Prominent Neurosurgery Books of the Western World: How They Defined the Era of Modern Neurosurgery in the 19th Century.

The aim of this article is to introduce the 19th century neurosurgery books to reveal their contributions to modern neurosurgery. Methods In this study, 29 books were accessed, and reviewed, and the resources from the late 18th century and early 20th century were included. However, neurology or general surgery books that included neurosurgical subjects or chapter were excluded unless there were revolutionary ideas in their relevant chapters. The books of this period observed to have some common differences from the books that were written in the previous century. Parallel to the concept of cerebral localization, which started to develop in this period, neurosurgery evolved from skull surgery to brain surgery. Due to the advancements in patient care, anesthesia and sterile techniques, surgical medical branches showed rapid development in the 1800s. During this period, cerebral localization concept changed the comprehension and approach in neurosurgery and opened the gate of a new era in the field of neurological surgery unlike other branches and helped to establish modern neurosurgery. 19th century surgeons became able to operate on more complex cases with more advanced techniques. Knowledge of published pioneer papers and books help understanding of emergence of neurological surgery as a separate discipline.

The Mayo, Cushing, and Osler Influence on A. L. Rhoton: A Historical Vignette of the Interconnectedness Between Highly Influential Neurosurgery Leaders over 100 Years.

The careers of the Mayo brothers, Harvey Cushing, and Sir William Osler greatly shaped medical and surgical practice in the late 19th century and early 20th century and created a legacy to influence decades of physicians to follow. Additionally, these individuals were instrumental in the founding of neurosurgery as a distinct surgical specialty. Alongside these great men, Dr. Albert L. Rhoton Jr., revolutionized neurosurgical practice through his study of neuroanatomy and development of microsurgical technique in the second half of the 20th century. This review of the interactions and relationships between the Mayo brothers, Cushing, and Osler and their influences on Rhoton highlights the 100-year-long interconnectedness shared between these giants in the history of neurosurgery.

Art and Neurosurgery: The Importance of Medical Illustration.

Art in neurosurgery has been a critical part of the discipline for centuries. Numerous cultures, such as ancient India, China, and Egypt, and more contemporary scientists, such as Leonardo da Vinci, Max Brödel, and Norman Dott, have significantly contributed to medical illustration. Today, advancements in three-dimensional technology have allowed for the creation of detailed neuroanatomy models for surgical planning and education. Medical illustrations are also used for research and outcome documentation as they help visualize anatomy and surgical procedures. Its use in education, surgical planning, and navigation remains integral to the advancement of neurosurgery. This review demonstrates the invaluable contribution of art in neurosurgery and how it has enabled continuous progress in the field.

The birth of modern military neurosurgery through the eyes of Harvey Cushing's war memoir From a Surgeon's Journal, 1915-1918.

Dr. Harvey Cushing is considered the father of modern neurological surgery, and his role and efforts in World War I continue to have a lasting effect on today's practice of neurosurgery. During World War I, he embodied the tenets of a neurosurgeon-scientist: he created and implemented novel antiseptic techniques to decrease infection rates after craniotomies, leading him often to be referred to as "originator of brain wound care." His contributions did not come without struggles, however. He faced criticism for numerous military censorship violations, and he developed a severe peripheral neuropathy during the war. However, he continued to stress the importance of patient care and his surgical prowess was evident. In this paper, the authors summarize Cushing's notes published in From a Surgeon's Journal, 1915-1918 and discuss the impact of his experiences on his own practice and the field of neurosurgery.

Childhood-onset Craniopharyngioma.

Craniopharyngiomas are rare embryonic malformational tumors of the sellar/parasellar region, classified by the World Health Organization (WHO) as tumors with low-grade malignancy (WHO I). The childhood adamantinomatous subtype of craniopharyngioma is usually cystic with calcified areas. At the time of diagnosis, hypothalamic/pituitary deficits, visual disturbances, and increased intracranial pressure are major symptoms. The treatment of choice in case of favorable tumor location (without hypothalamic involvement) is complete resection. It is important to ensure that optical and hypothalamic functionality are preserved. In case of unfavorable tumor location, that is with hypothalamic involvement, a hypothalamus-sparing surgical strategy with subsequent local irradiation of residual tumor is recommended. In the further course of the disease, recurrences and progression often occur. Nevertheless, overall survival rates are high at 92%. Severe impairment of quality of life and comorbidities such as metabolic syndrome, hypothalamic obesity, and neurological consequences can be observed in patients with disease- and/or treatment-related lesions of hypothalamic structures. Childhood-onset craniopharyngioma frequently manifests as a chronic disease so that patients require lifelong, continuous care by experienced multidisciplinary teams to manage clinical and quality of life consequences. For this review, a search for original articles and reviews published between 1986 and 2020 was performed in Pubmed, Science Citation Index Expanded, EMBASE, and Scopus. The search terms used were "craniopharyngioma, hypothalamus, pituitary obesity, irradiation, neurosurgery.

