Abstract and Introduction
Two key discoveries in the 19th century—infection control and the development of general anesthesia—provided an impetus for the rapid advancement of surgery, especially within the field of neurosurgery. Yet the field of neurosurgery would not have existed in the modern sense without the development and advancement of techniques in hemostasis. Improvement in intraoperative hemostasis came more gradually but was no less important to enhancing neurosurgical outcomes. The history of hemostasis in neurosurgery is often overlooked. Herein, the authors briefly review the historical progression of hemostatic techniques since the beginning of the early modern era of neurosurgery.
The popularization of general anesthesia and the discovery of the concept of antisepsis in the 19th century paved the way for rapid advancement in neurosurgery. William Morton's (1819–1868) now famous demonstration of ether anesthesia in 1846 at the Massachusetts General Hospital, and Joseph Lister's (1827–1912) later identification of microorganisms as causative of postoperative infection contributed greatly to improvement in neurosurgical outcomes; prior to this time, operations resulted in severe morbidity, and not infrequently were fatal. Although improvement in intraoperative hemostasis came more gradually, this was no less important to enhancing neurosurgical outcomes. Recognition of a need to stem unwanted bleeding, both above and beneath the cranium, and the consequent measures that grew to address this need allowed cautious attention to detail, surgical precision, and a greater meticulousness hitherto prevented by excessive blood losses, thereby enabling progress in the field. The history of hemostasis in neurosurgery is often overlooked; we take for granted its fundamental importance to intraoperative and perioperative neurosurgical care. In this article, we briefly review the historical progression of hemostatic techniques, from superficial to deep, since the beginning of the early modern era of neurosurgery.