title: Father of neurosurgery: Harvey Cushing's early experience with a pediatric brainstem glioma at the Johns Hopkins Hospital.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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."
authors.affiliation: University of Aberdeen, School of Medicine and Dentistry, Aberdeen, Scotland, United Kingdom.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Dmetrichuk
authors.forename: Courtney
authors.initials: C
authors.lastname: Pendleton
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Quiñones-Hinojosa
mesh_terms: D015142:Baltimore; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000266:history* / Q000601:surgery; D005910:Glioma / Q000175:diagnosis / Q000266:history* / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D006785:Hospitals, University; D006801:Humans; D009493:Neurosurgery / Q000266:history*; D019635:Neurosurgical Procedures / Q000266:history* / Q000379:methods; D010372:Pediatrics / Q000266:history*