Objectives of Neurosurgery after Brain Injury

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.