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Biomedical subjects

Richard L Rovit

Publications and source records attributed to Richard L Rovit.

5 recordsLinked to original sources
PubMed2003

Role of surgery in the treatment of microprolactinomas.

Prolactinomas are a common cause of reproductive and sexual dysfunction and account for a large proportion of pituitary adenomas. The objectives for treatment of hyperprolactinemia due to microprolactinomas are to suppress excessive hormone secretion, preserve residual pituitary function, and prevent disease recurrence. These objectives may be achieved in most patients harboring microprolactinomas by medical treatment with effective dopamine agonists or microsurgical or endoscopic adenomectomy by an experienced surgeon. The choice of pituitary surgery should be made in consideration of the volume and location of the adenoma, age of the patient, the desire for restoration of fertility, and the efficacy and tolerability of dopamine agonists. The presence of a symptomatic microprolactinoma, especially in a young patient, should remain an indication for micro- or endoscopic tumor removal. This article reviews the emergence of radiosurgery as a treatment for microprolactinomas.

Humans↗
PubMed2002

Rethinking neurosurgical subspecialization.

In this article, the authors trace the evolution of subspecialty development in the relatively young specialty of neurosurgery. The current categorization of neurosurgical subspecialties represents an incongruent group of "areas of interest" whose origins are historical in their development and whose boundaries are indistinct, artificial, and often fail to share a common theme. While subspecialty development has undoubtedly improved the quality of care of patients with neurosurgical disease in these respective areas, the authors present important questions invoked by the artificial boundaries. The current move towards formalization of subspecialty training and accreditation, with ultimate certification, poses both intended and unintended consequences. The implications of these trends in neurosurgery are discussed.

Adolescent↗
PubMed2002

A man for all seasons: W.W. Keen.

William Williams Keen was the catalyst for the advent of neurosurgery in the United States. He served in the Civil War and collaborated with Silas Weir Mitchell in studying injuries sustained to the nervous system. These studies culminated in the publication in 1864 of "Gunshot Wounds and Other Injuries of the Nerves and Reflex Paralysis," which first described causalgia, reflex sympathetic dystrophy, and secondary paralysis. His most monumental accomplishment undoubtedly was being the first surgeon in the United States to successfully remove a primary brain tumor (1887) and have the patient survive for more than 30 years. As the editor of "Surgery, Its Principles and Practice," Keen invited Harvey Cushing to write the section on surgery of the head, which propelled Cushing to international recognition and provided a foothold for the new specialty of neurosurgery. Multiple sources were reviewed to prepare this comprehensive biographical account of Keen's contributions. Emphasis is placed on those achievements that furthered the discipline of neurosurgery. Although a general surgeon, Keen had a special interest in the nervous system. He treated patients with trigeminal neuralgia, performed cortical excisions for patients with epilepsy, and devised the procedure of posterior upper cervical root sections for spasmodic torticollis. He was the first surgeon to perform and advocate ventricular punctures. He served as a consultant and surgeon to both Grover Cleveland and Franklin Delano Roosevelt.

Brain Neoplasms↗
PubMed2002

Irving S. Cooper and his role in intracranial stimulation for movement disorders and epilepsy.

Dr. Irving Cooper (1922-1985) was a pioneer in the field of functional neurosurgery. After years of treating patients with tremor by creating deep lesions with either anterior choroidal artery ligation or cryogenic thalamotomy, he began to utilize methods of electrical cerebral stimulation as treatment for a variety of disorders. Chronic cerebellar stimulation was employed for patients with epilepsy, cerebral palsy, and dystonia. While Dr. Cooper believed his results to be significant, there still remain many challenges to his claims. Later in his career, he placed deep brain electrodes in the internal capsule and thalamus for epilepsy and dystonia. His encouraging results from this small series were often overlooked. This paper reviews the science behind Dr. Cooper's work, his case series, and the controversies surrounding his results.

Electric Stimulation↗