Minimally-invasive tubular retraction ports for intracranial neurosurgery: History and future perspectives.

Brain retraction is a necessary yet potentially damaging requirement of accessing lesions located in deep structures. The development of minimally-invasive tubular retractors (MITRs) provides the theoretical advantage of maximizing visualization of and access to deep-seated lesions, all while minimizing collateral tissue damage. These advantages make MITRs preferable to traditional bladed retractors in the majority of deep-seated lesions. Several commercially-available MITR systems currently exist and have been shown to aid in achieving excellent outcomes with acceptable safety profiles. Nevertheless, important drawbacks to currently-available MITR systems exist. Continued pursuit of an ideal MITR system that provides maximal visualization and access to deep-seated lesions while minimizing retraction-related tissue damage is therefore important. In this review, we discuss the historical development of MITRs, the advantages of MITRs compared to traditional bladed retractors, and opportunities to improve the development of prospective MITRs.

Legacies of Neurosurgery and its Implications on Global Neurosurgery Today.

Trephination, the practice of boring a hole in the skull, is one of the oldest surgical procedures performed by and on humans. Fossil records show evidence of trephined skulls on separate continents throughout ancient history. Even more remarkably, fossils show that ancient humans actually survived the procedure, some more than once. Ancient mythologies and texts provide context to the fossil record, indicating that trephination was performed some of the time for medical indications, including traumatic head injury and intractable neurologic conditions. In the modern day, traumatic brain injury accounts for a significant percentage of the overall global burden of disease and its incidence is disproportionately increasing in low- and middle-income countries. In critical situations, neurosurgical intervention may be indicated. The burr hole procedure, or trephination, was identified as an essential surgical procedure that all first-level hospitals should be able to perform; however, there exists a dramatic lack of access to neurosurgical specialists and care globally, especially among low- and middle-income countries. Task-shifting/sharing is one paradigm that may be used effectively to broaden access to this life-saving procedure but it is at the moment a contested practice.

Precedent for the Present: Neurosurgery During the 1918 Wartime Influenza Pandemic.

In the early twentieth century, early neurosurgical pioneers marked their claims in the specialty during the combined threats of the Spanish influenza and World War I. Their stories, intimately connected, demonstrate personal and professional losses in the backdrop of overarching perseverance to achieve that which allowed neurosurgery to evolve into modernity. Today, as global order adapts to the severe acute respiratory syndrome coronavirus (SARS-COVID-19) pandemic, their stories provide an opportunity for reflection as we carve our way forward as a specialty.

Progress in neurosurgery: Contributions of women neurosurgeons in the Middle East.

The Middle East is known for its complex history and rich environment and culture. The region is home to a wide variety of traditions, cultures and religions, which have made the area vulnerable to political conflicts. Despite these difficulties, science and medicine have always thrived in the region, with many medical practices and principles established by physicians and scholars living in the Middle East. The first academic neurosurgical activity in the region started in the 1950s. The first women neurosurgeons in the Middle East started training in the 1970s, and were from Iran, Palestine, followed by Saudi Arabia in the 1970s. These pioneers have encountered serious challenges, yet have become role models for the next generation. These women have paved the way and facilitated neurosurgical training and practice for more women surgeons. The gradual increase in the number of women neurosurgical residents in the region leads to the expectation that women will play a more prominent role in the future as leaders in neurosurgery in the Middle East. This collaborative study, which identifies the known women neurosurgeons in the Middle East for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.

Progress in neurosurgery: Contributions of women neurosurgeons in Latin America.

Nearly 75 years after the first woman neurosurgeon was trained in Latin America, the field of neurosurgery is changing and the prominence of women neurosurgeons within the specialty is increasing. By researching the histories of individual physicians and neurosurgeons, as well as neurosurgical departments and societies, we present, for the first time, the history of the women in neurosurgery in Latin America. Women neurosurgeons in the region have made notable progress, inspiring subsequent generations and actively participating in organized neurosurgery, medical leadership outside neurosurgery, academic neurosurgery, and leadership in contemporary society. The establishment of "Women in Neurosurgery" networks and organizations has been important to the success of many of these efforts. This collaborative study, which identifies the known women neurosurgeons in Latin America for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.

The History of Neurosurgical Spinal Oncology: From Inception to Modern-Day Practices.

The neurosurgical management of spinal neoplasms has undergone immense development in parallel with advancements made in general spine surgery. Laminectomies were performed as the first surgical procedures used to treat spinal neoplasms. Since then, neurosurgical spinal oncology has started to incorporate techniques that have developed from recent advances in minimally invasive spine surgery. Neurosurgery has also integrated radiotherapy into the treatment of spine tumors. In this historical vignette, we present a vast timeline spanning from the Byzantine period to the current day and recount the major advancements in the management of spinal neoplasms.

