Charles Harrison Frazier

Charles H. Frazier (1870-1936), one of the pioneers of neurosurgery in the US, is known worldwide for devising surgical procedures to relieve trigeminal neuralgia and intractable pain.

Less well-known are his substantial contributions to understanding and treating pituitary and parahypophyseal lesions. Along with Bernard Alpers, he defined Rathke's cleft cysts as a different pathological entity from adenomas and hypophyseal stalk tumors (craniopharyngiomas [CPs]). The surgical challenge posed by CPs piqued Frazier's interest in these lesions, although he never published a complete account of his CP series. An examination of the Charles Frazier papers at the College of Physicians of Philadelphia allowed the authors to identify 54 CPs that he had treated during his career. In the early 1910s, Frazier developed the subfrontal approach, which would become the primary surgical route to access these lesions, providing better control of the adjacent vital neurovascular structures than the transsphenoidal route hitherto used. Nevertheless, strong adhesions between CPs and the third ventricle floor, the major reason underlying Frazier's disappointing results, moved him to advocate incomplete tumor removal followed by radiotherapy to reduce both the risk of hypothalamic injury and CP recurrence. This conservative strategy remains a judicious treatment for CPs to this day 1).

He devoted himself almost exclusively to neurosurgery based on his training in Germany on neurology, surgery, and surgical pathology and his accomplishments as a military physician during war years 2).

The University of Pennsylvania Medical School was the nation's first medical school, and its Department of Neurosurgery is one of the nation's oldest. The history of the Department of Neurosurgery at Penn is recounted, beginning with the pioneer surgeon Charles Harrison Frazier. The evolution of the current department, its contemporary status, and its residency program are described by Boockvar et al. 3)

3: Langfitt TW. Charles Harrison Frazier: his influence on the development of early neurosurgery in America and on the development of the University of Pennsylvania School of Medicine. Surg Neurol. 1990 Aug;34(2):129-31. PubMed PMID: 2195684.

4: Rhoads JE, Langfitt TW. Charles Harrison Frazier, M.D. 1870-1936. Surg Neurol. 1977 May;7(5):253-4. PubMed PMID: 324007.

5: GRANT FC. Charles Harrison Frazier: tangibles and intangibles. J Neurosurg. 1951 Mar;8(2):135-42. PubMed PMID: 14824977.

6: Grant FC. CHARLES HARRISON FRAZIER 1870-1936. Ann Surg. 1937 Apr;105(4):638-40. PubMed PMID: 17856967; PubMed Central PMCID: PMC1390379.

On the death of Dr. Frazier, Dr. Francis Grant became professor of neurosurgery at the University of Pennsylvania

Prieto R, Pascual JM, Barrios L. Charles H. Frazier's craniopharyngioma treatment: the pivotal role of the transfrontal approach. J Neurosurg. 2019 Nov 8:1-14. doi: 10.3171/2019.8.JNS191508. [Epub ahead of print] PubMed PMID: 31703208.
Kaya Y, Sarikcioglu L. Charles Harrison Frazier (1870-1936) and his legacy to neurosurgery. Childs Nerv Syst. 2015 Mar;31(3):355-8. doi: 10.1007/s00381-014-2543-z. Epub 2014 Sep 7. PubMed PMID: 25194856.
Boockvar JA, Virella A, Kotapka M, Flamm ES, Grady MS. Neurosurgery at the University of Pennsylvania Medical Center. Neurosurgery. 2000 May;46(5):1223-8. PubMed PMID: 10807255.
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