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The last three decades in neurosurgery have been the era of image-guided surgery. Neurosurgeons who were trained to perform surgery without sophisticated parenchymal imaging, were used to large craniotomies, free-hand biopsies, palpation of the brain surface, and interpretation of angiograms, x-rays, or air studies. Computed tomography, as the first high-resolution imaging tool to study brain tissue,...
Image guided brain surgery became a reality in the mid-1970s after the introduction of the first methods to obtain axial imaging using computed tomography (CT) [9]. The recognition of cranial disease much earlier in its clinical course prompted the need for concomitant minimally invasive technologies to both diagnose and to treat the newly recognized brain tumors and vascular malformations. Subsequently,...
Professor Lars Leksell selected Cobalt-60 as the ideal photon radiation source for radiosurgery after investigating protons and cross fired photons form early generation linear accelerator [1,2]. The first Gamma Knife (179 Co-60 sources) created a discoid-shaped lesion suitable for movement disorder and intractable pain surgery. Clinical experience with the Gamma Knife began in 1967 with the treatment...
The Gamma Knife was developed by Lars Leksell and Borje Larsson, to achieve their goal of an efficient, precise, hospital-based stereotactic radiosurgery system [1]. Clinical work with the Gamma Knife began in 1967 and the first patient had a craniopharyngioma. The patient’s head was immobilized using a plaster-molded headpiece. Subsequently, gamma knife surgery was performed in patients with pituitary...
Any description of the Leksell stereotactic system must begin with a historical vignette that describes the genesis of its creation. Lars Leksell was a brilliant, innovative, and persistent pioneer in the emerging field of neurological surgery. His creative genius eventually led him to become professor of neurological surgery at the Karolinska Institute in Stockholm, Sweden. His career, however, began...
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