scholarly journals Dr. Louise Eisenhardt’s personal notes: how she and Dr. Cushing collected data and followed patients

2021 ◽  
pp. 1-6
Author(s):  
Kelsey N. Hundley ◽  
T. Glenn Pait ◽  
Analiz Rodriguez ◽  
John D. Day
Keyword(s):  
Brain Tumor ◽  
Tumor Diagnosis ◽  
Collective Knowledge ◽  
Considerable Effort ◽  
Tumor Registry ◽  
Record Keeping ◽  
Harvey Cushing ◽  
Clinical Records ◽  
Surgical Treatments

Dr. Louise Eisenhardt was one of the first neuropathologists and was responsible for the development of tumor diagnosis guidelines. This historical vignette reviews her previously unseen handwritten notes in which she describes methods used by her and Dr. Harvey Cushing to obtain patient follow-up data for their Brain Tumor Registry. Her description spans 50 years, using “every possible clue to be jumped upon in [their] clinical records and correspondence.” Their follow-up was divided into two periods: early follow-up (1912–1932) and registry (1933–1961). During early follow-up, patients were asked to write to them on the anniversary of their operation. The foundation of the registry necessitated the use of “considerable effort on [their] part to gather up old threads” including renewed contact with patients after 15–20 years. Methods of follow-up included continued verbal and written correspondence with patients and “strong-arm methods,” including use of the Fuller Brush man and the exhumation of a body. Drs. Eisenhardt and Cushing believed “every case was important in adding to our collective knowledge of various types of tumors particularly in relationship to life expectancies and suggesting improvement in surgical treatments.” Dr. Eisenhardt’s meticulous record keeping allows for insights into the first known outcomes-related tumor registry in neurosurgery.

Louise Eisenhardt, M.D.: First editor of the Journal of Neurosurgery (1944–1965)

1994 ◽  
Vol 80 (2) ◽  
pp. 342-346 ◽  
Author(s):  
Lycurgus M. Davey
Keyword(s):  
Brain Tumor ◽  
Tumor Registry ◽  
Content Type ◽  
Harvey Cushing ◽  
Charter Member ◽  
High Standards ◽  
Literary Portrait ◽  
The Brain ◽  
Fine Print

✓ This is a literary portrait of Louise Eisenhardt, M.D., associate of Harvey Cushing, scholar, investigator, editor, teacher, and curator of the Brain Tumor Registry at Yale. She was a Charter Member of the Harvey Cushing Society which she served as President, long-term Secretary-Treasurer, and Historian. She achieved many “firsts” for women in medicine. A figure in the Homeric tradition of observing accurately and reporting honestly, Dr. Eisenhardt set high standards for both colleagues and students as well as for aspiring medical authors. She left a tradition worthy of emulation.

Conquering the third ventricular chamber

2009 ◽  
Vol 111 (3) ◽  
pp. 590-599 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Bruce Geryk ◽  
Devin K. Binder ◽  
R. Shane Tubbs
Keyword(s):  
Brain Tumor ◽  
Third Ventricle ◽  
Diagnostic Methods ◽  
Benign Tumors ◽  
Patient Records ◽  
Tumor Registry ◽  
The Third ◽  
Harvey Cushing ◽  
Special Challenge ◽  
The Brain

Surgery within the third ventricle was a special challenge early in the conception of the discipline of neurosurgery due to a lack of diagnostic methods and difficulty in reaching and removing lesions affecting this vital region. Walter Dandy and Harvey Cushing performed pioneering approaches of the third ventricular region. The authors have reviewed the previously undisclosed efforts of Cushing to approach the third ventricle through a direct review of his available patient records at the Cushing Brain Tumor Registry. The authors compare these efforts to those of Dandy published in Dandy's pioneering work Benign Tumors in the Third Ventricle of the Brain: Diagnosis and Treatment. Based on the review of these records, the authors attempt to examine the foundations of surgery within the third ventricle.

