Document Type : Review Article
Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, USA
This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified tumors, shifts in midline position of a calcified pineal gland due to a mass in the cranium, or foreign metallic objects within the skull. Walter Dandy reported in 1918 that he visualized cerebral ventricles by introducing air as a contrast agent through a trocar into one of the occipital lobes or the right frontal horn of the ventricular system. Dandy localized lesions that distorted or shifted the ventricles. In 1920, Dandy placed air by lumbar puncture into the spinal subarachnoid space that could visualize the brain and entire ventricles. Antonio Egas Moniz with the assistance of his neurosurgeon colleague, Almeida Lima, obtained X-ray images of cerebral arteries of dogs and decapitated human heads from corpses after injecting strontium bromide into their carotid arteries. Satisfied by these experiments, Moniz injected strontium bromide directly into carotid arteries of five patients which failed to show intracranial vessels. In the sixth patient, intracranial arteries were outlined but that patient died of cerebral thrombosis presumably due to the hyper-osmolality of that contrast agent. Finally, on June 18, 1927, Moniz injected 22% sodium iodine into a 20-year-old man and obtained clear visualization of his carotid artery and intracerebral branches after temporarily occluding the artery with a ligature. Direct percutaneous puncture of the cervical carotid artery remained the primary technique unto the 1960s to visualize intracranial blood vessels until Seldinger’s technique was introduced in 1953. Computerized axial tomography (CAT) and magnetic resonance imaging (MRI) replaced cerebral arteriography for localizing tumors and epidural or subdural hemorrhage. However, angiography is used currently for embolization of aneurysms and removal of thrombi or emboli in patients with acute stroke.
- Physics 1901-1921. Amsterdam, Netherlands: Elsevier; 1967.
- Roentgen WC. On a new kind of rays. Science 1896; 14; 3(59): 227-31
- The Nobel Prize in Physics 1901. [Online]. [cited 2020 Dec 10]; Available from: URL: https://www.nobelprize.org/prizes/physics/1901/summary/>
- Fowler GR. A case of gunshot - wound of the head in which the bullet was located by means of the rontgen - rays and the telephonic probe, and removed by operation. Brooklyn Medical Journal 1896; 10: 753-5.
- Cushing HW. Haematomyelia from gunshot wounds of the spine. Am J Med Sci 1898; 115(6): 654-83.
- Church A. Cerebellar tumor: Recognized clinically, demonstrated by the X-ray, and proved by autopsy. Q Bull Northwest Univ Med Sch 1899; 1(1): 33-6.
- Alper MG. Three pioneers in the early history of neuroradiology: The Snyder lecture. Doc Ophthalmol 1999; 98(1): 29-49.
- Haschek E, Lindenthal OT. A contribution to the practical use of X-ray photography. Wien Klin Wochenschr 1896; 9: 63-4. [In German].
- Dandy WE. Ventriculography following the injection of air into the cerebral ventricles. Ann Surg 1918; 68(1): 5-11.
- Luckett WH. Air in the ventricles of the brain following a fracture of the skull. J Nerv Ment Dis 1913; 40(5): 326-7.
- Dandy WE. Rontgenography of the brain after the injection of air into the spinal canal. Ann Surg 1919; 70(4): 397-403.
- Dandy WE. Localization of brain tumors by cerebral pneumography. Amer J Roentgenol 1923; 10: 610-2.
- Schuller A. Roentgenographic diagnosis of intracranial affections by means of the Dandy procedure. Wien Klin Wochenschr 1922; 35: 709-11. [In German].
- Taveras JM, Wood EH. Diagnostic neuroradiology. Baltimore, MD: Williams and Wilkins; 1964. p. 1-960.
- Fulton JF. Harvey Cushing: A biography. Springfield, IL: Charles C Thomas; 1946.
- Dandy WE. The brain. In: Lewis D, editor. Practice of surgery. Hagerstown, MD: Prior; 1932.
- Moniz E. L'Encéphalographie artérielle, son importance dans la localisation des tumeurs cérébrales. Paris, France: Masson; 1927. p. 72.
- Lima PA. Cerebral angiography. London, UK: Oxford University Press; 1950.
- Lowis GW, Minagar A. The neglected research of Egas Moniz of internal carotid artery (ICA) occlusion. J Hist Neurosci 2003; 12(3): 286-91.
- Becker N, Liebermann D, Wesch H, Van KG. Mortality among Thorotrast-exposed patients and an unexposed comparison group in the German Thorotrast study. Eur J Cancer 2008; 44(9): 1259-68.
- Forssmann-Falck R. Werner Forssmann: A pioneer of cardiology. Am J Cardiol 1997; 79(5): 651-60.
- Seldinger SI. Catheter replacement of the needle in percutaneous arteriography. A new technique. Acta Radiol Suppl (Stockholm) 2008; 434: 47-52.
