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Unforgettable live-on-stage demo of remote critical care neurosurgery in action.
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Neurosurgery for EveryoneM A R K W I L S O N
@markhwilson
Extracting the Stone or The Cure of Folly
Hieronymous Bosch 1494
“Master, cut away the stone My name is Lubbert Das”
France 6000 BC 40/120 skulls
!
Peru 1000AD 66/411 skulls
Engraving of trephination from Hieronymus Braunschweig’s Buch
der Cirgia 1497
Dr
Dr John Clarke (American) 1664 18th Century, France
Bart Hughes 1962Children have a higher state of consciousness and since children's skulls are not fully closed one can return to an earlier child like state of consciousness by self trephination
www.holeintheheadmovie.com
Heartbeat in the brain
Amanda Fielding, Countess of Wemyss
Ran for MP for Chelsea 1978
But what about
Neur
otRa
uma
If you’re not dead - you should not die
E X T R A D U R A L M A N A G E M E N T
Tension Pneumothorax in your head
Thanks @karelhabig!
I N D I C AT I O N S
• Brain Injury with CT evidence of Extradural Haematoma
• Midline shift / severe effacement
• Pupil dilatation
• Delay in Neurosurgical availability
B U R R H O L E E VA C U AT I O N
Is a thoracostomy for the head…
• Correct side
• Correct location
• Local anaesthesia
• Incision
• Self retainer
• Drill
• Remove inner table
The
Futu
re
V O L U N T E E R ?
P U P I L S
Fixed
Unreactive
Comatosed
Dilated
F U C D• Recent Met analysis n=68
• EDH
• Mortality 30.9% (CI 15.2-49.3)
• Good Outcome 57% (CI 39.-75)
• SDH
• Mortality 73% (CI = 58-85)
• Good Outcome 5.6% (0.9-13.8)
• Prospective Study Needed
@markhwilson
www.goodsam.co.uk