Dmetrichuk Jennifer M, Pendleton Courtney, Jallo George I, Quiñones-Hinojosa Alfredo
University of Aberdeen, School of Medicine and Dentistry, Aberdeen, Scotland, United Kingdom.
J Neurosurg Pediatr. 2011 Oct;8(4):337-41. doi: 10.3171/2011.7.PEDS11101.
The early 20th century posed several challenges in the diagnosis and surgical treatment of intracranial tumors. However, this was a time in which more information was becoming more readily available based on pathological examination and surgical case reports. Such early work was crucial in shaping the current understanding of the nervous system and in developing modern treatment strategies. An early historical overview of the diagnosis and surgical interventions in pediatric patients with brainstem gliomas has not been described. Furthermore, Dr. Harvey Cushing's contributions to this field have not been reported.
Following institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the authors reviewed the Johns Hopkins Hospital surgical files dating from 1896 to 1912.
The authors describe Cushing's early experience with a pediatric brainstem glioma during his time as a young attending physician at the Johns Hopkins Hospital. The case, presented in 1909, described the clinical events in a 15-year-old schoolgirl who presented with signs of a cerebellopontine lesion. A suboccipital exploration was performed by Cushing; his findings and surgical approach are described.
Harvey Cushing's early contributions to the field of pediatric neurosurgery, and to the operative treatment of pediatric brainstem gliomas have remained largely unknown. The case presented here represents the early work of the American "Father of Neurosurgery."
20世纪初，颅内肿瘤的诊断和外科治疗面临诸多挑战。然而，在那个时期，基于病理检查和手术病例报告，更多信息变得更容易获取。这类早期工作对于塑造当前对神经系统的理解以及制定现代治疗策略至关重要。目前尚未有关于小儿脑干胶质瘤诊断及外科干预的早期历史概述。此外，哈维·库欣博士在该领域的贡献也未见报道。
经机构审查委员会批准，并承蒙艾伦·梅森·切斯尼档案馆提供便利，作者查阅了约翰·霍普金斯医院1896年至1912年的外科手术档案。
作者描述了库欣在约翰·霍普金斯医院担任年轻主治医师期间，对一例小儿脑干胶质瘤的早期诊疗经历。该病例于1909年呈现，讲述了一名15岁女学生出现桥小脑病变体征的临床情况。库欣进行了枕下探查；文中描述了他的发现及手术方法。
哈维·库欣在小儿神经外科领域以及小儿脑干胶质瘤手术治疗方面的早期贡献在很大程度上尚不为人知。此处呈现的病例代表了美国“神经外科之父”的早期工作。
