Irving S. Cooper (1922–1985): a pioneer in functional neurosurgery

Abstract

Irving S. Cooper (1922-1985), the son of a salesman, worked his way through high school, college, and medical school to become one of the pioneers in functional neurosurgery. He developed several novel techniques for the surgical management of Parkinson's disease and other crippling movement disorders. A keen interest in the physiology of movement disorders was kindled by his doctoral research and continued during his neurosurgical training. He began to apply this knowledge to surgical practice in 1952 when he began his faculty career as Assistant Professor of Surgery at New York University. At the time, surgical treatment of parkinsonian tremor focused on various techniques used to interrupt the pyramidal tract. During a subtemporal approach for a cerebral pedunculotomy, he inadvertently injured and, subsequently, was forced to occlude the anterior choroidal artery. Much to Cooper's surprise, following emergence from anesthesia the patient's tremor and rigidity were abolished without any residual hemiparesis. This serendipitous observation, together with Meyer's earlier work on the role of the basal ganglia in motor control, helped focus surgical efforts on targets within the basal ganglia and, subsequently, within the thalamus to alleviate the movement disorders associated with Parkinson's disease. While at New York University, Cooper developed chemopallidectomy and, later at St. Barnabas Hospital in the Bronx (1954-1977), he used cryothalamectomy as a surgical technique for primary control of tremor in patients with Parkinson's disease. Cooper authored many original papers on surgical techniques and several textbooks on the lives of patients afflicted with Parkinson's disease and other crippling movement disorders. Although considered controversial, this fascinating and complex neurosurgeon made significant contributions to this field.

The pathophysiology of parkinsonian tremor: a review

“…Early attempts removing parts of the motor cortex or lesioning of the internal capsule were successful in suppressing tremor but produced other unacceptable side effects [29,30,127]. Lesions within the thalamus or the zona incerta have been successful targets for thermocoagulation during stereotactic procedures [29,54,55] and recently it has been demonstrated that chronic stimulation of these same thalamic targets but also of the subthalamic nucleus and the pallidum are all able to efficiently suppress parkinsonian tremor [10, 11,74,75,80,97,150].…”

History of cryosurgery

“…Рабо-та I. Cooper вызвала взрыв интереса к жидкому азоту, в итоге этот метод стал стандартным во многих областях ме-дицины. После первоначальных широкомасштабных клинических испытаний, предпринятых в 70-х годах про-шлого века, некоторые варианты методики стали стан-дартными процедурами [50].…”

Irving S. Cooper and His Role in Intracranial Stimulation for Movement Disorders and Epilepsy

“…He would expound on his large series of clinical results versus the small series or animal studies of others, even demonstrating his patients' results to audiences [1]. While he firmly believed the technique had its place in the neurosurgical repertoire, he realized it was far from a panacea.…”

“…Irving S. Cooper was a controversial academician whose work in functional neurosurgery has been both hailed and derided for decades [1]. Beginning in the 1950s, Cooper's accomplishments led to new treatments for movement disorders, epilepsy, cerebral palsy, dystonia, and psychoaffective disorders.…”