Coup And Contre-Coup Injury: Observations On The Mechanics Of Visible Brain Injuries In The Rhesus Monkey
Ayub K. Ommaya, M.D., F.R.C.S., Robert L. Grubb, Jr., M.D., and Ronald A. Naumann, M.D.
The distribution of coup and contre-coup contusions and subdural hematomas after frontal and occipital impacts has been studied in the rhesus monkey. The effect of skull fracture on these lesions is noted, and the data compared to known postmortem observations in man. The translation/cavitation theory for brain injury as presently conceived is not supported by these data. The skull distortion and head rotation hypothesis offers opportunities for developing a better theory for brain injury by direct as well as indirect impact. The significance of these observations for design of protective devices is briefly discussed.
Ayub K. Ommaya, 78; Neurosurgeon and Authority on Brain Injuries
Washington Post Staff Writer
Monday, July 14, 2008
Dr. Ayub Khan Ommaya, 78, a neurosurgeon, an internationally known expert on brain injuries and the inventor of a device that facilitates treatment of brain tumors, died July 10 at his home in Islamabad, Pakistan, of complications from Alzheimer’s disease.
The longtime Bethesda resident was a retired chief of neurosurgery at the National Institute of Neurological Disorders and Stroke and professor of neurosurgery at George Washington University.
Before Dr. Ommaya’s work in the 1960s, there was no effective way to deliver chemotherapy treatments for brain tumors. His invention of the Ommaya reservoir, a plastic dome-shaped device with a catheter attached to the underside, made possible the delivery of chemotherapy to the brain and spinal cord. In addition, the device served as a prototype for all medical ports now in use.
Dr. Ommaya also developed the centripetal theory of traumatic brain injury, which allowed scientists to understand and model how brains are affected by blunt force. As chief medical adviser to the National Highway Traffic Safety Administration and director of NHTSA’s head injury prevention program, he created a model for brain injuries that led to design changes and the development of safety devices in motor vehicles worldwide.
Known as the “singing neurosurgeon,” Dr. Ommaya was a trained opera tenor who often sang before and after surgery, to the delight of patients and their families and his hospital colleagues.
Born in Rawalpindi, Pakistan, he was a national champion swimmer. He received his medical degree from King Edward Medical College in Pakistan in 1953 and, as a Rhodes Scholar, received his master’s degree from Balliol College, Oxford University, in 1956. During medical school, he trained as an amateur boxer and was a member of the crew team at Balliol.
He came to the United States in 1961 as a visiting scientist at the National Institutes of Health and later became an associate neurosurgeon. He was chief of neurosurgery from 1974 to 1979 and began teaching at George Washington University in 1970.
In 1977, Dr. Ommaya was part of a team of GWU surgeons that saved the life of a Rochester, N.Y., teacher by removing a snake-like tangle of blood vessels at the base of his brain, a rare abnormal growth that had paralyzed both his arms and legs and was threatening to cut off his breathing. In a history-making operation that lasted 19 hours, the man was chilled for a time to 65 degrees, his heart and lung were stilled and his brain activity was halted.
Dr. Ommaya, who told The Washington Post that he got through the surgery on just a couple of candy bars, said that it was “like dissecting out hundreds of tiny snakes — you have to dissect them out individually without cutting them or damaging the nerves and the spinal cord.”
As a transportation safety expert, he commissioned “Injury in America” (1985), a report that led to the creation of the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. The center provides synthesis, direction and funding for the field.
He also invented an inflatable collar, similar to an airbag, that attaches to motorcycle helmets as a protection against spinal injury.
In 1997, Dr. Ommaya was called as a defense expert witness in the highly publicized trial of Louise Woodward, a British au pair accused of killing an 8-month-old baby in her care. He maintained that the child, Matthew Eappen, could not have been killed by violent shaking, as prosecutors claimed.
Sitting in the witness stand of a Cambridge, Mass., courtroom, he bounced a wad of Silly Putty on the floor to illustrate the damage that could be caused by impact. “The demonstration elicited a burst of laughter from jurors and observers — a rarity in a trial that has featured emotionally wrenching testimony from the baby’s parents and others,” the Patriot Ledger (Quincy, Mass.) reported at the time.
Dr. Ommaya retired in 2001.
His marriages to Parvaneh Modaber and Wendy Preece ended in divorce.
Survivors include his wife of 28 years, Ghazala N. Ommaya of Bethesda and Islamabad; three children from his second marriage, David Ommaya of Los Angeles, Alexander Ommaya of Bethesda and Shana Ommaya of Vienna; three children from his third marriage, Asha Ommaya of London and Iman Ommaya and Sinan Ommaya, both of Bethesda and Islamabad; two brothers; a sister; and five grandchildren.