The origins of neuroimaging and Johann Puluj: Early X‐rays and the foundations of radiographic neuroanatomy

Neuroimaging plays a central role in modern neuroanatomy education and neurological diagnosis, yet its roots trace back to the foundational era of X-ray technology. This article examines the historical trajectory of early X-ray methods, with particular focus on the pioneering, though often overlooked, contributions of Johann Puluj. Although early X-rays could not image the brain or spinal cord, they enabled detailed imaging of the skull and vertebral column, structures essential to neuroanatomical understanding. Puluj's innovations, including the use of an inclined anticathode, led to high-quality skeletal radiographs, such as the first published full-body X-ray of a stillborn infant taken on February 2, 1896, and published in the Prague newspaper on February 11 and in a British professional journal in April of the same year. These images laid the groundwork for radiographic anatomy and served as early teaching tools in medical education. By correlating skeletal changes with neurological conditions such as increased intracranial pressure, neurofibromatosis, or congenital malformations, plain radiographs established the early logic of clinical neuroimaging. The conceptual frameworks they introduced for understanding neuroanatomy, for teaching its principles, and for applying them in clinical practice were subsequently expanded by the advent of more advanced dynamic radiographic techniques. Recognizing Puluj's pioneering contributions to the history of X-ray discovery not only restores accuracy to the scientific record but also emphasizes the lasting educational significance of early imaging practices. This study highlights the importance of incorporating historical perspectives into neuroanatomy curricula to enrich learners' appreciation of modern imaging techniques and their foundational origins.