H. August van Alphen (deceased) Contents Chapter 1 Chapter 2.1 Chapter 2.4 Chapter 2.8 Chapter 2.11 Chapter 3 Chapter 4 Chapter 4.3 Chapter 4.4 Chapter 5.1 Index A SHORT REVIEW ON THE HISTORY OF THE WORLD FEDERATION OF NEUROSURGICAL SOCIETIES. (1955-2000) Modern Neurosurgery did not start until the end of the 19th and the beginning of the 20th century. Before World War II neurosurgery was not generally recognized as an independent medical specialty, in particular not in Europe. This was different from the United States where such independence had developed in a progressive way already. In Europe, neurosurgery was mostly submitted to the hegemony of neurologists and sometimes also of general surgeons in that period. The continuous dominating attitude of the neurologists towards the growing self-respect of the neurosurgeons led irrevocably to a growing need for emancipation of neurosurgery as a separate specialty. The delayed development in Europe showed its reflection within the Organization of the International Congresses of Neurology. At the first post-war International Congress of Neurology in Paris, 1949, Alfonso Asenjo, from Chile, arranged for a meeting with a group of neurosurgeons in order to discuss how neurosurgery might present itself at international congresses in the future. In the end of a deliberate discussion it was decided to participate as a separate group. Some years later, at the preparatory meeting prior to the Neurological Congress in Lisbon, it was proposed that one of the official scientific topics should regard neurosurgery. This proposal met only partial acceptance by the neurologists. Although the Lisbon Congress became successful, a growing discontent developed among the neurosurgical and other "splintergroups" as they were called by Sir Francis Walshe, one of the leading neurologists. It was still felt that neurosurgery did not receive a sufficient opportunity to present its full potentialities. In order to meet these objections to a certain degree the next convention to be held in Brussels broadened its name to: Intentional Congress of Neurological Sciences. This reconciling move did not fully satisfy the feelings of equivalence of the neurosurgeons, however. At the first meeting of the Organizing Committee of the Brussels Congress Sir Geoffrey Jefferson, supported by a group of neurosurgeons, brought strongly to the fore that an own organization was wanted "which would meet with and cooperate with International Neurological Congresses whenever and where ever possible". This rebellious meeting implicated the beginning of the divorce of neurosurgery from the neurological international organization. Although ambivalent feelings and hesitations still lingered among Europeans. The Americans unanimously considered the time to be ripe for autonomy of neurosurgery. William B. Scoville was given the task to give it shape. He wrote an extensive letter to the officers of the neurosurgical societies in Europe and America and to outstanding leaders in neurosurgery, explaining the actual situation. As a great majority of the answers to his letter were positive, William Scoville arranged for a meeting of senior European neurosurgeons and representatives of 17 national neurosurgical societies, which was held in Brussels on September 4 and 5, 1955. After ample discussions and deliberations it was decided to institute "an international organization composed of and controlled by the component neurosurosurgical societies". Thus the birth of the World Federation of Neurosurgical Societies had taken place although the baby had not yet received its official name. It was officially baptized somewhat later when the Constitution had been drafted and ratified at the executive session during the International Congress of Neurological Sciences in Brussels on the historical date of Saturday, July 20, 1957. The International Congress of Neurological Sciences was composed of: 1) the 6th Neurological Congress, 2) the 4th International E.E.G. Congress, 3) the 3d International Neuropathology Congress, 4) the 3d Meeting of the International League against Epilepsy, 5) the 5th Symposium Neuroradiologicum and 6) the First International Neurosurgical Congress. The Committee of the First International Congress of Neurological Surgery was presided by Sir Geoffrey Jefferson with Marcel David as secretary. At the opening of the Executive Committee meeting on July 20, 1957, the president welcomed 99 officers and delegates. Committee on the Constitution, the Nominating Committee and the Program Committee were unanimously ratified. There were 382 neurosurgeons participating in the Congress. The topics were: extrapiramidal pathology, states of consciousness in neurology, therapeutic applications of hypothermia, stereotactic methods and supratentorial angiomas. The E.C. elected as the first site to host the first independent International Neurosurgical Congress in 1961 in Washington D.C. The nominating proposed the slate for the next Congress and coming four years. This slate was accepted unanimously with Paul C. Bucy as president and Bronson Ray as secretary. The interim meeting was held in Copenhagen. Dr. James White, chairman of the program committee presented the following topics: 1) radioactivity and heavy radiation particles in neurosurgery, 2) re-evaluation of surgery in