Raupp: 50 years of neuroradiology

Raupp: 50 anos de neurorradiologia

HISTORICAL NOTE

Raupp: 50 years of neuroradiology

Raupp: 50 anos de neurorradiologia

Daison Nelson Ferreira Dias

Fellow, Neuroradiology, SERPAL Clínica de Diagnóstico, Porto Alegre RS, Brasil. Master, Neurosciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brasil

^{Correspondence}

ABSTRACT

OBJECTIVE: Evaluate the laboral and intellectual contributions of a founder of Brazilian Neuroradiology to the development of specialty.

METHOD: Interviews were conducted with Dr. Raupp and contemporary doctors. Then we made a literature review with the Raupp search term aiming to identify those papers which included major changes in the diagnostic and therapeutic neurosurgical.

RESULTS: The colleagues consulted were unanimous in recognizing the work of avant-garde and the importance of Dr. Raupp to the development of neuroradiological methods, especially in the pre-computed tomography fase.

CONCLUSION: The work of Dr. Raupp was fundamental for the consolidation of Brazilian Neuroradiological School over the past five decades. He developed diagnostic and therapeutic techniques in congruence with the practices of the specialty on the global stage and he promoted education through medical residency programs.

Key words: neuroradiology, interventional radiology, Raupp, medical residency programm.

RESUMO

OBJETIVO: Avaliar a contribuição laboral e intelectual de um dos fundadores da Neurorradiologia Brasileira para o desenvolvimento da especialidade.

MÉTODO: Foram realizadas entrevistas com o Dr. Raupp e com médicos contemporâneos. Em seguida, foi feita uma revisão de literatura com o termo Raupp com o objetivo de identificar os trabalhos que definiram mudanças importantes na avaliação diagnóstica e terapêutica neurocirúrgica.

RESULTADOS: Os colegas consultados foram unânimes no reconhecimento do trabalho de vanguarda e da importância do Dr. Raupp no desenvolvimento das técnicas neurorradiológicas, especialmente na fase pré-tomografia computadorizada.

CONCLUSÃO: O trabalho do Dr. Raupp foi fundamental para a consolidação da Escola Neurorradiológica Brasileira ao longo das últimas cinco décadas. Ele desenvolveu técnicas diagnóstica e terapêutica em congruência com as práticas da especialidade no cenário mundial e promoveu o ensino através dos programas de residência médica.

Palavras-chave: neurorradiologia, radiologia intervencionista, Raupp, programa de residência médica.

Son of Daniel Velho Raupp and Adahir Leinhardt Raupp, Sérgio Fer-nando Raupp was born on August 29 in 1936 at Rio Pardo and he gradu-ated at Medicine School from Univers-idade Federal do Rio Grande do Sul on Dezember 16 in 1960 (Fig 1). In the same month Raupp defended the thesis Ra-diculografia com contraste hidro-solúvel, he was building clinical experience with a unpublished theme in the Americas^1,2 becoming the second Brazilian physi-cian to devote himself to Neuroradi-ology, second only to the Dr. José Zá-clis, Neuroradiologist at the Hospital das Clínicas of Faculty of Medicine at the Universidade de São Paulo since 1947^3,4.

Academic and scientific career

Intellectual wit of the Dr. Sérgio evi dent in the excerpt from his thesis "if we respect the sci-ence authority of teachers, at any time we refrain from thinking, and we were looking at the scientific truth from evolutive and plastic eminently angle, never static or dogmatic way"¹, found an environment conducive to the development of a new specialty given the volume of medical consults and prestige enjoyed by the service Dr. Eliseu Paglioli, at Pavilhão São José. By self-taught also used the pneumo-rachis, pneumo -mielography or gas mielography, liposoluble contrasted positive mielography, the discography or nucleography, the vertebral flebog-raphy, the subclavian angiography, the aortography, the retrograde catheterization, among other types of punc-ture for injection of contrast for diagnostic purposes^5-9.

