Egas Moniz: 90 Years (1927–2017) from Cerebral Angiography

Abstract

In June 2017 we celebrate the 90th anniversary of the pioneer discovery of cerebral angiography, the seminal imaging technique used for visualizing cerebral blood vessels and vascular alterations as well as other intracranial disorders. Egas Moniz (1874–1955) was the first to describe the use of this revolutionary technique which, until 1975 (when computed tomography, CT, scan was introduced in the clinical practice), was the sole diagnostic tool to provide an imaging of cerebral vessels and therefore alterations due to intracranial pathology. Moniz introduced in the clinical practice this fundamental and important diagnostic tool. The present contribution wishes to pay a tribute to the Portuguese neurosurgeon, who was also a distinguished neurologist and statesman. Despite his tremendous contribution in modern brain imaging, Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for prefrontal leucotomy, the neurosurgical intervention nowadays unacceptable, but should rather be remembered for his key contribution to modern brain imaging.

Transcarotid Mechanical Thrombectomy for Embolic Intracranial Large Vessel Occlusion after Endovascular Deconstructice Embolization for Carotid Blowout Syndrome

“…In the subsequent years, a direct percutaneous approach to the ICA followed by femorocerebral angiography was developed. 9 Currently, direct carotid artery access is used as an alternative to the transfemoral approach for endovascular procedures when the tortuosity and stenosis cannot be overcome. Numerous types of endovascular interventions can be administered via carotid artery access, including embolization, angioplasty, stenting, and thrombectomy, even in children.…”

Direct puncture of the V3 segment of the vertebral artery in acute basilar artery stroke: an alternative approach in desperate circumstances

“…Moniz was the first to describe direct VA puncture in the 1920s,2 with subsequent refinement in techniques over the subsequent decades before falling out of favour following the advent of non-invasive CT imaging and improved catheter angiography techniques 3–5…”

Preventing Rupture: Clipping of Unruptured Intracranial Aneurysms

“…The most important step in this direction belonged to the invention of the angiography as a superior instrument for diagnosing intracranial pathologies. The first cerebral angiography was performed by Egas Moniz (1874Moniz ( -1955 in 1927, a technique which remained the only dependable diagnostic method for identifying intracranial lesions until the introduction of computed tomography (CT) nearly 50 years later [1,4,[29][30][31]. Fascinatingly enough, an editorial published in The Lancet in 1931 predicted the probability of not only diagnosing intracranial aneurysms through this tool but also as an opportunity for therapy in later years [1,29].…”

“…The first cerebral angiography was performed by Egas Moniz (1874Moniz ( -1955 in 1927, a technique which remained the only dependable diagnostic method for identifying intracranial lesions until the introduction of computed tomography (CT) nearly 50 years later [1,4,[29][30][31]. Fascinatingly enough, an editorial published in The Lancet in 1931 predicted the probability of not only diagnosing intracranial aneurysms through this tool but also as an opportunity for therapy in later years [1,29]. The endovascular coils presently used were preceded by detachable balloons that could be deployed inside vascular lesions and would harden to result in a controlled localized thrombosis [1,4,32].…”