List Archives

Tue May 26 14:53:30 BST 2009

We used to make 4 burr holes on the side suggested by lateralization,
usually were  lucky to evacuate clot through one of them. But the main
problem was that in 30-35 % of cases there was no evacuable hematoma inside.
Jarek

2009/5/26 Miranda Voss <mvossak at yahoo.co.uk>

>
> No, truly blind, most recently in Burundi just after the war when we
> couldn't even get a plain x ray.
>
> Didn't realise the Australian case was post-scan and thought the general
> flavour of the posts suggested that all you need in a remote environment is
> a Black and Decker, a doctor with a bit of backbone and a non litiginous
> environment and all will be well. Clearly not! My misunderstanding.
>
> It can be very difficult to find the clot without a scan and I hope I never
> have to do it again.
>
> Miranda Voss
> Worcester, South Africa.
>
>
> The Australian story was post-CT demonstrating an extra-axial
> collection.....are your cases truly blind or post CT? -
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Miranda Voss
> Sent: Monday, 25 May 2009 9:00 p.m.
> To: trauma-list at trauma.org
>  Subject: Blind burr holes
>
>
> 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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-- 
_______________________
Jarek Gucwa

jarekgucwa at gmail.com

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Blind burr holes