His original studies in South America on expansive processes in the posterior fossa provides diagnostic and topographic precisions impressive ¹⁰. Intraoperative an-giography was another innovation that Dr. Raupp intro-duced in our country³, helped lead to the cure several pa-tients in a single neurosurgical approach⁷. In the case of arteriovenous malformations, has already watched the poor prognosis in those who had deep venous drainage and intraparenchymal hematoma^7,8. The rigor of his prac-tice and observation allowed the identification of bene-fits in different ways of catheterization¹¹, and criticism about the complications of direct puncture of the ver-tebral arteries abandoning this technique in mid-1970¹². In 1975, he reveals the zonoangiografia¹³ showing with a new technique the vascular structures of the brain stem and cerebellum defining a method that complements the investigation of posterior fossa. The work on vertebro-basilar angiography and zonoangiography were orig-inal and independent contributions of Dr. Raupp to the Neuroradiology¹⁴.

In addition, he devoted himself to the study of ve-nous circulation in the brain works whose descriptions were not limited to anatomical details but described the situations in which individual characteristics defined the most frequent variations in the development of some ve-nous branches, as the interdependence between histolog-ical development of the superficial sylvian, Trolard and Labbé veins, or the presence of the uncinate or uncal vein, originates in the anterior perfurated substance, pro-jecting antero-inferiorly, reaching the cavernous sinus¹⁵. Accordingly, so proliferous was that his anatomics prep-arations were widely used in anatomy classes and con-ferences and served as the basis for the thesis defense of Livre-Docência¹⁶.

The creation of the Center of Diagnostic and Thera-peutic Neuroradiology (Fig 2) expanded the usefulness of the techniques that served not only to Neurosurgery but also other specialties from the Santa Casa Complex^17-20.

The Neuroradiology has evolved, however, with a range of endovascular therapies that use alcoholic solu-tions, chemotherapeutic agents, detachable microcoils and/or Onyx, among other materials for embolization of dural fistulas, arteriovenous fistulas, arteriovenous malformations, aneurysms, tumors of central nervous system or metastases.

The peers' recognition

"My friendship with Sérgio Raupp started already in school, in Colégio Rosário, in Porto Alegre, which we were both students. Today I remember the boy happy, bubbly, wisecracking. Later we were colleagues in the Faculty of Medicine of UFRGS, in Porto Alegre, and again he showed the same energy, the same intellec-tual qualities now associated with a tremendous dedica-tion by study and practice of medicine. Later our paths parted, because I went to Public Health, but remained Sérgio gives me admiration for their truly pioneering work in the field of Neuroradiology. His name is forever inscribed in the history of Gaucha and Brazilian medi-cine.", Moacyr Scliar, Public Health Physician and Writer, member of the Academia Brasileira de Letras, in corre-spondence to the author.

"I still a 5^th year medical student, ahead to the control desk, when I had got his first lesson in Neuroradiology. Constitutes the first person to give me a solid foundation of conduct, criteria of rational analysis, and take me to the scientific reasoning, show where you might make a mistake, preventing the error, and if you are wrong how can you try to correct the error.", Dr. Enedir Borges Teix-eira, first physician of the RS to work as a neurosurgeon outside the state capital, in correspondence to the author.

Final considerations

Dr. Raupp reaches 50 years of experience with sev-eral titles: Citizen Emeritus of Rio Pardo, Specialist in Neurosurgery, in Neurology, in Computer Tomography, in Neuroradiology, Member of Academia Brasileira de Neurologia, Member of Colégio Brasileiro de Radiologia, Member of Academia Brasileira de Neurocirurgia - man-agement headed by José Ribe Portugal.

The work of Dr. Sérgio Raupp extinguished the words "exploratory craniectomy" and have defined a school of topographic diagnosis precision since pre-CT and MRI fases. It is because until the development of neuroradio-logical methods, the physical examination was the only option to the topographic diagnosis of the disease in the pre-operative stage.

Today, however, Dr. Raupp is the head of Neuroradi-ology at Santa Casa de Porto Alegre, is professor at the Faculty of Medicine of PUCRS and working in his clinic, SERPAL, where he coordinates the neuroradiological dis-cussions with resident doctors and heads of neurosurgi-cals services.

The rauppian's work was the vanguard in neuroradio-logical diagnosis in our country. He is the older Neuro-radiologist in Brazil. Dr. Raupp obtained the respect and recognition from their peers for ethical practices and sci-entific thinking over half a century.

