Department of Neurosurgery, "Prof. Dr. N. Oblu" Emergency Clinical Hospital, Iasi, Romania.
Department of Psychiatry, "Grigore. T. Popa" University of Medicine and Pharmacy, 16 University Street, Iasi, Romania.
Neurosurg Rev. 2021 Dec;44(6):3001-3022. doi: 10.1007/s10143-021-01496-3. Epub 2021 Feb 12.
Brainstem is one of the most complex structures of the human body, and has the most complex intracranial anatomy, which makes surgery at this level the most difficult. Due to its hidden position, the brainstem became known later by anatomists, and moreover, brainstem surgery cannot be understood without knowing the evolution of ideas in neuroanatomy, neuropathology, and neuroscience. Starting from the first attempts at identifying brainstem anatomy in prehistory and antiquity, the history of brainstem discoveries and approach may be divided into four periods: macroscopic anatomy, microscopic anatomy and neurophysiology, posterior fossa surgery, and brainstem surgery. From the first trepanning of the posterior fossa and later finger surgery, to the occurrence of safe entry zones, this paper aims to review how neuroanatomy and brainstem surgery were understood historically, and how the surgical technique evolved from Galen of Pergamon up to the twenty-first century.
脑干是人体最复杂的结构之一，具有最复杂的颅内解剖结构，使得这一水平的手术成为最困难的手术。由于其隐藏的位置，脑干直到后来才被解剖学家所认识，而且，如果不了解神经解剖学、神经病理学和神经科学的思想演变，就无法理解脑干手术。从史前和古代首次尝试确定脑干解剖结构开始，脑干的发现和入路历史可以分为四个时期：大体解剖学、显微解剖学和神经生理学、后颅窝手术和脑干手术。从第一次在后颅窝钻孔到后来的手指手术，再到安全进入区域的出现，本文旨在回顾神经解剖学和脑干手术是如何在历史上被理解的，以及手术技术是如何从帕加马的盖伦发展到 21 世纪的。
