Walter Dandy

Walter Edward Dandy ( born April 6, 1886 in Sedalia, Missouri, † April 19, 1946 in Baltimore) was an American neurosurgeon and neuroscientist. He is considered one of the founders of modern neurosurgery. Among his important innovations and inventions include the description of the Liquorkreislaufs in the brain, surgical treatment of hydrocephalus, discovery and introduction of Pneumencephalographie the CSF spaces in the diagnosis of intracranial mass lesions, intracranial aneurysm of a first operation and the birth of cerebrovascular neurosurgery.

Life and work

Walter Edward Dandy was born on April 6, 1886 as the son of a railway engineer in Sedalia (Missouri ) in the USA. His parents had immigrated from England. In Sedalia Dandy spent his school years, he spent his college years at the University of Missouri. Because of his achievements, he was awarded a Rhodes Scholarship, which would have allowed him a free study at Oxford University. Dandy did not take the scholarship to but because he wanted to study medicine, which at that time was not represented at Oxford. With the support of the zoologist Curtis, in whose laboratory he had worked, Dandy went in 1907 to the Johns Hopkins Medical School in Baltimore. After passing the state exam (1910 ) he went to the Hunterian Laboratory for experimental animal surgery.

Here he was first introduced to the neurosurgeon Harvey Cushing in touch. At the suggestion of Cushing, he examined the blood supply to the pituitary gland. In 1911, he was internally and came to the surgical department, where he remained as a resident as a resident assistant and from 1916. In 1918 he settled as a general surgeon. That same year, Dandy began in " Johns Hopkins Hospital" (Baltimore) as a surgeon, later working as a neurosurgeon, where he remained until his death in 1946. In 1932 he was elected a member of the Leopoldina.

Even as a " resident assistant " to Dandy Liquorstudien had turned; In 1913 he published his first papers on hydrocephalus and the Liquorkreislauf. Dandy was able to prove, first, that the CSF production was carried out by the choroid plexus and secondly, the cerebrospinal fluid is not absorbed into the brain's ventricles. He was able to show at the corpse, that in every case of idiopathic hydrocephalus a passage obstacle was detected. He made ​​the difference between obstruierendem ( " occlusive " ) and a communicating ( " communicating " ) hydrocephalus. In a communicating hydrocephalus, Dandy could create choroid remedy by surgical extirpation of the plexus. These studies constitute the basis for the discovery and application of encephalography after spinal air introduction and cerebral ventriculography in the diagnosis of brain tumors, making the big time of neurosurgery began.

The ventriculography

The introduction of ventriculography was done after long study and reflection. To contrast the cerebral ventricles Dandy had tried various substances such as thorium, iodides, Collargol, Bismutum take many attempts subnitrate; had all but proved too strong irritant. On the idea of ​​using air as a contrast agent, he came after he had seen a spontaneous -onset pneumoperitoneum after intestinal perforation in which the air that had accumulated under the diaphragm, showed a very clear contrast in the radiograph. The ventriculography allowed now, hydrocephalus and the location of a brain tumor to determine as well that he had to be found at the operation. Dandy turned almost exclusively to the brain surgery.

Contributions to Neurosurgery

The first work on the treatment of brain tumors Dandy published in 1921. During the same year, he described his method of operation at Zirbeldrüsentumoren. In 1922, he was able to report on the surgical removal of tumors in the third ventricle. In the same year his work has appeared on the surgical treatment of pituitary tumors. His studies of the nervous and vascular supply of the hypophysis from 1910 were supplemented by animal experimental work.

Of the other contributions, the Dandy delivered to neurosurgery, had singled out the following:

  • The Akustikustumoren were first radical operation of Dandy.
  • 1937, succeeded as the first Dandy to diagnose an aneurysm of the circle of Willis and eliminate operational.
  • Distance from infiltrative growing brain tumors ( gliomas ) by extensive resections of lobes of the brain, until the removal of an entire cerebral hemisphere ( hemispherectomy ).
  • Surgical treatment for herniated discs.
  • Neurotomy (nerve transection ) of the sensory root of the trigeminal nerve in trigeminal neuralgia.

Publications (selection)

  • Ventriculography Following the Injection of Air into the Cerebral Ventricles. In: Ann Surg 68:5, 1918
  • Localization or elimination of Cerebral tumor by ventriculography. In: Surg Gyn 30:329, 1920
  • The Treatment of Brain Tumors. In: JAMA 77:1853, 1921
  • Surgery for total extirpation of the tumor in the cerebello - pontine angle. In: Johns Hopkins Hosp Bull, 33:344, 1922
  • Diagnosis, Localization and Removal of Tumor of the Third Ventricle. In: Johns Hopkins Hosp Bull, 33:188, 1922
  • Mechanisms and Symptoms of tumor of the Third Ventricle and Pineal Body. Williams & Wilkins Co., Baltimore 1929
  • Surgery of the Brain. W. F. Prior Co., Inc., Hagerstown 1936
  • Recent Advances in the Diagnosis and Treatment of Ruptured intervertebral discs. In: Ann Surg, 115:514, 1942.
  • Intracranial Arterial aneurysm. Comstock Publ Co., Ithaca, N. Y. 1944
  • Dandy's Selected Writings compiled by Charles E. Troland and Frank J. Otenasek. Springfield, Oxford, Toronto 1957

Associated eponyms

  • Dandy operations:
  • Dandy characters: exacerbation of sciatica by coughing, blowing your nose, sneezing as a sign of discogenic sciatic irritation.
  • Dandy-Walker syndrome: variant of dysraphism syndrome with congenital hydrocephalus, cystic enlargement of the fourth ventricle, atresia of the foramen Magendi and poor education of the cerebellar vermis.
Sedalia (Missouri) JAMA (journal) Integrated Authority File
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