William Macewen and the first documented successful resection of a brain tumor.

William Macewen was a visionary fearless Scottish surgeon who performed the first documented successful resection of a brain tumor on July 27, 1879. The pioneering operation received little attention at the time, and even today Macewen is under-recognized for his historic accomplishment. In this vignette, the author discusses details of Macewen's landmark procedure and describes two other groundbreaking brain tumor operations, one performed by Rickman Godlee 5 years later and another performed by Zanobi Pecchioli almost half a century earlier.

Sir Rickman John Godlee-Contributions in Addition to His 1884 Tumor Resection, A Review.

BACKGROUND: Sir Rickman John Godlee (1849-1925) was widely known for performing the first documented surgery to resect a tumor from the brain. METHODS: The case was performed on November 25, 1884, on a 25-year-old farmer who presented with a left-sided Jacksonian March seizure. RESULTS: The case was highly publicized because the tumor was localized by Dr. Hughes Bennett and subsequently resected by Sir Godlee based on the patient's clinical presentation and physical examination alone. CONCLUSIONS: Aside from this widely publicized case, little has been written about Sir Godlee. Sir Godlee was also known to be an outstanding anatomist who displayed exceptional skills in surgical dissection. He was known for being an excellent teacher. Sir Godlee was deeply influenced by his uncle, Lord Joseph Lister, a renowned physician who popularized antiseptic methods. Sir Godlee was also known for publishing his uncle's biography, Lord Lister.

The advent of epilepsy directed neurosurgery: The early pioneers and who was first.

Efforts to treat epileptic seizures likely date back to primitive, manmade skull openings or trephinations at the site of previous scalp or skull injuries. The purpose may have been the release of "evil spirits," removal of "cerebral excitement," and "restoral of bodily and intellectual functions." With progressive discoveries in brain function over the past 100 to 300 years, the cerebral cortical locations enabling voluntary movements, sensation, and speech have been well delineated. The locations of these functions have become surgical targets for the amelioration of disease processes. Disease entities in particular cerebral-cortical areas may predispose to the onset of focal and or generalized seizures, which secondarily interfere with normal cortical functioning. Modern neuroimaging and electroencephalography usually delineate the location of seizures and often the type of structural pathology. If noneloquent brain regions are involved, open surgical biopsy or removal of only abnormal tissue may be undertaken successfully. A number of the early neurosurgical pioneers in the development of epilepsy surgery are credited and discussed in this article.