the treatment of pain, 3) space occupying lesions of the central nervous system, 4) management of hydrocephalus and 5) biology and chemistry of the nervous system. There was a closed television set with the operating room in the John Hopkins Hospital in Baltimore. Via a panel it was possible to discuss with the surgeons in Baltimore during the surgical procedure. On October 15, 1961 the president officially opened the Congress with the words, that this was the first independent Neurosurgical Congress. There was also a warm and wholeheartedly welcome from the President John F. Kennedy. There were 849 participants during the E.C. Meeting. It was decided that the next Congress would be in Copenhagen September 3 - 8, 1965 and the interim meeting in Vienna 1963. The liaison Committee was installed. The slate proposed by the nominating committee was accepted with Dr. Edward Busch as president with Mr. Nothfield (U.K.) as secretary for Congress affairs and Dr. Earl Walker as secretary for federation affairs. During the interim meeting in Vienna in 1963 the president stated that the program of the next Congress would be centered on trauma. The congress will be in the Falconer Center in August 22-27, 1965. There were 835 participants (incl. the accompanying). At the first E.C. meeting Dr. Asenjo on behalf of the Congreso Latino Americano de Neurocirurgia requested that the affiliation with the Federation be terminated since most countries in South America have their independent national societies. With regret this resignation was accepted. At the second meeting of the E.C. on August 23 Dr. Busch stated that an increasing seriousness of the problem of head injuries had been so clearly brought out in the previous day program that he had requested the reporters to prepare an appropriate statement for transmission to governmental and medical bodies. Moreover, he appointed an ad hoc committee to continue on the ways and means of maintaining interest and activity in the resolution of the problems of head traumas. This was the foundation of the Committee on Neurotraumatology, one of the most important and active scientific committees with an own constitution and Bylaws. The slate of the nominating committee was adopted and Dr. Earl A.Walker was the new president with Dr. Kristiansen (Oslo) as secretary for federation affairs and Colin MacCarty for congressional affairs. At the third meeting of the E.C. Dr. Sirlois introduced an amendment to the Constitution to provide for a first and second Vice-President; this was approved. Already before the Congress of Copenhagen there had been a discussion to have a joint Congress with the neurologists and it was decided to compose a committee with the assistance of the Liaison Committee to prepare such a congress. It was also decided that New York would be the place to host such a joint Congress in 1969 and the interim meeting will be held in Madrid in 1967. During that meeting the plans for the joint meeting of WFN and WFNS were outlined. Five international organizations were planning to meet in association with the major Congresses; accordingly the programs were arranged over a period of eight days to prevent major conflicts. The Congress Liaison Committee discussed the themes for common sessions. Cerebrovascular disease, epilepsy and dementia were considered the most appropriate topics. The E.C. concurred in these subjects and directed the program committee to arrange for chairmen and speakers. The opening ceremony of the combined Congresses on September 20, 1969 took place in the Hilton hotel. The U.S. President Richard Nixon sent a hearty welcome. On the next day a series of special lectures were given by seven outstanding neurosurgeons. The attendance of neurosurgeons reached the number of 893. At the first E.C. meeting Tokyo was elected as host of the V International Congress October 7-12, 1971. The nominated slate was accepted and Dr. Keiji Sano (Tokyo) would be the next president of the Federation and Congress, while Willem Luyendijk (Holland) as secretary for federation affairs and Shozo Ishii (Tokyo) as secretary of Congress affairs. Dr. Walker closed the Congress with words of great appreciation and gratitude. The presentations of the panels and of the speakers of course were the highlights of the Congress etc. In spite of the precious words it was decided to have in Tokyo again an separate Congress. At the interim meeting in Prague June 26,1971, during the founding Congress of the E.A.N.S., the following topics were proposed for the five morning sessions of the V International Congress: 1) recent advances in the study of tumors of the central nervous system, 2) recent advances in neurotraumatology, 3) recent advances in cerebrovascular and circulatory pathology, and 4) recent advances in functional neurosurgery. Since the 100th birthday of Otfrid Foerster would be celebrated during the Tokyo Congress,it was suggested that his pupil Dr. Kuhlendal (Germany) deliver a memorial tribute. Upon the recommendation of the A.C.The Office of a Historian to be held for 8 years was established in Tokyo. October 7, 1973 the V Congress was opened in the presence of the Prince and Princess of Japan. There were 1905 participants. During the scientific sessions a total of 305 papers, 27 movies, 6 special lectures and 12 early seminars were