Harvey Cushing as a book collector, bibliophile, and archivist: the precedence for the genesis of the Brain Tumor Registry

2009 ◽  
Vol 111 (5) ◽  
pp. 1091-1095 ◽  
Author(s):  
Christopher J. Wahl ◽  
R. Shane Tubbs ◽  
Dennis D. Spencer ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Brain Tumor ◽  
Medical Student ◽  
Student Experience ◽  
Yale University ◽  
Tumor Registry ◽  
Strong Interest ◽  
Harvey Cushing ◽  
The World ◽  
The Brain ◽  
Medical Books

Influenced by individuals such as his parents, Osler, and Halsted, and by his early medical student experience, Harvey Cushing developed a strong interest in collecting, especially antiquarian medical books. Even today, his collection housed at Yale University is one of the most prestigious in the world. Cushing's interest in archives is further manifested and reinforced by his establishment of the Cushing Brain Tumor Registry. The following is a review of Cushing's background not as an eminent clinician and surgeon but as an individual best described as a bibliophile, archivist, and ardent collector of medical paraphernalia.

Current Clinical State of Advanced Magnetic Resonance Imaging for Brain Tumor Diagnosis and Follow Up

2018 ◽  
Vol 53 (1) ◽  
pp. 45-61 ◽  
Author(s):  
Michael Iv ◽  
Byung C. Yoon ◽  
Jeremy J. Heit ◽  
Nancy Fischbein ◽  
Max Wintermark
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Tumor ◽  
Magnetic Resonance ◽  
Tumor Diagnosis ◽  
Clinical State ◽  
Resonance Imaging ◽  
Brain Tumor Diagnosis

William P. Van Wagenen (1897–1961): pupil, mentor, and neurosurgical pioneer

2013 ◽  
Vol 119 (3) ◽  
pp. 789-795 ◽  
Author(s):  
Kristopher T. Kimmell ◽  
Anthony L. Petraglia ◽  
Mary Ann Ballou ◽  
Webster H. Pilcher
Keyword(s):  
Brain Tumor ◽  
20Th Century ◽  
Neurological Disease ◽  
Resident Education ◽  
Medical Center ◽  
Tumor Registry ◽  
Harvey Cushing ◽  
Rochester Medical ◽  
The University ◽  
Operative Skill

William Perrine (“Van”) Van Wagenen (1897–1961) was the first Chief of Neurosurgery at the University of Rochester Medical Center (URMC), serving from 1928 to 1954, and was a leading figure in 20th-century neurosurgery. He was a devoted pupil of Dr. Harvey Cushing and helped to found the Harvey Cushing Society (now the AANS) in honor of his mentor and was elected as its first President in 1932. He served as the 27th President of the Society of Neurological Surgeons in 1952. Upon his death in 1961 he bequeathed an endowment for the Van Wagenen Fellowship, which has advanced the education of many leaders in American neurosurgery. His legacy of operative skill, his commitment to resident education and research in neurological disease, his inspiration for the foundation of the Cushing Brain Tumor registry, and his contributions to organized neurosurgery form the foundation of the legacy of neurosurgery at URMC.

scholarly journals Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2320
Author(s):  
Paolo Ferroli ◽  
Ignazio Gaspare Vetrano ◽  
Silvia Schiavolin ◽  
Francesco Acerbi ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Performance Status ◽  
Tumor Resection ◽  
Patient Specific ◽  
Invasive Treatment ◽  
Tertiary Referral Center ◽  
Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

scholarly journals Excision of Greater Superficial Petrosal Nerve Schwannoma Via a Pure Endoscopic Endonasal Approach

2021 ◽  
pp. 014556132110263
Author(s):  
Zhenlin Wang ◽  
Siyuan Zhang ◽  
Yan Qi ◽  
Lianjie Cao ◽  
Pu Li ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Clinical Features ◽  
Middle Cranial Fossa ◽  
Nerve Sheath Tumor ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Greater Superficial Petrosal Nerve ◽  
Clinical Records

