[Dr. Anand Veeravagu] When a person suffers a severe traumatic brain injury,
and say, for example, they're in Afghanistan.
They had an IED explosion underneath the vehicle
that they were driving, and they've hit their head really bad.
The first thing that will happen is they'll be triaged
by their medic, they'll be airlifted and taken to a hospital
that can support a polytrauma patient.
We're talking a hospital that's capable of
delivering a very high level of care.
Now, if the patient has suffered a traumatic brain injury
and has been evaluated by either
an emergency doctor or a neurologist or a neurosurgeon
and is suffering from an increase in brain swelling,
sometimes medications just don't help bring that swelling down.
One of the procedures that neurosurgeons perform
is something called a craniectomy.
A craniectomy is really the removal
of a large piece of skull, usually about 13 inches,
to make room for an expanding and a swelling brain.
That piece of bone, if it's something
that occurs in the war zone, is usually discarded,
because as you know, when there's a traumatic injury,
it's not often that it's just a clean traumatic injury.
There's usually shrapnel, there's usually dirt,
and the bottom line is the
bone specimen is usually contaminated.
Usually, that piece is discarded in the sense
that it's put in a freezer and stored away
without necessarily thinking that it's going to be replanted.
When patients have recovered, the brain swelling has come down,
and they return back stateside to their VA or to Walter Reed,
we can perform a reconstruction procedure.
That's what I'm most familiar with.
We usually use a special CT scan of the patient's head,
which draws an outline of the defect.
Then we use a 3D printer to print a perfect match,
Usually that's made out of something called peek,
and that's a type of plastic-like substance.
Once that implant is built,
we're able to surgically implant it
and reconstruct the calvarium,
so patients don't have to walk around with a helmet.
If they were to fall, because remember,
most of these patients are still recovering,
they're in rehab, they're actively moving—
if they were to fall, they're protected from an injury
to the actual surface of their brain.
A craniectomy procedure is really a life-saving procedure
with the hopes of preventing brain damage
that may result from uncontrolled swelling.
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Dr. Anand Veeravagu describes this life-saving neurosurgical procedure, performed to prevent brain damage resulting from uncontrollable swelling in the brain.
Produced by Christian Lindstrom and Justin Rhodes, BrainLine Military.
Anand Veeravagu, MD is a neurosurgeon in training at Stanford University School of Medicine. He is a former White House fellow and special assistant to Secretary of Defense Chuck Hagel. He previously served as chief neurosurgery resident at the Palo Alto Veterans Affairs Hospital.
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