EVOLUTIONS & REVOLUTIONS IN NEURO SURGERY

Neuro Surgery Department managed by

Dr. Anup Chakrabarty, MS, MCh (AIIMS, New Delhi)

EARLIEST EVIDENCE OF NEUROSURGERY DATES BACK TO NEOLITHIC PERIOD – 7000 TO 3000 B.C. ARCHEOLOGISTS HAVE DISCOVERED  HUMAN  SKULLS WITH CRANIECTOMY DEFECTS IN  WIDELY SEPARATED GEOGRAPHIC LOCATIONS AROUND THE  WORLD. OLDEST KNOWN WRITTEN DOCUMENTS DEALING WITH NEUROSURGICAL TOPICS - EDWIN SMITH PAPYRUS – 1700 B.C. BRAIN IS MENTIONED FOR THE FIRST TIME IN HISTORY.  DIAGNOSIS & TREATMENT OF 48 INJURED PATIENTS ARE DESCRIBED. HIPPOCRATES (400 B.C.) -
FIRST RECORDED DOCUMENT OF TREPANATION (SURGICALLY OPENING THE SKULL) DESCRIPTIONS OF -NEUROSURGICAL INSTRUMENTS. TILL 19TH CENTURY NEUROSURGERY WAS PRACTICED SPORADICALLY AND IN A VERY CRUDE FORM RESULTING IN POOR OUTCOMES. 

1^st  REVOLUTION 19TH CENTURY

ANESTHESIA – 1846

ANTISEPSIS - 1867 

ASEPSIS - 1891

Neuro-Surgery Became Safe

FIRST TEXTBOOK ON SURGERY OF NERVOUS SYSTEM WAS WRITTEN BY ERNST VON BERGMAN OF GERMANY      IN 1870. PAUL BROCA OF PARIS (1876) WAS THE FIRST SURGEON TO LOCALLISE NEUROLOGICALLY AN INTRACRANIAL LESION (AN EXTRADURAL ABSCESS IN THE    SPEECH AREA) AND TO DRAIN   IT SURGICALLY.  MACEWEN NEUROLOGICALY LOCATED A TUMOR (MENINGIOMA) AND REMOVED IT SURGICALLY IN 1879. WILLIUM GOWER DIAGNOSED A SPINAL TUMOR NEUROLOGICALLY WHICH WAS REMOVED SUCCESSFULLY BY SIR VICTOR HORSLEY IN 1887. BETWEEN 1886-1896 MORE THAN 500 DIFFERENT SURGEONS REPORTED BRAIN OPERATIONS BUT BETWEEN 1896 & 1906 THIS NUMBER FELL BELOW 80. 

 SECOND REVOLUTION

X-Ray- 1895   -    Röntgen

Vetriculography 1917  Sir Walter Dandy

Pneumoencephalography – 1917–  Sir Walter Dandy

Myelography  –1922  – Siccard & Forester

Angiography  1927    Egas Moniz

THIRD REVOLUTION

n  C.T. SCAN

n  M.R.I.

FOURTH REVOLUTION

n   OPERATING MICROSCOPE

–   ILLUMINATION

–   MAGNIFICATION