Minim Invasive Neurosurg 2009; 52(1): 1-4
DOI: 10.1055/s-0029-1202818

© Georg Thieme Verlag KG Stuttgart · New York

Axel Perneczky, 1.11.1945–24.1.2009

N. J. Hopf, R. Reisch
Further Information

Publication History

Publication Date:
26 February 2009 (online)

Axel Perneczky was born on November 1st, 1945 in a small town called Krasnogorsk near Moscow/Russia where his Hungarian parents were imprisoned. His father had been a soldier in World War II. Only a year later the family moved to Budapest/Hungary where he grew up and first mentioned his irrevocable decision to become a neurosurgeon at the age of 10 years. Consequently, he started medical school in 1964. In 1965 the family took refuge in Vienna/Austria were he continued his medical education. During the last 3 years of medical school he started his work in the Department of Anatomy under the instruction of Professor Hajek and Professor Platzer. His great interest was already surgical oriented anatomy. After graduation in 1971 he trained for two years in general and trauma surgery. In 1973, he finally started to fulfil his dream and became a resident in Neurosurgery at the University Hospital Vienna under the direction of Professor Koos. Driven by his great interest in microsurgery, he spent one year of his training with Professor Yasargil in Zurich/Switzerland. Axel Perneczky was appointed Professor of Neurosurgery at the University of Vienna in 1980. In 1988, he followed the call to the chair in Neurosurgery at the Johannes-Gutenberg-University Mainz/Germany where he worked as the chairman until his recent death. In 1998 Axel Perneczky was awarded “doctor honoris causa” of the University Pécs/Hungary.

Axel Perneczky dedicated his academic life to the struggle of reducing the surgical risks for his patients. His vision is best described by the term “minimal invasive key-hole concept”, a term he coined himself early on in his neurosurgical career. The basic idea of this concept is to enable even complex surgical procedures through stepwise smaller, less traumatic, and sometimes unusually located openings ([Fig. 1]), And thus, reducing not only the morbidity associated with the approach itself, but also enabling shorter recovery times and addressing cosmetic issues. The easier it sounds, the tougher it is to realize this concept in the daily neurosurgical routine. Axel Perneczky worked very hard to master it. At the beginning he was getting more criticism than support. However, over the last decade his tremendous contributions to the fields of “Minimally Invasive Neurosurgery” and “Endoscopic Neurosurgery” have been nationally as well as internationally highly appreciated.

Fig. 1 Schematic drawing of different small key-hole approaches to the sella region (taken from: Perneczky A, Müller-Forell W, von Lindert E, Fries G: Keyhole Concept in Neurosurgery. Stuttgart, New York: Thieme; 1999).

Axel Perneczky belonged to the first generation of neurosurgeons who were raised with microsurgery and quickly became a master in this field. Supported by his mentor Professor Koos, he was co-author of the book “Color Atlas of Microsurgery” which was first published in 1984 and quickly advanced to the standard work in microsurgery. Driven by his clear vision that the same or even better results must be accomplishable with less invasive surgical strategies, he finally ran across endoscopic techniques. From the very first contact with an endoscope, Perneczky was convinced that this technique held the key to the future of neurosurgery. But he also was convinced that, beside technology also precise and surgically oriented anatomical knowledge, detailed preoperative imaging, and sophisticated instruments were crucial to succeed with his ideas. That is why he himself referred to his vision as “key-hole concept” rather than “key-hole surgery”. He consequently first studied the basic requirements and published the book “Endoscopic Anatomy for Neurosurgery” in 1993 followed by “Key Hole Concept in Neurosurgery” in 1999 and just recently “Key Hole Approaches in Neurosurgery” in 2008.


N. J. Hopf, MD 

Professor and Chairman

Departement of Neurosurgery


Klinikum Stuttgart

Kriegsbergstr. 60

70174 Stuttgart



R. Reisch, MD 

Professor of Neurosurgery

University Hospital Zurich

Frauenklinikstraße 10

8091 Zurich