**1. Introduction**

Beginning with Harvey Cushing's work in the early 1900s, modern neurosurgical advancements are often entwined with parallel developments in both medical and nonmedical technologies [1]. Just as the application of microscopy, endoscopy, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound in neurosurgery have revolutionized and transformed the field, artificial intelligence (AI) is poised to do the same [2]. The past decade has witnessed exponential growth in research seeking to reconcile AI and neurosurgery, with primary goals of improving patient outcomes and enhancing quality of care. Academic interest toward the intersection of the two fields is very evident, with literature search permutations of the phrase "neurosurgery and AI" revealing over 20,000 absolute publications in the last 10 years on the PubMed database [3]. As AI grows in sophistication, ease of applicability, and prominence, it may grow and develop to be intrinsically tied with neurosurgical care in the future. This chapter will provide an overview of the current thoughts and applications of AI in neurosurgery within pre-, intra-, and postoperative contexts, evaluate the nuances of AI functionality in both developmental and use stages, consider implementation costs, feasibility, and

limitations. We will also discuss any misconceptions related to the integration of AI within neurosurgery, with a focus on dispelling both exuberantly optimistic and overly negative views.
