A History of Operations on the Mesencephalon and Thalamus
The period of most rapid progress of neurosurgery definitely belongs to the first third of this century thanks to Harvey Cushing (1869–1939) and others who devised those fundamental surgical techniques for a majority of the areas of the brain which are being-used to the present day. However, as regards the mesencephalon and thalamus, conditions prevailing at that time could not be expected to provide the necessary basis for perfect and safe surgical interventions. Systematic research and the endeavour to penetrate to these regions were impeded by the lack of technical facilities as well as by gaps in knowledge respecting the anatomy and functional role of both structures. Sporadically performed interventions in man met as a rule with failure by seriously interfering either directly or indirectly with neighbouring or more distant cerebral structures and causing severe neurological deficits, thus discrediting the experiment or therapeutic intervention and directly endangering the patient’s life. What is more, this first period of sporadic operations did not have the object of directly affecting the functions of either mesencephalon or thalamus. The history of direct incisions or punctures in the various areas of the brain stem or medulla with the object of interrupting certain groups of tracts or nuclei, is much more recent (Sjöqvtst, 1937) than operations for neoplastic, inflammatory or congenital diseases of these structures or their immediate neighbourhood.
KeywordsPineal Region Intractable Pain Zona Incerta Medial Geniculate Body Spinothalamic Tract
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