Progress in neurosurgery: Contributions of women neurosurgeons in Asia and Australasia.

At the end of the first 100 years of neurosurgery as a specialty, it is appropriate to look back and then imagine the future. As neurosurgery celebrates its first century, the increasing role of women neurosurgeons is a major theme. This article documents the early women pioneers in neurosurgery in Asia and Australasia. The contributions of these trailblazers to the origins, academics, and professional organizations of neurosurgery are highlighted. The first woman neurosurgeon of the region, Dr. T.S. Kanaka of India, completed her training in 1968, not long after the trailblazers in Europe and North America. She heralded the vibrant communities of neurosurgical women that have developed in the vast and diverse nations of the region, and the many formal and informal groups of women in neurosurgery that have introduced and promoted talented women in the profession. Contributions of women neurosurgeons to academic medicine and society as a whole are briefly highlighted, as are their challenges in this male-dominated specialty. The region is home to many deeply conservative societies; in fact, some nations in the region have not yet trained their first woman neurosurgeon. The fortitude of these individuals to achieve at the highest levels of neurosurgery indicates great potential for future growth of women in the profession, but also demonstrates the need for initiatives and advocacy to reach the full potential of gender equity.

Four Athenas - Europe's first female neurosurgeons.

In the early 20th century, a tumultuous era was yielding geopolitical and social change. Europe at large was undergoing redefinition of borders, political structures, and economies, while rebuilding societies after World War I. At the same time, neurosurgery was emerging as a new specialty, and women were allowed to study medicine for the first time in many European countries. These factors created a synergy, setting the stage for Europe's four first female neurosurgeons to emerge. In 1924, Germany's Alice Rosenstein began her neurosurgical career and contributed to the refinement of pneumoencephalography. Due to her Jewish background, she was forced to flee Europe, emigrating to the United States, where she did not continue to practice neurosurgery. In 1929, Russia's Serafima Bryusova began her neurosurgical training. She studied intracranial pressure in trephined patients and wrote the first Russian monograph on cerebral angiography before she was immobilized by severe arthritis. England's Diana Beck began her neurosurgical career in 1939. She contributed to the surgical treatment of intracerebral hemorrhage and researched idiopathic intracranial hypertension, even though many believed she could not be a successful surgeon due to her myasthenia gravis. In 1943, Romania's Sofia Ionescu started a prolific academic neurosurgical career. She developed a minimally-invasive technique to treat intracerebral hematomas and worked tirelessly to bring neurosurgery to all corners of her country. Europe's first women in neurosurgery were marked by war and adversity. Their stories carry within them a spirit of resilience, fortitude, and tenacity that continues to characterize women in neurosurgery today.

European women in neurosurgery: II - Historical characters and living legends.

A collaborative global working group of women neurosurgeons in multiple countries at different stages of their neurosurgical careers undertook the task of researching the history of European women in neurosurgery. While doing so, we happened upon many remarkable female neurosurgeons who overcame great adversity, made tremendous contributions to society and institutional neurosurgery, and displayed numerous talents beyond the operating room. In the first part of this paper, we recounted a chronology of female neurosurgeons in Europe, highlighting the most remarkable achievements of women in every decade, from the 1920's to 2020. In this paper, we honor fascinating women in European neurosurgery, both historical characters and living legends. These women have overcome great adversity and have also excelled in a huge variety of pursuits. While some were themselves refugees, we also have uncovered noteworthy examples of women who immersed themselves in humanitarian missions and who tried to better the world through political action. There are stories of women beating the odds, taking on biased institutions and proving their worth, in spite of the prevailing system. Most inspirational, we have discovered through our comprehensive research on the history of women in European neurosurgery that the future is increasingly female.

Historical Perspective on Surgery and Survival with Glioblastoma: How Far Have We Come?

BACKGROUND: Glioblastoma multiforme remains a therapeutic challenge. We offer a historical review of the outcomes of patients with glioblastoma from the earliest report of surgery for this lesion through the introduction of modern chemotherapeutics and aggressive approaches to tumor resection. METHODS: We reviewed all major surgical series of patients with glioblastoma from the introduction of craniotomy for glioma (1884) to 2020. RESULTS: The earliest reported craniotomy for glioblastoma resulted in the patient's death less than a month after surgery. Improved intracranial pressure management resulted in improved outcomes, reducing early postoperative mortality from 50% to 6% in Harvey Cushing's series. In the first major surgical series (1912), the mean survival was 10.1 months. This figure did not improve until the introduction of radiotherapy in the 1950s, which doubled survival relative to those who had surgery alone. The most recent significant advance, chemotherapy with the alkylating agent temozolomide, extended survival by 2.5 months compared with surgery and radiotherapy alone (14.6 and 12.1 months, respectively). This protocol remains the standard regimen for newly diagnosed glioblastoma. The innovative treatments being investigated have yet to show a survival benefit. CONCLUSIONS: With advancements in localization, imaging, anesthesia, surgical technique, control of cerebral edema, and adjuvant therapies, outcomes in glioblastoma improved incrementally from Cushing's time until the introduction of magnetic resonance imaging enabled better degrees of resection in the 1990s. Modest improvements came with the advent of biomarker-driven targeted chemotherapy in the first decade of the current century.

