title: Brain retractor systems.
abstract: OBJECTIVE
  Reviews of the brain retractor evolution are described. Instrument characteristics as well as the physiopathological and histopathological damage of the brain are induced by brain retraction.
  
  
  METHODS
  The literature related to the brain retractor was reviewed. Journals, books, personal testimony, government patents, and electronic media databases were analysed.
  
  
  RESULTS
  The brain retractor started as a hand-held flat ribbon manufactured on copper and stainless steel. This shape evolved into a shovel. Several shapes acquired from the early period were from a tappered, spoon shape covered by silicone. The posterior evolution was the development of the articulate arm, fixed to the skull or to the self-retaining subcutaneous retractor, or attached to a frame or to a stereotactic instrument. The pressure monitor was the most important safety addition.
  
  
  CONCLUSIONS
  In conclusion, a better monitor system needs to be developed to avoid brain injury.
authors.affiliation: Biomechanic Laboratory, Department of Neurosurgery, Wayne State University, School of Medicine, Detroit, MI, USA. manueldujovny@hotmail.com
authors.forename: Manuel
authors.initials: M
authors.lastname: Dujovny
authors.forename: Onyekachi
authors.initials: O
authors.lastname: Ibe
authors.forename: Alfred
authors.initials: A
authors.lastname: Perlin
authors.forename: Travis
authors.initials: T
authors.lastname: Ryder
mesh_terms: D001921:Brain / Q000601:surgery*; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation; D016343:Monitoring, Intraoperative; D009493:Neurosurgery; D019635:Neurosurgical Procedures / Q000295:instrumentation*