- Farinas P. A new technique for the arteriographic examination of the abdominal aorta and its branches. Am J Roentgenol 1941; 46: 641-65.
- Ziedses des Plantes BG. Subtraction: A radiographic method of imaging certain parts of the object separately. Fortschr Röntgenstr 1935; 52: 69-79. [In German].
- Mowla A, Singh K, Mehla S, Ahmed MK, Shirani P, Kamal H, et al. Is acute reperfusion therapy safe in acute ischemic stroke patients who harbor unruptured intracranial aneurysm? Int J Stroke 2015; 10(Suppl A100): 113-8.
- Singh K, Mowla A, Mehla S, Ahmed MK, Shirani P, Zimmer WE, et al. Safety of intravenous thrombolysis for acute ischemic stroke in patients with preexisting intracranial neoplasms: a case series. Int J Stroke 2015; 10(3): E29-E30.
- Shahjouei S, Tsivgoulis G, Goyal N, Sadighi A, Mowla A, Wang M, et al. Safety of intravenous thrombolysis among patients taking direct oral anticoagulants: A systematic review and meta-analysis. Stroke 2020; 51(2): 533-41.
- Mowla A, Kamal H, Lail NS, Vaughn C, Shirani P, Mehla S, et al. Intravenous thrombolysis for acute ischemic stroke in patients with thrombocytopenia. J Stroke Cerebrovasc Dis 2017; 26(7): 1414-8.
- Mowla A, Kamal H, Mehla S, Shirani P, Sawyer R. Rate, clinical features, safety profile and outcome of intravenous thrombolysis for acute ischemic stroke in patients with negative brain imaging. J Neurol Res 2020; 10(4): 144-5.
- AbdelRazek MA, Mowla A, Hojnacki D, Zimmer W, Elsadek R, Abdelhamid N, et al. Prior asymptomatic parenchymal hemorrhage does not increase the risk for intracranial hemorrhage after intravenous thrombolysis. Cerebrovasc Dis 2015; 40(5-6): 201-4.
- Kamal H, Mowla A, Farooq S, Shirani P. Recurrent ischemic stroke can happen in stroke patients very early after intravenous thrombolysis. J Neurol Sci 2015; 358(1-2): 496-7.
- Mowla A, Doyle J, Lail NS, Rajabzadeh-Oghaz H, Deline C, Shirani P, et al. Delays in door-to-needle time for acute ischemic stroke in the emergency department: A comprehensive stroke center experience. J Neurol Sci 2017; 376: 102-5.
- Warach S, Johnston SC. Endovascular thrombectomy for ischemic stroke: The second quantum leap in stroke systems of care? JAMA 2016; 316(12): 1265-6.
- Rajabzadeh-Oghaz H, Varble N, Davies JM, Mowla A, Shakir HJ, Sonig A, et al. Computer-assisted adjuncts for aneurysmal morphologic assessment: Toward more precise and accurate approaches. Proc SPIE Int Soc Opt Eng 2017; 10134.
- Shirani P, Mirbagheri S, Shapiro M, Raz E, Mowla A, Semsarieh B, et al. Endovascular reconstruction of intracranial aneurysms with the pipeline embolization device in pediatric patients: A single-center series. Interv Neurol 2020; 8(2-6): 101-8.
- Baharvahdat H, Ooi YC, Kim WJ, Mowla A, Coon AL, Colby GP. Updates in the management of cranial dural arteriovenous fistula. Stroke Vasc Neurol 2020; 5(1): 50-8.
- Waqas M, Rajabzadeh-Oghaz H, Tutino VM, Vakharia K, Poppenberg KE, Mowla A, et al. Morphologic parameters and location associated with rupture status of intracranial aneurysms in elderly patients. World Neurosurg 2019; 129: e831-e837.
- Varble N, Rajabzadeh-Oghaz H, Wang J, Siddiqui A, Meng H, Mowla A. Differences in morphologic and hemodynamic characteristics for "Phases-Based" intracranial aneurysm locations. AJNR Am J Neuroradiol 2017; 38(11): 2105-10.
- Rajabzadeh-Oghaz H, Varble N, Shallwani H, Tutino VM, Mowla A, Shakir HJ, et al. Computer-assisted three-dimensional morphology evaluation of intracranial aneurysms. World Neurosurg 2018; 119: e541-e550.
- Roa JA, Ortega-Gutierrez S, Martinez-Galdamez M, Maud A, Dabus G, Pazour A, et al. Transcirculation approach for endovascular embolization of intracranial aneurysms, arteriovenous malformations, and dural fistulas: A multicenter study. World Neurosurg 2020; 134: e1015-e1027.
- Valenstein ES. Great and desperate cures: The rise and decline of psychosurgery and other radical treatments for mental illness. New York, NY, US: Basic Books; 1986.