Walter Edward Dandy

Walter Edward Dandy (April 6, 1886 – April 19, 1946) was an American neurosurgeon and scientist. He is considered one of the founding fathers of neurosurgery, along with Victor Horsley (1857–1916) and Harvey Williams Cushing (1869–1939).

Dandy is credited with numerous neurosurgical discoveries and innovations, including the description of the circulation of cerebrospinal fluid in the brain, surgical treatment of hydrocephalus, the invention of air ventriculography and pneumoencephalography, the description of brain endoscopy, the establishment of the first intensive care unit 1).

He first described the basic mechanism and classification of hydrocephalus as:

Obstructive hydrocephalus or Non Obstructive hydrocephalus.

Despite advances in understanding of the underlying process, current classification systems still rely upon Dandy’s classification scheme 2).

Subtemporal decompression, first advocated by Walter Edward Dandy for the treatment of benign intracranial hypertension or pseudotumor cerebri.

Dandy can be credited with the first detailed description of the vein of Galen malformation, the first description of x-ray visualization of an intracranial aneurysm, the first characterization of basilar artery dolichoectasia, and the publication of the first comprehensive operative case series of arteriovenous malformations, cavernous malformations, and developmental venous anomalies.

Dandy performed the first surgical trapping of a cavernous internal carotid artery (ICA) aneurysm by clipping the supraclinoid ICA and ligating the cervical ICA, the first clipping of an intracranial aneurysmand he also executed the first intracranial surgical clipping of the ICA to treat a carotid-cavernous fistula which marked the birth of cerebrovascular neurosurgery 3). 4).

While selectively sectioning the pain fibers in trigeminal neuralgia (which usually lie posteriorly) of the trigeminal nerve via an occipital craniectomy Dandy, as quoted in Wilkins, noted that vascular compression of the trigeminal nerve at the pons was a frequent finding 5).

During his 40-year medical career, Dandy published five books and more than 160 peer-reviewed articles while conducting a full-time, ground-breaking neurosurgical practice in which he performed during his peak years about 1000 operations per year. 6).

He was recognized at the time as a remarkably fast and particularly dextrous surgeon. Dandy was associated with the Johns Hopkins Hospital University School of Medicine and the Johns Hopkins Hospital his entire medical career. The importance of his numerous contributions to neurosurgery in particular and to medicine in general has increased as the field of neurosurgery has evolved.

Fox, WL. Dandy of Johns Hopkins. Williams and Wilkins, Baltimore, Maryland, 1984.
Dandy WE, Blackfan KD. Internal hydrocephalus: an experimental, clinical and pathological study. Am J Dis Child. 1914;8(6):406-482.
Dandy WE. Intracranial aneurysm of the internal carotid artery. Ann Surg. 1938;107:654–9.
Kretzer RM, Coon AL, Tamargo RJ. Walter E. Dandy's contributions to vascular neurosurgery. J Neurosurg. 2010 Jun;112(6):1182-91. doi: 10.3171/2009.7.JNS09737. PubMed PMID: 20515365.
Wilkins RH: Historical perspectives, in Rovit RL, Murali R, Jannetta PJ (eds): Trigeminal Neuralgia. Baltimore: Williams & Wilkins, 1990, pp 1–25
Sherman, IJ, Kretzer, RM, Tamargo, RJ. “Personal recollections of Walter E. Dandy and his brain team.” Journal of Neurosurgery 105: 487-93, 2006.
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