The History of Brain Surgery

Brain surgery has a long history, predating written records. Doctors through the ages in a variety of cultures tried to treat various diseases and injuries of the brain through surgical methods. These attempts generally had a high mortality rate, and doctors avoided surgery except in worst-case scenarios. Medical advances of the 19th century resulted in the development of modern neurosurgery.

Prehistorical

• Archaeologists have found evidence that Neolithic people in Europe, Asia, Africa and the Americas practiced trepanation, the drilling of holes into the skull with a tool known as a trephine. They base their conclusion on the presence of healed-over wounds in skulls found at ancient burial sites. Although the absence of written records means that scholars do not know the reasoning behind prehistorical trepanations, scholars have speculated that disorders like epilepsy or mental illness may have been attributed to evil spirits that could only be released through the drilling of holes into the skull.

Greeks

• Ancient Greeks conjectured about the structure of the brain and recounted attempts at brain surgery. For instance, Hippocrates (470 B.C.--360 B.C.) described brain injuries that he felt could be treated with a trephine. Similarly ,Galen (131 A.D.--201 A.D.), a doctor who treated gladiators in Pergamon, regularly saw brain injuries and wrote of his surgical attempts to remove fragments of skull embedded in the brain resulting from physical trauma.

Medieval Period

• Physicians who attempted brain surgery during the medieval period of Europe relied on the practices of the ancient Greeks as reported by Arabic sources. As among the ancient Greeks, surgical efforts were limited to the treatment of traumatic brain injuries, and patients often died from post-surgical infections.

Modern

• In the late 19th century, the development of antiseptic methods and anesthesia led to the advent of modern surgery. In the area of brain research, Hughling Jackson, an English physician, pinpointed the location of particular functions in the cerebral cortex through the observation of seizure patients during the 1870s. Experiments on animals confirmed his research, which made possible the first modern brain surgery in 1884, when Rickman Godlee removed a brain tumor. Surgeons like William Macewen in Glasgow, Victor Horsley in London and Ernst Von Bergman in Germany followed suit, performing brain surgeries in the 1880s. During this period, neurologists, using their knowledge of localized functions of the brain, would direct the surgeon to the proper area for operation.

Neurosurgery Today

• After the early surgeries of the 1880s, physicians made rapid advances in neurosurgery. Harvey Cushing, an American physician, developed microsurgery to treat aneurysms and pioneered the method of using X-rays to guide the surgeon at the turn of the century. Neurologists and neurosurgeons founded journals and professional associations relating to the field of neurosurgery in the first half of the 20th century. As neurosurgery became its own field, sub-specialties followed, including pediatric, spinal and vascular neurosurgery.