The evolution of stereotactic radiosurgery in neurosurgical practice.

INTRODUCTION: Stereotactic radiosurgery (SRS) was born in an attempt to treat complex intracranial pathologies in a fashion whereby open surgery would create unnecessary or excessive risk. To create this innovation, it was necessary to harness advances in other fields such as engineering, physics, radiology, and computer science. METHODS: We review the history of SRS to provide context to today's current state, as well as guide future advancement in the field. RESULTS: Since time of Lars Leksell, the young Swedish neurosurgeon who pioneered the development of the SRS, the collegial and essential partnership between neurosurgeons, radiation oncologists and physicists has given rise to radiosurgery as a prominent and successful tool in neurosurgical practice. CONCLUSION: We examine how neurosurgeons have helped foster the SRS evolution and how this evolution has impacted neurosurgical practice as well as that of radiation oncology and neuro-oncology.

The historical perspective in approaches to the spheno-petro-clival meningiomas.

The current literature regarding surgical treatment for tumors in the sphenopetroclival (SPC) region is merely scarce. Through a comprehensive literature review, we investigated the indications, outcomes, and complications of different surgical approaches to the SPC meningiomas. Given its complicated relationship between these slow-progression tumors and some critical neurovascular structures in the SPC region, surgical treatment of these tumors faces the challenge of achieving a maximal grade of resection, while preserving patient functionality. The development of new surgical techniques and approaches in recent years have permitted the advancement in the treatment of these tumors, with acceptable rates of morbidity and mortality. The choice of a surgical approach as a treatment for the lesion depends mainly on the type of tumor extension, surgeon's preferences, and the displacement of neurovascular structures. Rather than focusing on one single strategy of treatment, the skull-base surgeon should tailor the approach based on the origin and features of the lesion; as well as the peculiarities of the surgical anatomy. This strategy aims to decrease morbidity and to optimize tumor resection and patient quality of life.

Trepanation of the Outer Table as a Treatment for Scalping Injuries: Historical Perspective and Modern Applications.

Complex cranial wounds represent complex surgical problems. In modern times, these are mostly due to accidental trauma. During the period of the American Frontier, violent scalping was a common practice. Innovative techniques were utilized to improve outcomes for this condition that still have relevance in today's practice. We provide a historical perspective with vignettes that identify survivors of violent scalping from the American Frontier as well as the surgical techniques used to treat them. The techniques identified were then modified for modern practice and applied to a complex cranial wound. A review of primary and secondary historical sources was carried out. Nine separate incidences of violent scalping were identified from this period. Successful treatment relied on exposure of the diploe leading to granulation tissue formation and eventual scalp coverage. This was accomplished as a byproduct of the violence of the scalping or as an application of the technique first described by Augustin Belloste in 1696. Application of this technique in a modern setting may allow for improved wound healing. Trepanation of the outer table to aid in healing and closure of complex cranial wounds has a long history of successful practice and can be successfully applied to modern practice.

Dominique Anel, John Hunter, and the Eponymous Hunterian Ligation of Aneurysms: Conception to Current Practice.

The contributions of both Dominique Anel and John Hunter in the development of the eponymous Hunterian ligation of aneurysms are presented. John Hunter, the "father of scientific surgery" lent his name to the eponymous practice of applying ligatures to aneurysmal dilatation of arteries. However, evidence suggests that the operation might antedate him by decades. Dominique Anel was a surgeon in the time of Louis XIV who, after his initial apprenticeships in Toulouse and Montpellier, subsequently served in the French navy. He famously described the lacrimal syringe that bears his name but was also interested in diseases of the bones and arteries. Anel described his technique of ligating an aneurysm of the brachial artery in the winter of 1709-1710 in Turin. His description of ligating just the upper end of the aneurysm without touching the sac was described in his collected works in 1714. This technique was exactly the same as that used by Hunter. However, Hunter had based his decision not to excise the sac on his own research. Hunterian ligation was used routinely before endoaneurysmorrhaphy, after which its popularity declined. Hunterian ligation has been superseded by development of surgical clips and endovascular techniques for intracranial aneurysms. However, the technique is still described occasionally in vascular and neurosurgical literature in the context of treating large aneurysms not amenable to traditional treatment modalities.