The Evolution of the Diagnosis of Brain Tumors: A Look Back into the Beginnings of Neurosurgery

Introduction: While historical studies of the neurosurgical field have extensively glossed the evolution of the general discipline since the Mesolithic period, our research endeavors to highlight the non-linear progress of clinical interventions in various cultures and time periods for intracranial tumors, and the preeminent role of tumors in informing early modern treatments like intracranial localization in the late 19th century and tissue analysis in the early 20th. We focus on concurrent efforts of attempted surgical tumor resection with advances in neurology and antisepsis that rapidly expanded medicinal approaches to identifying and combating intracranial growths.

Methods: We performed an extensive literature review of the history of neurosurgery with an oncological focus, parsing the timeline into four distinct eras: (1) prehistoric and ancient medicine to the 19th century advances in chemistry and neurology; (2) tissue analysis and early categorization of tumors in the early 20th century; (3) mid to late 20th century evolution of cellular tumor classification; and (4) molecular neuropathology in the 21st century. We will focus intently in the first of those eras to develop a thorough grasp of neurosurgery prior to its fortification as a unique surgical discipline.

Results: Neurosurgery began with trepanation for cranial decompression, treating epilepsy, and/or freeing “evil spirits." While significant improvements across the globe in anatomical knowledge occurred during the ancient period and through Renaissance, surgical practice with tumors was limited by certain faulty scientific consensuses and remained stagnant until pioneering medical professionals established scientific principles through clinical practice to further elucidate pathological realities.

Conclusion : Neurosurgery and its interventions for intracranial tumors have evolved in an indirect fashion, unfolding through a process of trial, error, and tradition in both medical and scientific realms. Identifying key milestones and points of stagnancy which created the discipline emphasize the codependency of surgical procedure and scientific discovery in the history of neuro-oncological care.