Models For Delivering High Quality Emergency Neurosurgery In High Income Countries

Emergency neurosurgery encompasses serious and high-risk cranial and spinal conditions across all ages. The authors provide an overview of the changes occurring within emergency surgery to meet the challenges provided from unscheduled care. Considering the wider landscape of emergency surgery provides a context for the changes occurring within emergency neurosurgery. The delivery of emergency neurosurgery within the UK, the Republic of Ireland, the Netherlands, and the United States of America (USA) is then described to provide an overview of different models of care.

Emergency Neurosurgery is a constantly evolving specialty, resulting in ever increasing challenges posed on the higher specialty trainee. The focus of this Element is to guide the reader on the application of robust and easily applicable management strategies whilst dealing with the most challenging aspects of their professional workload. The authors have categorised the various subgroups of emergency neurosurgical workload, devised a comprehensive management algorithm, included case scenaria related to the most challenging emergency situations and highlighted easily overlooked clinical information. In summary, this Element will provide robust and easily applicable management strategies whilst dealing with the most challenging aspects of the emergency neurosurgical workload.

Seizures are a presenting feature of many neurosurgical disorders, and can arise as a result of neurosurgical treatment or its complications. Recognition and effective management of seizures can be life-saving, and will minimise long term seizure induced morbidity. In this Element the authors describe seizure diagnosis, emergency and ongoing management, and considerations in neurosurgical conditions.

Central nervous system, affliction, although rare, represents one of the most severe extra-pulmonary manifestations of tuberculosis, potentially leading to substantial morbidity and mortality if not promptly addressed. Cranial tuberculosis can manifest in various forms, including tuberculomas, encephalitis, abscesses, and meningitis, with the latter being the most critical and carrying a poor prognosis if left untreated. Spinal tuberculosis, accounting for approximately 50% of musculoskeletal TB cases, can present with a spectrum of symptoms, ranging from simple back pain to more severe neurological deficits such as weakness and deformity. Anti-tuberculosis medications remain the cornerstone of treatment, and this Element offers an algorithmic approach to managing referrals of suspected tuberculosis, incorporating pertinent clinical information to facilitate effective decision-making.

This book is a combination of ideas and experiences from over 100 dedicated and brilliant neurosurgeons around the world. Their common goal is to provide data for a deeper understanding of the multi-faceted aspects of neurosurgery and, by doing so, to better serve patients across the globe. Scientific curiosity, deep dedication, incredible work ethics, entrepreneurship, and creativity are the common traits among all neurosurgeons, and not the exception. By allowing readers to see the field of neurosurgery from the perspectives of surgeons spanning five continents, this book serves to provide multiple, diverse viewpoints and to build a foundation for future collaborations. The book’s 24 chapters are organized into 3 parts. Part I provides the reader with an overview of the role of neurosurgery in worldwide health care, its evolution over the past decades, the current state and future directions of each neurosurgical subspecialty across the five continents. Over the years, the overarching goal for neurosurgeons has been to develop new, more effective and high-end solutions for complex diseases and to provide access to neurosurgical services for all patients. Part II discusses the differences and similarities of neurosurgery education and training across the globe, providing a snapshot of how new tools, technology, and paradigms reduce inequality and increase access to neurosurgical education. Educational accomplishments and challenges still present for the in different regions of the world are reviewed. Part III focuses on economic aspects influencing neurosurgery globally, including how to make efficient decisions in the face of scarcity, yet demand. The authors provide theories, models, and tools helpful to apply when planning to allocate resources, not just financial, but also human and intellectual. A deeper understanding of economics does not necessarily provide the answer to the problem; rather it provides the tools to find an answer, or, ideally, multiple possible solutions. Neurosurgery and Global Health is the first comprehensive guide to the role of neurosurgery in the global health care sphere, providing an in-depth compendium about the understanding of the neurosurgical role within global health, its efforts in the education of tomorrow’s workforce, and the economic aspects driving the field.

Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.

An inspiring story of doctors who changed the health care of an African nation Dr. Dilan Ellegala arrives in Tanzania, shocked to find the entire country has just three brain surgeons for its population of forty-two million. Haydom Lutheran Hospital lacks even the most basic surgical tools, not even a saw to open a patient’s skull. Here, people with head injuries or brain tumors heal on their own or die. When confronted with a villager suffering from a severe head trauma, Dilan buys a tree saw from a farmer, sterilizes it, and then uses it to save the man’s life. Yet Dilan realizes that there are far too many neurosurgery patients for one person to save, and of course he will soon be leaving Tanzania. He needs to teach someone his skills. He identifies a potential student in Emmanuel Mayegga, a stubborn assistant medical officer who grew up in a mud hut. Though Mayegga has no medical degree, Dilan sees that Mayegga has the dexterity, intelligence, and determination to do brain surgery. Over six months, he teaches Mayegga how to remove tumors and treat hydrocephalus. And then, perhaps more important, Dilan teaches Mayegga how to pass on his newfound skills. Mayegga teaches a second Tanzanian, who teaches a third. It’s a case of teach-a-man-to-fish meets brain surgery. As he guides these Tanzanians to do things they never thought possible, Dilan challenges the Western medical establishment to do more than send vacationing doctors on short-term medical missions. He discovers solutions that could transform health care for two billion people across the world. A Surgeon in the Village is the incredible and riveting account of one man’s push to “train-forward”—to change our approach to aid and medical training before more lives are needlessly lost. His story is a testament to the transformational power of teaching and the ever-present potential for change. As many as seventeen million people die every year because of a shortage of surgeons, more than die from AIDS, malaria, and tuberculosis combined. Dilan Ellegala and other visionaries are boldly proposing ways of saving lives.

Vols. for 1963- include as pt. 2 of the Jan. issue: Medical subject headings.