Walter Edward Dandy (April 6, 1886-April 19, 1946) was an
American neurosurgeon. He is considered as one of the founding fathers of
modern neurosurgery.
After graduation Dandy
became the sixth appointee to the Hunterian Laboratory of Experimental Medicine
under Harvey W. Cushing from 1910-1911. In 1911, he earned a Master of Arts
degree for his work in the Hunterian Laboratory, and went on to join the Johns
Hopkins Hospital surgical house staff for one year as Cushing's Assistant
Resident (1911-1912). Dandy completed his general surgery residency at the
Johns Hopkins Hospital under William S. Halsted in 1918. While Dandy was
introduced to the nascent field of neurosurgery by Cushing, it was George J.
Heuer who completed Dandy's neurosurgical training after Cushing's departure
for the Peter Bent Brigham Hospital in Boston in September 1912. Heuer had
graduated from the Johns Hopkins University School of Medicine , worked as
Cushing's first Assistant Resident and
served as Halsted's Chief Resident.
One of the earliest products of the Hunterian experience was Walter Dandy. During the two years after medical school, Dandy completed his monumental work on cerebrospinal fluid production, judged by many to be the finest piece of surgical research ever accomplished. While still a house officer, he devised pneumo-encephalography, which was the basis of neurological imaging for nearly 50 years. Dandy went on the be the most famous surgeon of his generation and the greatest technician the field has known. His innovations introduced surgery for disc disease, surgery for aneurysms and arteriovenous malformations as well as surgery for functional disease. The modern scope of neurosurgery was encompassed by Dandy.
Dandy joined the staff of the Johns Hopkins Hospital in 1918 and
immediately focused his energies on the surgical treatment of disorders of the
brain and spinal cord. When Heuer left Hopkins in 1922 to become the head of
surgery at the University of Cinicinnati, Dandy remained as the only
neurosurgeon at the Johns Hopkins Hospital until his death in that hospital in
1946.
One of the earliest products of the Hunterian experience was Walter Dandy. During the two years after medical school, Dandy completed his monumental work on cerebrospinal fluid production, judged by many to be the finest piece of surgical research ever accomplished. While still a house officer, he devised pneumo-encephalography, which was the basis of neurological imaging for nearly 50 years. Dandy went on the be the most famous surgeon of his generation and the greatest technician the field has known. His innovations introduced surgery for disc disease, surgery for aneurysms and arteriovenous malformations as well as surgery for functional disease. The modern scope of neurosurgery was encompassed by Dandy.
Dandy is credited with numerous neurosurgical discoveries
and innovations, including the description of the circulation of CSF in the
brain, surgical treatment of hydrocephalus, the innovation of air
ventriculography & pneumoencephalography, the description of brain
endoscopy, the establishment of first intensive care unit and first clipping of
an intracranial aneurysm.
Walter Dandy trained under Cushing at John Hopkins Hospital.
Dandy made a number important contributions to neurosurgery. Dandy developed
the technique of pneumoencephalography and provided the neurosurgeon the
opportunity to localize a brain tumor by analyzing the displacement of air in
the ventricles.
Dandy was an innovative neurosurgeon, considerably more
aggressive in style and technique than Cushing.
Dandy was first to show that acoustic neuroma could be
removed in totality.
In 1913 and 1914,
Dandy and Kenneth D. Blackfan published two landmark papers on the production,
circulation, and absorption of CSF in the brain and on the causes and potential
treatments of hydrocephalus. Hydrocephalus is the buildup of CSF within the brain,
an often lethal condition if left untreated. They described two forms of
hydrocephalus, namely "obstructive" and "communicating,"
thus establishing a theoretical framework for the rational treatment of this
condition.
He first introduced the technique ablating and removing the
choroid plexus to reduce the production of CSF
for treating hydrocephalus.
In 1921 Dandy
reported a case of hydrocephalus caused by obstruction of outflow of CSF from
the fourth ventricle. In 1944 A. Earl Walker (who eventually became chairman of
neurosurgery at Johns Hopkins) described a similar case of congenital closure
of the outflow of the fourth ventricle. This congenital anomaly became known as
the Dandy-Walker cyst. It is associated with closure of the foramina of Luschka
and Magendie (the outflow openings of the fourth ventricle), atrophy of the
cerebellum and cerebellar vermis, dilation of the fourth ventricle,
hydrocephalus, and often atrophy of the corpus callosum.
Dandy was among the first to surgically deal with cerebral
aneurysms by obliterating them with snare ligatures or metal clips.
Dandy's surgical
innovations proceeded at an astounding rate as he became increasingly
comfortable operating on the brain and spinal cord. He described in 1921 an
operation for the removal of tumors of the pineal region, in 1922 complete
removal of tumors of the cerebellopontine angle (namely acoustic neuromas), in
1922 the use of endoscopy for the treatment of hydrocephalus ("cerebral
ventriculoscopy"), in 1925 sectioning the trigeminal nerve at the
brainstem to treat trigeminal neuralgia, in 1928 treatment of Ménière's disease
(recurrent vertiginous dizziness) by sectioning the vestibular nerves, in 1929
removal of a herniated disc in the spine, in 1930 treatment of spasmodic
torticollis, in 1933 removal of the entire cerebral hemisphere
("hemispherectomy") for the treatment of malignant tumors, in 1933
removal of deep tumors within the ventricular system, in 1935 treatment of
carotid-cavernous fistulas (CCFs), in 1938 ligation or "clipping" of
an intracranial aneurysm, and in 1941 removal of orbital tumors.
Walter Dandy’s many contributions have earned him a prominent place in the annals of neurological surgery.
Sources:
The society of Neurological Surgeons
Youmans Neurological Surgery ( H. Richard Winn)
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