Cushing and the treatment of brain wounds during World War I

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Harvey Cushing, perhaps the most important founder of American neurosurgery, was an Army neurosurgeon in France from 1917 to 1918. Over a 3-month period in 1917 he and his team operated on 133 soldiers with a brain wound. The operative mortality rate for their last 45 patients was 29%, considerably lower than the usual postoperative mortality rate of approximately 50% for those with a brain wound. This accomplishment was lauded at the time and eventually, for some, it was Cushing who was responsible for lowering the postoperative mortality rate of brain wounds during World War I. As the decades passed he was eventually credited as the “originator of brain wound care.” This report shows that these attributions are misplaced. Cushing merely followed the enlightened surgical precepts of the time developed by Continental (European) surgeons. It also examines Cushing's writings to ascertain how these misperceptions concerning his originality might have been generated.

Abbreviations used in this paper: BJS = British Journal of Surgery; BMJ = British Medical Journal; WW = World War.

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Address correspondence to: Michael E. Carey, M.D., 900 Amethyst Street, New Orleans, Louisiana 70124-3606. email: michaelbettycarey@yahoo.com.

Please include this information when citing this paper: published online February 25, 2011; DOI: 10.3171/2011.1.JNS101259.

© AANS, except where prohibited by US copyright law.

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    Robert Bárány (1876–1936) graduated from medical school in Vienna in 1900. He joined an otology clinic there in 1903 and did his seminal work on the human vestibular system thereafter. Following WWI he was Professor of Otology at the University in Uppsala, Sweden. This US government picture is from a Wikipedia article on Bárány.

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