The demonstration of the basic brain mechanism through studying the partially commissure-sectioned Gern entspreche ich der Bitte, fur diesen Band ein Vorwort zu schreiben, wurde doch hier ein Thema Welche Erweiterung unseres Wissens urn die Grundlagen brachte die Physiologie. Mit welcher Sicherheit konnen wir he ute die Temperatur und den Kreislauf den Erfordernissen des Hirnstoffwechsels nach Traumen bzw.
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Toggle navigation. New to eBooks. Filter Results. Last 30 days. Last 90 days. All time. Specifically he notes that neurosurgeons should be competent in neuropathology, and should be able to recognize the appropriate response to a given form of epilepsy.
The start and development of epilepsy surgery in Europe: a historical review
When Penfield arrived in Montreal to begin his professional life, he was quite aware and perceptive of the changes taking place in his discipline. There were two themes in particular that interested him: The first was specialization and professionalization of neurosurgery as a field.
In a brief address he published in in the Canadian Medical Association Journal he wrote,. The result has been a rapid expansion of this speciality. But Penfield does not seek to simply introduce new methods in a neurosurgery. Rather, Penfield encourages neurosurgeons to assess his work critically and adapt it to their practice after careful consideration.
He also calls for his peers, neurosurgeons of a new generation, to incorporate the scientific method as a way of problem-solving and practice in neurosurgery. Something Hidden: a biography of Wilder Penfield.
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Halifax, N. A history of neurological surgery. Mansfield Centre, Conn. Epilepsy and surgical therapy. Archives of Neurology and Psychiatry , 36 3 , A history of neurosurgery : in its scientific and professional contexts. Park Ridge, Ill. Hero Worship. Toronto, O. Journal of the American Medical Association , 10 , The mechanism of cicatricial contraction in the brain.
Brain , 50, The structural basis of traumatic epilepsy and results of radical operation. Brain, 53, The radical treatment of traumatic epilepsy and its rationale. Canadian Medical Association Journal, 23, An address on the field of neurosurgery. Canadian Medical Association Journal, 19, No responses yet. Mail hidden required. Notify me of follow-up comments via e-mail.
Copyleft Marzieh Ghiasi. Some Rights Reserved. Penfield also provides extensive descriptions, photographs and diagrams of anatomical pathologies, such as scarring, that he observed in brain tissues of epileptic patients. Penfield also includes before and after pictures of tissues that have undergone the scar-excision procedure.
These pictures are evidence of the phenomena that Penfield describes, and also evidence of the results of his procedure. The third step in the scientific method of inquiry is experimentation to test a given hypothesis. Like his predecessor, Hughlings-Jackson, Penfield provides in his paper detailed descriptions of behaviors and sensations observed in patients as readouts of events in the epileptic brain. However, advances in the field also allow Penfield to include behavioral descriptions that are readouts of his experiments with electric stimulation of the brain.
For example, he describes stimulating an area of the brain and the visual and auditory hallucinations that result from this, thereby deducing that this area must be responsible for somatosensation . Penfield is also able to induce epileptic attacks, which he recognizes as an innovation that allows neurosurgeons to localize epileptic foci to where there are no obvious anatomical abnormalities . The fourth step in the scientific method is forming a conclusion based on evidence and recognizing the limitations of the study. In his case studies, Penfield correlates observations, including recoded patterns of attack and anatomical pathologies, with experiment, using electrical exploration, to form an extremely detailed localization of epileptic foci .
He is well-aware of the limitations of his procedure and clearly delineates the conditions under which it can be done successfully. He acknowledges that his procedure cannot be hailed as a cure to epilepsy; as for instance, there are certain patterns of attack that he has not been able to reproduce .
When outlining his conclusions, he also provides alternative conclusions—proving that his own conclusions are drawn in consideration of multiple points of view. Penfield is also determined in his paper to counter what he perceives to be inaccuracies in the field. For example, he describes conducting a surgical procedure thought to affect epilepsy by reducing pressure in the brain, and provides evidence from his own patients that the protocol does not to a level that can justify conducting it .
In this paper, Penfield also addresses criticisms targeted at his surgical procedure at length. As discussed previously, phrenology was discredited with the rise of modern neurology, and along with it localization theories of the brain also met extensive criticism. Evidently these criticisms persisted into the s as Penfield notes in his paper that his work is not a new kind of phrenology.
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He emphasizes that localization in brain tissue does not confine a function to a single area. Rather, it suggests that a particular area "forms an essential link in a mechanism that may well involve distant tracts and connections" . He re-emphasizes this point throughout the paper. As described, he was concerned about the outcomes, in the form of potential scarring and complications, from invasive surgery of the brain. Although his concerns were relieved following his work with Foerster, and the surgical protocol justified at length in his publications, some of his peers remained skeptical of outcomes for patients.
To address these concerns, in many of his papers, Penfield examined patients for cognitive function months after large amounts of tissue had been removed. In his paper he addresses these concerns by compiling extensive follow-ups on patients. He strongly focuses on the scientific method and empiricism as the only way to approach modern neurosurgery. This was accomplished through establishing hypothesis, and doing careful experimental study before forming any conclusions. Although in his paper Penfield establishes a broad framework for understanding and operating on different types of epileptic lesions, he emphasizes that one cannot generalize from one anomaly to another.
In particular he set limits on practitioners in that surgery must only be done after physiological and pathological dynamics of the condition have been fully studied . He emphasizes the importance of taking patient-histories, similar to practitioners like Hughlings-Jackson, and being in touch with patients  He also encourages neurosurgeons to engage in careful and considerate practice. Specifically he notes that neurosurgeons should be competent in neuropathology, and should be able to recognize the appropriate response to a given form of epilepsy.
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When Penfield arrived in Montreal to begin his professional life, he was quite aware and perceptive of the changes taking place in his discipline. There were two themes in particular that interested him: The first was specialization and professionalization of neurosurgery as a field. In a brief address he published in in the Canadian Medical Association Journal he wrote,. The result has been a rapid expansion of this speciality.
But Penfield does not seek to simply introduce new methods in a neurosurgery. Rather, Penfield encourages neurosurgeons to assess his work critically and adapt it to their practice after careful consideration.
Related Cerebral Localization: An Otfrid Foerster Symposium
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