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Barrow makes international news with neurological detective story

A tale of medical sleuthing has cast an international spotlight on Phoenix’s Barrow Neurological Institute.

After a two-year international investigation, Barrow researchers have concluded that Napoleon likely would have conquered Russia in 1812 if not for the life-saving surgery performed on Russian general Mikhail Kutuzov by the French surgeon Jean Massot, who operated on Kutuzov after bullets twice passed through his head.

“It’s a story of how medicine changed the course of civilization,”

says Dr. Mark C. Preul, Newsome Family Endowed Chair of Neurosurgery Research Director at Barrow.

And it’s a story that has piqued the interest of media worldwide. Outlets that have picked up the story include Radio Free Europe, Science Daily, Medical Daily, The Times of India and International Business Times. They credit Barrow’s researchers with essentially rewriting history.

“Napoleon Bonaparte’s failed attempt to invade Russia in 1812 may not be as widely known as his defeat at the Battle of Waterloo two years later, but it is largely credited as the beginning of the end for the French commander,” writes Dana Dovey of Medical Daily. “A new study presents compelling evidence to suggest that the true reason for Napoleon's blunder in Russia was not due to his poor military judgment but rather the skilled hands of a French brain surgeon.”

We’re fortunate to work with a client such as Barrow, which has so many interesting stories to tell.

The media coverage is perhaps not surprising because Kutuzov is to Russians what George Washington is to Americans. He was immortalized by Tolstoy in War and Peace.

For more than two centuries, history has focused on Kutuzov's incredible story. He survived being shot in the head in 1774 and 1788 and went on to become one of Russia's legendary heroes by repelling Napoleon's invaders. His story has been called a miracle. But by combing primary sources in Russian and French, the Barrow team found that Massot played a critical role in the drama, employing techniques that foreshadowed modern neurosurgery to help Kutuzov survive what appeared to be mortal wounds.

Dr. Preul led the research team in collaboration with fellow Barrow Neurological Institute researchers Dr. Sergiy V. Kushchayev and Dr. Evgenii Belykh and five other researchers. The study, titled "Two bullets to the head and an early winter: fate permits Kutuzov to defeat Napoleon at Moscow," was published in the Journal of Neurosurgery.

"We wanted to find out what really happened and basically identify this surgeon who saved Mikhail Kutuzov," Dr. Preul says. "Massot's facts were somewhat buried. He is at the vanguard of surgical technique. He uses incredibly modern techniques that we still use today."

What they found was evidence that the first bullet wound, sustained in a battle with the Turks in Crimea in 1774, had destroyed Kutuzov's frontal lobe. That explained Kutuzov's erratic behavior after the injury - but it also provided clues to the brilliant strategy he used to defeat Napoleon and his seemingly invincible Grande Armée.

Kutuzov's injury most likely impaired his ability to make decisions; observers noticed that his personality was altered after the first gunshot wound. So instead of challenging Napoleon's superior forces in the autumn of 1812, Kutuzov put off a confrontation. He ordered Moscow burned and fled with his army to safety east of Moscow. Napoleon's army pursued and invaded Moscow. But it lacked food and supplies and succumbed to an early Russian winter. Napoleon abandoned the army in December and returned to Paris in defeat.

"The other generals thought Kutuzov was crazy, and maybe he was," Dr. Preul says. "The brain surgery saved Kutuzov's life, but his brain and eye were badly injured. However, ironically, the healing resolution of this situation allowed him to make what turned out to be the best decision. If he had not been injured, he may well have challenged Napoleon and been defeated."

Dr. Preul says some questions about Kutuzov's injuries - and Massot's operations on them - can't be completely answered without a medical examination. Kutuzov's body has not been examined since his autopsy shortly after his death in April 1813. But this much is clear: Kutuzov would not have been in command without Massot's efforts.

"Although some would say fate allowed the brilliant Russian general, who became the personification of Russian spirit and character, to survive two nearly mortal head wounds, the best neurosurgical technique of the day seems to have been overlooked as a considerable part of Kutuzov's success," the researchers wrote.

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