William E. Hunt
William Edward Hunt (1921 – 1999) was an American neurologist and neurosurgeon.
Born in Columbus as the fifth physician in four generations of his family, Hunt graduated with honors and as a Phi Beta Kappa member from Ohio State University. He would then go on to work in the United States Army as a general surgeon for two years, before returning to his alma mater to train, work and eventually become the head of the division of neurological surgery, where he presided for over 25 years.
Hunt was a well-renowned neurosurgeon of his time, internationally known for his work in cerebral vasculature and spinal cord injury, and was the first person to ever receive the Lifetime Achievement Award of the Neurological Society of America.
He is eponymous with the ophthalmologic entity Tolosa-Hunt syndrome, and the Hunt-Hess classification for intracranial haemorrhages.
Biography
- Born 26 November 1921 in Columbus, Ohio
- 1943 – Graduated Bachelor of Arts cum laude from Ohio State University
- 1945 – Graduated Doctor of Medicine with honors from Ohio State University
- 1945-1946 – Intern at the Philadelphia General Hospital
- 1946-1948 – General surgeon in the Medical Corps of the United States Army
- 1948-1949 – General surgery at the White Cross Hospital in Columbus
- 1949-1952 – Neurosurgical training under Dr. Henry G. Schwartz, Barnes Hospital of the University of Washington
- 1953-1991 – Faculty member of the Ohio State College of Medicine
- 1964-1989 – Director of the Division of Neurological Surgery at Ohio State University
- 1968-1974 – Served on the American Board of Neurological Surgery
- 1973-1988 – Principal and Director of the Center for Spinal Cord Injury Research at Ohio State University
- 1988 – Awarded the first Lifetime Achievement Award of the Neurological Society of America and its Gold Medal
- Died 26 January 1999, due to a recurrent rupture of his thoracic aorta
Medical Eponyms
Tolosa-Hunt syndrome (1954, 1961)
A severe unilateral periorbital headache and ophthalmoplegia resulting from a non-caseating granulomatous inflammation of the cavernous sinus and/or superior orbital fissure. Etiology is often idiopathic, but it may be triggered by trauma, aneurysms, or tumors in the area.
First officially described by Eduardo Tolosa in 1954.
William Hunt, alongside John Meager, Harry LeFever, and Wolfgang Zeman, described six cases of painful ophthalmoplegia believed to be related to an inflammatory lesion in the cavernous sinus in their 1961 paper ‘Painful opthalmoplegia. Its relation to indolent inflammation of the cavernous sinus’. The cases span from a period of 1953 (pre-dating Tolosa’s publication) and contain the first classification of Tolosa-Hunt Syndrome.
Pain may precede the ophthalmoplegia by several days. or may not appear until some time later. It is not a throbbing hemicrania occurring in paroxysms, but a steady pain behind the eye that is often described as “gnawing” or “boring”
- Pain may precede the ophthalmoplegia by several days. or may not appear until some time later. It is not a throbbing hemicrania occurring in paroxysms, but a steady pain behind the eye that is often described as “gnawing– or “boring”
- Neurologic involvement is not confined to the third cranial nerve, but may include the fourth, sixth, and first division of the fifth cranial nerves. Periarterial sympathetic fibers and the optic nerve may be involved.
- The symptoms last for days or weeks.
- Spontaneous remission occurs, sometimes with residual neurologic deficit.
- Attacks recur at intervals of months or years.
- Exhaustive studies, including angiography and surgical exploration, have produced no evidence of involvement of structures outside the cavernous sinus. There is no systemic reaction.
Hunt-Hess Scale (1968)
A graded scale used to predict the rate of mortality based solely on the clinical features seen in a patient presenting with an aneurysmal subarachnoid haemorrhage.
William Hunt, alongside his resident at the time Robert Hess, originally developed this scale to determine the surgical risk in patients presenting with aneurysmal subarachnoid haemorrhages. The scale is a modified version of Edmund Botterell’s classification.
