Serendipity and Observations in Functional Neurosurgery: From James Parkinson ’s Stroke to Hamani’s & amp; Lozano ’s Flashbacks

Background: Serendipity and observations have a noble tradition in medicine, including neurology, and are responsible for many medical treatments (carbamazepine for tic douloureux, amantadine for Parkinson ’s disease, gabapentin for restless legs…). We aimed at examining the contribution of serendipity and observations to functional neurosurgery. Scholarly publications relevant to the history of functional neurosurgery for movement and psychiatric disorders were reviewed, starting from the pre-ste reotactic era. The documents were scrutinized with respect to indications for surgery, surgical methods, and brain targets, in view of determining whether serendipitous discoveries and other observations contributed to various functional neurosurgical procedures.Summary: James Parkinson ’s observation that tremors disappeared in the arm of a person with shaking palsy after a hemiparetic stroke encouraged neurosurgeons in the first half of the 20th century to perform ablative procedures on central motor pathways. Following a lobotomy performed by Browder that extended too far medi ally in a psychiatric patient with coexisting Parkinson’s disease (PD), it was noted that the Parkinsonian signs improved. This encouraged Russel Meyers to carry out open surgery on the caudate nucleus and basal ganglia in PD. Cooper introduced ligation of the anterior choroidal artery as a treatm ent for PD following a surgical accident during a pedunculotomy. Cooper later started to perform stereo...
Source: Stereotactic and Functional Neurosurgery - Category: Neurosurgery Source Type: research