Oliguria is one of the clinical hallmarks of renal failure. The broad differential diagnosis is well known, but a rare cause of oliguria is intracranial hypertension (ICH). The actual knowledge to explain this relationship is scarce. Almost all literature is about animals where authors describe the Cushing reflex in response to ICH. We hypothesize that the Cushing reflex is translated towards t...

Neurological surgery was defined as a separate surgical specialty by Harvey Cushing and a few other surgeons, most of whom were trained and influenced by Cushing. One of these, Raphael Eustace Semmes, became the first neurosurgeon in Memphis, Tennessee, in 1912. After World War II, Semmes and his first associate, Francis Murphey, incorporated the Semmes-Murphey Clinic, which has been primarily ...

Subclinical Cushing syndrome (SCS) is a hypothalamic-pituitary-adrenal axis abnormality characterized by autonomous cortisol secretion in patients with no typical signs or symptoms of Cushing syndrome. SCS patients may have adverse metabolic and cardiovascular effects due to slight, but continuous glucocorticoid secretion. Glucocorticoids also affect behavior, mood, neural activity, and a numbe...

This video demonstrates an endoscopic transsphenoidal resection of an corticotropin-secreting pituitary microadenoma. The patient is a 62-year-old man who was found to have a 5-mm pituitary adenoma after he exhibited signs and symptoms of Cushing disease. His endocrine laboratory studies confirmed central hypercortisolism.This video highlights dissection of the adenomapseudocapsule from the rem...

career in which he made important discoveries in several branches of medicine. In neurosurgery, some may argue that McEwen of Glasgow or Horsley of London rather than Cushing was the founder of the speciality. However Harvey Cushing was the first full time neurosurgeon and it was his work in the early days of the speciality that made it safe. Indeed, when he started in neurosurgery in 1899 the ...

In this issue, Chiodini and colleagues (1) measured the prevalence of subclinical hypercortisolism in 219 consecutive patients 44 to 72 years of age with suspected idiopathic osteoporosis. These individuals had no known secondary cause of osteoporosis, had not received drugs known to influence bone or cortisol, and had no apparent signs or symptoms of cortisol excess (including moon facies, red...