Walter E. Dandy: his contributions to pituitary surgery in the context of the overall Johns Hopkins Hospital experience
Walter E. Dandy (1886–1946) was an outstanding neurosurgeon who spent his entire career at the Johns Hopkins Hospital. After graduating from medical school in 1910, he completed a research fellowship in the Hunterian laboratory with Harvey Cushing and then joined the Department of Surgery as resident, rising to the rank professor in 1931. Dandy made several contributions that helped building the neurosurgical specialty, most famously the introduction of pneumo-ventriculography to image brain lesions for which he received a Nobel prize nomination. He also performed many pituitary surgeries, although his role in this area is less known and overshadowed by that of Cushing’s.
This retrospective cohort study was designed to unveil Dandy’s pituitary work and place it in the context of the overall pituitary surgeries performed at the Johns Hopkins Hospital.
Pituitary surgery data were obtained by screening the paper and electronic surgical pathology records of the Department of Pathology, as well as the general operating room log books of the Johns Hopkins Hospital housed in the Chesney Medical Archives.
A total of 3211 pituitary surgeries associated with a pathological specimen were performed between February 1902 and July 2017 in 2847 patients. Most of the surgeries (2875 of 3211 89%) were done by 21 neurosurgeons. Dandy ranks 4th as number of surgeries, with 287 pituitary operations in 35 years of activity. He averaged 8 pituitary surgeries per year, a rate that positions him 6th among all Hopkins neurosurgeons. With the exception of his first operation done in July 1912 while Cushing was still at Hopkins, Dandy approached the pituitary gland transcranially, rather than transphenoidally. The majority of Dandy’s pituitary patients had a pathological diagnosis of pituitary adenomas, followed by craniopharyngiomas and sellar cysts. In the decades Dandy operated, pituitary surgeries represented 0.56% of the total Johns Hopkins surgeries, a percentage significantly greater (p < 0.001) than the 0.1% observed in modern days. Dandy’s pituitary clinical work was matched by important experimental studies done in the early stages of his career.
This study highlights the role of Dandy as an important contributor to advance our understanding of pathophysiology and treatment of pituitary diseases.
KeywordsWalter E. Dandy Harvey W. Cushing Pituitary surgery History of endocrinology
- 2.Marie P (1886) Sur deux cas d’acromégalie: hypertrophie singulière non congénitale des extrémités supérieures, inférieures, and céphalique. Rev Med Liège 6:297–333Google Scholar
- 7.Krause F (1905) Hirnchirurgie (Freilegung der Hypophyse). Deutsche Klin 8:1004–1024Google Scholar
- 8.Cushing H (1912) The pituitary body and its disorders. Clinical states produced by siroders of the hypophysis cerebri. Philadelphia: J.B. Lippincott CompanyGoogle Scholar
- 13.Dandy Marmaduke ME. The personal side of a premier neurosurgeon. Philadelphia: Lippincott Williams & WilkinsGoogle Scholar
- 27.Heuer GD (1918) A new hypophysis operation. Devised by G. J. Heuer. Presented by W.E.D. in Heuer’s absence. the Johns Hopkins Medical Society. Johns Hopkins Hosp Bull 29:154–155Google Scholar
- 28.Dandy W (1922) An operation for the removal of large pituitary tumors. Bull Johns Hopkins Hosp 33:189Google Scholar
- 29.Dandy W, Reichert F (1925) Studies on experimental hypophysectomy; effect on the maintenance of life. Johns Hopkins Hosp Bull 37:1–13Google Scholar
- 30.Reichert F, Dandy W (1936) Polyuria and polydipsia (diabetes insipidus) and glycosuria resulting from animal experiments on the hypophysis and its environs. Bull Johns Hopkins Hosp 58:418Google Scholar
- 32.Dandy W, Leet Reichert F (1938) Studies on experimental hypophysectomy in dogs; somatic, mental and glandular effects. Bull Johns Hopkins Hosp 62:122–155Google Scholar