• Matthew Protas, Emre Yilmaz, Akil P Patel, Joe Iwanaga, Rod J Oskouian, and R Shane Tubbs.
• Department of Anatomical Sciences, St. George's University, Grenada, West Indies.
• World Neurosurg. 2018 Aug 1; 116: 396-401.

IntroductionDuring the late 19th century, the seeds of modern neurosurgery were planted to bloom into what it is now known. Wars such as the American Civil War and Crimean War drove the need to find better ways of preventing mortality from gunshot wounds to the head. However, the mortality rate from all major surgical procedures to the head, neck, and face remained staggering. Herein, we describe the surgical treatments for head and neck injuries in order to improve our understanding of neurosurgical procedures performed during the late 19th century.MethodsA literature search was conducted using PubMed and Google Books for available articles pertaining to treatment for gunshot wounds to the head during the 19th century. Search terms included "Gunshot wounds, Treatment, Civil War," "Gunshot wound, Treatment 19th century," and "Gunshot wounds, Treatment, 1800s." Literature was excluded if not in English or if no translation was provided. Most of the information was taken from the International Encyclopedia of Surgery Volume II.ResultsSurgical care for gunshot wounds to the cranium were based on depth and involved finding the bullet, controlling the bleeding, and preventing further brain injury. Surgical treatment for a gunshot wound to the face or neck involved controlling the bleeding, with a focus on maintaining the airway.ConclusionsBecause of improved understanding of infectious processes and technologic advances in surgical equipment, the late 19th century was a major milestone in creating modern day neurosurgery. The methodology behind today's treatments is no different from that of the late 19th century.Copyright © 2018 Elsevier Inc. All rights reserved.

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