given. During the first E.C. meeting, presided by the first vice-president Dr. Rottgen (Germany), in absence of the president Dr. Sano, it was decided that the next Congress would take place in Sao Paulo (Brazil), probably in May or June 1977. The interim meeting would be in Oxford in 1975. The interruption of this meeting and the absence of the president was caused by protest demonstrations of students, psychiatrists and nurses of the Tokyo University Psychiatrists Union, who demanded A.O. that all the papers on functional neurosurgery be withdrawn. After long discussions a solution was found. In the recent past it was also decided to have a federation president with his officers and a president of the Congress. Only the Congress president would be a member of the federation A.C. After the proper procedure Dr. Norlen (Sweden) was elected as president of the federation with Dr. Luyendijk as secretary and Dr. Aloyso de Mattos Pimenta as the next president of the Congress with Dr. Paulo Mangabeira (both from Brazil) as secretary for the congressional affairs. The interim planning E.C. meeting took place in Oxford (U.K.) during the first EANS Congress. Dr. Mangabeira reported that the themes in Sao-Paulo would be: 1) cerebrovascular lesions, arterio-venous malformations of the brain and spinal cord with cerebro-vascular bypasses, 2) pan spinal cord procedures, 3) tumors-non-operative treatment of malignant gloms, 4) trauma of cervical spine c.q. Cord (to be organized by the Committee of Neurotraumatology), 5) surgical treatment of mental diseases, and 6) seminars on the daily practice of neurosurgery. The official opening of the VI International Congress took place in the Governors Mansion with a local cultural performance. There were 1500 participants. A total of 318 scientific papers were presented and 390 were read by title, 6 cinematography demonstrations were shown. There were 16 booths of scientific exhibits. At the E.C. meeting it was decided to add the offices of assistant secretary and assistant treasurer. Munich was elected as the site of the next Congress in 1981. The slate of the Nominating Committee was adopted and Dr. Karl August Bushe (Germany) was the president of the Congress with Dr. Dietz as secretary for affairs of the Congress, while Dr. Charles Drake (Canada) was the president for federation affairs with Willem Luyendijk reelected as secretary and Dr. Walder (Holland) as assistant secretary. The interim planning committee took place in Paris July, 1979. A so-called Young Neurosurgeons Committee was established, an Award to be bestowed to five young neurosurgeons with the best papers. The Editorial Advisory Committee reported that the establishment of a federal journal at that time wasn't advisable. Regretfully the Committee proposed that the Bulletin, initiated and taken care from the very beginning by Dr. Scoville be disconnected. There was also the announcement that federation news be published in national and international journals, several of which had indicated interest in printing a page or so of federation news two or three times a year. This report was accepted and Dr. Scoville was invited to make appropriate arrangements for publication of federation activities. The opening ceremony of the VII International Congress took place on July 13, 1981. The first Awards for young neurosurgeons were bestowed during the opening Ceremony. Four symposia were sponsored by commercial firms namely: Treatment of edema, indications for spinal cord stimulation, new developments in C.T. scanning and monotherapy of epilepsy. In all 840 papers were presented, 36 posters and 28 movies shown. There were 45 commercial exhibits. At the first E.C. meeting July13, Dr. Bushe reported that 1446 active and 560 associate members had registered. Dr. Dietz reported that he received 956 abstracts. Invitations to host the next Congress in 1985 were received from the Canadian, Indian society and Pan- African society. By vote Toronto was chosen to be the next site with Brussels as the site for the interim meeting. The report of the Committee on the Constitution was adopted with a few minor changes. For the first time the slate of the nominating committee wasn't accepted as there was a minority report in favor of a second candidate for the presidency. After a long discussion it was decided to have a secret vote between the two candidates and Willem Luyendijk became the president of the federation, with Alphons Walder as secretary, while Alan Hudson (Toronto) was elected as President of the Congress with Stanley Schatz as secretary for the Congress. In order to avoid problems as mentioned above, it was decided to introduce the procedure to nominate from the floor. The name of such candidates should be handed to the secretary before the second E.C. meeting in writing and supported by at least 5 member societies from 2 different continental organizations. These names should be added to the slate of the nominating Committee and voted upon at the 3d session of the E.C. It was also decided to introduce a medal of honor for outstanding neurosurgeons next to the honorary presidents who are elected because of their merits towards the Federation. The names of the first medallists are Dr. Gerard Guiot (France), Dr. Bronson Ray (U.S.A.) and Dr. Zhimizu. The next E.C. meeting took place