The birth of experimental neurosurgery: Wilder Penfield at Montreal's Royal Victoria Hospital, 1928-1934

Wilder Penfield is well known as the founder of the Montreal Neurological Institute (MNI), the site of his most important contributions to the investigation and treatment of epilepsy and to our understanding of the structure-function relationship of the brain. The seeds of the MNI were sown 6 years before its opening in 1934, when Penfield accepted the position of head of the Subdepartment of Neurosurgery at McGill University's Royal Victoria Hospital (RVH). Penfield took this position because of the facilities made available to him to pursue the neuropathological research that he had undertaken with Pío del Río Hortega in Madrid, and to continue his investigation into the nature and treatment of posttraumatic epilepsy that he began with Otfrid Foerster in Breslau. Penfield and his first neurosurgical research fellows Joseph Evans, Jerzy Choróbski, Nathan Norcross, Theodore Erickson, Isadore Tarlov, and Arne Torkildsen studied the substrate of focal epilepsy, the innervation of cortical arteries, the function of the diencephalon, the microscopic structure of spinal nerve roots, and the ventricular system in health and disease. In his 6 years at the RVH, Penfield and his fellows effected a paradigm shift that saw neurosurgery pass from empirical practice to scientific discipline.