Cognitive function fifty-six years after surgical treatment of temporal lobe epilepsy: A case study.

We report a long-term follow-up investigation of a patient who was operated in 1954 to relieve intractable temporal lobe seizures characterized by automatism and amnesia. Neuropsychological review at 16 months after surgery showed a slight residual impairment of verbal comprehension and verbal recall and good nonverbal skills. Seizure-free since the operation except for two attacks in the early postoperative years, the patient has been off medication for 25 years and has pursued a successful career as an artist.

Josef Klingler's models of white matter tracts: influences on neuroanatomy, neurosurgery, and neuroimaging.

During the 1930s, white matter tracts began to assume relevance for neurosurgery, especially after Cajal's work. In many reviews of white matter neurobiology, the seminal contributions of Josef Klingler (1888-1963) and their neurological applications have been overlooked. In 1934 at the University of Basel under Eugen Ludwig, Klingler developed a new method of dissection based on a freezing technique for brain tissue that eloquently revealed the white matter tracts.

Anatomy, technology, art, and culture: toward a realistic perspective of the brain.

In the 15th century, brain illustration began to change from a schematic system that involved scant objective rendering of the brain, to accurate depictions based on anatomical dissections that demanded significant artistic talent. Notable examples of this innovation are the drawings of Leonardo da Vinci (1498-1504), Andreas Vesalius' association with the bottega of Titian to produce the drawings of Vesalius' De humani corporis fabrica (1543), and Christopher Wren's illustrations for Thomas Willis' Cerebri Anatome (1664). These works appeared during the Renaissance and Age of Enlightenment, when advances in brain imaging, or really brain rendering, reflected not only the abilities and dedications of the artists, but also the influences of important cultural and scientific factors.

Epilepsy surgery: historical highlights 1909-2009.

This review focuses on some historical highlights of the surgery of epilepsy, beginning with the reports of Horsley, Krause, and Cushing to which appeared in 1909, the year that The International League Against Epilepsy (ILAE) was inaugurated. We then outline key contributions from Europe and North America, and examine particularly the evolution of our understanding of temporal lobe seizures, which have now become the most common form of epilepsy amenable to surgical cure.

Osler vindicated: glioma of the leg center with Jacksonian epilepsy; removal and cure, with a 50-year follow-up. Historical vignette.

On December 14, 1883, William Osler, then pathologist at the Montreal General Hospital, presented the specimen of a brain with an almond-sized glioma beneath the right motor cortex to the Montreal Medico-Chirurgical Society. The brain specimen was from a young woman who had suffered from intermittent Jacksonian seizures for 14 years and had eventually died in status epilepticus. Aware of the pioneering removal of a tumor from the cortex reported on in 1885 by Bennett and Godlee, Osler wrote of his case, "this was an instance in which operation would have been justifiable and possibly have been the means of saving life.

From lateral to mesial: the quest for a surgical cure for temporal lobe epilepsy.

Purpose: A gap of more than a hundred years occurred between the first accounts of mesial temporal sclerosis and recognition of its role in the pathogenesis of psychomotor seizures. This paper reviews how the understanding and surgical treatment of temporal lobe epilepsy developed, particularly from the work of Penfield, Jasper, and their associates at the Montreal Neurological Institute (MNI).

Methods: Publications on EEG and surgery for temporal lobe seizures from 1935 to 1953 were reviewed and charts of selected patients operated on at the MNI in the same period were examined.

The physiologist and the neurosurgeon: the enduring influence of Charles Sherrington on the career of Wilder Penfield.

Wilder Penfield, a Rhodes scholar from Princeton University, New Jersey, was a student in the first course on mammalian physiology given in 1915 at Oxford University by Charles Sherrington, newly arrived from Liverpool where, as Holt Professor of Physiology for 20 years, he had become a leading authority on the physiology of the nervous system. The practical 'exercises' as well as graduate research on the Golgi apparatus and the decerebrate preparation, carried out by Penfield in Sherrington's laboratory, gave him the groundwork to develop his career as a physiological surgeon, who made fundamental observations on functional localization in the human brain during the surgical treatment of patients afflicted with epilepsy.

The first case of invasive EEG monitoring for the surgical treatment of epilepsy: historical significance and context.

Purpose: Controversy persists about when EEG became a fundamental tool in the preoperative investigation for epilepsy surgery. We revisit Penfield's first use of invasive EEG monitoring, emphasizing its historical importance for the evolution of epilepsy surgery.

Methods: Patients' hospital charts and articles published before 1940 regarding EEG and epilepsy or EEG and cerebral lesions were reviewed to evaluate the historical context of the surgery.

William Osler at Mcgill University: the Baby Professor and his early contributions to neurosurgery.

Between 1870 and 1884, as both a medical student and a member of the faculty, Sir William Osler performed approximately 1000 postmortem examinations at McGill University in Montreal. He conducted 786 of these examinations during his 7 years (1877--1884) of service as a pathologist at the Montreal General Hospital. The results of these were carefully recorded and catalogued either by him or by those who compiled the Pathological Report of the Hospital.

Osler and the "medico-chirurgical neurologists": Horsley, Cushing, and Penfield.

Sir Victor Horsley's lecture "On the Technique of Operations on the Central Nervous System," delivered in Toronto in 1906, set the stage for an appraisal of Sir William Osler as a protagonist for the emerging specialty of neurosurgery. During his time at McGill University from 1871 to 1884, Osler performed more than 1000 autopsies. Hispathological reports covered the topics of cerebral aneurysm, apoplectic hemorrhage, vascular infarction, subdural hematoma, meningitis, multiple sclerosis, cerebral abscess, and brain tumor.

Theodore Brown Rasmussen (1910-2002): epilepsy surgeon, scientist, and teacher.

Theodore Brown Rasmussen succeeded Wilder Penfield as director of the Montreal Neurological Institute (MNI) and held this post from 1960 to 1972. During his career, Rasmussen probably performed more operations for epilepsy than any other surgeon of his time; he became the foremost authority in this field. His meticulous follow-up analyses of the MNI seizure series provided substantial evidence for the success of surgery in the treatment of focal epilepsy.

Harvey Cushing's Canadian connections.

During his surgical career between 1896 and 1934, Harvey Cushing made eight visits to Canada. He had a broad impact on Canadian medicine and neurosurgery. Cushing's students Wilder Penfield and Kenneth McKenzie became outstanding leaders of the two major centers in Canada for neurosurgical treatment and training.