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Hi, this is Attorney Gordon Johnson. I want to talk about some of the objectives of neurosurgery
or brain surgery. As we talked about in our previous video, the single biggest thing that
typically is a risk factor after a severe brain injury is the increase in intracranial
pressure that comes from the flow of blood into the brain without it being properly drained
out of the brain or as a result of a bruise which creates swelling much like your ankle
might swell up. The objectives or neurosurgery are really two-fold. One would be to go in
and actually fix a bleed, going in a repair the blood vessels that's bleeding, or two,
to do something that will reduce the intracranial pressure or give that swelling and that phenomenon
that's causing the intracranial pressure someplace to go. Anytime they do brain surgery they
obviously have to find a way inside the skull and they will typically do that by removing
some type of a bone flap. It wouldn't be as big as taking off the top of the skull like
I just did here, but they might take, make a flap perhaps as big as a quarter of this
top half in my hand, and they do that by making drill holes like you might in woodworking
shop, drill holes, and then taking a little saw and connecting those holes and removing
the flap. Now if they take the flap out, go and do the surgery and put the flap back that's
typically called a craniotomy. If they go in and leave the flap off for an extended
period of time, to give the swelling someplace to go and allow the brain to expand into an
area that isn't compressed by the skull that might be called a craniectomy. A craniectomy
is where they actually leave the bone flap off for a substantial period of time. As you
can see if it was as dramatic as the entire top, you would have the brain having lots
of room to expand and allowing it more room. But they don't take that much off, they take
off enough to reduce the pressure. Now the other thing they may do is put in a drain
to drain off some of the excess fluids. They would typically call that a shunt, now the
drain will go off someplace else on the body where the amount of fluid isn't as critical
as it would be inside the brain.