Early evolution of neurological surgery: conquering increased intracranial pressure, infection, and blood loss

Neurosurg Focus. 2005 Apr 15;18(4):e2. doi: 10.3171/foc.2005.18.4.3.

Abstract

At the end of the 19th century, the early evolution of the specialty of neurological surgery was restricted by complications related to infection, increased intracranial pressure, and excessive intraoperative blood loss. These complications often caused mortality rates of 30 to 50%. An improved understanding of pathophysiological factors involved in increased intracranial pressure, along with meticulous surgical techniques learned from William Halsted, allowed Harvey Cushing to increase the safety of neurosurgical procedures that were then in their infancy. Cushing's later development of the "silver clip" and incorporation of electrosurgical techniques facilitated safe resection of brain tumors previously assumed to be inoperable. These pivotal accomplishments paved the way for the establishment of our specialty.

Publication types

  • Biography
  • Historical Article
  • Review

MeSH terms

  • Brain Neoplasms / history
  • Brain Neoplasms / surgery
  • Electrocoagulation / history
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Intracranial Hypertension / history
  • Intracranial Hypertension / physiopathology
  • Intracranial Hypertension / prevention & control
  • Intraoperative Complications / etiology
  • Intraoperative Complications / physiopathology
  • Intraoperative Complications / prevention & control*
  • Neurosurgery / history*
  • Neurosurgical Procedures / history
  • Neurosurgical Procedures / methods
  • Neurosurgical Procedures / trends
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control*
  • Postoperative Hemorrhage / physiopathology
  • Postoperative Hemorrhage / prevention & control
  • Surgical Instruments / history
  • Surgical Wound Infection / history
  • Surgical Wound Infection / physiopathology
  • Surgical Wound Infection / prevention & control

Personal name as subject

  • Harvey Cushing