Brooke Swearingen, M.D.
Education and Training
Education
1977
Sc.B.
Brown University
1981
M.D.
Harvard Medical School
Postdoctoral Training
1981-1982
1982-1983
1984-1987
1987-1988
Surgical Intern
Asst. Resident
in Neurosurgery
Resident in
Neurosurgery
Chief Resident
in Neurosurgery
Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital
Licensure and Certification
1981
1993
Massachusetts medical license
Certification, American Board of Neurological Surgery
Professional Appointments
Academic Appointments
1988
Instructor
Harvard Medical School
1992 Assistant Professor Harvard Medical School
Hospital Appointments
1988
Assistant Visiting
Neurosurgeon
Massachusetts General Hospital
1994
Associate Visiting Massachusetts General Hospital
Neurosurgeon
Awards and Honors
1977
1977
1977
1977
1988
1988
magna cum laude with honors
Brown University
Harvey Baker Fellow
Brown University
Phi Beta Kappa
Brown University
Sigma Xi
Brown University
Charles Elsberg fellowship New York Academy of
Sciences
Research Fellow
The Medical Foundation
Service Assignment
1988-current Neurosurgical Staff
1994-current Consultant
Massachusetts General
Hospital
Spaulding Rehabilitation
Hospital
Major Committee Assignments
1994
Chair, Ad hoc committee for tenure appeal,
MGH
1996-current Chair, Neurosurgical Operations Improvement MGH
1996-97
Member, Neuroscience ICU planning committee MGH
Major Administrative Responsibilities
1996-current Co-director, Neuroscience ICU
MGH
Professional Society Involvement
1988-current Congress of Neurologic Surgeons
Member
1993-current American Association of Neurological Member
Surgeons
Part II C: Clinician Scholar Ladder
Report of Clinical Practice and Teaching
A. Narrative
In addition to a busy practice in general, hospital-based, academic neurosurgery, I
have focussed on pituitary disease as an area of special interest. Our approach to the
management of pituitary disease has been multidisciplinary through the Neuroendocrine
Clinic; we (the neuroendocrinologists, neurologists, and neurosurgical staff) have built a
center of excellence of national reputation. Our surgical results for Cushing's disease and
acromegaly are on a par with any published in the world literature, and the Clinic was the
subject of a recent national review (Biller, Swearingen, Klibanski, Zervas, JCEM 1997).
This work has led to an increasing number of invited national presentations. I have devoted
considerable time to patient and commmunity education through articles published in the
Neuroendocrine Newsletter, participation in patient and physician education seminars, and
advising the Pituitary Tumor Network Association, a patient support and educational group.
In addition to this surgical focus, I devoted a significant amount of time to the
administration of the neuroscience ICU and in the development and implementation of
clinical pathways for neurosurgery as part of the MGH operations improvement effort.
B. Scholarly contributions
1. Current Research Projects
Our current clinical study involves a retrospective review of over 1000
transsphenoidal procedures done by Dr. Zervas and myself, in an attempt to ascertain
long-term mortality and morbidity and contribute to the epidemiology of pituitary disease.
Preliminary results were presented to the Congress of Neurologic Surgeons meeting,
September, 1997 and has resulted in publications in the Journal of Clinical Endocrinology
and Metabolism and the Annals of Internal Medicine.
2. Research Funding Information
1991-1996 NEI Physician Scientist award, advisor Dr. Linda Chun, project entitled
"Neurotrophic factors for retinal ganglion cells"
C. Teaching Contributions
Graduate Medical Courses
1. Neurosurgical Grand Rounds presentations: Approximately four lectures per
academic year. Recent topics include: jugular venous saturation monitoring in head
trauma, discussion of central neurocytoma, management of Cushing's disease, topics in
operations improvement. Preparation time 10-15 hours each.
2. Spaulding Rehabilitation Hospital Grand Rounds: Craniofacial reconstruction after
head trauma, 1995.
Preparation time 10 hours.
Continuing Medical Education Courses
1. "Pituitary Puzzles: The differential diagnosis of sellar lesions" for Clinical
Endocrinology Postgraduate Course presentations April, 1996 and April, 1997. Preparation
time 20 hours. Attendance 250.
2. "The Acute Management of Traumatic Brain Injury" for course entitled "The
Neurorehabilitation of Traumatic Brain Injury Patients" Spaulding Rehabilitation Hospital,
October, 1994. Preparation time 20 hours. Attendance 100.
