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Fedor Krause (1857-1937): the father of German 

neurosurgery 

Claudia Florida Costea1,2, Dana Mihaela Turliuc1,2, Anca Sava1,2, 

Gabriela Florența Dumitrescu1, A.I. Cucu1, Emilia Patrașcanu2,3, 

Daniela Trandafir2,4, Ș.Turliuc2 

1“Prof. Dr. N. Oblu” Emergency Clinical Hospital Iași, Romania 
2“Grigore T. Popa” University of Medicine and Pharmacy Iași, Romania 
3Regional Institute of Oncology Iași, Romania 
4“Sf. Spiridon” Emergency Clinical Hospital Iași, Romania 

 
Abstract: Rightfully regarded as the father of German neurosurgery, Fedor Krause made 

a major contribution not only in world neurosurgery, but also in medicine. The aim of 

this paper is to highlight once more the significance and importance of Fedor Krause’s 

work and exceptional human quality. 

Key words: Fedor Krause, history of German neurosurgery, ophthalmology 

 
Birth and youth of Fedor Krause 

The one who would one day become the 

father of German neurosurgery, Fedor Krause 

(1857-1937), was born on 10 March 1857 in 

Friedland, a Silesian town from Germany. His 

father was a public servant in the district of 

Waldenburg and died when Fedor was still 

young (6). When he was nine years old, his 

mother decided to move the family to Berlin, 

where it led an extremely modest life, at times 

bordering on poverty. This did not prevent 

Fedor from studying at “Sophien Gymnasium” 

in Berlin, where he became known for his 

talent (6), studying piano and violin and 

winning many awards (28, 30).  

Fortunately, due to financial support from 

a private sponsor, the young Fedor was able to 

continue his studies at post-graduate level, 

choosing medicine (30). He thus began his 

medical studies in 1875 and wrote his doctoral 

thesis in 1879, passing his final examinations 

in March 1880. After graduating from the 

medical school of Berlin, Krause worked for 

two years as an ophthalmologist in prestigious 

ophthalmology clinic of professor Julius 

Hirschberg’s (1843-1925). In this early period, 

Krause also worked with famous 

bacteriologists of the time, the likes of Robert 

Koch (1843-1910) and Karl Friedländer (1847-

1887), the pathologist Karl Weigart (1845-

1904) and the surgeon Bernhard von 



 

 

 

 

 
242 | Costea et al - Fedor Krause (1857-1937) 

 

 

 

 

 

 

 

Langenbeck (1810-1887), who left their mark 

on the young physician and motivated him to 

study bacteriology and histopathology. In his 

later works Fedor would approach various 

unexplored topics in these medical fields. He 

worked with the renowned bacteriologist 

Robert Koch at the “Imperial Board of Health” 

(23) and he aroused his interest to study the 

systemic manifestations of tuberculosis, 

especially bone tuberculosis (24).  Krause 

published many articles and papers as a result, 

the most important of which was “Die 

Tuberkulose der Knochen unde Gelenke” 

(Tuberculosis of the Bones and Joints, 1891) 

(16). 

The beginnings of neurosurgery. The 

collaboration with Professor Richard 

von Volkmann 

Passionate by neuro-ophthalmology and 

visual pathways, Krause became more and 

more interested in neurosurgery. Thus, in 

1883, he moved to Halle, where he worked 

until 1892 as a resident surgeon in the famous 

surgery clinic of Richard von Volkmann 

(1830-1889), a renowned professor who was 

also chairman at the University of Halle at that 

time (3, 15). Volkmann was an important 

name in German surgery, one of the first 

Listerians, and the one who introduced the 

practice of antisepsis in Germany, in the 

period of the Franco-Prussian war (12). While 

he lived in Halle, Krause had a beautiful and 

sincere collaboration and friendship with 

professor Volkmann (4).   

The city of Halle was a heavily 

industrialized city and work accidents 

resulting in head injuries were frequent. Thus, 

in 1885, together with Volkmann, Krause 

reported 36 surgical interventions for 

posttraumatic extradural and subdural 

hematomas, with no postoperative deaths (4). 

