Harvey Cushing's early treatment of meningiomas: The untold story

Courtney Pendleton, Alessandro Olivi, Henry Brem, Alfredo Quiñones-Hinojosa

Research output: Contribution to journalReview article

Abstract

Background: In his 1938 monograph, Cushing tabulated 313 meningioma cases treated throughout his career at the Johns Hopkins and the Peter Bent Brigham Hospitals. Of these, 18 patients were treated at the Johns Hopkins Hospital. Cushing provided basic demographic, perioperative, and outcomes data in his tables, but the operative details for many of his early meningioma cases have not been previously described. Methods: After institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the surgical files for the Johns Hopkins Hospital from the period 1896 to 1912 were reviewed. Cases diagnosed as endothelioma or dural endothelioma were selected for further analysis. Results: Of the 14 patients with available records, 1 were male. The mean age was 34.4 years. Nine patients (64.3%) died during their inpatient stay. Cushing used staged resections in an attempt to minimize blood loss, morbidity, and mortality, albeit with limited success. Conclusions: The operative details demonstrate Cushing's early attention to hemostasis, and use of staged resections in patients with large, highly vascular meningiomas. Cushing's first 18 cases of meningiomas, treated while a young attending physician at the Johns Hopkins Hospital, are not the most elegant operations in his lengthy series, but serve as an illustration of his ability to transform clinical challenges into opportunities for improvement.

Original languageEnglish (US)
Pages (from-to)217-221
Number of pages5
JournalWorld neurosurgery
Volume80
Issue number1-2
DOIs
StatePublished - Jul 1 2013

Keywords

  • Harvey Cushing
  • Meningiomas

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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