3. "The surgical management of pituitary disease" for course entitled "Review &
Update in Pituitary Disease" sponsored by the Neuroendocrine Center for New England
endocrinologists, November, 1995. Preparation time 10 hours. Attendance 100.
4. “Transsphenoidal Surgery and Radiosurgery” for the Clinical Endocrinology
Postgraduate Course, April 1998. Preparation time 50 hours. Attendance 250.
5. “Current management of secretory adenomas” for the Clinical Endocrinology
Postgraduate Course, April, 1999. Preparation time 30 hours. Attendance 250.
6. “Management of secretory adenomas, surgery and radiosurgery” for the Clinical
Endocrinology Postgraduate Course, April, 2000. Preparation time 30 hours. Attendance
250.
7. “ Management of secretory adenomas, surgery and radiosurgery” for the Clinical
Endocrinology Postgraduate Course, April, 2001. Preparation time 30 hours. Attendance
250.
8. “Management of secretory adenomas, surgery and radiosurgery” for the Clinical
Endocrinology Postgraduate Course, April, 2002. Preparation time 30 hours. Attendance
250.
Advisory and Supervisory Responsibilities
Supervision and training of neurosurgical residents assigned to the clinical service,
including operative instruction. Two residents per year assigned to a team consisting of
myself and three other surgeons. This is a constant part of clinical practice and time cannot
be estimated apart from general clinical activity.
Regional, National or International Contributions
Invited presentations
1.
"Management of Cushing's disease and acromegaly" presented at the invitation of
the Congress of Neurologic Surgeons,October, 1994. Attendance 50.
2.
"Clinical Decision-making in pituitary adenomas" presented at the invitation of the
American Association of Neurologic Surgeons, April, 1995. Attendance 50.
3.
"Controversies in the management of acromegaly" presented at the invitation of the
American Association of Clinical Endocrinology, Seattle, May 3, 1996. Attendance 250.
4.
"Long-term mortality after transsphenoidal surgery" presented at the invitation of the
American Academy of Neurological Surgeons, Tucson, 1996. Attendance 250.
5.
"Transsphenoidal surgery and radiation therapy for pituitary adenomas" presented
at the invitation of the Endocrine Society, Minneapolis, June 13, 1997. Attendance 200.
6.
"Mortality in acromegaly" presented at the invitation of the International Society of
Pituitary Surgeons, Malmo, Sweden, July, 1997. Attendance 50.
7.
"Surgical management of prolactinomas" presented at the invitation of the
American Society of Reproductive Medicine, Cincinnati, October, 1997. Attendance 200.
8.
“Transsphenoidal surgery for pituitary adenomas” presented at the invitation of the
American Association of Clinical Endocrinology, Orlando, April 30, 1998. Attendance 250.
9.
“Transsphenoidal Surgery and New Radiation Techniques for Pituitary Adenomas”
presented at the invitation of the American Association of Clinical Endocrinologists,
Orlando, Fla., May 1, 1998. Attendance 250.
10.
“Management of CSF rhinorrhea after medical therapy of a prolactinoma” presented
at the invitation of the Endocrine Society, Naples, Fla., June 29-30, 1998. Attendance 100.
11.
“Current therapy for acromegaly: surgery and radiosurgery” presented at the
invitation of the Endocrine Society, Boston, MA, November 1, 1998. Attendance 250.
12.
“Management of CSF rhinorrhea after transsphenoidal surgery” presented at the
invitation of the Congress of Neurological Surgeons, Boston, November 2, 1999.
Attendance 50.
13.
“State of the Art Strategies for Diagnosis & Management of Acromegaly” panelist at
the invitation of The Endocrine Society, Toronto, June 23, 2000. Attendance 300.
14.
“Cushing’s Syndrome” presentation at the “Meet the Professor” seminar, The
Endocrine Society, Toronto, June 23, 2000. Attendance 150.
15.
“Surgical Management of Cushing’s Disease” presentation at the invitation of the
Congress of Neurological Surgeons, Philadelphia, PA September 24, 2002.
Bibliography
Original Reports
1.
Beyerl BD, Borges LF, Swearingen B, Sidman RL. Parasagittal organization of the
olivocerebellar projection in the mouse. J Comp Neurol. 1982; 209:339-346.
2.
Swearingen B, Heros R. Common carotid occlusion for unclippable carotid
aneurysm. Neurosurgery 1987;21:288-295.
3.
Chapman PH, Swearingen B, Caviness VS. Subtorcular occipital encephaloceles.
