VATICAN CITY - The Vatican will review security procedures after a woman jumped a barrier and rushed at Pope Benedict XVI for the second time in two years, this time knocking him down before guards pulled her away, a Vatican spokesman said yesterday.

Benedict, 82, wasn't hurt in Thursday night's incident and delivered his traditional Christmas Day greetings yesterday in 65 languages from the loggia overlooking St. Peter's Square. While a bit unsteady at first, he also delivered a short speech about the world's trouble spots without problem.

The incident in St. Peter's Basilica raised fresh questions about papal security, however, after officials said the same woman had jumped the barrier at the 2008 Midnight Mass in a failed bid to get to the pope. She even wore the same red-hooded sweat shirt.

Italian officials also remarked on the odd similarity of the breach to a Dec. 13 assault on Prime Minister Silvio Berlusconi by a man with a history of psychological problems. That attack in Milan broke Berlusconi's nose and two teeth.

The Vatican identified the woman involved in Thursday night's incident as Susanna Maiolo, 25, a Swiss-Italian national with psychiatric problems who was immediately taken to a clinic for treatment.

Interior Ministry officials said Maiolo lived in Switzerland. The ANSA news agency said she had traveled to Rome specifically for the Mass as she did last year.

In the 2008 case, Maiolo never managed to reach the pope and was quietly tackled by security. On Thursday night, she launched herself over the barricade as Benedict walked down the aisle at the start of his Christmas Eve service. As security guards wrestled her to the ground, she grabbed on to Benedict's vestments, bringing him down with her.

While Benedict was unhurt, a retired Vatican diplomat, French Cardinal Roger Etchegaray, 87, fell and fractured his hip in the commotion. He will be operated on in the coming days, said Nicola Cerbino, a spokesman at Rome's Gemelli hospital.

Virtually anyone can get into a papal Mass: Tickets are required but easy to get if requested in advance. Identification cards are not needed to gain entry, though visitors pass through a metal detector.

The Rev. Federico Lombardi, the Vatican spokesman, said it was not realistic to think the Vatican could ensure 100 percent security for the pope, considering he is regularly surrounded by tens of thousands of people for his weekly audiences, Masses, papal greetings, and other events.

"It seems that they intervened at the earliest possible moment in a situation in which 'zero risk' cannot be achieved," he said.

Vatican security officials will nonetheless review the episode and "try to learn from experience," Lombardi said.

It was the first time a potential attacker has come into direct contact with Benedict during his nearly five-year papacy. Security analysts have frequently warned that the pope is too exposed in his public appearances, but Lombardi noted that such events were a necessary part of the job.

"People want to see him up close, and he's pleased to see them closely, too," Lombardi said.

The injured cardinal, Etchegaray, the emeritus archbishop of Marseille, was seen leaving the basilica in a wheelchair after the fall. Despite the fracture, his condition is "good," Lombardi said.

The cardinal received several high-ranking visitors yesterday at his hospital bedside, including Benedict's personal secretary, Monsignor Georg Gaenswein, and the retired Vatican No. 2, Cardinal Angelo Sodano.

It is up to Vatican judicial authorities to decide whether and how to proceed with any possible charges against Maiolo. Lombardi said he did not know how the matter would be handled but said the Vatican justice system was usually "very benevolent."

There have been other security breaches at the Vatican.

In 2007, during an open-air audience in St. Peter's Square, a mentally unstable German man jumped a security barrier and grabbed the back of the pope's open car before being swarmed by security guards.

Then there was the 1981 assassination attempt against Pope John Paul II by Turkish gunman Mehmet Ali Agca. John Paul suffered a severe abdominal wound as he rode in an open jeep at the start of his weekly audience in the Vatican piazza.