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In theory, any organ system inside the body can be subjected to stereotactic surgery. Difficulties in setting up a reliable frame of reference, however (such as bony landmarks which bear a constant spatial relation to soft tissues), have limited its application to brain surgery. Besides the brain, biopsy and surgery of the breasts has also been tried.
The stereotactic method was first developed by two British scientists in 1908, working at University College London Hospital, Sir Victor Horsley (a physician and neurosurgeon) and Robert H. Clarke (an engineer). The device they developed (the Horsley-Clarke apparatus) was used for animal experimentation and used a Cartesian (three-orthogonal axis) system. Improved designs of their original device came into use in the 30s for animal experimentation and are still in wide use today in all animal neuroscience laboratories.
However, using the Horsley-Clarke apparatus for human brains was difficult, because of the high variability of spatial relations between the skullFor symbolic or mythic uses of the human skull, see Skull (symbolism). A skull or cranium is a bony structure which serves as the general framework for a head. The skull attempts to protect the brain, acting as a form of natural helmet. Humans In humans, and the brain. By using contrasted brain radiographyRadiography is the creation of radiographs, photographs made by exposing a photographic film or other image receptor to X-rays. Since X-rays penetrate solid objects, but are attenuated by them in a way that depends on the density of the objects, the pictu, however (particularly pneumoencephalogram s and ventriculography ), reference points inside the brain could be used, instead of bone landmarks. The first stereotactical devices for humans used the pineal glandEndocrine system The pineal gland or epiphysis is a small endocrine gland located near the middle of the brain. The pineal body is located above the superior colliculus and behind and beneath the stria medullaris, between the laterally positioned thalamic and the foramen of Monro . Later, other structures, such as the anterior and posterior commissure s became the most commonly used internal cerebral landmarks.
Using this approach between 1947Events January January 1 British mines nationalized January 1 Nigeria gains limited autonomy January 1 The Canadian Citizenship Act went into effect January 3 Proceedings of the United States Congress are televised for the first time. January 10 United Na and 19491949 is the common year starting on Saturday. see link for calendar) Events January-February January 4 RMS Caronia of the Cunard Line departs Southampton for New York on her maiden voyage January 4 February 22 Series of winter storms in Nebraska, Wyoming,, two American neurosurgeons, Ernest A. Spiegel and Henry T. Wycis , and a Swedish neurosurgeon, Lars LeksellLars Leksell (1907-1986) was a Swedish physician and Professor of Neurosurgery at the Karolinska Institute in Stockholm, Sweden. He was the inventor of radiosurgery. Life and Work Lars Leksell was born in Fassberg, Sweden on November 23rd 1907. He graduat, developed the first stereotactic deviced used for brain surgery in humans. Spiegel and Wycis' system was of the Cartesian coordinate type (also called translational) and Leksell's was of the polar coordinate system, much easier to calibrate and to use in the surgical room. The stereotactic localization system was also used by Leksell in his next invention, radiosurgeryRadiosurgery is a medical procedure which allows non-invasive brain surgery, i. without actually opening the skull), by means of directed beams of ionizing radiation. It is a relatively recent technique ( 1951), which is used to destroy, by means of a pre of the brain, using the Gamma Knife system, and by other neurosurgeons, using linear accelerators, proton beam surgery and neutron capture surgery .
The method continued to evolve, and presently uses a complex mixture of image-guided surgery using intraroom computed tomography, magnetic resonance imaging and stereotactic localization.