in Brussels on August 28, 1983 in the presence of 23 Officers and 84 delegates. Dr. Alan Hudson informed the members about the meeting in Toronto (July 7-13, 1985) Plenary scientific sessions will be held on topics of current interest and free communications in the afternoon. There are also breakfast seminars. A major session is planned on training and registration. There has also been installed an ad hoc committee on editorial advice concerning Dr. Bucy's proposal to adopt "Surgical Neurology" as substitute of the WFNS Bulletin. "Modern Neurosurgery 1", containing the papers of the Munich Congress has been published and "Modern Neurosurgery 2" will be prepared with the papers of Toronto. The "History of the World Federation" written by Earl Walker ( Historian 1973-1985) will be presented in Toronto at the prize of $5 - I 0. At the opening ceremony of the EANS Congress (in the future this will be performed during WFNS Congress only) the Medal of Honor were presented to the above mentioned Medallists by the president after an introduction of one of their pupils. A "Laudations" booklet on the Medallists and produced by their pupils will also be distributed. The medallists to be honored in Toronto will be : Dr. Denek Kune (Czechoslovakia), Dr. Lars Leksell (Sweden), Dr. Lawrence Pool (U.S.A.) and Dr. Manuel Velasco Suarez (Mexico). The committee on the Constitution and Bylaws ( chair Dwight Parkinson) proposed some minor changes, which were accepted and some major changes like a quorum of the E.C. (1/3) will be considered in Toronto. Another point concern the role of the Parliamentarian. After an extensive discussion the following version is adopted. There may be appointed a Parliamentarian by the president and in case of procedural dispute resolution shall be based upon Robert' s Rules of Order. Further on, it is decided that scientific committees will be instituted. The chairman of these Committees and of the Committee of Liaison and Public Relations will be members of the Program Committee. Voting by Proxy will not be allowed. The Committee of Neurotraumatology will publish yearly a volume on Neurotraumatology under auspices of the Federation. The site of the Congress in 1989 was also decided during this interim meeting. The 6 years from now will provide for more time and opportunity for preparative organization. Because of the remarkable extension of the secretarial work it is strongly pleaded to provide for professional Central Secretarial Office. The opening Ceremony of the VIII International Congress in Toronto on July 7, 1985 was a very colorful and impressive one. In front of the audience an Academic profession of representatives of the Government, officials of the Toronto University, Pioneers of Canadian Neurosurgery and the Officers of the WFNS and of the Congress entered the Auditorium and were seated on the platform, all wearing their caps, hoods and gowns. In front of these, the central place of honor was taken by her Excellency, the Governor General, Right Honorable Jeanne Sauvé. The Medals of Honor were handed to the distinguished neurosurgeons and the Awards to the five young neurosurgeons and the Volvo Award to the author of the best paper on Neurotraumatology. Concerning the scientific program there were 233 general sessions, 289 specific sessions and 47 lunch discussion groups on several subjects presided by experts in the respective fields of Neurosurgery. There were also videotapes sessions on various techniques; 505 posters were exhibited. The E.C. meetings were on 7, 9, 11 July with an attendance of 96, 87 and 95 members. Dr. Earl A. Walker was appointed as Parliamentarian; 2484 had registered for the Congress. The Federation had officially applied for registration and incorporation, effected in The Hague (Holland), July 1, 1987 (reg. no. 411496). Introduced by his son Barett the foundation of William Beecher Scoville is introduced. In remembrance of him this Award will be bestowed on neurosurgeons for technical innovations. An ad hoc committee should select the best recipient for this Award. The next Interim meeting will be in Barcelona (Spain) during the EANS congress. Romania was accepted as affiliate member-society. The application of the Brazilian Academy was rejected because of a too high percentage overlapping with the national Brazilian Society. The following recommendations were presented by the Chairman-of the C&B Committee: the nominating committee should be extended to 11 members. In case of divergent opinions a minority report should be acceptable and presented in addition to the usual slate. The past chairman should remain as a member of the new committee. All officers (with an exception of the president) should be allowed to continue directly for a new term. Chairmen of the Committees should be elected by and from the respective committees. The site of the International Congress should be elected 6 years in advance including the president of that Congress. Applications for a next International Congress should be sent by the secretary of the Society, at least 18 months before the interim meeting. The slate of new officers is accepted as a whole. Dr. Kemp Clark (U.S.A.) is the next president with Dr. H. Alphons Walder as secretary for federation affairs and B. Ramamurthi as president of IX Congress in New Delhi with Dr. Ajeit