Here’s a look at the history of brain surgery from ancient times to the modern day. To find out more about advanced radiotherapy, please visit our website.
Neurosurgery is a famously difficult and risky procedure. However, thanks to pioneering medical researchers and highly skilled surgeons over the years, there are now some very safe, effective and less invasive ways to operate on the brain. For example, one of the most precise and innovative ways to treat brain tumours is Gamma Knife surgery.
Gamma Knife is not traditional open surgery, so it eliminates the high level of risk and complications involved with making incisions into the skull. Instead, it uses precisely focused gamma rays to target the tumour cells via an external machine. The exact location of the tumour is determined by advanced AI-assisted imaging techniques.
However, such technologically advanced procedures are a very long way from the earliest experimentations with brain surgery. Here’s an overview of how this most challenging yet potentially life-saving procedure has evolved over the years.
Archeologists and historians have unearthed evidence that a primitive form of brain surgery known as ‘trepanation’ was performed as early as 7,000 BCE in pre-Incan civilisation in Peru, and also in Ancient Greece and Egypt, and some areas of south east Asia.
Trepanning involves detaching the scalp and drilling a hole in the skull, and was thought to relieve headaches or the pressure caused by a large tumour. It may also have been carried out to treat mental illnesses, epilepsy and head trauma.
Skulls that have undergone trepanation have been found with evidence of new bone growth, suggesting that some patients survived the procedure. However, it is difficult to assess how effective it was at relieving their symptoms. Early practitioners had a very limited knowledge and understanding of the brain, so any treatments would be very rudimentary.
The field of knowledge was advanced by Hioppcrates (470 BC-360 BC), the Ancient Greek polymath who is considered to be the founding father of modern medical ethics. He left detailed texts containing accurate descriptions of clinical head injuries, spasms, and seizures.
Cornelius Celsus lived in ancient Rome in the first century AD, and there is evidence that he carried out skillful surgery on depressed brain fractures. The Islamic school of brain surgery that flourished between 800 and 1200AD is also considered to be influential on later generations of neurosurgeons.
Despite these advancements, brain surgery was likely to have been a last resort and only carried out in rare circumstances. Before modern anaesthetics and antibiotics were invented, it was an extremely dangerous and painful procedure, and the risk of bleeding and infections probably outweighed the benefits in most cases.
The world’s first successful brain tumour was carried out by a Glaswegian surgeon named William Macewen in 1879. The patient was a young girl named Barbara Watson who presented with a large lump over her left eye, and was suffering from recurring seizures.
Macewen had a specialist interest in neurosurgical procedures, and had explored the safest methods of accessing the brain and infection control measures. He went on to carry out a successful operation to remove the tumour, and the patient went on to make a good recovery.
Macewen published an account of the procedure and outcome in the Glasgow Medical Journal in 1879, although his achievements weren’t widely recognised until almost ten years later in 1888.
The first primary brain tumour operation involving a direct opening of the skull was carried out by Mr. Rickman J. Godlee in 1884 in a London hospital. The 25 year old patient survived the procedure, but died of apparent complications 25 days later. However, a post-mortem revealed that all traces of the tumour had successfully been removed.
Like other forms of medicine, great advancements were made in neurosurgery during the 20th century thanks to a more detailed understanding of brain anatomy, better surgical techniques, and widespread use of anaesthetics and antibiotics. X-rays also enabled the position of tumours to be pinpointed more accurately.
The American neurosurgeon Harvey Cushing is credited with pioneering the framework for modern neurosurgery, which has significantly improved outcomes and patient survival rates.
In the 21st century, minimally invasive techniques for treating brain tumours such as stereotactic radiotherapy have come to the forefront. One of the most advanced forms is the previously mentioned Gamma Knife, which makes use of computer assisted navigation for the most efficient and precise method of destroying tumour cells.
Such techniques avoid the significant risks of open surgery, and have a low risk of causing damage to the surrounding brain tissue.
To find out more about advanced radiotherapy and neurosurgical treatments for glioblastoma, please visit the Amethyst Radiotherapy site.
Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours
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