AKNOWLEDGMENTS – To Librarian, Archivist and Photographer, Nádia Raupp Meucci, by photographic work. To Professors Dr. Paulo Niemeyer Filho, Neurosurgeon, and Sérgio Novis, Neurologist, by yours testimonials to author.

Received 8 October 2010

Received in final form 12 January 2011

Accepted 19 January 2011

• 1. Raupp SF. Radiculografia com contraste hidro-solúvel. Porto Alegre: Universidade Federal do Rio Grande do Sul; 1960.
• 2. Dahne J, Raupp S. Vantagens no uso dos contrastes-hidro-solúveis nos síndromes da cauda equina. Neurobiol 1963;26:198-203.
• 3. Piske RL, Raupp E, Freitas JMM, Campos CMS, Abath C, Jr NdS. History of the Neuroradiology in Brazil. In: Cabanis EA, Iba-Zizen M-T (Eds). A history of neuroradiology (1895-2002). Paris: XVIIth Symposium Neurora-diologicum; 2002: 217.
• 4. Valente M. Neuroradiology in Brazil. In: Cabanis EA, Iba-Zizen M-T (Eds). A history of neuroradiology (1895-2002). Paris: XVII^th Symposium Neurora-diologicum; 2002:215.
• 5. Raupp S, Dahne J, Campos Z. Neurorradiologia nas afecções raquimedu-lares. J Bras Med 1964;8:1367-1379.
• 6. Raupp S, Carvalho FLD. Radiculografia.  Arq Neuropsiquiatr 1966;24:190-193.
• 7. Raupp S, Teruchkin S, Vidaurre JC. Angiografia cerebral trans-operatória. Arq Neuropsiquiatr 1963;26:142-144.
• 8. Ferreira NP, Raupp S, Dahne JAM. Malformações arteriovenosas do lobo parietal: revisão clínico-cirúrgica de 17 casos. Arq Neuropsiquiatr 1968;26: 136-140.
• 9. Ruggiero G. L'Encephalographie Fractionnee. Paris: Masson et Cie; 1957.
• 10. Raupp S, Paglioli E. Radiologia nos processos expansivos da fossa posterior. Arq Neuropsiquiatr 1964;22:293-302.
• 11. Raupp SF, Bolli PA. Cateterismo retrógrado em neuro-radiologia. Arq Neuropsiquiatr 1970;28:125-127.
• 12. Raupp SF, Mello LR. Angiografia vértebro-basilar por cateterismo retró-grado. Arq Neuropsiquiatr 1970;28:127-130.
• 13. Raupp SF. Vertebro-basilar zonoangiography. Acta Radiol 1976;347(Suppl): S205-S208.
• 14. Raupp SF, Ramos FF. Angiografia vértebro-basilar trans-operatória por cateterismo retrógrado. Arq Neuropsiquiatr 1970;28:130-134.
• 15. Raupp SF, Paglioli EB, Alencastro LCD. Sistema venoso encefálico: anatomia funcional. In: XVI Congresso Latinoamericano de Neurocirurgia. Caracas: Acta Neurológica Latinoamericana; 1975.
• 16. Paglioli EB. Atlas anátomo-radiológico do sistema venoso intracraniano. Porto Alegre: Missau; 1978.
• 17. Raupp SF. Acertos e desacertos neurorradiológicos. In: Siqueira MG, Novaes V (Eds). Tumores intracranianos. Porto Alegre: Edições Missau Ltda; 1982:125-143.
• 18. Letti N, Raupp S, Schneider I. Fístula entre a artéria ocipital e o seio lateral com sindrome de tuba aberta. Rev Bras Otorrinolaringol 1977;43:126-131.
• 19. Sant'Anna GD, Saffer M, Mauri M, Facco S, Raupp S. Encephalocraniocuta-neous lipomatosis with otolaryngologic manifestations: a rare neurocu-taneous syndrome. International J Pediatr Otorhinolaryngol 1999;49:231.
• 20. Raupp EF, Raupp SF. Neurorradiologia Intervencionista. In: Bonamigo TP (Ed). Condutas cirúrgicas. Porto Alegre: FFFCMPA/ISCMPA; 1993:307-320.

Publication Dates

• Publication in this collection
  19 July 2012
• Date of issue
  June 2011

History

• Accepted
  19 Jan 2011
• Reviewed
  12 Jan 2011
• Received
  08 Oct 2010