Wilson: Neurosurgery for Everyone

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

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

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  • 1. Neurosurgery for Everyone M A R K W I L S O N @markhwilson
  • 2. Extracting the Stone or The Cure of Folly Hieronymous Bosch 1494 “Master, cut away the stone My name is Lubbert Das”
  • 3. France 6000 BC 40/120 skulls ! Peru 1000AD 66/411 skulls
  • 4. Engraving of trephination from Hieronymus Braunschweig’s Buch der Cirgia 1497 Dr Dr John Clarke (American) 1664 18th Century, France
  • 5. 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
  • 6. www.holeintheheadmovie.com
  • 7. Heartbeat in the brain Amanda Fielding, Countess of Wemyss Ran for MP for Chelsea 1978
  • 8. But what about Neuro tRaum a If you’re not dead - you should not die
  • 9. 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
  • 10. Thanks @karelhabig!
  • 11. 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
  • 12. 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
  • 13. TheFuture
  • 14. V O L U N T E E R ?
  • 15. P U P I L S Fixed Unreactive Comatosed Dilated
  • 16. 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
  • 17. @markhwilson
  • 18. www.goodsam.co.uk