Kumar Banerji as secretary. The interim A.C. and E.C. meetings took place on September 6, 1987 during the E.A.N.S. Congress in Barcelona. At the E.C. meeting 11 Honorary Presidents, 21 officers of the federation members. Congress and 80 delegates representing five continental organizations and 40 member-societies and 5 observers representing 5 affiliate member-societies were present. As a consequence of the good co-operation of the secretary with the chairmen of the committees a written report could be distributed among the members of the E.C., what promoted the discussion. First of all the last Historian (Dr. Earl Walker) presented his report, and in his "Swansong" he gave a survey of the history of the federation from 1955-198 1. He discussed the negative aspects of the fast growing number of participants of the Congress preventing the personal contact A.O. As mentioned already his last report has been published as an impressive book. The next item on the Agenda concerns the voting on the site of the 1993 Congress. Mexico was elected with Acapulco as the site. The new chairman of the C&B Committee Dr. Ablin presented the amendments on the Constitution and Bylaws accepted already in Toronto. The officers of the Congress informed the E.C. about the progress of the preparations of the Congress. The chairman of the Editorial Committee reported on the distribution of a Newsletter twice a year written by the president and secretary since 1982. Dr. Luyendijk presented the names of distinguished colleagues who will be bestowed on the Medals of honor in New Delhi namely: Dr. Kristiansen (Norway), Dr. Handa (Japan) Dr. Chandy (India). The chairman of the Committee on Ethics and legal affairs Dr. Rovit presented three proposals: 1) the WFNS recognizes that diseases involving the central and peripheral nervous system are a significant source of death, disability and suffering to the populations of all nations. Adequate, well-trained personal with appropriate resources and equipment must be available to care for these patients. This proposal is seconded and carried. This proposal should be brought forward to the societies and eventually to their individual governments. The second proposal is that the concept " Brain Death", as defined by well recognized clinical and laboratory criteria, be utilized as an alternate method of determining cessation of life. This motion is also carried. A third motion about the restriction of intervention with patients in instances of incurable and terminal illness will be referred to the national societies for further consideration and decided upon at a next meeting in two or four years. The chairman of the long-range Committee, Dr. Alan Hudson brings forward some recommendations like the establishment of a Central Office (already proposed in 1983). After some discussions on the financial aspect etc. Dr. Clark then secures vote approval of the proposal. The second item is about the financial support for federation expenses. Till now the president and secretary receive each $ 5000 yearly. After extended discussions a motion has been adopted to raise these to $12.000,00 per annum and $4.500,00 for the treasurer. This means up to these amounts. These proposals will become effective in New Delhi. Another proposal is that a profit of 10% will be built in the Congress budget. That means that 10% goes to the federation and the loan will be repaid within 6 months. Dr. Drake's report on standardization of grading subarachnoid hemorrhages will be published in the major neurosurgical journals. The official opening of the IX International Congress took place on October 6, 1989 in the Taj Palace Hotel in New Delhi, There were I 800 active neurosurgeons and 500 accompanying persons registered. 1366 abstracts were submitted and 318 posters. At the first E.C. meeting 9 honorary Presidents, 10 officers of the federation, 7 officers of the Congress were present. The 5 continental organizations were represented by 7 delegates, 37 member-societies by 60 delegates and 2 affiliate members by two observers. Moscow was voted as site of the interim meeting in 1991. Dr. Ablin described the extensive work of the C&B Committee in making significant changes in the Bylaws. The suggested changes were distributed among the E.C. members and were available for discussion. These did concern the Nominating Committee, terms of the chairs of The committees were limited to two terms, etc. A vote followed accepting the new Bylaws without dissent. The financial committee revealed an important problem: that the profit of S 250.000,00 couldn't be transferred to the federation Bank as the Indian laws forbids such a transfer to a Bank outside India. After a long discussion the E.C. agreed with the proposition to establish an Institution which would take care for educational courses and fellowships for Indian colleagues. A motion to abandon the publication of Modem Neurosurgery was defeated. There were three societies admitted namely the People Republic of China, Morocco and Jordan. The various committees reported on their activity like the education committee having Courses in Korea and Taiwan. Dr. Ablin reported from the World Directory that today the number of neurosurgeons in the various areas are as follows: North America 4230 with a ratio of 1 to 87000 people, South America 2198 with