Sup Sup Forums

sup Sup Forums
neurosurg here
ama

this one is worse
they're both dead

Yikes.

What the fuck happened to these poor sods?

different type of trauma
still a bad day

Post full pic of your degree, prove yourself

While we're at it anyone wanna swap irl info and criminal activities?

hope this suffices

dead

what are you on about?

you ever open up soemone's skull and think "I want to put my dick in this brain"?

What is your wage?
How old are you?
Do you have any hobbies?

Nothin' just an inside joke.

Right so I haven't gotten around to having another mri scan since I was a kid (like over 10 years ago) but I had an excess of grey matter, nothin' serious but ya know, they told me to come in in another decade or so to get another mri scan but basically what kind of effects could one expect from growing up with too much grey matter in their brain?

no, but that's a great question

more than I need
old enough to know i should have moved on from Sup Forums long ago
athletics

'excess of grey matter' doesn't mean anything to me
you got the report from the mri? post it up and we can sort it

pic is an aneurysm, my favorite case

Also do you have doctor in your family

>what kind of effects could one expect from growing up with too much grey matter in their brain?
pic related

How many repeat lumbar/cervical facet nerve ablation procedures could one have before it was no longer viable and/or there was an issue preventing further denerveration? What would be the next step after these options are exhausted... fusion?

What part do you slice out for Complex Partial Seizures?

do your own homework scrub

Are medical cost for what you do inflated?

How much years of schooling did you do? Also what's your pay like?

do you guys still perform lobotomies

Dang that's pretty great seeing the brain like that.
And nah I haven't talked to them about it in a long time and haven't got the results sorry. Nothin' too bad I'll find out later on this year.

Yep

nope
only one

true story

physiatrists/pain management usually do those
i don't so can't comment on what's next
if you are seeing a doc, already had a scan, and you're still having issues, you can ask your doc if a referral is indicated. if it's just neck/back pain though, most likely you don't need surgery and should just stretch/exercise

haha I can confirm to you sir that this post is being made by human hands!

Have you prescribed much? Opiates?

Hve you been offered gifts to prescribe a particular new drug to patients?

yeah
human hands from the 72nd century
damn goo backs
comin' back in time
takin' our jerbs

the bad part
duh
pic related

not quite sure what you mean
rephrase the question please

USA so 4y undergrad, 4y medical school, 7y residency, additional fellowship 1-3y is optional
Pay is more than i need but not enough to compensate for the stress.
never do it for the money

no

Der te juuubs!

Is the actual cost of your medical care overpriced?

Fuck you ok! It's tough work being a 72nd century pansexual liberal immigrant jew!

Idk if this is related, but since a while i have been listening to some liquid noise inside my head, sometimes standing, most of them when i lay down, for a long time i believed that was my imagination 'till my girlfriend who was pretty quiet at my side, also listened to it and asked me "user, did your head just made a liquid noise?" and then i felt a bit worried, you know what it is? Is something i should worry about?

What the fuck is that white crystal and brown thing?

Matrix shit.

>the bad part
>duh
>pic related
a little more info?
>not quite sure what you mean
>rephrase the question please
not that user, but I would think he means what sort of markup is done on cost of procedures and such.

Not OP, but quite a bit of work-up is needed before going ahead with epilepsy surgery. Although complex partial seizures are most commonly caused by temporal lobe epilepsy, and the most type of epilepsy surgery is an anterior temporal lobectomy, MRI and admission for EEG/video telemetry (to record seizures) would be needed at a minimum before surgery.

why did you become a neurosurgeon? i was thinking about doing something with medicine do you have any tips?

>'till my girlfriend
stopped reading there, user.

that sounds like a problem

I have a friend, male, 34 years old. He had a massive stroke that left him in intensive care for two weeks, doctors discovered a tumor (cancer) and they operated and removed most of it, he is now radio and chemo. He has some problem speaking but he is doing therapy and improving. Previous to this he suffered seizures all his life and was under constant medication.

Is he going to die soon? I haven't see him in about eight months (he lives in Europe), should I rush there to see him before he gets worse?

i'd demand proof as well
that escort thread made me roll my eyes

minimal opiates for post-op incisional pain only
i got no tolerance for drug seeking behavior

that's an interesting question and, in the US, it is not easily answered
the 'value' (cost) of a given procedure is not necessarily proportional to the complexity/hours/stress/headaches of it (though they try to structure it to take this into account)
tl;dr: if you need a hole in the head 5 minutes ago or you will die, are you going to quibble?

pic: bad infection

What was the first time cutting a live head open like?
Was it fun?
Roughly how many people survive gunshot suicide to the head?

Gnarliest, most fucked up brain you've had to work on?

What was the most stressful surgery you have ever performed?

>if you need a hole in the head 5 minutes ago or you will die, are you going to quibble?
if they don't have insurance, yes

How the fuck do u get an infection in the brain

Answer my question about medial branch nerves and the viable amount of regeneration/ablation cycles.... I'm an injured war vet with a fucked back, respect me!

Im flattered Dr. user, the most interesting question award!

danks u 4 ur cervix

'murca

You ever heard the term "mind-fuck"?

Some time ago i read that bacteria do that kind of shit

Kek'd

Its a bad day when you need another hole in your head.

doesn't sound like a problem to me

white crystal? da fuck you smoking, user?
there is an aneurysm clip occluding the neck of the aneurysm.

