title: Harvey Cushing's early experience with pediatric gliomas.
abstract: OBJECTIVE
  Diagnosing and operating pediatric patients with intracranial lesions posed a greater diagnostic challenge for physicians during the early twentieth century. At the time, an intracranial neoplasm was indistinctively diagnosed as a glioma, encompassing a broad category of brain tumor pathologies. The treatment and surgical interventions followed for children diagnosed with gliomas is not well-described in the literature from this time.
  
  
  METHODS
  Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files from 1896-1912. Patients 18 years or younger, who underwent surgical intervention by Cushing for suspected intracranial tumors, were selected.
  
  
  RESULTS
  Of the eight pediatric cases diagnosed with gliomas by Cushing, four cases were later diagnosed as medulloblastomas by Dr. Cushing in 1925. Of the remaining four pediatric cases, one was diagnosed as a brainstem glioma and another as a ventricular glioma. We describe the remaining two cases.
  
  
  CONCLUSIONS
  These examples illustrate Cushing's approach to treating brain tumors diagnosed as gliomas in pediatric patients, focusing on an initial decompression and followed by a thorough surgical exploration for tumor. Furthermore, these cases demonstrate Cushing's early attempts to manage such lesions in children and highlight the challenges faced in diagnosing and localizing intracranial lesions within this group of patients.
authors.affiliation: School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Neda I
authors.initials: NI
authors.lastname: Sedora-Román
authors.forename: Courtney
authors.initials: C
authors.lastname: Pendleton
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mohyeldin
authors.forename: Alfredo
authors.initials: A
authors.lastname: Quiñones-Hinojosa
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000266:history* / Q000601:surgery; D002648:Child; D005260:Female; D005910:Glioma / Q000266:history* / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008297:Male; D009493:Neurosurgery / Q000266:history*; D010372:Pediatrics / Q000266:history*