a ratio of 1/135000, Asia over 5000 neurosurgeons with a ratio of 1/700000, Africa with nearly 228 neurosurgeons with a ratio of 1/2500000 and Europe 3500 neurosurgeons with a ratio of 1/300000. A vote was cast to elect the slate and this was accomplished. The new president of the Federation would be Dr. Lindsay Symon (U.K.) with Dr. Sean Mullan (U.S.A.) as secretary for federation affairs. Dr. Mauro Loyo Varela (Mexico) will be the president of the Congress in Acapulco in 1993 with Dr. Fernando Rueda Franco as secretary. Before the interim meeting in Moscow there were three A.C. meetings with discussions on the location of the Central Office, the activity of the neurosurgical educational Courses, the cooperation with FIENS, the Dr. Scoville Award was discussed. The term of the members of the committees and in particular the multiple chairmanship was discussed. The interim meeting of the E.C. took place in Moscow June 23 1991. The discussion on the desirability of a central office continued. The president favored the location in Geneva. The WHO offered facilities in their offices for a reasonable price. The secretary mentioned that for the first time the past secretary had provided him with a written "Take-Over". There was also a discussion on the subject of the profit of the Congress and whether the host society would receive a part of the profit for educational purposes in their own society. No decision was taken. The election of the next site of the Congress in 1997 was between Paris, Amsterdam and Istanbul. Madrid withdrew his candidacy. Amsterdam was elected. The following candidates for the Medal of Honor were presented: Valentin Logue (U.K.), Bernard Pertuiset (France), Kurt Schurman ( Germany) and Thor Sundt (U.S.A.). There was also the initiation of the Hon. President's luncheon by Raymond Thomnpson from Baltimore. The chairman of the Noiminating Committee James Ausman emphasized again the goals of the WFNS and the importance to receive the names of good and dedicated candidates and also to have more first and second vice-presidents in order to have the meetings all over the world well represented. During the A.C. meeting in New Orleans April 20, 1992 it was decided to have the Central Office in the building of the WHO. in Geneva on the basis of a two years trial. Dr. Brock mentioned that it was decided to discontinue "Modern Neurosurgery" because of a too big lapse between the presentations of the papers and the edition and therefore a lack of interest. There were successful visits of the president and secretary to China and Russia with very important observations. There was also a very well attended and successful educational course in Buenos Aires in August 1991. Dr. Lindsay Symon reported on the Central Office which probably will be opened on July 1992. There is a half time working executive secretary installed, Mrs. Janette Joseph. She is British and therefore fluent in English. About the reports of the committees it was decided that these should be available in writing to the members of the E.C. but that it wasn't necessary any more that the chairman of the committees had to read these extensively during the meeting. It was also announced that the official opening of the Central office would be on July 17, 1992, 10 years after Willem Luyendijk as president and Alphons Walder as secretary had taken the initiative!. Successful postgraduate courses have been held in Argentina, Morocco, Brazil, India and Pakistan. There were activities from the Committee on Neuro-oncology, pediatric neurosurgery, neurotraumatology etc. The Federational News was sent to more than 20 neurosurgical and neurological journals. Dr. Levy wrote a very interesting essay entitled "Where does the PAANS go from here". As president of the African organization he extensively discussed the problems and future of the PAANS and in particular the needs of the neurosurgeons in order to take proper care of their patients. Dr. Ablin as chairman of the C&B committee sent a number of amendments to be considered and eventually accepted in Acapulco. During an A.C. meeting in Boston it was decided that the position of the central office would be qualified as Headquarters of WFNS and repository of the Archives. The budget for 1993 was $ 37.000. The executive secretary is performing well and learning the job and the individuals involved quite rapidly. New courses include a course in Egypt March 1994. Concerning the election of the president another candidate was brought forward, but not on the way usually performed just before the second meeting of the E.C., but brought forward and promoted already one year before the elections. This problem could easily be solved at the time of the elections in Acapulco. The X Congress was opened October 17, 1993 in the Convention Hall of Acapulco. The ceremony was an impressive performance on the traditional way. The Medals of Honor were handed with the laudations and also the first Scoville Award by Mrs. Scoville to Dr. Verbiest. The names of the five young neurosurgeons were mentioned and also the Volvo prize winner and the Codman pediatric and Neuro-oncology prize winner. October 17, 1993 the first meeting of the E.C. was held with an attendance of 95 officers and delegates. The secretary of the Congress reported the following numbers of registration: