Wilson: Neurosurgery for Everyone

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

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Wilson: Neurosurgery for Everyone

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

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