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PIONEERS IN NEUROLOGY

Theodore Brown Rasmussen (19102002)

Frank W. Stahnisch

Amy S. Nakashima

Received: 13 November 2012 / Revised: 24 January 2013 / Accepted: 29 January 2013 The Author(s) 2013. This article is published with open access at Springerlink.com

Abstract Dr. Theodore Rasmussen was a Canadianneurosurgeon, neurologist, and neuropathologist who pri-marily specialized in the treatment and histopathology of epilepsy. In addition to his eponym, Rasmussen syn-drome, a chronic form of encephalitis accompanied byepilepsy, his contributions included the renement of neurosurgical techniques, thoroughly cataloguing out-comes following surgery for epilepsy, and cortical mappingstudies conducted with Dr. Wilder Peneld.

Keywords Calgary Epilepsy therapy Hemispherectomy History of medicine Montreal Theodore Rasmussen 20th century

In the history of medicine, innovations are often accom-panied by great curiosity, along with strong criticisms; such

phenomena can likewise be seen as antecedents of revolu-tionary change in clinical practice and medical theory [ 10].This was the case with the Canadian neurological surgeonDr. Theodore Rasmussen (19102002), who specialized inneurological and surgical treatments for epilepsy [ 3]. WhileRasmussen is associated with Rasmussens Syndrome [ 1],a pediatric condition he characterized, in which chronicencephalitis is accompanied by epileptic seizures, his con-tributions to neuroscience extend well beyond this epony-mous disease.

Rasmussen was born in Provo, Utah, the son of AndrewT. Rasmussen (18831955), who later became a neuroanat-omy professor at the University of Minnesota [ 5]. TheodoreRasmussen received his medical training at that sameuniversity, where he graduated in 1934, before beginning atwo-year internship at Kings County Hospital in Brooklyn.Between 1936 and 1939, he was a Fellow in Neurology at theinnovative Medical Facultyof the Mayo Clinic in Rochester,Minnesota, continuing his neurosurgical training between1939 and 1942 at the Montreal Neurological Institute (MNI)in Canada under the eminent neurosurgeons Wilder GravesPeneld (18911976), William Cone (18971959) andArthur Elvidge (18991985). He received an M.Sc. researchdegree in neurology in 1939, but after completion of hispostgraduate training Rasmussen was conscripted intothe US Army Medical Corps. He was made the chief of theneurosurgical section of the 14th Evacuation Hospital onthe Ledo Road in the ChinaIndiaBurma war zone. He wasnot discharged until 1945, after which he returned to Canadaand became a Clinical Lecturer in Neurology and Neuro-surgery at McGill University. Only two years later,Rasmussen received a Professorship in Neurological Sur-gery at the University of Chicago and married his Canadianance e, Catherine Archibald (19211998). They lived inChicago until 1954, when Rasmussen returned to Montreal

F. W. Stahnisch ( & ) A. S. NakashimaDepartments of Community Health Sciences and History,Hotchkiss Brain Institute and Institute for Public Health,University of Calgary, 3280 Hospital Drive N.W., Calgary,AB T2N 4Z6, Canadae-mail: fwstahni@ucalgary.ca

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as a professorat McGill,whilealso serving as Neurosurgeon-in-Chief at the Royal Vic (Victoria Hospital). He later wenton to succeed Peneld as the director of the MNI, servingfrom 1960 to 1972 [ 4].

Surgical treatment options for epilepsy had been mark-edly advanced in Germany by the Breslau neurologistOtfrid Foerster (18731941), with whom Peneld had

learned his operative techniques during two research peri-ods in 1928 and 1931. Upon returning from Europe,Peneld successfully developed a similar treatment centrein Montreal, where patients cortices were neurophysio-logically mapped and stimulated in intraoperative settings.Together with his mentor Peneld and a number of German-speaking e migre neuroscientists, among whomwere Jerzy Olszewski (19131964) and Fred Andermann(b. 1930), Rasmussen succeeded in further developingneurological and operative treatment options for epilepsy[9]. As a most versatile neurological surgeon, he laterpioneered hemispherectomy as a curative therapy tosuppress the cortical spread of pathologic activity inintractable epilepsy. This option became used in childrenwhose brains were sufciently plastic to adapt to the loss of half the cortex, allowing physiological functions to berelearned even after such a drastic operation [ 7].

