April 8 is World Neurosurgeons Day, when the achievements of dedicated surgeons who carry out highly complex and precise procedures on the brain are celebrated.
April 8 is World Neurosurgeons Day, when the achievements of surgeons who carry out highly complex and precise procedures on the brain are celebrated. Leading edge technology such as Gamma Knife surgery has enabled the development of brain surgery that is less invasive, safer, and more effective than ever before.
However, these advancements may not have been possible without the dedicated efforts of Harvey Williams Cushing, the man widely regarded as the father of modern neurosurgery. World Neurosurgeons Day marks the date of his birth on 8 April 1869. Here’s a look at his achievements, and how neurosurgery has evolved since his death in 1939.
Harvey Cushing was born in Cleveland, Ohio, and graduated from Yale College in 1891. He went on to study at Harvard Medical School in Boston, and received his medical degree in 1895.
From here, he completed an internship at Massachusetts General Hospital, where he successfully developed new anesthesia practices and was among the first medics to recognise the potential of X-rays as a diagnostic tool.
In 1896, Cushing started work at the Johns Hopkins Hospital in Baltimore, where he was mentored by the distinguished surgeon William Halsted, and was also strongly influenced by the professor of medicine Sir William Osler. He also spent a year studying with some of the finest surgeons in Europe.
By this time, Cushing had decided to focus his career on neuroscience, and he developed a reputation as one of the most meticulous brain surgeons of his generation. Previously, neurosurgery was considered a last resort with a low success rate: many procedures resulted in fatal bleeding or infections, or permanent brain damage.
Cushing introduced a range of innovations that resulted in a much higher success rate, particularly for the treatment of brain tumours. He developed a classification system for different types of tumours, and used X-rays to accurately locate the position of the tumour in the brain.
He also developed new methods for controlling bleeding and better anaesthesia techniques. One of his most significant legacies was the identification of Cushing’s syndrome, a disorder caused by excess cortisol production due to a pituitary gland tumour.
Cushing was also a prolific writer and talented draughtsman, and he made detailed notes and illustrations of all his work, and these, alongside his many publications that made original contributions to the field of neurosurgery, have educated and inspired future generations of medical professionals.
Neurosurgeons built on the foundations laid by Cushing to develop further groundbreaking techniques that have resulted in more precise and less invasive brain tumour treatment that has a lower risk of side effects.
For example, modern imaging techniques such MRI scans and CT scans have enabled neurosurgeons to more accurately locate the position of tumours. Recently, this process has become even more precise due to the introduction of AI technology, which can be used to automate the process of tumour delineation.
This enables tumours without clearly defined boundaries to be located in a more precise and consistent manner, reducing the risk of human error and variables in interpretation. AI assisted delineation is much quicker compared to a fully manual process of segmenting tumour contours. This speeds up the treatment process and improves patient outcomes.
For open surgery to remove brain tumours, modern procedures are designed to be less invasive with smaller incisions. Many neurosurgeons make use of robotic and AI-driven systems for more accurate and controlled guidance during procedures.
Radiosurgery was first developed to treat brain tumours by the Swedish neurosurgeon Lars Leksell. stereotactic radiosurgery involves delivering localised irradiation in one session to a precisely targeted area of the brain, in order to kill the abnormal tumour cells while having minimal impact on the surrounding healthy brain tissue.
Stereotactic radiosurgery was introduced for the treatment of inoperable arteriovenous malformations, acoustic neuromas, and brain metastasis.
One of the most effective and low-risk forms of stereotactic radiosurgery is Gamma Knife surgery. This makes use of multiple radiation beams with a level of accuracy greater than 0.5mm.
The individual beams are too weak to damage normal brain tissue as they are directed onto the target area, but the beams intersect on the target area to provide effective impact on the abnormal cells.
This minimally invasive procedure has a much lower risk of side effects compared to other forms of brain surgery, and most patients can return home on the same day and will require just one session of treatment.
If you would like to find out more information about Gamma Knife surgery, please get in touch with a member of our team today.
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