It is generally agreed that the surgical risk in intracranial aneurysm is closely related to the patient’s condition at the time of surgery, as well as to other factors such as age, associated disease, and the location of the aneurysm…we have felt that the intensity of the meningeal inflammatory reaction, the severity of neurological deficit, and the presence or absence of significant associated disease should provide the best clinical criteria for the estimate of surgical risk.
Hunt, Hess 1968
Key Medical Attributions
Hunt was featured in an interview hosted by the American Association of Neurological Surgeons, where he details his contributions to the management of aneurysms as well as his eponymous classification.
Major Publications
- Hunt WE, Meagher JN, Lefever HE, Zeman W. Painful opthalmoplegia. Its relation to indolent inflammation of the carvernous sinus. Neurology. 1961; 11: 56-62 [Tolosa-Hunt syndrome]
- Hunt WE, Meagher JN, Barnes JE. The Management of Intracranial Aneurysm. J Neurosurg. 1962; 19(1): 34-40
- Hunt WE, Meagher JN, Hess RM. Intracranial aneurysm. A nine-year study. Ohio State Med J. 1966; 62(11): 1168-1171.
- Hunt WE, Hess RM. Aneurysm of the posterior cerebral artery with unexpected postoperative neurological deficit. Case report. J Neurosurg. 1967; 26(6): 633-5.
- Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968; 28(1): 14-20. [Hunt-Hess classification]
- Hunt WE. Tolosa-Hunt syndrome: one cause of painful ophthalmoplegia. J Neurosurg. 1976; 44(5): 544-549
- Hunt WE. Presidential Address to the Neurosurgical Society of America. Neurosurgery 1980; 6(2): 121–122
- Hunt WE, Brightman RP. The Tolosa-Hunt syndrome: a problem in differential diagnosis. Acta Neurochir Suppl (Wien). 1988;42:248-52.
References
Biography
- Faculty Information Services. Ohio State University News Services. July 24, 1974.
- Saxon W. William E. Hunt, 77; Neurosurgeon Developed Aneurysm Classification System. New York Times. Jan 31, 1999.
- Paulson GW. Pioneers of Neuroscience in Central Ohio. Housecall. 2002; 5(3): 2.
Hunt-Hess
- Botterell EH, Lougheed WM, Scott JW, Vandewater SL. Hypothermia, and interruption of carotid, or carotid and vertebral circulation, in the surgical management of intracranial aneurysms. J Neurosurg. 1956 Jan;13(1):1-42.
- Aulmann C, Steudl WI, Feldmann U. Validierung der prognostischen Aussagekraft neurochirurgischer Aufnahmeskalen nach Rupturen zerebraler Aneurysmen. Zentralbl Neurochir. 1998; 59(3): 171-80.
- Rosen DS, Macdonald RL. Subarachnoid hemorrhage grading scales: a systematic review. Neurocrit Care. 2005; 2(2): 110-8
Tolosa-Hunt
- Smith JL, Taxdal DS. Painful ophthalmoplegia. The Tolosa-Hunt syndrome. Am J Ophthalmol. 1966 Jun;61(6):1466-72.
- Kline LB, Hoyt WF. The Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiatry 2001; 71: 577–82.3083.
- La Mantia L, International Headache Society. Tolosa-Hunt syndrome: critical literature review based on IHS 2004 criteria. Cephalalgia 2006; 26(7): 772–781.
- Colnaghi S et al. ICHD-II diagnostic criteria for Tolosa-Hunt syndrome in idiopathic inflammatory syndromes of the orbit and/or the cavernous sinus. Cephalalgia. 2008; 28(6): 577-84
Lewis is an RMO at Royal Perth Hospital. He is currently interested in critical care medicine.
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Bill was married to Charlotte Curtis, Lifestyle Editor and later Op-Ed page editor of the New York Times. He was brilliant.