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A new approach towards creating an efficient pipeline from diagnosis to removal of brain tumors is possible through the help of artificial intelligence. AI is being used by brain surgeons to identify tumors as accurately and quicker than a pathologist¹. How tumor biopsy's are normally conducted is through a process of removing tissue and sending it to a lab to be frozen, stained, and examined through a microscope. While this procedure takes about 30 minutes, the new technology created using AI would allow this process to be completed in under 3 minutes¹. This is through the use of lasers quickly scanning the removed tissue to produce microscopic images to be read directly in the operating room¹.

A study of this process was published in the journal of Nature Medicine by the Neurosurgery department at the University of Michigan. This advancement of technology would allow not only efficiency, but accuracy for identifying potential brain tumors.

Sources:

(1) https://www.nytimes.com/2020/01/06/health/artificial-intelligence-brain-cancer.html

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Job Janszoon van Meekeren was a Dutch surgeon who reported performing the first successful bone graft cranioplasty¹. This procedure consists of repairing skull bone that has damaged by replacing the bone with a graft. van Meekeren had used canine bone to accommodate the patient's defect, which lead future surgeons to develop more advanced replacements to transform this into a routine neurosurgical operation. Prior to van Meekeren, a physician called Fallopius was the first to describe the idea of the cranioplasty and determine its success based on if the dura mater was compromised or intact¹. This showed that physicians at the time were becoming aware of the complexities of neurotraumas and how brain anatomy contributed to the overall success of different procedures.

Sources:

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152220/

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The Contribution of Female Neurosurgeons in the 15th Century

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The Contribution of Female Neurosurgeons in the 15th Century

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While men have dominated the medical field all throughout history, records dating back from the 15th century in the Middle East detail the discoveries made by female surgeons in the advancement of neurosurgery¹. "Tabibe," meaning female physicians, was recorded in the texts of the Turkish physician Serefeddin Sabuncuogl where it described their primarily focus on examining fetal hydrocephalus¹. The book describes how they refined the procedure to successfully deliver a fetus with hydrocephalus or macrocephalus, a condition caused by a build-up of cerebrospinal fluid in the ventricles forming an expanded skull. This record is an important part of the history of brain surgery and its attempts to save not only a patient's life but also a mother's.

Sources:

(1) https://pubmed.ncbi.nlm.nih.gov/16721484/

(2) https://fetaltonewborn.org/hydrocephalus/

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In 927, it is recorded that two brothers performed a craniotomy to remove a tumor from the brain of King of Dhar¹. An anesthetic called "samohine" was given to the patient before the procedure, and its effects were reversed by putting onion and vinegar into their mouth once it was completed¹. This demonstrates an attempt to improve the outcome of neurosurgery, and an understanding that the brain was a delicate organ that required stillness and a gentle approach. It is also seen in the works of Ambroise Paré where he applied mixtures of natural herbs and oils to head traumas that showed he understood the importance of anesthetics for brain operations and showed significantly better recovery than painful procedures like cauterization².

Sources:

(1) https://www.researchgate.net/profile/Vineet-Kamal/publication/315863734_Biostatistics/links/5d3d28584585153e59276820/Biostatistics.pdf

(2)https://www.sciencedirect.com/science/article/pii/S1878875019328256

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The Church Condemns Craniotomies in 1163

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The Church Condemns Craniotomies in 1163

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Cranial trephination is one of the oldest neurosurgical procedures conducted in human history and has undergone advancement treatment purpose and techniques¹. However in 1163, the Roman Catholic Church began to have more delegation on the progress of medicine and ultimately slowed down the access and advances in surgery¹. An official order was given to "detest blood" and made surgery a condemnable act¹.

Europe entered a period of slow development in the field of medicine until the Renaissance where craniotomy became a popular form of treatment again¹. During this time, Ambroise Paré began to make advances in the field of neurosurgery and discovered new forms of treatment for neurotraumas that was beyond trephination¹.

Sources:

(1) https://pubmed.ncbi.nlm.nih.gov/27150646/

(2) https://wellcomecollection.org/articles/Y5cQ_BEAAF9hozWk

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First Display of Sophisticated Neurosurgery in Ancient Greece

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First Display of Sophisticated Neurosurgery in Ancient Greece

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A discovery in Greece lead archaeologist to determine that physicians in Ancient Greece in the third century had advanced knowledge of neurosurgery. Skeletal remains of a woman show she had undergone brain surgery that was more complex than trephination¹. Based on the skull remains, it is hypothesized that a surgeon had used a sharp tool to scrape away at the bone instead of drilling or hammering to prevent further harming the brain tissue to an existing cranial fracture¹. This type of technique is similar to the one that is used in current neurosurgical procedures to relieve pressure and remove defected fragments of bone¹. Additionally, this discovery reveals that physicians at the time began to specialize in different anatomical medicine, such as the brain, in order to develop such specific skills.

Sources:

(1) https://www.independent.co.uk/news/world/europe/skeleton-reveals-ancient-greek-brain-surgery-795739.html

(2) https://www.nbcnews.com/id/wbna23581918

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Ambroise Paré is known as the Father of Gentle or Modern Surgery, however, he was also a pioneer in the field of neurosurgery. He was born in 1510 and spent most of his life in France in the midst of continuous war and political oppression¹. This lead him to be trained as a surgeon dedicated for soldiers where he observed the methods used to treat war-related injuries and offered less painful techniques towards treatment¹.

He would be a great guide throughout this historical lesson on the advancements of neurosurgery because he was the first to establish the foundation towards neurosurgery as a specialization in medicine¹. He discovered that amputee patients suffered from phantom pain and that it originated in the brain based on his extensive knowledge of human anatomy¹. He also depicted each layer of the outer brain and how it relates to why head-traumas impacted each patient differently according to which part was injured.

Sources:

(1) https://www.sciencedirect.com/science/article/pii/S1878875019328256