After spending four years in the “Surgical 

Hospital” in Halle, Krause defended his 

habilitation thesis entitled “Malignant 

Neuromas and Their Nerve Fiber Content”, in 

1887, which, despite being regarded as 

inadequate for the profession of general 

surgeon, it was eventually accepted, with 

Volkmann’s help. In 1889, after professor 

Volkmann died of pneumonia, Krause became 

the deputy chief of surgery for one year, after 

which he was replaced by the German surgeon 

Friedrich Gustav von Bramann (1854-1913). 

Afterwards, Krause moved to Hamburg where 

he became employed as an “oberarzt” at 

“Altona Municipal Hospital”. In 1990 

returned to Berlin where he was appointed 

Honorary Professor in the Friedrich-Wilhelms 

University (e.g. Humboldt University of 

Berlin) and chief of surgery at “Augusta 

Hospital” (30). 

Throughout his life, Fedor Krause 

venerated his mentor, and remained loyal to 

him even after he passed away.  His disciples 

said that Krause always spoke fondly of him, 

even while scrubbing with his assistants (32). 

Moreover, Krause also wrote memoires about 

him and even dedicated a book to him, entitle 

“Zur Erringerung an Richard von Volkmann” 

(In Richard von Volkmann’s memory), 

published one year after the professor’s death 

(6).  

In Berlin, Krause began collaboration with 

the neurologist Hermann Oppenheim (1858-



 

 

 

 

 
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1919) together with whom he studied 

neuroanatomy, neurophysiology and 

neurosurgery. Krause regarded this 

collaboration and friendship very highly as 

well. Later on, in the foreword to his book 

“Chirurgie des Gehirns und Rückenmarks 

nach eigenem Erfahrungen” (Sugery of the 

Brain and Spinal Cord – Based on Personal 

Experiences), Krause wrote: “I am most 

grateful to Hermann Oppenheim. Hardly a 

week, frequently not a day, passed in which we 

did not consult at the bedside or in the 

operating-room. This invaluable and lasting 

connection, and the constant harmonious 

collaboration, bore in time fruit that we are 

now proud of in our operative therapy, despite 

the numerous and discouraging experiences” 

(12, 19).  

Krause’s contributions in epileptology 

and functional neurosurgery 

Influenced by the classical cortical 

stimulation work of Fritsch and Hitzig, Ferrier 

and Sherrington, Krause thought that he could 

use electricity in neurosurgery and neurology 

as well. Through this discovery, Krause was 

considered to be the first surgeon who 

performed the first intraoperative electrical 

stimulation on the cerebral cortex (35). 

Throughout his life, Krause operated on 

400 epileptic patients, which was by far the 

highest number of patients at that time (13). 

He was also the one who performed the first 

detailed motor map of the human cortex (25), 

and who used faradic stimulation to 

differentiate between the facial from the 

audiovestibular nerve in a patient with 

tinnitus, when he made a section of eighth 

cranial nerve (25, 32). It is important to note 

that Krause was not only the first to describe 

the locating of a cranial nerve through electric 

stimulation, but also the first to record the 

spread of the current artifacts products (8). 

Krause’s operative neurosurgical 

techniques 

During the First World War, Krause was a 

surgical consultant (“Generalarzt”) for the 

German army, gaining experience in treating 

head injuries. After the war, he went to Central 

and South America, in countries such as Brazil 

and Argentina, in 1920 and 1911, lecturing 

and performing brain surgery (5).  

In 1893, Krause described the subtemporal 

extradural approach to the trigeminal nerve 

roots and Gasserian ganglion (Gasserian 

ganglionectomy) (17, 25). Despite the 

proximity of the gasserian ganglion to the 

internal carotid artery, Krause wrote that, in 70 

cases of Gasserian ganglionectomy, he never 

injuried the carotid artery, which attests to his 

outstanding surgical skills (12). 

Seven years later, Krause removed a bullet 

from the clinoid process and optic foramen 

region of a young man who attempted to 

commit suicide out of love, through a frontal 

approach to the sella. Krause noticed that he 

had a very good view of the sellar region. Still 

in 1900, before the “Berlin Medical 

Association”, he performed surgery on a 

cadaver (20) and proposed this type of 

approach for tumors in this region. Four years 

later he attempted an unsuccessful resection of 

tuberculum sella meningioma and in 1908 a 

pituitary adenoma in an acromegalic patient, 

which was followed by improvement (12). 



