Harvey Cushing and “birth hemorrhage”: early pediatric neurosurgery at The Johns Hopkins Hospital

Historical vignette

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Of Harvey Cushing's many contributions to neurosurgery, one of the least documented is his early surgical intervention in children and his pioneering efforts to establish pediatric neurosurgery as a subspecialty. Between 1896 and 1912 Cushing conducted nearly 200 operations in children at The Johns Hopkins Hospital. A review of his records suggests that the advances he made in neurosurgery were significantly influenced by his experience with children. In this historical article, the authors describe Cushing's treatment of 6 children, in all of whom Cushing established a diagnosis of “birth hemorrhage.” By reviewing Cushing's operative indications, techniques, and outcomes, the authors aim to understand the philosophy of his pediatric neurosurgical management and how this informed his development of neurosurgery as a new specialty.

Article Information

Address correspondence to: Edward S. Ahn, M.D., Department of Neurosurgery, The Johns Hopkins Hospital, Harvey 811, 600 North Wolfe Street, Baltimore, Maryland 21287. email: eahn4@jhmi.edu.

© AANS, except where prohibited by US copyright law.



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    Harvey Cushing's preoperative illustration of the child from Case 5 (our Case 2). Cushing describes this child as having a “quite definite bulging of anterior fontanelle which is quite tense.”



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