Ancient Greece helped pave the way for modern brain surgery, according to a new historical review that traces the roots of cranial operations back thousands of years.
The study, published in the Journal of Clinical Neuroscience, was led by Marcos Cherem-Kibrit of the Department of Neurosurgery at Hadassah Hebrew University Medical Center in Jerusalem, Israel.
The review looks at how brain surgery evolved from prehistoric skull drilling to today’s high-tech operating rooms. Researchers found that early physicians in Greece, along with those in Rome, Egypt, and among the Inca in South America, laid much of the groundwork for the field.
Greek and Roman doctors wrote about trepanation, the practice of cutting or drilling holes into the skull, in their medical texts, the study noted. Those writings, including works attributed to Hippocrates and Galen, showed an early grasp of how to treat head trauma and neurological problems, researchers said.
Skull drilling survival rates reveal surprising ancient medical skill
The practice itself dates back even further, to the Mesolithic era, long before Greek civilization took shape.
Ancient healers in Peru achieved survival rates between 75% and 91% when they preserved the dura mater, the membrane covering the brain, during trepanation, the study found. That single step kept many patients from developing fatal meningitis, researchers said.
War, more than anything else, pushed the procedure forward, according to the review. World War I and World War II, followed by the Korean War, the Vietnam War, and more recent conflicts in the Middle East, forced surgeons to develop faster and safer techniques.
Battlefield demands led to standardized wound cleaning methods, mobile surgical units, and quicker evacuation systems for wounded soldiers, the study said.
From ancient Greece to robotic tools: The evolution of brain surgery
Those wartime pressures eventually shaped the tools surgeons use today. Neuroimaging, minimally invasive procedures, and robotic-assisted surgery all trace back to lessons learned on the battlefield, researchers said.
Modern military medicine has also begun pairing surgery with psychological support and rehabilitation, recognizing that recovery involves more than just the operation itself.
Cherem-Kibrit and colleagues said the goal of the review was to show how culture, conflict, and science came together over centuries to shape one of medicine’s oldest procedures.
From the earliest holes drilled into skulls in ancient Greece and beyond to the precision instruments used today, the history of brain surgery reflects a steady push toward saving more lives.
The researchers said understanding this history offers a perspective on how far the field has come, and how much of it grew out of necessity rather than planning.
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