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Question for our doctors
Topic Started: Jan 11 2011, 10:47 AM (398 Views)
kenny
HOLY CARP!!!
That congresswoman had brain surgery and they said they left part of her skull removed in anticipation of brain swelling.

So, how do they bandage her head with the skull gone?
Is something actually touching her brain and if not wouldn't it dry out?
How do they keep the removed skull and skin tissues alive till they are ready to put it back?
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Kincaid
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HOLY CARP!!!
Ick. I had a friend whose wife had to have the top of her head taken off due to swelling. He described it like taking the top off a Halloween pumpkin.
Kincaid - disgusted Republican Partisan since 2006.
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George K
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Finally
Couple of options:

1) The brain swelling is the major concern. To allow the brain to swell without compressing its vascular supply, the surgeon might remove part of the skull, and implant it into the abdominal wall to keep the bone alive. Then, he just closes the scalp over the defect. The soft skin/scalp will allow some swelling without the pressure of the bone. REmember, the skull is made of bone and there is very little room available for brain swelling. Once the danger has passed, a week or so after the injury, the patient is taken back to the OR, the piece of skull is removed from the abdominal wall, and put back into place.

2) If the bone cannot be salvaged, the surgeon fabricates a piece of artificial skull from a piece of titanium mesh with bone-like stuff (cement) put into it. THat is then placed in the defect, and the scalp covers it.

I had a lady about 6 months ago who had a tumor growing into her skull from the inside (metastatic breast), and there was no way to salvage the bone, so the titanium mesh was used.
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Mikhailoh
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If you want trouble, find yourself a redhead
Amazing.
Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball
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The 89th Key
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Truly
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kenny
HOLY CARP!!!
Wow, amazing.

So when the bone fragment is placed into the abdomen it is it connected to blood vessels, or does bone not need blood?
Why doesn't the immune system attack it?

I'm just trying to bone up on these things.
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bachophile
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HOLY CARP!!!
i dont do heads. i know nothing of neurosurgery,

i do belly.

sometimes we keep the belly open. sometimes with a bogota bag (look it up)


Edited by bachophile, Jan 11 2011, 12:00 PM.
"I don't know much about classical music. For years I thought the Goldberg Variations were something Mr. and Mrs. Goldberg did on their wedding night." Woody Allen
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George K
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Finally
bachophile
Jan 11 2011, 12:00 PM
i dont do heads. i know nothing of neurosurgery,
We have a sign on the door to OR 7 - that's the heart room. It says, "THIS ISN'T BRAIN SURGERY."
Quote:
 
So when the bone fragment is placed into the abdomen it is it connected to blood vessels, or does bone not need blood?
It needs some, but not like muscle or organs. The passive transfer of nutrients from the abdominal wall is enough to keep it alive.
Quote:
 
Why doesn't the immune system attack it?
It's your own bone. The immune system sees it as such.
Quote:
 
sometimes we keep the belly open. sometimes with a bogota bag (look it up)
I hate that.

Even worse is when you can't close the chest after a heart. We used to take a piece of V-Drape (look it up) and suture it to the edges of the wound. Then, if the patient survived for 3-4 days, we'd bring them back and wire the sternum shut.

I hate that more.
Edited by George K, Jan 11 2011, 12:09 PM.
A guide to GKSR: Click

"Now look here, you Baltic gas passer... "
- Mik, 6/14/08


Nothing is as effective as homeopathy.

I'd rather listen to an hour of Abba than an hour of The Beatles.
- Klaus, 4/29/18
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Big John
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Senior Carp
you know how you want to cross your legs during some conversations? I was like cringing trying to cross my head but it didn't work.





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VPG
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Pisa-Carp
I had brain surgery ( twice) about four years ago. I was told in my case they opened it like a flap (twice) and re closed it. The cut is shapped like a reversed question mark. Starts at my hair line above my forehead and ends in front of my right ear. They had a drain in it for quite some time. I lived !
I'M NOT YELLING.........I'M ITALIAN...........THAT'S HOW WE TALK!


"People say that we're in a time when there are no heroes, they just don't know where to look."
Ronald Reagan, Inaugural, 1971

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Big John
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Senior Carp
wow.

All I ever had was a crushed face from slamming into the windshield post at 60mph in a freeway head-on. the top part of my skull stayed intact but the eye sockets, cheeks, nose bridge, jaw and roof of my mouth weren't nearly so lucky.





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Piano*Dad
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Bull-Carp
Drilling into the head is a rather old practice, and in the past it was sometimes done for the right reasons!

Trepanning

Stephen Maturin performed the technique to drain fluid and release swelling in Master & Commander.
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kenny
HOLY CARP!!!
Piano*Dad
Jan 11 2011, 12:14 PM
Charming. Posted Image
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KlavierBauer
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HOLY CARP!!!
You've all already seen my open chest...


This brain stuff is amazing.
"I realize you want him to touch you all over and give you babies, but his handling of the PR side really did screw the pooch." - Ivory Thumper
"He said sleepily: "Don't worry mom, my dick is like hot logs in the morning." - Apple

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