How safe is Neuro Surgery?

How Safe is Neurosurgery?

During the early stages of neurosurgery, success rates were very poor and mortality rates were high. It reduced when steroids came in to practice in the fifties. Another landmark was the introduction of operating microscope in the early seventies, which opened the floodgates of micro neurosurgery. This improved the operative field illumination and reduced the risks of the surgery. Technological advancements paved way to new innovations like video recording which made teaching possible. The surgical procedures could be recorded and used for teaching purposes also. These new inventions made neurosurgery  popular. Other technological landmarks during the same period in imaging and neuroanesthesiology made neurosurgery more secure. In the 21st century, the face of neurosurgery has changed entirely and it is now considered as the most safe and successful field.







1940s’ saw the advent of Sulphonamides and Pencillin and they had a very large role to play in the control of wound infection. The infection rate in all surgeries fell down dramatically and operative results became better, but still neurosurgeons had to battle another condition called brain swelling or brain edema. The neural tissue used to swell  when handled and this used to produce a lot of morbidity. Steroids were invented in 1950’s and this came as a panacea for neurosurgeons. Steroids controlled brain edema well and the surgical outcome became much better.


The introduction of CT scan in late 1970’s took neurosurgical diagnostic capabilities to new heights. The head injury management took a paradigm shift form wait and watch policy to immediate intervention and helped save many a life. CT scan was a noninvasive modality and the only side effect was exposure to radiation. The innovation of CT scan sent all the invasive investigations to back seat, making neurological investigations safer. Around the same time refinements in angiography also started and safer modes like Seldinger’s technique came in to vogue. Through this technique one could enter the vascular tree from an area like groin and any vessel could be entered. The contrast media also became less toxic and investigation related morbidity also became less.


In eighties another investigative modality called Magnetic Resonance Imaging was introduced. Here there is no radiation involved and a magnet is used to induce sudden change in the flow of water molecules in the body. The lesions are better delineated and many features like Functional MRI, MR Spectroscopy have made diagnosis easier and accurate. The state of art is having a MRI or CT scan in the operating room and these modes aid in the total excision of the lesions in the brain.


With all these technological advances neurosurgery has become very safe.

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Dr. Saisudarsan
Star Hospitals (A Unit of Unimed Health Care Pvt Ltd) 8-2-596/5, Road. No. 10, Banjara Hills, Hyderabad – 500 034, Telangana India


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