participants 2308; residents 228; accompanying 497; exhibitors 482 and staff 293. A motion to continue indefinitely the Central Office in Geneva was made and seconded and approved by acclamation. There were satisfactory completed applications from the neurosurgical societies of Lithuania, the Czech Republic, Slovakia and Slovenia and these were all accepted as full members. Dr. Hoffman reported on a pediatric course in Geneva, Turkey, Bombay, Seoul and in the U.S.A. Dr. Thomas reported on the neuro-oncology committee . Dr. Dohrmann as Chairman of the Committee on Neurotraumatology stated that the Committee had redefined the goals and was active in several different areas. Firstly on conferences and publications, secondly on disaster assistance, thirdly on education for developing countries and fourthly on prevention. The ICRAN will be in Brisbane. Dr. Leigh Atkinson as Chair of the Committee of Education reported on 8 courses. There was also a discussion on the financing of the training of young neurosurgeons from developing Countries. Dr. Brock stated that a basic training in developed countries should be sufficient. Dr. Symon re-emphasized the fact that funds obtained from WFNS activities will go to the federation treasury without specific designation. It was noted that the Directory chairmanship will move to Dr. Perlin with feelings of great gratitude towards the past Chairman Dr. George Ablin. There was a discussion on the interest of spine surgery and A.O. Dr. Brock and Dr. Verbiest stated that the orthopedics take more and more over the spine surgery. A committee on the spine was considered. On behalf of the Committee on Ethical and Legal Affairs Dr. Rovit brought forward again the resolution with regard to the management of incurable disease and terminal illness and a motion was made and seconded to approve this resolution. The proposed amendments on the Bylaws were also adopted. Dr. Luyendijk as historian confirmed that the Archives were transported to Geneva for storage. He strongly suggested that copies of all correspondence should be sent to Geneva. The Chairman of the nominating committee Dr. James Ausman commented on the committee and that the major concern of the federation be centered on Education, Development of Standards, Encouragement of Research and Prevention. Thirty-two Member-societies sent their nominations and there were three nominations from the floor. The site of the interim meeting vote was between Berlin, Orlando and Taipei with Berlin as the winner for 1995. A Committee on Spine was installed with Dr. Russell Hardy as the chairman. A new logo was adopted according to a version developed by Dr. Spetzler and Dr. Brock. The third meeting of the E.C. was attended by 118 officers and delegates. There was an extensive discussion on the important issue of material aid to developing countries. Concerning the slate the president invited the two candidates for the next presidency to present themselves with a five minutes speech. The next president was Dr. Armando Basso ( Buenos Aires) with Dr. Laws (U.S.A.) as secretary for federation affairs. Dr. Guus van Alphen as President of the Congress in Amsterdam (Holland) 1997 with Dr. Thomeer as secretary. Two ad hoc committees were installed on Material Aid and Skull Base surgery. Statement of the retiring President Dr. Symon: He made some general remarks that the Constitution provided for governance through the A.C., which dealt with the day to day activities of the federation and E.C. which dealt with policy and other major issues. He emphasized that there was no third house and he also emphasized the fact that advice from the honorary presidents was appreciated when requested. After the Congress there was an A.C. meeting in Paris, November 28, 1993. The Chairman of the Educational Committee developed his plans for Courses in Turkey, Peru, Eastern Europe, Iran and Asia. Dr. Brotchi discussed the financial situation and suggested also to invite the suppliers of material & drugs to give some financial support. The education committee developed a so called "neurosurgeon consultant program", "guidelines for resident selection", and "guidelines for neurosurgical clinical care". The Chairman of the Educational Committee provided also a list of WFNS speakers for the Courses to be held all over the world and in particular in developing countries. There was another A.C. meeting in Cartagena (Colombia) and in Geneva. The last one has become a meeting to be held every year in February. Dr. Poza, Chairman of the Ethical Committee of the WFNS and EANS, wrote a draft of "Good Practice", a guide for neurosurgeons handling on various aspects like standards of private and professional life, duty, clinical career, etc. In the spring of 1995 the first number of Federation News was introduced by the president Armando Basso. It was expected to have two numbers a year as a successor on distance of the Bulletin (Dr. Scoville), followed by the Newsletter 1982-1989 by the president and secretary. This Newsletter had as editor Dr. Pickard (UK), editor of federation publication. During the A.C. meeting in Geneva the president showed his enthusiasm on the attendance of the NGO meeting with the WHO. The A.C. and some of the scientific committees will serve as advisory committees to the WHO. During the A.C. and E.C. interim