Neurosurgeons utilize specialized drills and techniques to penetrate the skull without damaging underlying brain tissue
the verdict
SUPPORTED
the evidence backs this
refutedsupported
the weight of evidence
6 sources for · 0 against
Peer-reviewed literature documents that neurosurgeons use specialized cranial drilling tools and techniques designed to create holes in the skull while preventing damage to the underlying brain tissue.
A handheld, portable cranial drilling tool for safely creating holes in the skull without damaging brain tissue is presented. Such a device is essential for neurosurgeons and mid-level practitioners treating patients with traumatic brain injury. A typical procedure creates a small hole for inserting sensors to monitor intra-cranial pressure measurements and/or removing excess fluid. Drilling holes in emergency settings with existing tools is difficult and dangerous due to the risk of a drill bit unintentionally plunging into brain tissue. Cranial perforators, which counter-bore holes and automatically stop upon skull penetration, do exist but are limited to large diameter hole size and an operating room environment. The tool presented here is compatible with a large range of bit diameters and provides safe, reliable access. This is accomplished through a dynamic bi-stable linkage that supports drilling when force is applied against the skull but retracts upon penetration when the reaction force is diminished. Retraction is achieved when centrifugal forces from rotating masses overpower the axial forces, thus changing the state of the bi-stable mechanism. Initial testing on ex-vivo animal structures has demonstrated that the device can withdraw the drill bit in sufficient time to eliminate the risk of soft tissue damage. Ease of use and portability of the device will enable its use in unregulated environments such as hospital emergency rooms and emergency disaster relief areas.
Al-Zahrawi and Arabian neurosurgery, 936-1013 AD.
The authors highlight the neurosurgical contributions of an Arabic surgeon by the name of Abul-Qasim Al-Zahrawi, known in Western literature as Abulcasis. This man lived during the Middle Ages from 936 to 1013 AD and wrote a 30-volume treatise on medicine. A significant part of his work on surgery consists of early descriptions of neurosurgical diagnosis and treatment, including the surgical treatment of head injuries and skull fractures, spinal injuries and dislocations, hydrocephalus and subdural effusions, headache, and many other medical afflictions. He described neurosurgical instruments such as cranial drills that avoided puncture of the dura mater. Abulcasis is known for his concepts of pain as a symptom and his emphasis on anatomy of the skull and brain in relation to the neurosurgical operations of that period. Because his works were translated from Arabic to Latin, Hebrew, and Turkish with only recent or limited translation into the modern occidental languages, the historic role played by this man has been largely unknown by neurosurgeons who are not fluent in these languages.
Published in Surgical neurology (1986)
The history of the neurosurgical engine. The opening of the skull of a living human being dates back to early civilization. The procedure may have been performed as early as the Neolithic period. Surgeons have continued to search for a better, easier, quicker, and safer method to open the skull. Today, most neurosurgeons are well acquainted with the surgical drill; however, few are familiar with the development of this instrument from its beginnings in dentistry to its use in modern neurosurgery. As cerebral localization advanced in the late 19th century, so, too, did the demands for better techniques for entering the cranial cavity and exposing more extensive areas of the brain. Mechanical devices began to appear in operating theaters throughout the world. Despite the enthusiasm of its inventors, the surgical engine was used by but a few pioneer cranial surgeons. The use of a surgical engine in the operating room has become commonplace. Its presence continues to demand respect. There is no doubt that this instrument has helped advance neurosurgery. Its development and refinement are rich in history and closely parallel the development of modern neurosurgery.
Results of burr hole and open or closed suction drainage for chronic subdural hematomas in adults. Chronic subdural hematomas in adults are not technically difficult to treat. They probably constitute one of the most common potentially curable lesions with which the average neurosurgeon deals. Despite this (or perhaps because of it) numerous treatments, radically differing from one another, have been advocated. Fine judgment is called for in deciding whether or not to operate in the first instance, make a flap or one or more burr or twist drill holes, use a drain, employ suction, inflate the brain, leave the bone flap out. In a personal series of 71 chronic subdural hematomas, 46 were treated with a red rubber catheter drain through a burr hole and 23 with a closed system suction drain. The results of this series suggest that closed system suction drainage through a single burr hole is the better of the two techniques. It has important theoretical advantages and the procedure is simple and fast. The complication rate is low and patients have a shortened postoperative hospital stay. Published in The Canadian journal of neurological sciences.
[Rhinogenic subdural abscesses in childhood and their successful treatement (author's transl)].
Three cases of rhinogenic subdural abscesses are described, and the characteristic symptoms of the lesions summarized. Each presents a typical temporal sequence which is similar to that of frontal brain abscesses and permits differentiation of each into initial, latent and terminal stages. In collaboration with our neurosurgeon, a treatment was devised which included drilling two or more bore holes over the abscess area and irragating this site with an antibiotic solution. This technique provided favourable conditions for rhinosurgical operation as well as for complete healing.
Published in HNO (1975)
Neurosurgical involvement in tumors of the orbit. The neurosurgeon has a great deal to offer in the therapy of orbital tumors. Dr. Dandy's supposition that all orbital tumors could be approached by the intracranial route is certainly correct, but technical advances have made the medial and lateral approaches to the orbit more useful for most tumors which are confined to the orbit (22, 25). For those which involve the posterior orbit and canal and have intracranial extensions, the intracranial approach is excellent. Since Dandy's first description of the procedure in 1922, there have been 29 patient reports concerning the results of transcranial canalicular decompression for non-traumatic causes. The most common diagnosis was meningioma (15), and other tumor diagnoses were fibrous dysplasia (7) and hemangioma (2). One-third of the patients were improved; one-third had vision stabilized; and one-third were made worse by surgery. Modern techniques with the microscope and high speed drill have greatly improved these results. Our own experience in the decompression of 15 canals in 11 patients is as follows. There were six patients with meningioma, and two were bilateral.
Everything we examined (6)
This check searched the claim as stated. It did not run a separate search for evidence against it.