Modern Brain Surgery 1879 – No Room for Error!

Actor Michael J. Fox, who has Parkinson's disease, asked a neurosurgeon: 

"Why is brain surgery one of the most demanding tasks, requiring the highest level of human intelligence?" 

After pausing for a moment, the neurosurgeon replied: 

"Because there is no margin for error."

In its rudimentary forms, brain surgery is among the oldest medical procedures. People have had holes drilled in their skulls since prehistoric times (trepanation). Even the Greek physician Hippocrates believed that some brain injuries could be treated with trepanation. However, the first successful modern neurological operations were performed in the 1800s.

In 1876, Scottish surgeon William Macewen treated a child with a brain abscess in the left frontal region after the child fell, cut his eyebrow, and developed convulsions and aphasia (a disorder involving language processing). Macewen was not permitted to operate, and the child died. Believing that the child's death had been unnecessary, Macewen found an abscess the size of a pigeon's egg during the autopsy.

In 1879, however, Macewen began performing brain surgery to treat patients with brain abscesses. This work took place before the invention of X-rays. To determine where to make an incision during surgery, Macewen drew on patients' symptoms and the latest research into the functions of different brain regions. His work would not have been possible without breakthroughs in anesthesia and antiseptics.

In 1884, British surgeon Rickman John Godlee became the first person to perform an operation to remove a brain tumor (an abnormal growth of tissue). In 1887, British surgeon Victor Horsley performed the first operation in which a spinal cord tumor was successfully removed. 

Description of the Article Image: From the right, the first photograph shows William Macewen, the second Rickman John Godlee, and the third Victor Alexander Haden Horsley.

Historical Figures Mentioned in This Article: William Macewen (1848–1924), Rickman John Godlee (1849–1925), Victor Alexander Haden Horsley (1857–1916)

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