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Mon May 25 09:59:57 BST 2009

Re: Congratulations to Australian Doctor

I also read this case with great admiration for the doctor, the system and the outcome. However, I would like to give another perspective on blind burr holes. 

I have had to do it a handful of times when in the bush with no possibility of referral/advice (NOT South Africa) and I think it is a HORRIBLE operation. I have only done it with documented decrease in consciousness and localising signs, but I have never found a nice hematoma that could be evacuated with good results; either high pressure brain has come pouring out of the burr hole, or occasionally there has been bleeding that I have not been able to stop satisfactorily. It has always left me feeling far from warm and fuzzy and to be honest, I am now very reluctant to do it.

Am I the only general surgeon/occasional skull trephiner who has never had a patient waking up on the end of the drill?

Miranda Voss
Worcester, South Africa

From: "ramalinga reddy" <drarumalla at yahoo.com>
To: trauma-list at trauma.org
Congrats to Rob Carson for saving the chaild
 Many times doctors are afraid to do such thing for fear of legal implications
 It is the medical faculty which should educate the general public so that 
 litigations are minimised and doctors do such things confidently
 Hats off to Dr RobCarson

Dr.A.R.Reddy 
SKS Neuro Hospitals 
Mobile: 9849018017

--- On Fri, 22/5/09, trauma-list-request at trauma.org <trauma-list-request at trauma.org> wrote:

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Blind burr holes