Departments of Neurosurgery and Oncology, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
J Neurosurg. 2011 Nov;115(5):924-8. doi: 10.3171/2011.5.JNS101855. Epub 2011 Jun 17.
A multitude of theories characterized medical thought on migraine in the early 20th century. Newly discovered historical case files revealed Dr. Harvey Cushing's previously unpublished early attempts at surgical cure of migraine. Following institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the authors reviewed the microfilm surgical records for The Johns Hopkins Hospital from 1896 to 1912. Patients undergoing surgical intervention by Dr. Harvey Cushing for the treatment of migraine were selected for further review. All 4 patients in the series were women and ranged in age from 29 to 41 years old. The women were admitted and observed in the hospital until a migraine occurred. Surgeries were performed while the women were in the midst of an attack. Cushing used surgical strategies including decompression, temporal artery ligation, and removal of the spine of the second vertebra. In each case, the patients' headaches eventually returned following surgery. Cushing relied on a combination of contemporary theories on migraine including humeral science, vasospastic theory, organic cause, and increased intracranial pressure. His unpublished efforts foreshadowed future surgical efforts at curing migraines.
20 世纪初，大量理论主导了医学对偏头痛的认识。新发现的历史病例档案揭示了 Harvey Cushing 医生以前未发表的、对偏头痛进行手术治疗的早期尝试。经过机构审查委员会的批准，并承蒙 Alan Mason Chesney 档案的好意，作者查阅了 1896 年至 1912 年约翰霍普金斯医院的手术记录缩微胶卷。选择 Harvey Cushing 医生对偏头痛进行手术干预的患者进行进一步的审查。该系列中的所有 4 名患者均为女性，年龄在 29 至 41 岁之间。这些女性在住院期间一直观察，直到偏头痛发作。手术在女性偏头痛发作期间进行。Cushing 使用了包括减压、颞动脉结扎和第二颈椎棘突切除术等手术策略。在每种情况下，患者的头痛最终在手术后又复发了。Cushing 依靠对偏头痛的当代理论的综合运用，包括肱骨科学、血管痉挛理论、器质性病因和颅内压增高。他未发表的努力预示着未来治疗偏头痛的手术努力。
