Obituary: Professor Edward Hitchcock

Edward Robert Hitchcock, neurosurgeon: born Rhymney, Monmouthshire 10 February 1929; FRCS 1959; Senior Lecturer and Reader in Surgical Neurology, Edinburgh University 1965-78; FRCS Ed 1970; ChM (Birm) 1973; Professor of Neurosurgery and Head of Department, Birmingham University 1978-93; Honorary Consultant Neurosurgeon, Midland Centre for Neurosurgery and Neurology 1978-93; married 1953 Jill Trenowath (three sons, one daughter); died Smethwick, Birmingham 29 December 1993.

EDWARD HITCHCOCK was Professor of Neurosurgery at Birmingham University, based at the Midland Centre for Neurosurgery and Neurology at Smethwick; a man of enormous vitality, with the imagination to devise new methods of neurosurgical treatment, and the initiative and courage to implement them. In making these advances he had exceptional support from his patients, many of them severely disabled, who placed great trust in him. His main research interests were in stereotactic surgery (a special method for performing neurosurgery deep within the brain), neuroprosthetics, brain tumours and neural transplantation. In particular he was a pioneer in treating Parkinson's disease by neural transplantation.

Hitchcock trained in neurosurgery at Oxford and Manchester. Before coming to Birmingham in 1978, he was for 13 years Senior Lecturer and then Reader in Surgical Neurology at Edinburgh, where he established an international reputation in stereotactic and functional neurosurgery with special reference to the operative treatment of intractable pain - for which he devised new operative procedures involving the brain stem and spinal cord - and to the neurosugical treatment of epilepsy causing psychiatric disorders.

Once at the Midland Centre for Neurosurgery and Neurology (MCNN), Hitchcock soon established it as a centre of international standing for stereotactic and functional neurosurgery. Neurosurgeons came from many countries to study with him; he treated many patients from abroad. He developed his own stereotactic frame, a device to direct electrodes, probes and radiotherapy accurately to target sites within the brain and spinal cord. With this frame system, now used in many neurosurgical centres, Hitchcock treated large numbers of patients with diverse clinical problems including intractable pain, movement disorders (especially Parkinson's disease), brain tumours and cerebrovascular malformations. During stereotactic operations he made extensive studies of the physiological function of structures deep within the human brain and spinal cord.

In Britain Hitchcock led the use of stereotactic techniques to biopsy brain tumours and to drain intracranial cysts and abcesses, and he introduced the technique of stereotactic radiosurgery in which irradiation from a linear accelerator is concentrated stereotactically to treat cerebrovascular malformations and certain brain tumours.

He continued a long-standing research interest, regrettably unfinished, in the development of a visual prosthesis to work on the brain to treat blindness.

In 1988 there was great interest world-wide when Hitchcock first reported the treatment of severe Parkinson's disease by the stereotactic implantation in a patient's brain of neural tissue taken from foetuses that had been aborted spontaneously. This work was controversial. Anti-abortionists protested at the use of foetal material. Some clinicians and neurobiologists questioned the timing of the experiment and certain details of the techniques. However there was great support from patients with severe disability who could see no prospect of getting improvement with conventional medications.

Despite the severity of their disease some of those treated by Hitchcock showed clinical improvement. With support from the Parkinson's Disease Society, especially from its branches at Walsall and elsewhere in the Midlands, Hitchcock continued to treat patients by this method, always with strict protocols and independent clinical assessment to enable the long-term results to be evaluated properly. Biologically, follow-up studies have shown the survival of foetal cells implanted by Hitchcock in the brains of patients with Parkinsonism - an important advance in neural transplantation. Clinically the technique is still experimental, though regarded widely as having great promise for the treatment of Parkinson's disease and possibly for other neurodegenerative disorders.

Hitchcock additionally treated large numbers of patients whose problems required the more common, though nonetheless demanding, operations of general neurosurgery.

Hitchcock's academic life was very full. At Birmingham his laboratory research concentrated on neural transplantation, issues relevant to his clinical treatment of Parkinson's disease, and neuro-oncology, the biology of intracranial tumours. In scientific journals he wrote more than 170 articles dealing with his clinical or laboratory research; he made major contributions to more than 30 books and monographs. He was an active member of many neurosurgical societies round the world. He organised large scientific meetings with flair. He was an excellent chairman and from the floor would join vigorously in scientific debate. His contributions were well expressed, often amusing, always fair.

Hitchcock put new life into the teaching of clinical neuroscience at Birmingham. Medical undergraduates were attracted by his dynamic teaching and learned much from his clear exposition. To neurosurgeons in training he was stimulating, approachable and supportive.

Socially he was outstanding. He mixed easily with people of all backgrounds. He was a generous and most welcoming host and an excellent companion whose wide-ranging conversation could enliven any occasion. He spoke well on radio: one thinks especially of his BBC series concerned with the various stages of a medical career and of his contributions to a Radio 3 series concerned with the meaning of words. He also had a convincing presence on television and the gift of expressing neurosurgical issues, including ethical and technical ones, in words that made things clear to the lay public. An excellent BBC documentary dealt with his stereotactic brain implantation to treat Parkinson's disease. It was characteristic of him that this should emphasise the team aspect of his work and the hopes and fears of the patients being treated. The programme was also remarkable for having been produced by his son - a source of lasting pleasure and satisfaction to them both and to their friends.

In the little time he had available for recreation he entered with zest into activities such as dry-fly fishing and the flying of microlite aircraft.

Edward Hitchcock had a lively, creative mind with boundless energy and the courage to put surgical advances to the test. He never spared himself in looking after his patients who admired and trusted him. His life as a doctor was a splendid witness to his Christian faith. His premature and totally unexpected death is a tragedy for his patients, for his hospital colleagues and for neurosurgery.

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