Inauguration of pediatric neurosurgery by Harvey W. Cushing: his contributions to the surgery of posterior fossa tumors in children

Historical vignette

View More View Less
  • 1 Department of Neurologic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota; and Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓Development of posterior fossa surgery remains Harvey Cushing's hallmark contribution to pediatric neurosurgery. During the era before Cushing, posterior fossa lesions were considered inoperable, and only osseous decompressive surgery was offered. The evolution of Cushing's surgical expertise from subtemporal decompressions to total extirpation of vascular fourth ventricular tumors, combined with a dramatic decrease in his operative mortality rate, reflects the maturation of modern neurosurgical techniques. A comprehensive review of the medical records of Cushing's pediatric patients treated between 1912 and 1932 revealed that procedures such as lateral ventricular puncture (to decrease cerebellar herniation), transvermian approach to midline tumors, and electrocoagulation were the key factors punctuating the path to his pioneering achievements in posterior fossa surgery. The outcome of such operations was improved by his recognition of the importance of tumor mural nodule in cyst recurrence, as well as elucidation of the histogenesis of pediatric posterior fossa tumors to tailor treatment including radiotherapy.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address reprint requests to: Aaron A. Cohen-Gadol, M.D., Department of Neurologic Surgery, Mayo Clinic, Joseph 1–229, Saint Mary's Hospital, 1216 Second Street SW, Rochester, Minnesota 55905. email: cohengadol.aaron@mayo.edu.
  • 1.

    Bailey P, & Cushing H: A Classification of the Tumors of the Glioma Group on a Histogenetic Basis With a Correlated Study of Prognosis. Philadelphia: JB Lippincott Co, 1926 Bailey P, Cushing H: A Classification of the Tumors of the Glioma Group on a Histogenetic Basis With a Correlated Study of Prognosis. Philadelphia: JB Lippincott Co, 1926

    • Search Google Scholar
    • Export Citation
  • 2.

    Bailey P, , Sosman M, & Van Dessel A: Roentgen therapy of gliomas of the brain. AJR Am J Roentgenol 19:203264, 1928 Bailey P, Sosman M, Van Dessel A: Roentgen therapy of gliomas of the brain. AJR Am J Roentgenol 19:203–264, 1928

    • Search Google Scholar
    • Export Citation
  • 3.

    Black PM: Harvey Cushing at the Peter Bent Brigham Hospital. Neurosurgery 45:9901001, 1999 Black PM: Harvey Cushing at the Peter Bent Brigham Hospital. Neurosurgery 45:990–1001, 1999

    • Search Google Scholar
    • Export Citation
  • 4.

    Black PM: Peter Bent Brigham Hospital. J Neurosurg 75:987988, 1991 Black PM: Peter Bent Brigham Hospital. J Neurosurg 75:987–988, 1991

    • Search Google Scholar
    • Export Citation
  • 5.

    Cushing H: The control of bleeding in operations for brain tumors. With the description of silver “clips” for the occlusion of vessels inaccessible to the ligature. Trans Ann Surg Assoc 54:119, 1911 Cushing H: The control of bleeding in operations for brain tumors. With the description of silver “clips” for the occlusion of vessels inaccessible to the ligature. Trans Ann Surg Assoc 54:1–19, 1911

    • Search Google Scholar
    • Export Citation
  • 6.

    Cushing H: Electro-surgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet 47:751784, 1928 Cushing H: Electro-surgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet 47:751–784, 1928

    • Search Google Scholar
    • Export Citation
  • 7.

    Cushing H: The establishment of cerebral hernia as a decompressive meaure for inaccessible brain tumors; with the description of intramuscular methods of making the bone defect in temporal and occipital regions. Surg Gynecol Obstet 1:297314, 1905 Cushing H: The establishment of cerebral hernia as a decompressive meaure for inaccessible brain tumors; with the description of intramuscular methods of making the bone defect in temporal and occipital regions. Surg Gynecol Obstet 1:297–314, 1905

    • Search Google Scholar
    • Export Citation
  • 8.

    Cushing H: Experiences with the cerebellar astrocytomas: a critical review of seventy-six cases. Surg Gynecol Obstet 52:129204, 1931 Cushing H: Experiences with the cerebellar astrocytomas: a critical review of seventy-six cases. Surg Gynecol Obstet 52:129–204, 1931

    • Search Google Scholar
    • Export Citation
  • 9.

