A history of brain imaging technology in neurosurgery

In the closing decades of the nineteenth century, diagnosis of cerebral lesions was based on the clinical examination, and often the localization and operative approaches were based on observation of seizures. The attribution of certain symptoms and signs to dysfunction arising at an identifiable focal point in the brain was the basis for clinicopathologic correlation and rational treatment. As beautiful as brain anatomy was and as skillful as clinical examination could be, there was no means to produce images of a living patient that could be used to diagnose and treat that same patient. On November 8, 1895, all of this changed with Wilhelm Röntgen's discovery of X-rays. This article aims to elucidate seminal points in the history of medical imaging as applied to the brain that have had a major impact on neurosurgery.