Walter Edward Dandy (1886-1946): The epitome of adroitness and dexterity in Neurosurgery.

Walter Edward Dandy did pioneering work in Neurosurgery in the early part of the 19th century. He worked all his life at the Johns Hopkins Hospital in USA and contributed extensively to research in hydrocephalus, the physiology of the cerebrospinal fluid and devised the technique of pneumoencephalography, apart from performing the first clipping operation in cerebral aneurysm and the division of the trigeminal nerve in neuralgic pain. This article summarizes his immense contributions in the field of Neurosurgery.

The First CT Scan of the Brain: Entering the Neurologic Information Age.

Computed tomography (CT) scan of the brain transitioned clinical neurology from the educated-guess world to the real computer-age world. One of the first CT scans-published by the British neuroradiologist James Ambrose-showed an intracranial hemorrhage and also suggested the use of iodine to demonstrate abnormal blood-brain barrier. In the USA, CT scans were rapidly commercialized and first placed at Mayo Clinic and Massachusetts General Hospital in the summer of 1973. CT scanning of the brain has revolutionized diagnostic acute neurology and neurosurgery and was the overture to an even larger revolution-magnetic resonance imaging. This historical vignette discusses the development of CT scanning of the brain and its connection with neurocritical care.

Pneumoencephalography in the workup of neuropsychiatric illnesses: a historical perspective.

Throughout history, neurosurgical procedures have been fundamental in advancing neuroscience; however, this has not always been without deleterious side effects or harmful consequences. While critical to the progression of clinical neuroscience during the early 20th century, yet, at the same time, poorly tolerated by patients, pneumoencephalography is one such procedure that exemplifies this juxtaposition. Presented herein are historical perspectives and reflections on the role of the pneumoencephalography in the diagnosis and treatment of neuropsychiatric illnesses.

E. Graeme Robertson--dynamics in fluid and light.

An eponymous lecture at the Australian and New Zealand Association of Neurologists Annual Scientific Meeting commemorates E. Graeme Robertson (1903-75), and some neurologists will know that particular Australian practices in clinical neurology, so far as they exist, have origins in his career. This is a historical article on the literary record of a man who had his own sense of history--an affinity with the past as well as an awareness of future generations of readers. He wrote authoritative texts on pneumoencephalography before new technology made it obsolete, and he produced a series of books on decorative architectural cast iron in Australian cities. A talent for visual interpretation seems to have drawn him to both of these topics; a common theme is contrast between light and dark, which is expatiated in images and in clear, well-written prose in his publications. We review his medical writings, including some largely forgotten principles of cerebrospinal fluid physics that he discovered when researching pneumoencephalography. We also explore his obsession with cast iron--its architectural historical significance, his techniques for photographing it, and some of the ways that it related to his life's work as a clinical neurologist.

Neuroradiology investigations before scanning.

Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X-ray contrast to outline the arteries.

[Investigating Quisling's brain]. / Undersøkelsen av Quislings hjerne.

The trial against Vidkun Quisling (1887-1945) started on 20 August 1945. The question of whether he might suffer from a brain disease came up in court, and on Saturday 25 August he was examined by pneumoencephalography and cerebral angiography on the right side. Nothing pathological was found. Later on it has been claimed that these examinations were "experiments which today would be regarded as life-threatening". This is not correct; they were standard procedures at the time. What is criticizable is that Quisling was brought back to court in a relatively short time after the examinations. This paper gives a brief historic account of the development of the two methods, emphasising the contributions of Norwegian physicians such as Arne Engeset (1906-73) and Leif Emblem (1907-91). It has been claimed that the pneumoencephalography of Quisling has been used as an example of a normal finding from encephalography in the internationally renowned textbook "Clinical examination of the nervous system".

Concepts of neurosurgical management of chronic subdural haematoma: historical perspectives.

The history of chronic subdural haematoma (CSH), spanning from its possibly earliest beginnings throughout the centuries until the early 1980s, was investigated within the context of four different epochs. In the 'era of uncertainty', successful trephination, the modem method of choice for the treatment of CSH, was developed by neolithic men. Various historical sources indicate that patients with CSH might have undergone surgery at that time. CSH might have been one of the ailments that had spectacular courses of salvation after trephination. The entity of CSH was first described in the 'era of pioneers' in the seventeenth century by Johann Jacob Wepfer. The misconception of 'pachymeningitis hemorrhagica interna' was introduced by Rudolf Virchow in 1857. By the end of the nineteenth century it became more widely accepted that trauma was a possible cause of CSH. Successful neurosurgical treatment of CSH was first reported by Hulke in 1883. Putnam and Cushing, in 1925, focused on surgery as the treatment of choice for CSH. In the 'era of diagnostic refinement', the introduction of pneumencephalography and angiography allowed the diagnosis of CSH much earlier. Subsequently, the typical signs and symptoms of patients suffering from CSH changed from apathy and coma to headaches and discrete focal neurological symptoms. In the 'era of surgical routine', neurosurgical approaches became smaller and less invasive. Removal of the haematoma was identified as the primary goal of surgery. The use of closed system drainage markedly improved reexpansion of the brain after surgery. Burr hole craniostomy and twist drill craniostomy became the surgical treatment of first choice because of their low morbidity and mortality. There is growing evidence, however, that the neurosurgical learning curve has reached a plateau.

[Adolf Bengel--the second inventory of lumbar pneumoencephalography]. / Adolf Bingel--Der zweite Erfinder der lumbalen Pneumenzephalographie.

In 1918, Walter Dandy reported contrasting liquor-filled spaces by air for the first time. He published the results in eight pneumencephalographies after lumbar air application in 1919. Without knowing about Dandy's papers Adolf Bingel performed his first lumbar encephalography in 1919. In contrast to Dandy, based on this experience Bingel developed ventricular imaging, improved the technique of lumbar puncture and did a scientific evaluation of the results.