J Neurosurg 1989;71:375-381.
4.
Louis DN, Swearingen B, et al. Central nervous system neurocytoma and
neuroblastoma in adults--report of eight cases. J NeuroOncology 1990;9:231-239.
5.
Klibanski A, Alexander JM, Hsu DW, Swearingen B, Zervas NT. Somatostatin
regulation of glycoprotein hormone and free subunit secretion in clinically nonfunctioning and somatotroph adenomas in vitro. Journal of Clinical
Endocrinology and Metabolism 1991;73:1248-1255.
6.
Swearingen B, Joseph M, Cheney M, Ojemann R. A modified transfacial approach
to the clivus. Neurosurgery 1995;35:101-105.
7.
Grinspoon S, Clemmon D, Swearingen B, Klibanski A. Serum-insulin-like growth
factor-binding protein-3 levels in the diagnosis of acromegaly. Journal of Clinical
Endocrinology and Metabolism 1995;80:927-932
8.
Alexander JM, Swearingen B, Tindall GT, Klibanski A. Human Gonadotroph
Adenomas Synthesize Endogenous Inhibin Subunit and follistatin mRNAs. J Clinical
Endocrinology and Metabolism 1995;80:147-182.
9.
Ogilvy CS, Barker FG, Joseph MP, Cheney ML, Swearingen B, Crowell RM.
Transfacial transclival approach for midline posterior circulation aneurysms.
Neurosurgery 1996;39:736-41.
10.
Katznelson L, Bogan JS, Trob JR, Schoenfeld DA, Hedley-Whyte ET, Hsu DW,
Zervas NT, Swearingen B, Sleeper M, Klibanski A. Biochemical Assessment of
Cushing’s Disease in Patients with Corticotroph Macroadenomas. J Clinical
Endocrinology and Metabolism 1998;83:1619-1623.
11.
Chaidarun SS, Swearingen B, Alexander J. Differential expression of estrogen
receptor beta in human pituitary tumors: Functional interactions with Era and a
tumor-specific splice variant. J. Clinical Endocrinology and Metabolism
1998;83:3308-15.
12.
Swearingen B, Barker FG, Katznelson L, Biller BMK, Grinspoon S, Klibanski A,
Moayeri N, Black P McL, Zervas NT. Long-term mortality after transsphenoidal
surgery and adjunctive therapy for acromegaly. J Clinical Endocrinology and
Metabolism 1998;83:3419-26.
13.
Swearingen B, Biller BMK, Barker FG II, Katznelson L, Grinspoon S, Klibanski A,
Zervas NT. Long-term mortality after transsphenoidal surgery for Cushing disease.
Ann Intern Med 1999; 130:821-824.
Proceedings of Meetings
1.
Harsh GR, Joseph MP, Swearingen B, Ojemann RG. Anterior Midline Approaches
to the Central Skull Base. In: Clinical Neurosurgery v. 43: Proceedings of the 1996
Congress of Neurological Surgeons meeting. Montreal: Congress of
Neurological Surgeons, 1996.
2.
Swearingen B, Barker FG, Zervas NT. Management of Pituitary Adenomas: The
MGH Experience. In: Clinical Neurosurgery v. 45.: Proceedings of the 1997
Congress of Neurological Surgeons meeting. New Orleans:CNS, 1997.
Clinical Communications
1.
Swearingen B, Heros R. Fatal rupture of a thrombosed giant basilar artery
aneurysm. Surg Neurol. 1985; 23:299-302.
2.
Rosenberg WD, Swearingen B, Poletti CE.
dysesthesias
associated with second cervical
report. Cephalgia 1990;10:259-262.
Contralateral trigeminal
nerve compression: a case
3.
Domingues RD, Mikulis D, Swearingen B et al.
Case report:Subcutaneous
sacrococcygeal myxopapillary ependymoma: CT and MR findings. Am J
Neuroradiology 1991;12(1):171-172.
4.
Eavey RD, Janfaza P, Chapman PH, Swearingen B, LiebschN, Weber A, Davis
KR,Ferguson WS. Skull base dumbbell tumor: Surgical experience with two
adolescents.
Annals of Otology, Rhinology & Laryngology 1992;101 ;939-
945.
5.
cyst
Tatter SB, Edgar MA, Klibanski A, Swearingen B. Symptomatic salivary-rest
of the sella turcica. Acta Neurochirurgica 1995;135:150-153
6.