meeting on May 7-9, 1995 in Berlin, four societies were accepted as full members and two as affiliate member societies. The federation Bank was moved from the Lombard Bank to the Rottschild Bank as advised by the treasurer Dr. Brotchi. A Committee of radiosurgery was installed with Dr. Ladislau Steiner as chairman. There were six applicants to host the Congress in 2001. Orlando, Jerusalem, Istanbul, .Marrakech, Sydney and Boston. Finally Sydney was elected to host the Congress in 2001. The chairman of the C&B committee advised the E..C. to accept the "Guidelines" of the Education committee as appendix to the Bylaws. The Committee on the Medals of Honor had nominated five highly esteemed colleagues; Dr. Jules Hardy, Dr. Paulo Niemeyer Sr., Dr. Gazi Yasargil, Dr. Ken Sugita (Posthume) and Dr. Arnoud de Vet. There was an extensive report of the committee of neurotraumatology on the following issues: a manual on prevention, guidelines and a glossary. There will be an ICRAN in Greece Sept. 8-11, 1996, in Russia July 6-11, 1997 and in Brazil in 1998. The committee on material aid (Dr. Mullan) was also very active. There was a meeting of the A.C. in Lima (Peru) July 7, 1995. The most important issue was the question whether the WFNS will become the official sponsor of the journal "Critical Review in Neurosurgery "( Editor Dr. Raimondi). Guidelines were discussed on the support of requirements for WFNS Meetings concerning the interim and Congress, There was a meeting of the A.C. in Minneapolis. There will be education courses in Santiago, Bolivia, Lebanon, Jordan and possibly in Russia and Greece, The yearly meeting of the A.C. took place in Geneva on February 22,1997. Dr. Pickard (Editor of federation publications) presented an extensive report on "Federation News" also questioning whether this could or would be continued or that the News could be published via Critical Reviews? The chairman of the education program gave an important report on the various courses from two in 1993 till five in 1996 and also the working of the " guidelines" and the "Think First" foundation. The International Congress, as officially opened on July 6 with an impressive Ceremony with A.O. musical entourage of the "Amsterdam Concertgebouw Orkest". The Medals of Honor were handed, The Scoville Award to Dr. Kelly. The Young neurosurgeons award, the Volvo and the Goodman awards will be handed during a special session were the prize - winners will present their papers. The first E.C. meeting was held on July 6, 1997 with 95 officers and delegates in attendance. There were 2400 active neurosurgeons registered, 550 accompanying persons and 550 technical support and exhibits registered. Dr. Avezaat (Scientific Chair Man) reviewed the scientific program. He noted that more than 1300 abstracts were received. The reports of the committees were presented and discussed. During the second meeting there were 101 attendants. Six new member societies were admitted. There was some discussion whether the name WFNS should be added to International Congress. The C&B report was discussed again and this discussion focused in particular on the position of continental organizations and their influence on the admission of new members. At the third meeting, Lahore (Pakistan) was elected as the site for the interim meeting during the Asian Australasian Congress ( or the first time in the history outside Europe), The slate from the Nominating Committee was accepted and Dr. Majid Samii is the new president (Germany), with Maurice Choux (France) as secretary. Dr. Noël Dan (Australia) will be the president of the Congress. There was also the establishment of a web site http://wfns.med.nyu.edu. During the meeting a new name for the Congress was adopted "XII th. World Congress of Neurosurgery", Sydney 2001 September19-23. There above "World Federation of Neurosurgical Societies". During the second meeting of the E.C. a list of files which were transported from the office of the historian to Geneva was published. From this date the Archives from the beginning of the federation till today are in the Central Office. For the first time in the history of the federation the congress in Amsterdam had a profit of more than 10%. Conform the propositions from the Long-Range Committee in 1987 (Chair Dr. Alan Hudson) this amount of $ 250.000.,00 was transferred to the Federational Bank. At the time of the A.C, meeting in Geneva, February 2000 and just before the postponed E.C. interim meeting in San Francisco April 2000, the WFNS consist of five continental organizations, seventy one member-societies and five affiliate member-societies. There are nineteen honorary-presidents; eight officers are member of the administrative council. In addition there are seven second vice-presidents representing the five continental organizations plus two at large. The Editor of the Federation News and the historian are also officers. The E.C. consist of all officers, delegates (two of each continental organizations and members society plus observers from the affiliate member-societies, which haven't a right to vote. There are 9 standing committees, 3 scientific and 19 ad hoc committees. According to the figures of the Directory Committee there are about 20.000 neurosurgeons all over the world. Respectfully, H. Alphons D. Walder, M.D., Ph.D. Historian WFNS