Wilson: Neurosurgery for Everyone

•

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SMACC Conference

Unforgettable live-on-stage demo of remote critical care neurosurgery in action.

Gesundheit & Medizin Seele & Geist

Neurosurgery for Everyone
M 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 1962
Children 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

Heartbeat in the brain
Amanda Fielding,
Countess of Wemyss
Ran for MP for
Chelsea 1978

But what about
Neuro
tRaum
a
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

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

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

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