Greater superficial petrosal nerve (GSPN) schwannomas are an exceedingly rare nerve sheath tumor. The current literature search was conducted using Medline and Embase database by key search terms. Only 31 cases have been reported in the literature so far. Facial palsy, hearing loss, and xerophthalmia accounted for 48.4% (15), 41.9% (13), and 29% (9) of all cases, respectively. The middle cranial fossa approach was used in all previous reports. A retrospective review of 2 GSPN schwannomas patients treated by endoscopic endonasal approach (EEA) in our center was collected. Clinical records, including clinical features, pre- and postoperative images, surgery, and follow-up information, were reviewed. In all cases, clinical features including facial numbness and headache were found, with tinnitus in case 1, hearing loss, xerophthalmia in case 2. Imaging studies showed a solid mass that originated in the anterior of the petrous bone. Two patients were treated by EEA. Furthermore, no recurrence was found during the follow-up period (15-29 months) in both of the 2 cases after the operation. Complete resection of GSPN schwannomas can be achieved via the pure EEA. Endoscopic endonasal approach for radical removal of tumors is safe and feasible.

scholarly journals 273 The Consequences of a Failed Screening Programme

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Sharrock ◽  
C Whelton ◽  
R Paton
Keyword(s):  
Screening Programme ◽  
Demographic Data ◽  
Late Presentation ◽  
Developmental Dysplasia ◽  
Late Diagnosis ◽  
Operation Rate ◽  
Increasing Trend ◽  
The Uk ◽  
Clinical Records ◽  
Surgical Treatments

Abstract Introduction Controversy exists surrounding the efficacy of the UK screening programme for developmental dysplasia of the hip (DDH). Method Clinical records were reviewed in children who were treated surgically for DDH. Demographic data, age and mode of presentation, and surgical treatments were analysed, as well as outcomes, re-operation rate and AVN incidence. Late diagnosis was defined as greater than 4 months. Results 106 children (16 male, 90 female) underwent surgery from 1997 to 2018. 95 hips were operated for dislocation and 22 were operated for dysplasia. 13 patients had bilateral dislocations. Of the dislocated hips, the median age at diagnosis was 9 months (IQR 2-19). 56% were diagnosed late. In the late diagnosis group the median age for diagnosis was 19 months (IQR 15-21). We have identified an increasing trend in late presentation in recent years. This has been matched with an increasing trend in operation rates for dislocation per 1000 births. Conclusions This study demonstrates that DDH is being diagnosed increasingly late, which correlates with an increased need for surgical management. This suggests that the current UK screening programme is failing to identify children with DDH in a timely fashion, which necessitates more aggressive surgical treatment and less favourable outcomes.

Benefit of Static FET PET in Pretreated Pediatric Brain Tumor Patients with Equivocal Conventional MRI Results

2021 ◽  
Author(s):  
Frederik Grosse ◽  
Florian Wedel ◽  
Ulrich-Wilhelm Thomale ◽  
Ingo Steffen ◽  
Arend Koch ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Tumor Tissue ◽  
Pediatric Brain Tumor ◽  
Ct Scans ◽  
Tumor Patients ◽  
Fet Pet ◽  
Conventional Mri ◽  
Pet Ct ◽  
Pediatric Brain

Abstract Background MRI has shortcomings in differentiation between tumor tissue and post-therapeutic changes in pretreated brain tumor patients. Patients We assessed 22 static FET-PET/CT-scans of 17 pediatric patients (median age 12 years, range 2–16 years, ependymoma n=4, medulloblastoma n=4, low-grade glioma n=6, high-grade glioma n=3, germ cell tumor n=1, choroid plexus tumor n=1, median follow-up: 112 months) with multimodal treatment. Method FET-PET/CT-scans were analyzed visually by 3 independent nuclear medicine physicians. Additionally quantitative FET-Uptake for each lesion was determined by calculating standardized uptake values (SUVmaxT/SUVmeanB, SUVmeanT/SUVmeanB). Histology or clinical follow-up served as reference. Results Static FET-PET/CT reliably distinguished between tumor tissue and post-therapeutic changes in 16 out of 17 patients. It identified correctly vital tumor tissue in 13 patients and post-therapeutic changes in 3 patients. SUV-based analyses were less sensitive than visual analyses. Except from a choroid plexus carcinoma, all tumor entities showed increased FET-uptake. Discussion Our study comprises a limited number of patients but results corroborate the ability of FET to detect different brain tumor entities in pediatric patients and discriminate between residual/recurrent tumor and post-therapeutic changes. Conclusions We observed a clear benefit from additional static FET-PET/CT-scans when conventional MRI identified equivocal lesions in pretreated pediatric brain tumor patients. These results warrant prospective studies that should include dynamic scans.

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