The year 2014 marks the centenary of the birth of Mario Milletti, an Italian neurosurgeon and a pioneer of modern neurosurgery in Italy. In 1950, together with the Austrian Wolfram Sorgo, he founded Acta Neurochirurgica. For this reason, I believe a short commemoration in this journal is appropriate.

Milletti (Fig. 1) was born in Pescia (Pistoia) on 29 April 1914, and he graduated with a degree in medicine from the University of Bologna. Early in his career, he devoted himself first to histology and embryology and then to pathologic anatomy (for several months in 1936 and in 1937, he attended the Institute of Pathology at the University of Leipzig under Werner Huech’s guidance); he wrote various works, 32, on histopathological topics, among which those concerning experimental modifications of liver cells are of particular importance. For a few years, he devoted himself to general surgery and was an assistant at the Surgical Clinic of Bologna University, first under the guidance of Raffaele Paolucci and then under the leadership of Gherardo Forni; his scientific production in the field of general surgery consists of 15 papers.

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Mario Milletti

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His work in neurosurgery began in 1942, at the age of 28 years. In 1942–43, he attended the Neurosurgical Clinic of Berlin with Wilheilm Tonnis, then the Neurosurgical Clinic in Stockholm with Herbert Olivecrona. In 1946, he spent 9 months at the Neurosurgical Clinic of Manchester with Sir Geoffrey Jefferson. Under the guidance of these masters of neurosurgery, Milletti improved his knowledge of diagnostic arteriography (with Tonnis), ventriculography and pneumoencephalography (with Olivecrona) as well as the surgical techniques for various neurosurgical diseases; in particular, in Manchester with Jefferson he was especially interested in cerebral aneurysms. In 1949–50, he visited the major neurosurgical centers in the United States. From 1947, Milletti was head of the Institute of Neurosurgery “Cesare Cavina” at the Maggiore Hospital in Bologna. He was one of the nine founders of the Italian Society of Neurosurgery (Turin, 29 May 1948) and a member of a number of Italian and foreign scientific associations. In 1950, he organized the “Neurochirurgicum Symposium” in Bologna, the first international neurosurgery meeting ever held in Italy.

In November 1951 at the first Congress of the Italian Society of Neurosurgery, he was a speaker on the topic of cerebral aneurysms. Milletti was very interested in saccular aneurysms, a subject on which he published several works [7, 9, 10, 14, 15] outlining all aspects of aneurysms. Figure 2 shows the title page of a long article, 216 pages, entitled “Aneurysms of cerebral vessels. Clinical diagnosis and surgical treatment,” published in 1952 [15], in which the author reports and expands on the lecture delivered the year before at the first Congress of the Italian Society of Neurosurgery. Some of the other papers reported cases presenting special features, such as multiple aneurysms [3, 4] or aneurysms of the optical-chiasmatic region [8]; Milletti reported cases he had observed at his Institute in Bologna and during his stays in Berlin, Stockholm and Manchester.

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Title page of Milletti’s work, “Aneurysms of cerebral vessels. Clinical diagnosis and surgical treatment”

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In the context of vascular diseases, two interesting works on thrombosis of the internal carotid artery in the neck [11] and of the posterior cerebral artery [18] should be pointed out. Milletti was interested in many other aspects of neurosurgical pathology, as is proved by his scientific works on brain tumors [23, 24], pediatric neurosurgery [21, 27, 28, 31], functional neurosurgery [19, 22, 26, 30] and other fields [16, 20, 29, 32].

Certainly he was very interested in diagnostic cerebral angiography, the subject of some of his publications [5, 6, 17, 25] and of a monograph [12]. His most important and best known work is probably a monograph, 79 pages long, published in 1951 in the first Supplement to Acta Neurochirurgica (Figs. 3 and 4a, b), dedicated to diagnostic arteriography of brain tumors [13]. In this, Milletti, based on 203 cases of cerebral tumors examined by means of angiography, investigated the possibility of establishing a differential diagnosis between different histological types, concluding that this is possible in an high percentage of glioblastomas and meningiomas.

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Title page of Acta Neurochirurgica (1950), Suppl. 1

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a, b First and second pages of Acta Neurochirurgica Suppl 1

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Due to a serious illness, Mario Milletti died in Bologna in March 1959 at the age of 45 years. He was commemorated by Filippo Caramazza on 29 February 1960 at the Medical Society of Bologna [1] and also briefly mentioned by Tonnis in Acta Neurochirurgica [33]. In a speech celebrating the 25th anniversary of the foundation of the Italian Society of Neurosurgery, Paolo Conforti, then president of the Society, said: “Mario Milletti and Marino Quarti Trevano (another founding member who died prematurely) are to all an example of the life, study, technique, and dedication to our discipline” [2].