Rasmussens collaboration with Peneld culminated inthe seminal work, The Cerebral Cortex of Man, in whichtheir intricate electrostimulatory and neurosurgical ndingswere published [ 6]. Together with the JapaneseCanadianphysician Juhn Atsuhi Wada (b. 1926), he further intro-duced intracarotid amobarbital tests for the functional lat-eralization of speech and memory, a research approach thatwas complementary with Rasmussens efforts to preservefunction when removing damaged neural tissue in epilepticpatients. In addition, he was a pioneer in pituitary glandsurgery and also performed innovative operations inpatients with cerebral and spinal tumours. Through hiscompilations of large data-sets that documented the out-come of epilepsy surgery, Rasmussen explored the ef-ciency of his surgical techniques, while also characterizingthe histopathology of chronic encephalitis in severalconditions:

We compared 100 patients with temporal lobe epi-lepsy, who exhibited the running down phenomenon (i.e.postoperative seizures that eventually remit following aperiod of months to years) following temporal resections,with two groups of patients ( ). We found a signicantcorrelation between prognosis and the size of the epilep-togenic area as dened [ 8].

Rasmussens thorough epidemiological research pro-gram, which examined the plastic adaptation of the humancortex after removal of epileptic tissue, sustained hisimpact on medicine beyond his time as an active neuro-surgeon and director of the MNI, while laying the basis for

his legacy as an outstanding investigator and teacher inclinical neuroscience. During the rst three postwar dec-ades, Rasmussen had probably performed more operationsfor epilepsy than most contemporary neurosurgeons. Hewas a member of The Society of Neurological Surgeonssince 1950, its president in 1970, and was eventuallyhonoured with the Societys Distinguished Service Award

in 1989. A number of his trainees later went on to headneurosurgery departments throughout North America. As aprivate man, Rasmussen was also a musician, playing boththe clarinet and saxophone, and had used these talentsalready to supplement his allowance in his early medicalschool days. His colleagues and students warmly rememberRasmussen for his social amenability and educationaltalents:

He was always precise and deliberate; rounds wereconducted at a half-trot. His aphorisms became part of themental fabric of all his trainees. Must not do that. Do not jiggle the brain, and Put up the side rails; the bed is highand the oor is hard, spring to mind. While not effusive inhis manner, he was never unkind or sarcastic [ 2].

After the death of his wife in 1998, he relocated west-ward from Montreal in Quebec to be with his children inCalgary, Alberta, where he was frequently approached bymembers of the Calgary Pathology Department who askedforadvice on histopathological specimensfrom patients withsevere epilepsy and brain tumours. Theodore Rasmussenpassed away in 2002.

Acknowledgments We are grateful for support from the MackieFamily Collection in the History of Neuroscience, the Hotchkiss

Brain Institute, the Institute for Public Health, the Osler Library of theHistory of Medicine and a CIHR Grant (No/EOG-123690). We gra-ciously thank Drs. Francis LeBlanc and Terence Myles (Calgary), aswell as Dr. William Feindel and Mr. Duncan Cowie (McGill) for theirassistance.

Conicts of interest On behalf of all authors, the correspondingauthor states that there is no conict of interest.

Open Access This article is distributed under the terms of theCreative Commons Attribution License which permits any use, dis-tribution, and reproduction in any medium, provided the originalauthor(s) and the source are credited.

References

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3. Feindel W (2003) Theodore Brown Rasmussen (19102002):epilepsy surgeon, scientist and teacher. J Neurosurg 98:631637

4. Gray C (1982) Theodore Brown Rasmussen. Can Med Assoc J126:202

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7. Rasmussen T (1983) Hemispherectomy for seizures revisited.Can J Neurol Sci 10:7178

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