“Every day I remind myself that my inner and outer life are based on the labors of other men, living and dead, and that I must exert myself in order to give in the same measure as I have received and am still receiving.”---- Einstein.

Hippocrates (375-460 B.c.), stated "Askin peri ta nosimata dio: ofeleein i mi vlaptin," (Ασκείν περί τα νοσήματα δύο: ωφελέειν ή μη βλάπτειν) which, roughly translated, means: In cases of disease there are two ways to provide: to help, or at least cause no damage. "Nil nocere" is the Latin tenant "do not harm......" Primum non nocerum. (First do no harm)”..

To do no harm to the patient We must understand and follow few principles which are overlooked. First is the dogma of dividing brain into functioning areas(eloquent areas) and functionlly silent (Nonelequent) areas. By diving brain into functioning and nonfunctioning areas by all anatomists and many neurosurgeons, there is tendency of removing some normal parts of brain along with the diseased part (tumour of the brain/cancerous part of the brain).

Thats why the concepts of lobectomies arose which allowed neurosurgeons to  remove the entire lobe of the brain to remove tumours, such as ..... frontal lobectomy ( removing frontal lobe for tumour), temporal lobectomy (removing diseased temporal lobe), occipital lobectomy. This concept was also applied to remove vascular malformations of the brain which were classified based of eloquency of the brain.

Prof Yasargil and his student Prof Valavanis followed the concept EVERY PART OF BRAIN IS ELOQUENT for the patient and proposed to remove only the tumour and not the entire lobe (http://www.uams.edu/update/absolutenm/templates/news2003v2.asp?articleid=8180&zoneid=15). Being the follower and student of Yasargil-Valavanis legacy i strongly believe every millimeter of the brain is eloquent and dividing brain into functioning and nonfunctioning shows our ( every neurosureons)  poor understanding of the brain. When its poorly understood we should be as conservative as it is required in removing only the diseased tumour and not the lobe.

The second dogma is the management of   brain diseases on the basis of standard protocols. This concept puts every patient into one standard group, neglecting the individual variability. No two people are same and no two diseases in same place in different person behave in similar pattern. Applying same standard protocol of treatment to different people with disease in same location donot consider the  individual variebility. Though standard protocols are needed to guide the treatment, each patient should be dealt individually and managed indipendently. The outcome of same disease in two different patients may not be same.

"Je le pansai, Dieu le guérit "....."I bandaged him and God healed him".

                                                                                                -Ambroise Paré