John Lester FIRTH, MB, BS London, FRCS Edinburgh

John Lester FIRTH, MB, BS London, FRCS Edinburgh.
Consultant Neurosurgeon,
Vacquoy, Rousay, Orkney KW17 2 PS
44/0 780 898 8687
44/0 185 682 1262
johnfirth@aol.com
neuroserve@aol.com
Clinical Teacher, Universities of Nottingham and Leicester Medical Schools.
Honorary Consultant Neurosurgeon, Clinical Neurosciences and the Spinal Unit,
University Hospital and Queen’s Medical Centre, Nottingham, NG7 2UH.
Former Regional Adviser in Neurosurgery, Royal College of Surgeons, London
Now concentrating on Neuro-, Spinal and Medico-Legal Review, Aviation Neuroscience.
St Thomas's Hospital Medical School, London.
Qualified: MB, BS University of London, 1962, FRCS, Edinburgh, 1967. GMC 0253633
1962-3: Casualty Officer (HP) and House Surgeon: St Thomas's Hospital, London (Mr N R
Barrett, Mr J M Pullen).
1963: Senior House Officer: Thoracic Surgical Unit, St Thomas's (Mr Barrett, Mr Kent
Harrison).
Registrar: National Hospital for Nervous Diseases, Queen Square (Mr Harvey Jackson).
1964: Lecturer in Anatomy: Royal Free Hospital Medical School, London (Prof Ruth
Bowden).
1965: Registrar: National Hospital for Nervous Diseases, Queen Square, London.
1966: Neurosurgical Registrar: King's College Hospital and the Guy's Maudsley
Neurosurgical Unit, London (Mr J J McCabe).
1968: Lecturer in Neurosurgery: Institute of Neurology, Queen Square (Prof Valentine
Logue) and Senior Registrar, The Hospital for Sick Children, Great Ormond Street (Mr
Kenneth Till and Mr Norman Grant), Maida Vale (Prof Valentine Logue and Mr Lindsay
Symon) and the Middlesex (Mr John Andrew) Hospitals. Concept & development of
Aviation Neurology for Dr Dennis Williams.
1974: part-time Consultant: MRC Medical Research Council’s Clinical Research Centre
and Northwick Park Hospital, Harrow, Middlesex.
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1976: Consultant Neurosurgeon: Trent Regional Department of Neurosurgery and
Neurology, Derbyshire Royal Infirmary, Leicester Royal Infirmary and Harlow Wood
Orthopaedic Hospital (developed combined neuro-orthopaedic spinal service with Mr Peter
Jackson, Mr G C W Baker and Mr J K Webb).
Clinical Teacher: Nottingham and Leicester Universities' Medical Schools.
1985: Department transferred to the University Hospital, Queen's Medical Centre,
Nottingham.
1993: Neuro-Orthopaedic Spinal Service and Spinal Unit (with Mr John Webb) re-located
from Harlow Wood to Queen's Medical Centre.
2001, July: Retired from full-time NHS practice. Emeritus then Honorary Consultant
Neuro-surgeon at QMC. Now engaged in Neuro-, Spinal and Medico-Legal review,
Aviation Neuroscience, Teaching & Research.
RESEARCH INTERESTS
1. Neuro-oncology:
Central nervous system Leukaemia in childhood (with Prof A S D Spiers). Primary
Cerebral Lymphoma (with Dr Eric Bessell and others).
2. Neuro-imaging
Development, assessment and clinical introduction of CT, EMI Subtraction, whole-body
CT, MR, EPI-EchoPlanar (real-time) and EVI-EchoVolumar imaging (with Dr Ivan Moseley,
Dr Louis Kreel, Prof Brian Worthington, Prof Sir Peter Mansfield, Dr Michael Stehling and
others).
3. Microsurgery and Microneurosurgery.
Concept, design, construction and development of neurosurgical procedures, instruments
and equipment including the counter-balanced microscope stand (with Prof M G Yasargil,
Zurich, the Department of Industrial Design, Loughborough University and others).
4. Central Nervous System Infection.
Prion/’slow viral’ states [Maida Vale Hospital with Dr Sam Nevin, Dr Robin Barnard, et al].
Viral encephalitis [Middlesex Hospital] and intracranial sepsis (with Dr Royce Darnell and
others).
5. Neurological complications of spinal deformity.
Initially in children, latterly throughout the age range from conception to maturity and
beyond, necessarily combined with pre-neuralation embryology, spinal dynamics and
deformity prediction (with Mr Peter Jackson, Mr Geoffrey Baker, Mr John Webb, Prof
Geoffrey Burwell and colleagues])
6. Intracranial pressure.
Measurement, management, modeling, averaging, integration and dynamic analysis.
Concept, design, development & clinical introduction of optic nerve sheath fenestration
(with Prof. Alistair Fielder and others).
POEMS, programmable oto-acoustic emission behavior during induced change in ICP.
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Firth, JL: CV, page 3 of 5
7. Cerebrospinal Fluid Circulation in health & disease.
Observation, measurement, analysis, modeling and treatment in Hydrocephaly,
Hydromyelia, Syringomyelia and the associated states. Development of lumbar sac
infusion testing and real time EchoPlanar imaging to address these problems.
8. Definition, investigation & treatment of Pre-senile Dementia & the reversible
dementias.
9. Cerebral Microcirculation & the Blood-Brain Barrier in man.
First experimental model of cerebrovascular autoregulation in man (with Dr Vince Wilson,
Dr William Dunn and Dr S J Wallis).
10. Second Messengers and the demonstration of species specificity in Man (with Dr
David Kendall).
