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Introduction:
The comprehension of pathologies responsive to neurosurgical treatment made substantial progress at the turn of the 20th century. Swiss surgeons like Emil Theodor Kocher (Berne) and Rudolf Ulrich Krönlein (Zurich), but also Hans Brun (Zurich/Lucerne) and the neurologist Otto Veraguth (Zurich) were important characters with pioneering achievements that fostered the development of a neurosurgical subspecialization. This time was a turning point with an increasing number of highly sophisticated surgical procedures being performed for the first time. For example, surgery of intramedullary spinal lesions was still in its infancy.

Methods:
The authors reviewed Veraguth and Brun’s original publications about their early experiences with the resection of cervical intramedullary tuberculomas between 1910 and 1916. These reports were put into the historical context of that time and their impact on the comprehension of pathologies of the spine was estimated.

Case report 1
In their first article the authors report on a 32-year old male who consulted Veraguth for severe both-sided neck and shoulder pain, accompanied by rapidly progressive sensorymotor deficits of the limbs. Additional respiratory disturbance due to left-sided phrenicus paresis led to the decision for explorative surgery on an estimated intraspinal tumour of the 4th or 5th cervical segment.
Surgery was performed in February 1910 under asepsis by dorsal midline incision and laminectomy of C3 and C4 with complete resection of an intramedullary tuberculoma. The neurologic deficits resolved over the next weeks, the patient was discharged eight weeks after surgery and regained normal gait and good muscle strength in both upper limbs. He survived three years and was able to return to work until dying of lung tuberculosis.

Case report 2
In their second article a 32-year old male with history of tuberculosis affecting the pleura, lung and genito-urinary system before development of left-sided cervico-brachialgia, atactic gait and Brown-Sequard-Syndrome is presented.
Also in this patient surgery of an estimated lesion of the 6th or 7th cervical medullary segment was performed with complete resection of an intramedullary tuberculoma of C6 in November 1913. Persisting right-sided symptoms during the following days lead to revision surgery with resection of a second intramedullary tuberculoma little above the initial location. In the following weeks, new brain stem symptoms occurred with facial paresis, trigeminal neuralgia, and paresis of brain nerves IX-XII. The patient suffered from progressive wasting and died January 5th on disseminated tuberculosis.

Conclusion:
Veraguth and Brun made significant contributions to the diagnosis and surgical treatment of intramedullary spinal lesions by their reports as early as in 1910 and 1916 – only 22 and 28 years after the initial description of resection of a thoracic intradural extramedullar tumor by Gowers and Horsley.