Electronic Stereotactic Atlases

Abstract

Localizing structures and functions in the brain is a quest which has concerned human being since its early history. Although it is known that trepanations have been performed in primitive societies such as in the Neolithic period (7000 year bc), in Egypt (3000 years bc) or in Peru (2000 year bc), these practices were motivated by religious reasons rather than by medical reasons, as far as we know. The first rational approaches of brain anatomy and physiology were those of Hippocrates (400 years bc) although the knowledge of brain anatomy was still rudimentary at this period. Surgical interventions in the brain have remained very empirical during the middle-ages with the notable exception of Ambroise Paré, who was able to treat fractures of the vertebral column and to make trepanations of the skull. Neurosurgery in fact began with Victor Horsley (1857–1924), while in an overlapping period Claude Bernard (1813–1878) developed his fundamental approach of experimental physiology, which opened an access to an understanding of brain functions. Localization of brain functions had for a while lost its way in the concepts of “Phrénologie” or “organology” of Franz Joseph Gall (1758–1828) and Johann Spurzheim (1776–1832) who proposed that the most complex human functions such as compassion, moral sense, vanity, feeling of property, kindness, and benevolence could be localized in specific parts of the brain, and even identified as a prominent development of the external shape of the skull in individual subjects with specific development of such functions. Brilliant neurologists, such as Paul Broca (1824–1880), Jean-Martin Charcot (1825–1893), John Hughling Jackson (1835–1911), and Joseph Babinski (1857–1932) have finally provided the bases of a really scientific exploration of the localization of brain functions. This scientific approach has developed rapidly in the domain of neurology based on the anatomo-clinical method which consists of a systematic comparison between the neurological symptoms observed in a living patient and the anatomic lesions discovered in this brain after death.