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Brain Surgery Barbarism With a Purpose

Katie Hafner's article with the NY Times shows just how damaging severe brain injury can be. Hafner's article focuses on a type of surgery often done on people suffering from stroke (where swelling of the brain can lead to big problems), called decompressive craniectomy. But this surgical procedure has been done in many types of patients beyond those suffering from stroke, including soldiers suffering from wounds in the field, and presumably on victims of car crashes in which they suffered traumatic brain injury.

The procedure involves removing a portion of the patient's skull, which alleviates pressure in a swelling brain where it otherwise would have none and would otherwise be fatal. But in those for whom the procedure has been done, many aren't experiencing very positive outcomes.

It may save your life, but you are very likely to be disabled.

That's why many surgeons aren't entirely enthusiastic about it. Hafner quotes neurosurgery department chairwoman Dr. Karin Muraszko of the University of Michigan: "All of us have seen miracles in people we've done this on, but the truth is we're also probably creating a larger population of patients who are significantly disabled."

It's arguable whether this is a good or bad thing. Obviously, the procedure can be life-saving in those who otherwise would've died. On the other hand, becoming permanently disabled is just as troubling, especially given the manner in which this procedure is performed, which of course gives rise to Hafner's line that surgery is barbarism with a purpose.

Source: Skull Surgery Offers Perils and Potential

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