Pituitary

, Volume 20, Issue 6, pp 683–691 | Cite as

Walter E. Dandy: his contributions to pituitary surgery in the context of the overall Johns Hopkins Hospital experience

  • Andrea Corsello
  • Giulia Di Dalmazi
  • Fabiana Pani
  • Paulina Chalan
  • Roberto Salvatori
  • Patrizio Caturegli
Article

Abstract

Background

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.

Purpose

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.

Methods

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.

Results

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.

Conclusions

This study highlights the role of Dandy as an important contributor to advance our understanding of pathophysiology and treatment of pituitary diseases.

Keywords

Walter E. Dandy Harvey W. Cushing Pituitary surgery History of endocrinology 

Supplementary material

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References

  1. 1.
    Rizzoli HV (1987) Dandy’s contributions to the foundation of neurological surgery. Pediatr Neurosci 13:316–322CrossRefPubMedGoogle Scholar
  2. 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
  3. 3.
    Cope VZ (1916) The pituitary fossa and the methods of surgical approach thereto. Br J Surg 4:107–144CrossRefGoogle Scholar
  4. 4.
    Caton R (1893) Notes of a case of acromegaly treated by operation. Br Med J 2:1421–1423CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Horsley V (1886) Brain surgery. Br Med J 2:670–675CrossRefGoogle Scholar
  6. 6.
    Horsley V (1906) On the technique of operations of the central nervous system. Br Med J 2:411–423CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Krause F (1905) Hirnchirurgie (Freilegung der Hypophyse). Deutsche Klin 8:1004–1024Google Scholar
  8. 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
  9. 9.
    Schmidt RF, Choudhry OJ, Takkellapati R, Eloy JA, Couldwell WT, Liu JK (2012) Hermann Schloffer and the origin of transsphenoidal pituitary surgery. Neurosurg Focus 33:E5CrossRefPubMedGoogle Scholar
  10. 10.
    Cohen-Gadol AA, Liu JK, Laws ER Jr (2005) Cushing’s first case of transsphenoidal surgery: the launch of the pituitary surgery era. J Neurosurg 103:570–574CrossRefPubMedGoogle Scholar
  11. 11.
    Liu JK, Cohen-Gadol AA, Laws ER Jr, Cole CD, Kan P, Couldwell WT (2005) Harvey Cushing and Oskar Hirsch: early forefathers of modern transsphenoidal surgery. J Neurosurg 103:1096–1104CrossRefPubMedGoogle Scholar
  12. 12.
    Dandy Marmaduke ME (2015) Walter Dandy (1886–1946): a personal retrospective. Neurosurgery 77:501–508 (discussion 508)CrossRefPubMedGoogle Scholar
  13. 13.
    Dandy Marmaduke ME. The personal side of a premier neurosurgeon. Philadelphia: Lippincott Williams & WilkinsGoogle Scholar
  14. 14.
    Campbell E, Walter E (1951) Dandy-surgeon, 1886–1946. J Neurosurg 8:249–262CrossRefPubMedGoogle Scholar
  15. 15.
    Dandy WE (1910) A human embryo with seven pairs of somites measuring about 2 mm in length. Am J Anat 10:85–108CrossRefGoogle Scholar
  16. 16.
    Dandy WE, Goetsch E (1911) The blood supply of the pituitary body. Am J Anat 11:137–150CrossRefGoogle Scholar
  17. 17.
    Dandy WE (1913) The nerve supply to the pituitary body. Am J Anat 15:333–343CrossRefGoogle Scholar
  18. 18.
    Cohen-Gadol AA, Laws ER, Spencer DD, De Salles AA (2005) The evolution of Harvey Cushing’s surgical approach to pituitary tumors from transsphenoidal to transfrontal. J Neurosurg 103:372–377CrossRefPubMedGoogle Scholar
  19. 19.
    Pendleton C, Adams H, Laws ER, Quinones-Hinojosa A (2010) The elusive Minnie G.: revisiting Cushing’s case XLV, and his early attempts at improving quality of life. Pituitary 13:361–366CrossRefPubMedGoogle Scholar
  20. 20.
    Pendleton C, Adams H, Mathioudakis N, Quinones-Hinojosa A (2013) Sellar door: Harvey Cushing’s entry into the pituitary gland, the unabridged Johns Hopkins experience 1896–1912. World Neurosurg 79:394–403CrossRefPubMedGoogle Scholar
  21. 21.
    Pendleton C, Adams H, Salvatori R, Wand G, Quinones-Hinojosa A (2011) On the shoulders of giants: Harvey Cushing’s experience with acromegaly and gigantism at the Johns Hopkins Hospital, 1896–1912. Pituitary 14:53–60CrossRefPubMedGoogle Scholar
