Early uses of brain imaging However, Mosso's manuscripts have remained largely unknown for more than a century, and therefore it was the structural radiographic techniques to dominate the field of the imaging of the human brain. Unfortunately, because the brain is almost entirely composed of soft tissue that is not radio-opaque, it remains essentially invisible to ordinary or plain x-ray examination. This is also true of most brain abnormalities, though there are exceptions such as a calcified tumor (e.g.meningioma, craniopharyngioma, some types of glioma); whilst calcification in such normal structures as the pineal body, the choroid plexuses, or large brain arteries may indirectly give important clues to the presence of structural disease in the brain itself. In 1918 the American neurosurgeon Walter Dandy introduced the technique of ventriculography whereby images of the ventricular system within the brain were obtained by injection of filtered air directly into one or both lateral ventricles of the brain via one or more small trephine holes drilled in the skull under local anaesthesia. Though not usually a painful procedure, ventriculography carried significant risks to the patient under investigation, such as haemorrhage, infection, and dangerous changes in intracranial pressure. Nevertheless, the surgical information given by this method was often remarkably precise and greatly enlarged the capabilities and accuracy of neurosurgical treatment. Dandy also observed that air introduced into the subarachnoid space via lumbar spinal puncture could enter the cerebral ventricles and also demonstrate the cerebrospinal fluid compartments around the base of the brain and over its surface. This technique was called pneumoencephalography. It further extended the scope for precise intracranial diagnosis, but at a similar cost of risks to the patient as well as being, in itself, a most unpleasant and often painful ordeal. Development of modern techniques In 1927 Egas Moniz, professor of neurology in Lisbon and Nobel Prize in Physiology or Medicine winner in 1949, introduced cerebral angiography, whereby both normal and abnormal blood vessels in and around the brain could be visualized with great accuracy. In its early days this technique likewise carried both immediate and long-term risks, many of them referable to deleterious effects of the positive-contrast substances that were used for injection into the circulation. Techniques have become very refined in the past few decades, with one in 200 patients or less experiencing ischemic sequelae from the procedure. As a result, cerebral angiography remains an essential part of the neurosurgeon's diagnostic