Transcranial surgery for pituitary tumors performed by Sir Victor Horsley

Jonathan R. Pollock, James Akinwunmi, Francesco Scaravilli, Michael P. Powell, Juha Jääskeläinen, Peter McL Black, James Tait Goodrich, Edward R. Laws

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE: To describe the clinical details and the operative method used in pituitary tumors by Sir Victor Horsley (1857-1916), which represent the earliest attempts at pituitary surgery. METHODS: Horsley's case books and postmortem records, archived at the National Hospital, Queen Square, London, were studied for patients with a primary diagnosis of a pituitary tumor admitted during the period 1886 to 1916 who were treated surgically. Contemporary records of nonpituitary cases were also examined to study aspects of Horsley's operative method. RESULTS: Four patients (three men and one woman) underwent craniectomy for removal of a pituitary tumor via the subtemporal approach between 1904 and 1907. All four patients experienced significant impairments of visual fields or visual acuity; one patient had severe trigeminal neuralgia. Evidence of acutely raised intracranial pressure was present in one patient. All patients underwent craniectomy under chloroform anesthesia. One patient died on the day of surgery, and the postmortem findings are presented. In the other three patients, neurological morbidity was recorded in the postoperative period in the form of new cranial nerve deficits, monoparesis with dysphasia, and seizures. The patient with trigeminal neuralgia experienced partial relief and was readmitted later for reexploration and Gasserian ganglionectomy via the same route. Four contemporary nonoperative cases of pituitary tumor are also presented. CONCLUSION: These cases provide insight into the presentation and operative treatment of pituitary tumors during the pre-Halsted era.

Original languageEnglish (US)
Pages (from-to)914-926
Number of pages13
JournalNeurosurgery
Volume52
Issue number4
StatePublished - Apr 1 2003
Externally publishedYes

Fingerprint

Pituitary Neoplasms
Trigeminal Neuralgia
Ganglionectomy
Cranial Nerves
Aphasia
Intracranial Pressure
Paresis
Chloroform
Visual Fields
Ambulatory Surgical Procedures
Postoperative Period
Visual Acuity
Seizures
Anesthesia
Morbidity

Keywords

  • Neurosurgical history
  • Pituitary tumor
  • Sir Victor Horsley

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Pollock, J. R., Akinwunmi, J., Scaravilli, F., Powell, M. P., Jääskeläinen, J., Black, P. M., ... Laws, E. R. (2003). Transcranial surgery for pituitary tumors performed by Sir Victor Horsley. Neurosurgery, 52(4), 914-926.

Transcranial surgery for pituitary tumors performed by Sir Victor Horsley. / Pollock, Jonathan R.; Akinwunmi, James; Scaravilli, Francesco; Powell, Michael P.; Jääskeläinen, Juha; Black, Peter McL; Goodrich, James Tait; Laws, Edward R.

In: Neurosurgery, Vol. 52, No. 4, 01.04.2003, p. 914-926.

Research output: Contribution to journalArticle

Pollock, JR, Akinwunmi, J, Scaravilli, F, Powell, MP, Jääskeläinen, J, Black, PM, Goodrich, JT & Laws, ER 2003, 'Transcranial surgery for pituitary tumors performed by Sir Victor Horsley', Neurosurgery, vol. 52, no. 4, pp. 914-926.
Pollock JR, Akinwunmi J, Scaravilli F, Powell MP, Jääskeläinen J, Black PM et al. Transcranial surgery for pituitary tumors performed by Sir Victor Horsley. Neurosurgery. 2003 Apr 1;52(4):914-926.
Pollock, Jonathan R. ; Akinwunmi, James ; Scaravilli, Francesco ; Powell, Michael P. ; Jääskeläinen, Juha ; Black, Peter McL ; Goodrich, James Tait ; Laws, Edward R. / Transcranial surgery for pituitary tumors performed by Sir Victor Horsley. In: Neurosurgery. 2003 ; Vol. 52, No. 4. pp. 914-926.
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