How'd you treat this unfortunate young boy with a chopstick penetrating three inches into his brain? #neurosurgery #trauma (case published online)
He accidentally shoved it up his nose.
His father said that the first he knew of the accident was when he heard him scream, and he said, “I turned around and was shocked to find that the long stick had gone into his head from his nose.”
Patient had great outcome despite awful event

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More from @OGdukeneurosurg

Jan 21
Bye bye anterior temporal lobe filled with tumor. Get a peak at underlying skull base.
See how dissection by @neurosurgatlas started with initial corticectomy. Note how valuable the suction is for subpial dissection. Note there was additional tumor removal after lobectomy.
See full education and video here neurosurgicalatlas.com/cases/medial-t…
Read 4 tweets
Jan 18
Champagne tap lumbar puncture is good, but a perfectly placed, first pass EVD in a patient with slit ventricles is so Rock Star.
How to place an external ventricular drain…
Indications include elevated intracranial pressure in trauma, stroke, brain bleed, infection, or hydrocephalus.
Read 4 tweets
Jan 16
Surgeons and Surgery People, what advice would you give to “New to OR” med students, nurses, techs etc?
It’s great to ask ?’s, but timing is key. When everyone is quiet, tense, & focused on a complex step, it’s not ideal to say I read a chapter about surgery, & would you show me anatomy you’re looking at, names & functions of tools, & all complications you’re worried about.
Discussing and learning from patient’s care is always good, but side conversations that are so loud or random they interfere with surgeon and team communication is not good.
Read 4 tweets
Jan 16
The pineal gland, located deep in brain, was described as the seat of the soul by Descartes, a center for all thoughts. He was wrong, but see this very cool endoscopic video of pineal region anatomy & surgery. 🧵
The pineal gland (green) is an endocrine organ, which produces the hormone melatonin in amounts which vary with the time of day.
Different lesions of pineal region
Read 5 tweets
Jan 15
Beautiful view of sella dura being opened up and resection of pituitary adenoma. 🧵
Relevant anatomy of pituitary adenomas
How a pituitary adenoma impacts vision
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Jan 8
The skull flap can come off this easily…
But it’s also possible to rip a brain tumor right out of the brain on bone flap removal… so be careful.
Read 4 tweets

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