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The first published account of a neurosurgical intervention performed on the North American continent is described. The operation took place in Mexico City in 1561. The neurosurgical intervention was performed by a Spanish surgeon, Pedro Arias de Benavides, on a 13-year-old boy who had sustained head trauma that caused an open depressed cranial fracture and exposed the cerebrum. A description of this case was first published in Valladolid, Spain, 6 years after the event, in a book entitled Secretos de Chirurgia ("Secrets of Surgery").