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Thoughts on the Brain

In preparation for the American Association of Neurological Surgeons Annual Meeting (aka, AANS, but was founded in 1931 as the Harvey Cushing Society) next week, I decided to brush-up on my brain and neurosurgery factoids–and, of course, share them with you.

  • The brain has been a mystery since time immemorial. Early philosophers were divided as to whether the seat of the soul lies in the brain or heart. Aristotle favored the heart, thinking that the function of the brain was merely to cool the blood. Hippocrates, the “father of medicine”, came down strongly in favor of the brain.
  • In the United States, the 1990s were officially designated as the “Decade of the Brain” to commemorate advances made in brain research.
  • The brain consumes up to twenty percent of the energy used by the human body, more than any other organ.
  • Although the human brain represents only 2% of the body weight, it receives 15% of the cardiac output, 20% of total body oxygen consumption, and 25% of total body glucose utilization.
  • According to Wikipedia, the Hieroglyphic for the word “brain” (c.1700 BC) looks like this:

While neuroscience has come a long way since Hippocrates, Walter Dandy, M.D., Sir Victor Horsley, and Harvey Cushing, M.D., most medical professionals are optimistic that a lot more progress will be made in the next 10 years–especially as it relates to the genetic understanding of brain tumors.

Some, like James I. Ausman, MD, PhD, author of a fascinating article titled, The challenge for neurosurgery in the 21st century,1 believe that:

The advances in scientific knowledge are so rapid that in 5 to 10 years, most of what one has learned is out of date. “

With revolutionary advances in genetics and molecular biology, Ausman’s  notion is that the practice of neurosurgery — and medicine in general– will be transformed.

For example:

  • Surgery will become minimally invasive and will eventually disappear as the targeted genetic and molecular treatments will eliminate the major diseases we face worldwide.
  • Neurosurgery will become a part of a broad specialty of neuroscience as neurologists, neurosurgeons, psychiatrists, physiatrists, neuroradiologists, and basic scientists practice together on a common brain.
  • Technological and information revolution will totally change the position of the physician in health care as artificial intelligent machines will perform functions better than any human.
  • Neurosurgery as we know it today will be of historical interest.
  • Technology will bring medical care to all people and eliminate the shortage of physicians.
  • Rehabilitation of the nervous system will become a dynamic specialty as nerve regeneration, and the prevention of further cell damage will predominate in therapy.
  • Recovery of the nervous system after injury and surgery will become the key to better outcomes as opposed to the care we now give.

Because of these advances, says Ausman,  life expectancy will pass 100 and go to 150, some predicting 400 years. But this is likely to have doomsday consequences…

The challenge of what to do with a healthy body and mind will overwhelm society that now cannot take care of its elderly.”

Inspiring, but also somewhat bleak.

What do you think? What’s your assessment of all the current and proposed future advances to neuroscience and medical technology?

1. PII: S0090-3019(07)01200-1
doi:10.1016/j.surneu.2007.10.012
© 2008 Published by Elsevier Inc.
Surgical Neurology
Volume 69, Issue 1 , Page 102, January 2008

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