Aneurysmal Subarachnoid Hemorrhage

Critical Care Management of Aneurysmal Subarachnoid Hemorrhage I.         Introduction: A ruptured aneurysm is a neurosurgical emergency. But, most often you will not rush these patients to the operating room. Instead, you can save their lives by: (1) treating hydrocephalus (2) preventing re-rupture (3) avoiding hyponatremia (4) preventing/treating vasospasm (5) avoiding comorbidities (DVT, pneumonia, UTI, seizure). II.         Initial Exam Outline ABC …

Joseph MillerAneurysmal Subarachnoid Hemorrhage

Superior parietal lobule approach

Superior parietal lobule Approach Introduction- The superior parietal lobule provides a surgical corridor between the motor and visual pathways. This approach should be well known to neurosurgeons for evacuation of hematomas, vascular malformations, and neoplasms. Anatomy- The SPL is posterior to the postcentral gyrus and postcentral sulcus. o   Anterior Border- Post central sulcus o   Lateral Border- Intraparietal sulcusThe SPL extends …

Joseph MillerSuperior parietal lobule approach

Upcoming Podcast #3

We are going to mix things up a little bit with podcast #3. Last week we discussed arteriovenous malformations and Schmalzy went on a diatribe about BlueCross/ARUBA trying to kill patients with AVMs. This week will be more practical and we will discuss aneurysmal subarachnoid hemorrhage. The basic scenario we will be addressing is you have a 42 yo with …

Joseph MillerUpcoming Podcast #3

Chiari decompression

Chiari Decompression   Introduction- “there are Chiaris and then there ARE Chiaris”. The key to a successful Chiari operation is to properly define the patients that will benefit the most from a suboccipital craniectomy, C1 laminectomy, and duraplasty. Patients with a Chiari 1 malformation present with a multitude of symptoms and for the large part all have headaches. The characteristic …

Joseph MillerChiari decompression

Mature Teratoma

Joseph MillerMature Teratoma

Maximally Invasive Teaching

Resident surgical education Tonight at Surgical Grand Rounds we had an interesting talk by Debra DaRosa. She is a PhD that specializes in resident surgical education and gives a compelling lecture. Her lecture was centered on several concepts. The basic idea was that people don’t learn if you just throw information at them. Like I mentioned in the introductory podcast, …

Joseph MillerMaximally Invasive Teaching