History of Brain Surgery: From Trephination to Modern Neurosurgery

Trephination (drilling skull holes) is the oldest known neurosurgical procedure, dating to the Neolithic period (~10,000 BCE) in France. Practiced in ancient Egypt (Old Kingdom, ~2600 BCE), India (Sushruta Samhita), and Greece (Hippocrates for head trauma).

Modern Neurosurgery Begins

The first documented successful brain tumor resection was performed in 1885 by British neurosurgeon Sir Victor Horsley. His 14-year-old patient had a tumor causing hemiplegia; Horsley removed it via craniotomy, and the boy fully recovered. This landmark surgery established neurosurgery as a scientific discipline, enabling future advances in technique, anesthesia, and technology.

Early trephination had high mortality due to anatomical ignorance and lack of asepsis. Horsley’s success marked the transition from empirical to evidence-based cranial surgery.