 

 

 

 

 
244 | Costea et al - Fedor Krause (1857-1937) 

 

 

 

 

 

 

 

 In 1903 he described the cerebellopontine 

angle approach, which he performed through 

an unilateral suboccipital osteoplastic flap 

(18). Nowadays, this approach is considered to 

be the predecessor of the retrosigmoid 

approach (14). It was performed for a 

vestibular schwannoma and Krause concluded 

that tumors located in the cerebellopontine 

angle can be now safely resected. Nonetheless, 

he considered them to be the most difficult and 

problematic of all brain tumors (31). 

Four years later, Krause resected a 

cerebellar tumor of the upper vermis, being 

regarded as the first surgeon who was 

successful in approaching the fourth ventricle 

(13). Twenty-six years later, at his funeral, the 

otologist Güttich wrote in his orbituary: 

“Krause was the first person who looked into 

the fourth ventricle of a living human being” 

(28). 

In 1913 he conducted a resection of a pineal 

tumor through an infratentorial 

supracerebellar approach which he patented in 

neurosurgery and which would bear his name 

(2, 27, 29). Krause also had a contribution in 

vascular neurosurgery, being the first 

neurosurgeon who operated cerebral 

angiomas. He attempted also to ligatures the 

feeding vessels (33). He also excelled in spinal 

cord neurosurgery and, together with the 

German neurologist Heinrich Oppenheim, in 

“Augusta Hospital” in Berlin, he performed 

the first discectomy and laminectomy in a 

patient who had been suffering from severe 

sciatic pain for several years and who 

developed an acute cauda equina syndrome. 

The surgery consisted in laminectomy L2-L4, 

splitting the dura, mobilization the cauda 

equina by a retractor, exploring the operation 

field and removing a small fibrocartilage mass, 

which they later considered to be an 

enchondroma (26).  

His work (Table no.1) is overwhelming and 

groundbreaking in the field of neurosurgery in 

Germany and in Europe at the beginning of 

the 19th century. One of the most important 

books he wrote is “Chirurgie des Gehirns und 

Rückenmarks nach eigenem Erfahrungen” 

(Sugery of the Brain and Spinal Cord – Based 

on Personal Experiences) (20). The first 

volume was published in 1909, comprising the 

detailed and didactic writings of over 300 

craniotomies with hand-drawn coloured 

illustrations of surgical procedures. Several 

years later, in 1911 and 1912, the second and 

third volumes were published. Even though 

his books were initially written in German, 

they became famous throughout Europe, in 

spite of the fact that they were translated into 

English later on (4). His didactic work 

represented true atlases and textbooks, 

comprising at the same time many surgical 

techniques, described in great detail, and 

examples of cases from Krause’s personal 

experience (32).  

Another important work was his 

monograph “Trigeminal Neuralgia: Including 

the Anatomy and Physiology of Nerves” in 

which Krause described his experience with 14 

patients suffering from trigeminal neuralgia, 

and reviewed the entire literature on the 

subject. His knowledge of ophthalmology 

allowed him to avoid keratitis, a common 

complication of the denervation of the cornea 

by sectioning the first branch of the trigeminal 

nerve (12). 



 

 

 

 

 
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TABLE I 

Chronology of Krause’s contributions (11, 12) 

Krause’s contributions on the surgical 

branches of medicine 

Apart from his monograph on 
neurosurgery, Krause also published a series of 
surgical monographs in which he studied 
various pathologies or described his 
innovations in: general surgery, plastic surgery 
(free transplantation of skin flaps (1) ), 
orthopedics (bone and joint tuberculosis, 
application of waking casts), urology (total 
cystectomy, bilateral ureterosigmoidostomy, 
reimplantation of the ureter into the bladder 
(1)), endocrine surgery (adrenotomy, 
transplantation of endocrinous tissue (22)), 
ENT surgery (sympathectomy, carotid artery 

ligation (22)), and so on.  
Moreover, in the field of anesthesiology, 

Krause highlighted the risk of cerebral oedema 
caused by ether and chloroform. Despite the 
fact that, while working with professor 
Volkman, Krause used this combination of 
morphine and chloroform, he was not 
convinced that this formula was beneficial for 
neurosurgical interventions. This motivated 
Krause to continue his research in the field of 
neuroanesthesiology (10). 

