Introduction of the Human Horsley-Clarke Stereotactic Frame

Abstract

It is well known that the Horsley-Clarke frame was developed and first used by Robert Henry Clarke and the pioneer neurosurgeon Victor Horsley in 1906 for making lesions in the central nervous system of animals. The Horsley-Clarke frame was extensively used throughout the next 4 decades for excitation and lesion production in animals. Aubrey Mussen, a student of Clarke, designed a stereotactic apparatus for use in humans, but no procedures were actually performed with the instrument. It is less appreciated that a Horsley-Clarke frame was also constructed for human use and first applied for depth electroencephalography by Robert Hayne and Frederic Gibbs in 1947. The assumed relationship between external landmarks and intracranial structures provided initial target localization, and pneumoencephalography confirmed depth electrode position. In many ways, the work of Hayne and Gibbs paralleled the simultaneous efforts of Ernest A. Spiegel and Henry T. Wycis. Events leading to the development of stereotactic frames and their subsequent use in humans for the treatment of epilepsy, movement disorders, and psychosurgery are reviewed.

Cognitive and Emotional Mapping With SEEG

“…While localization in epilepsy reached a new summit in the works of Hughlings Jackson, epilepsy in the English speaking world did not keep up with the sophistication of the French fusion of Charcot's anatomical and clinical thinking that was directly mapped to the brain and its networks by Jean Talairach, the psychiatrist who pioneered, along with his collaborators in the 1960s, a new stereotaxic method and means of determining anatomical correlations to a standard atlas in functional neurosurgery [e.g., (24)]. While a fruitful research stereotaxic apparatus was invented by the surgeon Victor Horlsey and Robert Henry Clarke, ushering in a new era of neuroscientific discoveries, it was not used in humans until the late 1940s by the founding epileptologist Frederic Gibbs at Harvard, along with Robert Hayne, and was not accompanied by an overall anatomical and localizationalist approach to epilepsy (25). Instead, Talairach, working closely with the neurophysiologist and neurologist Jean Bancaud, developed the means to combine astute localization of seizure semiology, individualized anatomy with functional correlations, and a stereotaxic approach to hypothesis testing, culminating in the 1950s and 1960s into the method that we now know as stereoelectroencephalography (26).…”

Historical Development of Stereotactic Ablative Radiotherapy

“…The concept originated with Clarke in 1895, the original device was constructed in 1905 and first used in 1906 (Clarke and Horsley 1906;Fodstad et al 1991;Jensen et al 1996). The definitive paper was published in 1908 (Horsley and Clarke 1908), after which the two pioneers ceased further collaboration (Fodstad et al 1991).…”

Intraoperative Feedback and Quality Control in Orbital Reconstruction

“…4e7 Their Horsley-Clarke apparatus, of which the first was produced at a cost of £300, included the use of geometric measurements in a Cartesian coordinate frame. 5,6 An atlas of the position of brain structures within the coordinate frame was generated for cats and monkeys, and the frame and atlas could even be compensated for different head sizes. 5 It was not until 1947 that a modified version of the apparatus, proposed by Spiegel and Wycis, was used in human brain surgery.…”