Fischman AJ, Thornton AF, Swearingen B etal. FDG
hypermetabolism
associated with inflammatory necrotic changes following radiation of meningioma.
J Nuclear Medicine 1997;38:1027-1029.
7.
Long Sb, Swearingen B, Frosch MP, Katznelson L, Henson JW. Hypothalamic
Neurocytoma: A newly recognized cause of central neuroendocrine
dysfunction.
Surg. Neurol. 1998.
Reviews and Educationally Relevant Publications
1.
Swearingen B, Heros R. Current therapy for giant aneurysms. Neurol and
Neurosurg Update Series 1988: Vol 7, 2-8.
2.
Swearingen B, Chapman P. Craniosynostosis. In: R. Dershowitz, ed.
Ambulatory pediatric care. Philadephia: JP Lippincott, 1993, 557-558.
3.
Swearingen B. Perioperative management of the neurosurgical patient. In:
Todres
D, Fugate J, eds. A practice of pediatric intensive care. Boston: Little
Brown,
1996:378-380.
4.
Swearingen B. Head injuries. In: Todres D, Fugate J, eds.
pediatric
intensive care. Boston: Little Brown, 1996:362-266.
A practice of
5.
Swearingen B, Peters CA. Spinal dysraphism. In: Morris PJ, Malt RA, eds.
Oxford
Textbook of Surgery. Oxford: Oxford University Press, 1994:2191-2192.
6.
Swearingen B, Zervas NT. Surgical management of Cushing's disease. In:
Schmidek HH, Sweet WH, eds. Operative neurosurgical techniques.
Philadelphia:
WB Saunders, 1996:301-304.
7.
Swearingen B. Surgical management of falx and parasagittal meningiomas.
In:
Schmidek HH, Sweet WH, eds. Operative neurosurgical techniques.
Philadelphia:
WB Saunders, 1996:513-516.
8.
Swearingen B, Thornton A, Zervas NT. Proton radiosurgery for pituitary
adenomas. In: Landolt A, ed. Pituitary adenomas--biology, diagnosis and
treatment. London:Churchill Livingstone, 1996:453-460.
9.
Swearingen B, Joseph M, Cheney M et al. A Modified Transfacial Approach to
the Clivus. In: Rengachary S, Wilkens R, eds. Neurosurgical Operative Atlas.
AANS, Park Ridge, Ill. 1996;5:129-134.
10.
Alexander J, Swearingen B. Molecular pathogenesis of human pituitary
tumors.
In: Raffel R, Harsh G, eds. Concepts in
Neurosurgery:
The
Molecular Basis of
Neurosurgical Disease. Williams & Wilkins. 1996:146-161.
11.
Biller BM, Swearingen B, Klibanski A, Zervas NT. Profiles of the
Neuroendocrine
Clinical Center. JCEM 1997;82:1674-1674.
12.
Swearingen B, Schaefer P, Klibanski A. Disorders of the Hypothalamus. In
Molitch,
M, ed. Atlas of Clinical Endocrinology, Current Medicine. 2000:212-220.
Non-Print Materials
Videotaped interview "The Experts Discuss Pituitary Tumors" produced by the
Pituitary Tumor Network Association for distribution as patient education material,
December, 1996.
Abstracts
1.
Swearingen B, Chun LLY. Growth of a purified population of postnatal rat
cortical
motoneurons in culture. Soc Neurosci
Abs. 186, 302:7.
2.
Swearingen B, Chun LLY. Growth of a purified population of cortical
motoneurons
in culture. Presented to the Congress of Neurologic Surgeons.
October, 1987.
3.
Hedley-Whyte ET, Hsu DW, Black P, Swearingen B, Zervas NT
Immunohistochemical and clinical correlations of 298 pituitary adenomas.
Presented to the 5th Workshop on Pituitary Adenomas.
4.
Chun L, Swearingen B. Survival requirements of purified postnatal rat retinal
ganglion cells. ARVO abs., 1991.
5.
Swearingen B. Cushing's disease: treatment using intra-operative
thermocoagulation and early re-operation. Presented to the Congress of
Neurologic Surgeons. October, 1994.
6.
Tang G, Swearingen B, Zervas N. Prolactinomas in men. Presented to
American Association of Neurological Surgeons,
April, 1997.
7.
Swearingen B, Chapman P, Loeffler J, Barker FG, Harsh G III, Zervas NT.
Proton
Radiosurgery in the Treatment of Acromegaly. Presented to the
Congress of
Neurological Surgeons, November, 1999.