Abstract：
From the time of Hippocrates to the early 19th century, knowledge advanced but that was an uneven process. Anatomy was basically defined by Galen and remained cast in stone until the early 16th century. Neuroanatomy was described by Galen but had little practical value, as brain surgery was not possible. The anatomy of the cranium was known and was largely correct. Care was taken to avoid the frontal air sinuses and the venous sinuses and the temporal region. The role of the brain in consciousness was not understood. It was considered the seat of the soul but there was a lack of understanding that damage to it could induce clinical symptoms such as stupor or paralysis. These were variously attributed to injuries to the meninges or the bone. This error was finally corrected in the 18th century when the brain was identified as responsible for much of the clinical disturbance following cranial trauma. All awareness that post traumatic neurological deficit was contralateral was ignored until the late 18th century, although several authors noted it. Likewise, the presence of CSF had to wait until the 18th century until it was recognized. Fissures were treated with trepanation, because of a perceived risk of infection developing between the bone and the dura. Depressed fracture fragments were elevated, replaced, or removed according to the details of the injury. Finally, for centuries surgeons blocked patients ears to reduce the sound of drilling, despite the fact that such a blocking would amplify the noise.
摘要：
从希波克拉底时期到19世纪初,知识进步，但这是一个不平衡的过程。解剖学基本上由Galen定义，直到16世纪初一直用石头铸造。Galen描述了神经解剖学，但没有什么实用价值，因为脑部手术是不可能的。颅骨的解剖结构是已知的，并且在很大程度上是正确的。注意避开额叶空气窦、静脉窦和颞区。大脑在意识中的作用尚不清楚。它被认为是灵魂的所在地，但人们缺乏理解，对它的损害可能会引起昏迷或瘫痪等临床症状。这些归因于脑膜或骨骼的损伤。这个错误最终在18世纪得到纠正，当时大脑被确定为造成颅脑外伤后的许多临床障碍的原因。直到18世纪后期，所有关于创伤后神经功能缺损是对侧的认识都被忽略了，尽管有几位作者指出了这一点。同样，CSF的存在必须等到18世纪才能得到认可。裂隙用钻孔治疗，因为感觉到骨和硬脑膜之间有感染的风险。凹陷的骨折碎片升高，替换,或根据受伤的细节移除。最后,几个世纪以来，外科医生阻塞患者的耳朵以减少钻孔的声音，尽管这样的阻塞会放大噪音。
