A Brief Review of the History of Global and Croatian Neurosurgery

Abstract

Neurosurgery is the oldest, but also the youngest medical discipline. Namely, archaeological findings confirm the existence of cranial bone trepanations in the Late Stone Age, while neurosurgery as a separate discipline was founded only at the beginning of the 20th century. Descriptions of head/spinal injuries, and trepanations, date back to ancient Egypt (Edwin Smith papyrus) and physicians like Hippocrates, the Alexandrian school, and Galen, who described his classification of cranial fractures, perfected trepanation and contributed to neuroanatomy and physiology. Unfortunately, with his disappearance, the study of the central nervous system ceased during the next millennium. Medieval contribution to neurosurgery is due to the work of Arab and Persian physicians (Albucasis, Avicenna), who collected, preserved, and improved the medical knowledge of ancient times, including neuroscience. With the arrival of the Renaissance in the early 16th century, significant advances in anatomy, medicine, surgery, and neuroscience began. Berengario da Carpi, Andreas Vesalius, and Ambroise Paré stood out as progenitors of this era. During the 19th century, at a time of progress in medicine and surgery, preconditions were created for more extensive and long-lasting neurosurgical procedures, while the era of modern neurosurgery began in the early 20th century with the pioneering activities of MacEwan, Horsley, Cushing, Elsberg, Dandy and many others. Further progress in neurosurgery was made through the use of an operating microscope, which from 1965 marked the era of modern microneurosurgery, founded by Yaşargil. The beginnings of neurosurgical activity in Croatia date back to the end of the 19th century when Theodor Wickerhauser published a record of the first craniotomy done in our country in 1886. In conclusion, modern neurosurgery as one of the most advanced medical professions is based on the achievements of its historical leaders, and on the cutting-edge diagnostic and surgical armamentaria, together with the superior neurosurgical service organization.