffini sent copies of his papers on muscle nerve endings to Sherrington. Ruffini also sent Sherrington eleven slides of 'Organi nervosi' and Sherrington was instrumental in getting Ruffini's work published in the Journal of Physiology.

Polish Neuroscientist

Adamkiewicz, Albert was a Polish Pathologist and his name is associated with an artery supplying lumbar segments of spinal cord. 

Adamkiewicz earned his medical doctorate in 1873 from the University of Breslau where he was a student-assistant to physiologist Rudolf Peter Heinrich Heidenhain. From 1879 until 1892, he was chief of general and experimental pathology at the Jagiellonian University in Cracow.
Adamkiewicz is remembered for his pathological examinations of the central nervous system. His research of the variable vascularity of the spinal cord was an important contribution to the development of modern clinical vascular surgery. He is credited with describing the major anterior segmental medullary artery, which is now known as the Adamkiewicz artery.

Although a radicular artery from the aorta accompanies the nerve root at many levels, most of these contribute little flow to the spinal cord itself. Major contributors of blood supply to the anterior spinal cord is from 6 to 8 radicular arteries usually at C3, C6, C8, T4 , T8 levels.
Artery of Adamkiewicz also known as arteria radicularis anterior magna is the main arterial supply for the spinal cord from T8 to conus. In about 85% persons,  it is located on the left side and situated tween T9 & L2. Usually it is very large and gives off cephalic and caudal branchgiving a characteristic hair-pin appearance on angiography.
In the early 1890s, Adamkiewicz published a series of articles claiming the discovery of a cancer-causing parasite he called Coccidium sarcolytus, as well as the existence of an anti-cancer serum. Further testing proved the serum a failure, and Adamkiewicz was severely criticized by the medical community at Jagiellonian University. Soon afterwards, he relocated to Vienna, where he practiced medicine at Rothschild Hospital.
He is credited for the creation of the Adamkiewicz test, a test for detecting tryptophan, an α-amino acid that is used in the biosynthesis of proteins.

Frey, Lucja was Polish Neurologist and his name is associated with Gustatory hyperhidrosis.

Russian Neuroscientists & Eponyms
Betz ,Vladimir A
Betz was a Russian Anatomist
Giant Pyramidal cells in the motor cortex

Darkschewitsch, Liverij Osipovich was a Russian clinical Neurologist and his name is associated with one of the accessory oculomotor nuclei in the midbrain.

Korsakoff, Sergei Sergeievich
Karsakoff was a Russian Psychiatrist
Korsakoff's Psychosis is seen in patients of chronic alcoholism. it includes a memory defect and fabrication of ideas

Roman Neuroscientist & Eponym

Claudius Galen was a Roman Physician. His name is associated with Great cerebral vein

Spanish Neuroscientist & Eponym

Cajal, Santiago Felipe Ramon Y was Spanish Histologist
Interstitial nucleus of midbrain
Neuron Doctrine on the basis of his observations with siver staining methods 

Swiss Neuroscientists & Eponyms

Forel, Auguste Henri was Swiss Neuorpsychiatrist.
Fibre bundles in the subthalamus , known as the fields of Forel
ventral tegmental decussation in the midbrain

Johann Friedrich Horner was a Swiss Ophthalmologist. Horner's syndrome is caused by interruption of sympathetic innervation of the eye.

Viennese Neurologist
Benedict Moritz was Viennese Neurologist
Occulomotor nerve palsy and ataxia including tremors

concept & some details from Inderbir Singh's  Textbook of Neuroanatomy ( Fundamental & Clinical ) 9th Edition, revised & Edited by Pritha S Bhuiyan, Lakshmi Rajgopal & K Shyamkishore. Publisher: Jaypee