Sellar door: Harvey Cushing's entry into the pituitary gland, the unabridged Johns Hopkins experience 1896-1912

Courtney Pendleton, Hadie Adams, Nestoras Mathioudakis, Alfredo Quiñones-Hinojosa

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Objective: To review the original surgical records from the Johns Hopkins Hospital, and analyze the records of patients Cushing treated for pituitary disorders from 1896 to 1912. Methods: Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the original surgical files from the Johns Hopkins Hospital. Patients presenting with pituitary-related symptoms, who underwent surgical treatment directed at the pituitary gland, were selected for further review. Results: Thirty-seven patients who underwent surgical intervention for pituitary disorders were found. Of these patients, 12 were mentioned only briefly in Cushing's 1912 monograph, whereas 6 were not described at all. The remaining 19 were documented by Cushing in his 1912 monograph. Cushing used three main surgical approaches to the pituitary: transsphenoidal, transcranial, and the subfrontal "omega incision." There were 6 inpatient deaths. The mean time to last follow-up was 41.0 months. At follow-up, headache was the most common unresolved symptom. Conclusion: This review highlights Cushing's accomplishments in the surgical treatment of suspected pituitary pathology during his early career as a young attending at Johns Hopkins Hospital. It reveals new information about patients whom Cushing did not include in his publications detailing his surgical experience at the Johns Hopkins Hospital.

Original languageEnglish (US)
Pages (from-to)394-403
Number of pages10
JournalWorld neurosurgery
Issue number2
StatePublished - Feb 2013


  • Harvey Cushing
  • Pituitary

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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