11 Head & Spinal Injury.
Mechanisms, modeling, prevention, practical protection and clinical management.
Clinically at Northwick Park, in Derby, Leicester & Nottingham and at the QMC, as a
member of the Nottingham WALDEGRAVE Initiative model head injury management
study. Chairman of the BSI British Standard Institute's PSM/18 Committee. Lecturer and
advisor at DCIEM, Defence and Civil Institute of Environmental Medicine, Toronto.
Neuroscience Advisor to and later Medical Panel Member of AGARD, NATO's Advisory
Group on Aviation Research and Development. Member of the European Head and Neck
Injury Consortium for the European Community Fourth Framework Research Funding
proposals. RAF Prospective Aircrew Ejection Management & Review program.
12. Aviation Neurology, Neuro-ophthalmology & the Aviation Neurosciences.
PUBLICATIONS include
SPIERS ASD, FIRTH JL, COLLINS CD: Treating the nervous system in acute leukaemia.
Lancet 1:433-434,17 Feb 1972.
FIRTH JL, LADURNER G, ZILKHA E et al: Improved localization by subtraction of E.M.I.
scans [letter]: Lancet 2:609,27 Sept 1975.
CHOUDHURY AR, TAYLOR JC, WHITAKER R, FIRTH JL: Further experience with
primary excision of brain abscess [letter]. Br Med J 2:1538-1539, 10 Dec 1977.
SPIERS ASD, BOOTH AE, FIRTH JL: Subcutaneous cerebrospinal fluid reservoirs in
patients with acute leukaemia. Scand J Haematol 20:289-296, 1978.
YASARGIL, M.G., SMITH, R.D., FIRTH, J.L.: The principles of microsurgery as applied
to aneurysm surgery. In Symon, L. (Ed.): Operative Surgery, Third Edition.
Butterworths, London-Boston. Pp 225-23 (1978).
YASARGIL, M.G., SMITH, R.D. FIRTH, J.L.: Anterior communicating arterial
aneurysms. In Symon., L. (Ed.): Operative Surgery, Third Edition. Butterworths,
London-Boston. Pp 233-251 (1978).
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GESSEY G, BAKER P, WHITE A, FIRTH JL: Lumbar sac infusion test revisited, in
Shulman K, Marmarou A, Miller JD, Becker DP, Hochwald GM, Brock M [Eds]:
Intracranial Pressure IV. New York, Springer, 1980 pp.456-459.
DARNELL, R., FIRTH, J. L., TAYLOR, J. C. & SHEPHARD, R. H. (1981). The Use of
Cefuroxime in the Treatment of Meningitis and Sepsis in the Central Nervous
System. Royal Society of Medicine, International Congress and Symposium
Series, Number 38, Cefuroxime Update, pp. 111-21
FIRTH JL: Introduction: Head Protection-State of the Art. in PEDDER JB, MILLS NJ (Eds):
Head Protection: The State of the Art. Symp Proc, 25 September 1982. Birmingham,
University of Birmingham, 1983 pp.1-4.
FIRTH JL: Return to flying after head injuries: a review. Aviat Space Environ Med 54:603-
608, 1983.
FIRTH, JL: Assessment of Neurological Disorders. In: Manual of Civil Aviation Medicine,
2nd Edition: Montreal, ICAO International Civil Aviation Organization, 1985. Part III,
Chapter 9: III-9-14 to III-9-21.
KEAN DM, WORTHINGTON,BS, FIRTH JL, HAWKES RC: The effects of magnetic
resonance imaging on different types of microsurgical clips (letter). J Neurol
Neurosurg Psychiatr 48:286-287, 1985.
GOEL IP, FIRTH JL: Bipolar techniques in microvascular neurosurgery. British Journal
of Plastic Surgery 38(3):442 (July 1985)
FIRTH JL: Equestrian Injuries. in SCHNEIDER RC, KENNEDY JC, PLANT ML (Eds):
Sports Injuries. Mechanisms, Prevention and Treatment. Baltimore, Williams and
Wilkins, 1985 431-449.
KNIGHT RS, FIELDER AR, FIRTH JL: Benign intracranial hypertension: visual loss and
optic nerve sheath fenestration. J Neurol Neurosurg Psychiatr 49:243-250, 1986.
BARNES K, BELL N, VASILLIOU D, FIRTH JL: Medical aspects of head protection at
work J Occup Accidents 8(3) November 1986, Pages 173-180
DONALD FE, SHARP JF, FIRTH JL, CROWLEY JL ISPAHANI P: Rhodotorula rubra
ventriculitis. J Infect 16:187-191, 1988.
STEHLING MK, BULLOCK PR, FIRTH JL, BLAMIRE A, ORDIDGE R, COXON R, GIBBS
P, MANSFIELD P: Gd-GTPA real-time studies of the brain with EPI. Proc 8th Ann
Meeting SMRM, Amsterdam, 1989:358.
MANSFIELD P, STEHLING MK, FIRTH JL, BLAMIRE A, ORDIDGE R, COXON R, GIBBS
P: Dynamic EPI of the brain using Gd-DTPA Proc VIth Symp Rad, Graz 1989:78.
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WORTHINGTON BS, STEHLING MK, ORDIDGE RJ, COXON R, HOUSEMAN AM,
CHAPMAN B, TURNER R, FIRTH JL and MANSFIELD P. An assessment of the
clinical potential of ultra-high-speed imaging of the brain by the echo planar
technique
FIRTH JL: Neurological dimensions of situational awareness. In AGARD-CP-478, Neuillysur-Seine,
AGARD, 1990.
www.nottinghamspine.co.uk