Krause the man 

Krause was a shy, sensible and nobly 
modest man (Figure 1). He did not like to 
attend large international meetings in order to 
present his techniques, preferring smaller 
conferences instead. What is more, when he 
was asked about how he would like people to 
remember him, he responded rather like a 
classical pianist than a neurosurgeon (9). 

 
Figure 1 - Fedor Krause (1857-1937), the father of 

German neurosurgery 

Year Pathology Approach/technique 

discovered 

1893 trigeminal neuralgia subtemporal extradural 

approach (Gasserian 

ganglionectomy) 

1897 tinnitus cerebellopontine angle 

approach (section of 

eight cranial nerve) 

1904 tuberculum sella 

meningioma                 

frontal transcranial 

approach to the sella 

1908 herniated lumbar disc 

(“enchondroma”) 

discectomy, 

laminectomy 

1908 arteriovenous 

malformation of the 

brain 

ligation of a feeding 

artery 

1909 pituitary adenoma sphenoid ridge approach 

to sella 

1913 pineal tumor supracerebellar 

infratentorial approach 



 

 

 

 

 
246 | Costea et al - Fedor Krause (1857-1937) 

 

 

 

 

 

 

 

Krause was described as a man with big 

hands, more suitable for manual labor than for 

brain surgery (34). Nonetheless, he had a 

sensitive and artistic nature, having difficulty 

in choosing, in his youth, between a career as a 

pianist or as a physician. 

In a letter from 1889, one year before his 

death, professor Volkmann wrote that his 

assistant, Fedor Krause, “had developed into a 

surgeon capable of performing all types of 

surgeries, that he led lectures and scientific 

work, and that he was endowed with an 

unusual clinical experience, with great talent 

and humane attitude” (32).  

Krause’s retirement 

After his official retirement, he withdrew to 

Rome, in 1930, together with his daughter, 

devoting the rest of his life to arts and music. 

Krause held a series of private concerts (6), for 

which he was praised and appreciated by 

Italian critics (11). 

Upon his 80th birthday, while he was being 

celebrated in Berlin, in 1937, the German 

surgeon Ferdinand Sauerbach said: “You can 

look back on your work with pride, and rejoice 

in its future progress and prosperity. Even the 

notable progress in surgery of the central 

nervous system in other countries rests to a 

large extent on your basic work” (32).  

Krause passed away during the same year, 

in Badgaatstein, forever remaining the father 

of German neurosurgery in the consciousness 

of the German people.  

Emil Heymann (1878-1936), Karl Max 

Behrend (1895-1963) and George Merrem 

(1908-1971) continued on their father’s path, 

contributing to the development of 

neurosurgery in Germany. They became great 

professors and modest men, like their mentor 

(1). George Merrem was trained by Emil 

Heymann (1878-1936), Krause’s successor in 

Berlin, who perpetuated Krause’s 

neurosurgical school (7) and developed 

neurosurgery in the German Democratic 

Republic after the Second World War.  

The Faculty of Medicine of Berlin awarded 

Krause in 1915 with the highest academic 

position, “ordentlichen Honorarprofessor” 

(21), and nowadays the German 

Neurosurgical Society awards the great 

neursurgeons with the "Fedor Krause Medal" 

for outstanding work in the field of 

neurosurgery, which is the highest honor in 

neurosurgery.  

Conclusions 

Fedor Krause is the father of German 

neurosurgery who has remained in the 

memory of the German people for his 

contribution not only in neurosurgery, but 

also in other branches of medicine. His main 

concern, however, for which he fought his 

entire life, was with finding safe approaches to 

inaccessible anatomical areas of the brain, 

which he actually succeeded. Through his 

entire activity, Krause is not only a pioneer in 

German neurosurgery, but a pioneer in world 

neurosurgery. 
 

Correspondence 

Dana Mihaela Turliuc 

“Grigore T. Popa” University of Medicine and 

Pharmacy, Iași, Romania 

E-mail: turliuc_dana@yahoo.com 



 

 

 

 

 
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