    Cushing H: Experiences with the cerebellar medulloblastomas. A critical review. Acta Pathol Microbiol Scand 7:185, 1930 Cushing H: Experiences with the cerebellar medulloblastomas. A critical review. Acta Pathol Microbiol Scand 7:1–85, 1930

    • Search Google Scholar
    • Export Citation
  • 10.

    Cushing H: William Stewart Halsted, 1852–1922. Science 56:461444, 1922 Cushing H: William Stewart Halsted, 1852–1922. Science 56:461–444, 1922

    • Search Google Scholar
    • Export Citation
  • 11.

    Fox WL: The Cushing—Dandy controversy. Surg Neurol 3:6166, 1975 Fox WL: The Cushing—Dandy controversy. Surg Neurol 3:61–66, 1975

    • Search Google Scholar
    • Export Citation
  • 12.

    German WJ: Dr. Louise Eisenhardt. J Neurosurg 26:285288, 1967 German WJ: Dr. Louise Eisenhardt. J Neurosurg 26:285–288, 1967

  • 13.

    Horrax G: Some of Harvey Cushing's contributions to neurological surgery. J Neurosurg 54:436447, 1981 Horrax G: Some of Harvey Cushing's contributions to neurological surgery. J Neurosurg 54:436–447, 1981

    • Search Google Scholar
    • Export Citation
  • 14.

    Laws ER Jr: Presidential address: Neurosurgery's man of the century: Harvey Cushing—the man and his legacy. Neurosurgery 45:977982, 1999 Laws ER Jr: Presidential address: Neurosurgery's man of the century: Harvey Cushing—the man and his legacy. Neurosurgery 45:977–982, 1999

    • Search Google Scholar
    • Export Citation
  • 15.

    Laws Jr E: Tradition in neurosurgery: doing well what has been done before. Neurosurgery 16:739753, 1985 Laws Jr E: Tradition in neurosurgery: doing well what has been done before. Neurosurgery 16:739–753, 1985

    • Search Google Scholar
    • Export Citation
  • 16.

    Light RU: The contributions of Harvey Cushing to the techniques of neurosurgery. Surg Neurol 35:6973, 1991 Light RU: The contributions of Harvey Cushing to the techniques of neurosurgery. Surg Neurol 35:69–73, 1991

    • Search Google Scholar
    • Export Citation
  • 17.

    Long DM: Harvey Cushing at Johns Hopkins. Neurosurgery 45:983989, 1999 Long DM: Harvey Cushing at Johns Hopkins. Neurosurgery 45:983–989, 1999

    • Search Google Scholar
    • Export Citation
  • 18.

    Moore MR, , Rossitch E Jr, & Black PM: The development of neurosurgical techniques: the postoperative notes and sketches of Dr. Harvey Cushing. Acta Neurochir 101:9399, 1989 Moore MR, Rossitch E Jr, Black PM: The development of neurosurgical techniques: the postoperative notes and sketches of Dr. Harvey Cushing. Acta Neurochir 101:93–99, 1989

    • Search Google Scholar
    • Export Citation
  • 19.

    Moore MR, , Rossitch E Jr, & Shillito J Jr: Cushing and epilepsy surgery: two successfully treated cases with long-term follow-up. Surg Neurol 32:241245, 1989 Moore MR, Rossitch E Jr, Shillito J Jr: Cushing and epilepsy surgery: two successfully treated cases with long-term follow-up. Surg Neurol 32:241–245, 1989

    • Search Google Scholar
    • Export Citation
  • 20.

    O'Connor JL, & Bloom DA: William T. Bovie and electrosurgery. Surgery 119:390396, 1996 O'Connor JL, Bloom DA: William T. Bovie and electrosurgery. Surgery 119:390–396, 1996

    • Search Google Scholar
    • Export Citation
  • 21.

    Tilney NL: Harvey Cushing and the Oxford connection. Surg Gynecol Obstet 155:8994, 1982 Tilney NL: Harvey Cushing and the Oxford connection. Surg Gynecol Obstet 155:89–94, 1982

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 166 77 6
Full Text Views 93 11 0
PDF Downloads 145 7 1
EPUB Downloads 0 0 0