Four Athenas - Europe's first female neurosurgeons

In the early 20th century, a tumultuous era was yielding geopolitical and social change. Europe at large was undergoing redefinition of borders, political structures, and economies, while rebuilding societies after World War I. At the same time, neurosurgery was emerging as a new specialty, and women were allowed to study medicine for the first time in many European countries. These factors created a synergy, setting the stage for Europe's four first female neurosurgeons to emerge. In 1924, Germany's Alice Rosenstein began her neurosurgical career and contributed to the refinement of pneumoencephalography. Due to her Jewish background, she was forced to flee Europe, emigrating to the United States, where she did not continue to practice neurosurgery. In 1929, Russia's Serafima Bryusova began her neurosurgical training. She studied intracranial pressure in trephined patients and wrote the first Russian monograph on cerebral angiography before she was immobilized by severe arthritis. England's Diana Beck began her neurosurgical career in 1939. She contributed to the surgical treatment of intracerebral hemorrhage and researched idiopathic intracranial hypertension, even though many believed she could not be a successful surgeon due to her myasthenia gravis. In 1943, Romania's Sofia Ionescu started a prolific academic neurosurgical career. She developed a minimally-invasive technique to treat intracerebral hematomas and worked tirelessly to bring neurosurgery to all corners of her country. Europe's first women in neurosurgery were marked by war and adversity. Their stories carry within them a spirit of resilience, fortitude, and tenacity that continues to characterize women in neurosurgery today.