María Cristina García-Sancho

María Cristina García-Sancho y Álvarez-Tostado de Penichet (née María Cristina García-Sancho y Álvarez-Tostado; May 22, 1919 – February 21, 2013) was the first Latin American and Mexican female neurosurgeon. She is best known for the García-Sancho One-step Bilateral Cordotomy, which she used in more than 1,600 cases at Mexico's National Institute of Oncology and the Women's Hospital for cancer patients.^[1]

On May 22, 1919, María Cristina García-Sancho y Álvarez-Tostado was born in Guadalajara, Jalisco, Mexico, to parents Luis García-Sancho and Ana Álvarez-Tostado Robledo. She had two brothers and one sister. Her family, composed of white-collar professionals, emigrated to Mexico City due to the economic conditions in Guadalajara following the Mexican Revolution. After selling their property, García-Sancho's parents traveled and settled in Mexico City when she was one-and-a-half years old.^[2]

García-Sancho completed her secondary education at the Motolinía School (now Motolinía International Institute) and later enrolled in the School of Medicine at the National Autonomous University of Mexico (UNAM) in 1941. She earned her neurosurgical degree with honors in 1947. Her interest in neurology developed during medical school, and upon graduation in 1947, she wrote a clerkship thesis titled The Sequelae of Traumatic Brain Injury, which discussed the long-term consequences of brain injury.^[1] In 1949, she began her three-year neurosurgical training at the Institute of Neurosurgery and Brain Research in Chile, supported by a scholarship from the Chilean government. Under the mentorship of Dr. Alfonso Asenjo Gómez, she completed her master's and doctoral degrees in neurosurgery at the Institute of Neurosurgery and Brain Research of Chile (now Dr. Alfonso Asenjo Institute of Neurosurgery) in 1951. Through her scholarship, she also studied in Europe, spending three months in Germany at the Max Planck Institute for Brain Research, where she worked with neurosurgeon Wilhelm Tönnis and neuropathologist Klaus-Joachim Zülch. In her time in Europe for over a year, she visited university hospitals and prominent doctors in France, Switzerland, Spain, Italy, Belgium and Portugal - where she visited Egas Moniz who invented angiography.^[2]

After her time in Europe, she returned to Mexico and worked at the La Raza Hospital, part of the Mexican Social Security Institute (IMSS), and later joined the National Cancer Institute in 1952. She served as the head of the Department of Neurosurgery at the National Cancer Institute of Mexico,^[1] and also began performing surgical procedures for the Women's Hospital. She saw more than 63,000 patients and she delivered pain control.^[2] She co-founded and became a director of the Mexican Society of Neurological Surgery.^[1]

García-Sancho has mentored numerous prominent neurosurgeons in Mexico, including Amelia Cabrera, María Teresa Ramírez Ugalde, Mario Echegaray Naveda, Manuel Mandujano, Estela Mandujano, José Carlos Palacios Márquez, Ramón Cerón Uribe, C. Freigó, Manuel Montoya, Miguel Ángel Hernández Absalón and Alfonso Peña Torres.^[2]

She presided over the First National Congress of Mexican Women Physicians in 1975 and received a medal and diploma as a professor emeritus in recognition of 35 years of academic work at UNAM.^[2]

García-Sancho has directed more than fifteen theses on pain and various neurological topics, some of which received honorable mention and were published in journals of the National Cancer Institute and the Society of Gynecology and Obstetrics.^[2]

García-Sancho also studied law at the Women's University of Mexico, where she graduated in 1989 with a thesis titled Current Laws on the Problem of Insemination and In Vitro Fertilization (Las leyes actuales frente al problema de la inseminación y fertilización in vitro).^[2]

García-Sancho improved the one-step cordotomy procedure in collaboration with the American surgeon Irving Cooper. Her technique reduced bilateral cordotomy to a one-step procedure. Cordotomy is a procedure in neurology where it relives severe pain that is typically linked to cancer. She introduced a method that cut the sensitive roots of the medulla. This is done after identifying the anterior roots and making a cut on the posterior part in the posteroanterior direction in the space between the exit of the posterior root and the emergence of the anterior root in the medulla.^[2]

Cordotomies are used for patients with severe cancer pain (level 3 of the World Health Organization pain ladder). Modern practice uses Percutaneous Cervical Cordotomy (PCC) as it is minimally invasive compared to the more invasive open surgery of the cordotomy. Cordotomy is typically limited to patients with a life expectancy of less than two years.^[3]

In the 1990s, with the improvement in pain management, the cordotomy was less used due to the rise of effective, non-invasive pain management (opioids), improved and less invasive techniques such as PCC, and the side effects associated with the cordotomy.^[4]

In April 1954, García-Sancho married Manuel Penichet, an industrialist, and they had a daughter, María Cristina Penichet García-Sancho. She became widowed in 1999 and had two grandchildren.^[2] García-Sancho died on February 21, 2013, at 93.^[2]

• García-Sancho, María Cristina (1949). "Neurosurgery in cerebral tuberculoma". Neurocirugia – via Scopus.
• García-Sancho, María Cristina (1949). "Relief of pain, surgical treatment". Neurocirugia – via Scopus.
• García-Sancho, María Cristina; Villavicencio, C. (1949). "La electroencefalografia en el diagnóstico y localización de los abscesos cerebrales" [Electroencephalography in diagnosis and localization of cerebral abscesses]. Neurocirugia – via Scopus.
• García-Sancho, María Cristina (1954). "Cirugía del dolor" [Pain Surgery] – via Google Scholar.
• García-Sancho de Penichet, María Cristina; de Gutierrez Cabrera, J.J (1963). "Early diagnosis of tumors of the pituitary gland. (Endocrine correlations)". Revista del Instituto Nacional de Cancerología – via Scopus.
• García-Sancho, María Cristina (1972). "El porque y los resultados del servicio de Neurocirugía en el Instituto Nacional de Cancerología" [The rationale and results of the Neurosurgery service at the National Cancer Institute] – via Google Scholar.
• García-Sancho, María Cristina (1974). "Dolor, diagnóstico y tratamiento" (in Spanish) – via Google Scholar.
• García Sancho y Alvarez Tostado, María Cristina (1989). "Las leyes actuales frente al problema de la inseminacion y fertilizacion in vitro" [Current laws regarding the problem of in-vitro fertilization and artificial insemination] (in Spanish). National Autonomous University of Mexico.