  22. 22.
    Pendleton C, Wand G, Quinones-Hinojosa A (2010) The autopsy was conducted “Under most inauspicious circumstances:” John Turner, Harvey Cushing’s case XXXII, and his unwitting contributions to the early understanding of acromegaly. Pituitary 13:324–328CrossRefPubMedGoogle Scholar
  23. 23.
    Pendleton C, Zaidi HA, Pradilla G, Cohen-Gadol AA, Quinones-Hinojosa A (2010) Harvey Cushing’s attempt at the first human pituitary transplantation. Nat Rev Endocrinol 6:48–52CrossRefPubMedGoogle Scholar
  24. 24.
    Liu JK, Das K, Weiss MH, Laws ER Jr, Couldwell WT (2001) The history and evolution of transsphenoidal surgery. J Neurosurg 95:1083–1096CrossRefPubMedGoogle Scholar
  25. 25.
    Dandy W, Goetsch E (1911) The blood supply of the pituitary body. Am J Anat 11:137–150CrossRefGoogle Scholar
  26. 26.
    Dandy W (1913) The nerve supply to the pituitary body. Am J Anat 15:333–343CrossRefGoogle Scholar
  27. 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. 28.
    Dandy W (1922) An operation for the removal of large pituitary tumors. Bull Johns Hopkins Hosp 33:189Google Scholar
  29. 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. 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
  31. 31.
    Dandy W (1940) Section of the human hypophysial stalk: its relation to diabetes insipidus and hypophysial functions. J Am Med Assoc 114:312–314CrossRefGoogle Scholar
  32. 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
  33. 33.
    Rizzoli HV, Walter E (1985) Dandy: an historical perspective. Clin Neurosurg 32:3–22PubMedGoogle Scholar
  34. 34.
    Dandy W, Blackfan K (1913) An experimental and clinical study of internal hydrocephalus. J Am Med Assoc 61:2216–2217CrossRefGoogle Scholar
  35. 35.
    Dandy W, Blackfan K (1914) Internal hydrocephalus: an experimental, clinical and pathological study. Am J Dis Child 8:406–482CrossRefGoogle Scholar
  36. 36.
    Dandy W (1918) Ventriculography following the injection of air into the cerebral ventricles. Ann Surg 68:5–11CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Hsu W, Li KW, Bookland M, Jallo GI (2009) Keyhole to the brain: Walter Dandy and neuroendoscopy. J Neurosurg Pediatr 3:439–442CrossRefPubMedGoogle Scholar
  38. 38.
    Brewster R, Bi WL, Smith TR, Gormley WB, Dunn IF, Laws ER Jr (2015) The neurosurgeon as baseball fan and inventor: Walter Dandy and the batter’s helmet. Neurosurg Focus 39:E9CrossRefPubMedGoogle Scholar
  39. 39.
    Sherman IJ, Kretzer RM, Tamargo RJ (2006) Personal recollections of Walter E. Dandy and his brain team. J Neurosurg 105:487–493CrossRefPubMedGoogle Scholar
  40. 40.
    Rizzoli HV (1985) Dandy’s brain team. Clin Neurosurg 32:23–37PubMedGoogle Scholar
  41. 41.
    Dandy WE (1934) Removal of cerebellopontile (acoustic) tumors through a unilateral approach. Arch Surg 29:337–344CrossRefGoogle Scholar
  42. 42.
    Dandy WE (1929) An operation for the cure of tic douloureux: partial section of the sensory root at the pons. Arch Surg 18:687–734CrossRefGoogle Scholar
  43. 43.
    Dandy WE (1928) Ménière disease: its diagnosis and a method of treatment. Arch Surg 16:1127–1152CrossRefGoogle Scholar
  44. 44.
    Dandy W (1942) Recent advances in the diagnosis and treatment of ruptured intervertebral disks. Ann Surg 115:514–520CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Andrea Corsello
    • 1
  • Giulia Di Dalmazi
    • 1
    • 2
  • Fabiana Pani
    • 1
    • 3
  • Paulina Chalan
    • 1
  • Roberto Salvatori
    • 4
  • Patrizio Caturegli
    • 1
    • 5
    • 6
  1. 1.Division of Immunology, Department of PathologyThe Johns Hopkins School of MedicineBaltimoreUSA
  2. 2.Division of Endocrinology, Department of Medicine and Aging Sciences“G. D’Annunzio” University of Chieti-PescaraChietiItaly
  3. 3.Department of Medical Sciences and Public Health, Endocrinology UnitUniversity of CagliariCagliariItaly
  4. 4.Division of Endocrinology, Department of Medicine, and Pituitary CenterThe Johns Hopkins School of MedicineBaltimoreUSA
  5. 5.Department of Molecular Microbiology and ImmunologyThe Johns Hopkins School of Public HealthBaltimoreUSA
  6. 6.Johns Hopkins PathologyBaltimoreUSA

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