A Stereotaxic Apparatus for Use in Cerebral Surgery

Abstract

“This invention relates to what may be termed stereotaxic surgical apparatus for use in performing operations within the cranium of living human beings …”, wrote Robert Henry Clarke in his patent specification No. 22,455 of 1912. He continues “[it] is designed to enable a so-called probe … to reach, with absolute precision and by the shortest path, any predetermined point within the cranium through a comparatively small opening formed in the wall of the latter, the primary object being to obviate the necessity of extensively laying open or partially dissecting the head and removing considerable portions of the cranial contents in order to gain access to the exact spot whereat the actual operation is required to be carried out.” Clarke did not have the resources of contrast neuroradiography to help him, and any extensive attempts to use his apparatus (Fig. 1) in the human case were foredoomed by the variability of structure of the brain in relation to the external bony features of the skull. Nevertheless, he is the father of modern stereotaxic surgery, and I can do no better than quote his description of the aims of the method in introducing this paper, adding perhaps that “extensively laying open or partially dissecting the head” in the areas in which we are interested may be fraught with danger to the life of the patient.