Harvey Cushing's Early Operative Treatment of Skull Base Fractures

Abstract

Objectives To review Dr. Harvey Cushing's early surgical cases at the Johns Hopkins Hospital, revealing details of his operative approaches to fractures of the skull base. Design Following institutional review board approval and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files. Setting The Johns Hopkins Hospital, 1896 to 1912. Participants A total of 24 patients underwent operative treatment for suspected fractures of the skull base. Main Outcome Measures The main outcome measure was operative approach, postoperative mortality, and condition recorded at the time of discharge. Results Overall, 23 patients underwent operative treatment for suspected skull base fractures. The mechanisms of injury were known for 22 patients and included workrelated injuries (41%), falls (23%), vehicle injuries (32%), and other trauma (5%). One patient had no mechanism of injury specified in the file. The outcome at the time of discharge from the hospital was "well" or "improved" in 12 patients (52%). The remaining 11 patients died during their admission. Conclusions Although Cushing's experience with selected skull base pathology has been previously reported, the breadth of his contributions to operative approaches to the skull base has been neglected.

The surgical history of head injury in motor vehicle collision

“…6 Even Harvey Cushing seems to have encountered this situation, having treated two children struck by passing automobiles in 1910 and 1911, both of whom recovered after surgery. 7 Four more similar cases of pediatric head injury involving automobiles were reported by Dr. Abraham O. Wilensky in 1919; one child was thrown from an automobile and two died of their injuries. 8 While it seems that children sustained head injury in MVCs commonly due to being struck by passing cars, the outcomes appear to have been favorable based on these case series.…”

“…The surgical literature in the early 20th century overall suggests that head injury in MVCs was primarily a pediatric problem, with adults less commonly affected. 7 There are several possible explanations for why children as pedestrians were so commonly involved in MVCs during this period. One may have been the tendency for children to play or suddenly run out into the street where they may put themselves at risk.…”

The surgical history of head injury in motor vehicle collision

“…6 Even Harvey Cushing seems to have encountered this situation, having treated two children struck by passing automobiles in 1910 and 1911, both of whom recovered after surgery. 7 Four more similar cases of pediatric head injury involving automobiles were reported by Dr. Abraham O. Wilensky in 1919; one child was thrown from an automobile and two died of their injuries. 8 While it seems that children sustained head injury in MVCs commonly due to being struck by passing cars, the outcomes appear to have been favorable based on these case series.…”

“…The surgical literature in the early 20th century overall suggests that head injury in MVCs was primarily a pediatric problem, with adults less commonly affected. 7 There are several possible explanations for why children as pedestrians were so commonly involved in MVCs during this period. One may have been the tendency for children to play or suddenly run out into the street where they may put themselves at risk.…”

The surgical history of head injury in motor vehicle collision

“…6 Even Harvey Cushing seems to have encountered this situation, having treated two children struck by passing automobiles in 1910 and 1911, both of whom recovered after surgery. 7 Four more similar cases of pediatric head injury involving automobiles were reported by Dr. Abraham O. Wilensky in 1919; one child was thrown from an automobile and two died of their injuries. 8 While it seems that children sustained head injury in MVCs commonly due to being struck by passing cars, the outcomes appear to have been favorable based on these case series.…”

“…The surgical literature in the early 20th century overall suggests that head injury in MVCs was primarily a pediatric problem, with adults less commonly affected. 7 There are several possible explanations for why children as pedestrians were so commonly involved in MVCs during this period. One may have been the tendency for children to play or suddenly run out into the street where they may put themselves at risk.…”

The surgical history of head injury in motor vehicle collision

“…6 Even Harvey Cushing seems to have encountered this situation, having treated two children struck by passing automobiles in 1910 and 1911, both of whom recovered after surgery. 7 Four more similar cases of pediatric head injury involving automobiles were reported by Dr. Abraham O. Wilensky in 1919; one child was thrown from an automobile and two died of their injuries. 8 While it seems that children sustained head injury in MVCs commonly due to being struck by passing cars, the outcomes appear to have been favorable based on these case series.…”

“…The surgical literature in the early 20th century overall suggests that head injury in MVCs was primarily a pediatric problem, with adults less commonly affected. 7 There are several possible explanations for why children as pedestrians were so commonly involved in MVCs during this period. One may have been the tendency for children to play or suddenly run out into the street where they may put themselves at risk.…”