History of Modern Neurosurgery

Nineteenth century witnessed the beginning of specialization in neurosurgery. The surgical personalities of the 19th century were varied and talented. Three important developments had contributed to the advancements:
1. Anesthesia:
                  Horace Wells, Morton, Warren and Simpson are credited for inventing anesthesia and patients freedom from pain during procedure.
2. Neurology: 
                  Fritsch, Hitzig, Paul Broca, Wernicke, Ferrier, John Hughling Jackson ( father of modern neurology), Hutchinson, William Gower, Bennet, Allen Starr had contributed immensely to neurological localization.
3. Antisepsis:
                Lord Lister introduced antisepsis in operation theater. Joseph Lister( 1872-1912) was born at Upton in the county of Essex and is considered as one of the greatest figures in  the history of surgery. He is best known for his antiseptic principles including introduction of carbolic acid sprays in the operating rooms , the result of which were published in the Lancet in 1967. The antiseptic principles described by Lister in 1867 reduced the infection rate significantly and gave a boost to the surgeons to proceed beyond the dura mater.
4. Development of Neurosurgical techniques &  Neuroradiology:
                  In 1884, Sir Rickmann Godlee operated upon a brain tumor for the first time solely on the basis of clinical localization by Hughes Bennet.
Sir William Macewen carried out his first surgery on brain abscess in 1881.
William Sharp ( 1840) : "Practical observation on injuries of the head"
Sir Charles Bell ( 1774-1842):  surgical drawings and illustrations.
Sir Victor Horsley, in 1892, invented bone wax which was initially made of bee's wax.
William W. Keen: " An American Textbook of Surgery" in 1890.
Sir Charles Ballance performed the first successful removal of an acoustic neuroma in 1894.
Fedor Krause
W.S.Halsted ( 1852-1922) was the first Professor of surgery at John Hopkins. Halsted was the first surgeon to introduce the use of gloves. Halsted's scrub nurse & wife was allergic to carbolic acid and he devised the glove primarily for her.
Harvey Cushing ( 1869-1939)- was perhaps the greatest neurosurgeon of all times.

1891 Quincke described lumbar puncture for relief of raised intracranial pressure.Heinrich Irenaeus Quincke (26 August 1842 - 19 May 1922) was a German internist and surgeon. His main contribution to internal medicine was the introduction of the lumbar puncture for diagnostic and therapeutic purposes (source: wikipedia).

                                                            Professor Heinrich Quincke (Source: wikipedia)




Roentgen discovered x-rays in 1896.
Walter Dandy described pneumoencephalography and pneumoventriculography in 1918.
In 1921, myelography was introduced when jean Sicard a French clinician and his pupil Jacques Forestier injected analgesics into the spine of a patient suffering from low back pain and subsequently found that the oil they used as a carrier for the analgesic, lipiodol, was radio-opaque.
The invention of myelography encouraged the Portuguese neurologist Egas Moniz to develop ' Arterial Encephalography'.
CT scan- 1967 Godfrey Hounsfield
MRI- Nobel Prize winning work of Block & Purcell in the 1940s, which was applied to medical imaging in 1970s.