Top 10 Most Influential Publications in Neurosurgery

A curated list focused on practice-changing influence: foundational concepts, pivotal trials, and technique-defining works.

author: [bhushan thombre]
date: 2025-08-26
tags: [neurosurgery, history, influential papers, landmark studies]

1) Teasdale & Jennett — The Glasgow Coma Scale (1974)

Defined a common language for level-of-consciousness assessment, standardizing triage, communication, and research across neurotrauma worldwide.

Reference: Teasdale G, Jennett B. Lancet. 1974.

2) Spiegel & Wycis — Human Stereotactic Apparatus (1947)

Brought stereotaxy to the OR, enabling accurate, minimally invasive targeting that underpins functional neurosurgery and modern DBS workflows.

Reference: Spiegel EA, Wycis HT, et al. Science. 1947.

3) Leksell — Stereotaxic Radiosurgery Concept (1951)

Introduced lesioning with focused radiation and a stereotactic frame—planting the seed for Gamma Knife and radiosurgery as a neurosurgical modality.

Reference: Leksell L. Acta Chir Scand. 1951.

4) Yaşargil — Microsurgery: Applied to Neurosurgery (1969)

Codified microsurgical technique, optics, and instrumentation—transforming outcomes for aneurysms, AVMs, and skull base tumors.

Reference: Yaşargil MG. Georg Thieme Verlag. 1969.

5) Jannetta — Neurovascular Compression in Trigeminal Neuralgia (1967)

Linked arterial compression at the root entry zone to classical TN and established microvascular decompression as an etiology-driven operation.

Reference: Jannetta PJ. J Neurosurg. 1967.

6) Dandy — Aneurysm Clip Era (1937–1938)

First successful obliterative clipping of an intracranial aneurysm, inaugurating definitive aneurysm surgery and decades of clip innovation.

Reference: Dandy WE. JAMA / historical summaries in J Neurosurg.

7) ISAT — Coiling vs Clipping for Ruptured Aneurysms (2002)

Practice-changing RCT showing improved 1-year independence with endovascular coiling in suitable ruptured aneurysms.

Reference: Molyneux AJ, et al. Lancet. 2002 (with long-term updates).

8) Stupp Trial — Temozolomide for Glioblastoma (2005)

Established chemoradiation as the GBM standard of care, improving survival and setting the template for subsequent trials and biomarkers.

Reference: Stupp R, et al. N Engl J Med. 2005.

9) NASCIS II — High-Dose Methylprednisolone in Acute SCI (1990)

Controversial yet influential; catalyzed protocols, debate, and research in spinal cord injury therapeutics and trial design for decades.

Reference: Bracken MB, et al. N Engl J Med. 1990.

10) Benabid — High-Frequency Thalamic Stimulation for Tremor (1991)

Demonstrated durable tremor control with chronic high-frequency stimulation—ushering in modern DBS.

Reference: Benabid AL, et al. Lancet. 1991.

Notes on Selection

• Scope: Works that changed daily practice, spawned new subspecialties, or standardized language/tools.
• Balance: Techniques (microsurgery, stereotaxy, radiosurgery), disease areas (vascular, tumor, functional, spine), and methodologies (scales, RCTs, monographs).
• Omissions: Many deserving items (e.g., Fisher CT grading for SAH, GOS, RESCUEicp, early Gamma Knife series) can be added in an extended list.

This list is by no means exhaustive or definitive, but aims to highlight publications that have profoundly shaped neurosurgical practice and thinking over the past century. I welcome suggestions for additions or revisions!