Leksell Stereotactic Apparatus

Abstract

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 under the direction of Ragnar Granit, a Nobel Prize-winning neurophysiologist with whom Leksell collaborated. Leksell's doctoral thesis presented the first description of the spinal cord gamma motor neuron system. Following this work, Leksell's neurosurgical training began in the department of Herbert Olivecrona. At this time, in the early 1940s, the alarming mortality rate for routine neurosurgical procedures approximated 40%. Poor outcomes, difficulty with anesthesia (neurosurgical patients were allowed to ventilate spontaneously) and severe blood loss during surgery were features that made a lasting impression on Leksell. He was struck by the paradox of crude instrumentation that was poorly designed for the delicate central nervous system. His subsequent career was committed to the development of less invasive surgical techniques that facilitated management of a wide variety of intracranial problems. During the subsequent four decades, he became one of the most original contributors to the field of neurological surgery.