>little more info?
such as? more specific please

not entirely inaccurate
short version: lotta workup at a specialized center is step one
significant delay in diagnosis is typical, sadly
if you have seizures that are not well controlled with meds, make sure you are being assessed at a specialized center. small community places may mean well but be out of their league

good question without an easy answer
like many things in life, i started the path with an idea/motivation. along the journey, the ideas/motivations evolve. it's 16 years just to get your first job. people change

do you like niggers op?

whats your favorite type of crainotomy

if i do end up going into medicine, i'm definitley going to think long and hard about if i can and want to do it. i know it sounds dumb but i just like to help people and i always thought hospitals and medicine were cool so it's like combine the two. how do you deal with the stress?

ikr

sorry to hear that, user
that sucks
not being flippant, but we all die
when? nobody knows
suss out the situation with people who know his status and decide to go when you feel it is appropriate. if he's getting chemo/radiation, his underlying disease isn't going to kill him yesterday (otw they wouldn't spend the money on the treatment)
you should write your bro a letter

hmm
can't remember the first time
usually you do the first one one someone you're not likely to damage if you do it poorly
GSW survival stats i don't know off the top of my head
influenced by presenting GCS and whether the bullet crosses the midline, among other things

Have you ever had a patients scull cap off and had a major urge to lick their brain experience the taste?

How hard is it to request a brain scan in a modern day hospital and how much would it cost? X ray and/or activity.

do you listen to music or anything while performing surgery?

if so, what genre?

Not OP but can confirm that it depends on country to country.

see pic subdural empyemas are just nasty, in general

a kid with an AVM, >16hours and i don't want to remember how many liters of blood products
i aged many moon during that case

actually, you get the surgery if you need the surgery
i don't do a wallet biopsy before taking care of the person
social work, etc, can sort that shit out after the life is saved

typically it'll spread from a sinus/ear infection that is chronic, but some people are just more likely to get them (EG immunocompromised)

what's your question, Sup Forumsruv?

the cunt of his wife won't update me on his status so I'm always asking third parties for info, thx for answering thou, I appreciate it.

Are there any differences between a black person's brain and a white person's brain?

OP. I am about to enter college with the goal of eventually getting an MD, MD/PhD, or MD/MBA. Would I be able to have my own private practice at some point and have clients for surgery and other neurological cases, or am I going to be constricted to one or the other?

fell down some stairs as a baby was found unconscious

should I get that checked out

Where is the best place to shoot yourself in the head to die?

the nose

true story

pterional
the work horse
if i need to get all fancy and do an OZ or some shit, i'm annoyed

if you want to go into medicine in the US, you better come up with a better reason, user
no offense, but that's basically copy pasta
working out relieves the stress, that and my motorcycle

no, but that is another outstanding question

user here is correct
variable

metallica, megadeath are in high rotation
and tay tay, naturally
music off when the microscope comes in

what's your opinion on neurosurgery for psychiatric purposes?

lol thanks i'll try to think of a better reason

Have you ever fucked up a procedure?

How many repeat lumbar medial branch ablation/neurotomy procedures could one viably receive before it was no longer safe/effective to repeat them; would the next logical step be a fusion of the affected joins

What, really?

Is it worth it to go into medicine? Currently thinking about going into nursing because I am a retard any advice?

brainstem or right above/in front of the brainstem. most of the time when somebody survives a self inflicted it's through the temples, or through the mouth but they aimed too high, but you fuck up the medulla and you're down for keeps.

np
hope he does ok
it's a long road

no

one step at a time, user
one step at a time
step one: go to college
2: figure out if you want to do medicine
3:???
4: there is no profit in medicine. don't do medicine for profit
MD, MD/PhD, or MD/MBA are three wildly divergent career paths

yeah. for sure. like yesterday.

don't listen to you'll just have no nose

for example?
pic related

On a scale of 1- 10 how steady are your hands and are you ambidexterous?

>most of the time when somebody survives a self inflicted it's through the temples

do they not just bleed out?

Can you give a client a boner if you touch the right spot?

Can you do it if touch the right spot on their brain?

this user is asking the important questions

>for example?
>pic related

psychosurgery, deep brain stimulation, stuff like that

it's legit, user, but it needs to be fleshed out
mainly for you
do it for the right reasons and it'll be gravy
don't lie to yourself or you'll be miserable and your patients will suffer and you'll try to shoot your nose or some shit

great question
lotta nuance
like, egregious error sticking my dick in the brain like user up there asked about? no
complications? absolutely
that's part of surgery
let's take doing an ACDF, routine case
vertebral artery injury is typically quoted as 1 in a thousand risk
i haven't had one. does that make me good? no, it means i haven't done a thousand yet
when it happens, does that mean i fucked up?
dunno
ask me after

didn't you already ask that above?

yes
totally
i am a brain doctor
trust me
shoot your nose

...

ok thank you for the advice, i really appreciate it!

that looks like a really gay message but it's true

decide what you want your days to be like
you have to wake up every day for many years
something has to get you out of bed
talk to nurses, talk to docs, talk to other professionals
figure out what path suits your personality/goals/interests
then do that

pseudo-jargon-y but not entirely inaccurate
the tough part is injuring the brainstem
shits small, fam. small target.
but really, it may be better to play with a puppy than aiming for your brainstem

i don't have an essential tremor, so greater than 9000?
i one-handed knot tie with my left because it's quicker but i'm right dominant
you have to go switch stance in cranial cases though

8 million ways to die, user
choose one

yes, but it's top secret and i'm not allowed to tell

i don't do dbs personally
they're trying to tweak all sorts of stuff with electrodes these days
i wouldn't recommend anything experimental, as a general rule

>i wouldn't recommend anything experimental, as a general rule

of course. it all seems pretty crude right now.

the devices and the implantation are routine
the trick is knowing where/when/why to stick the electrodes

so basically science has a general idea about what part of the brain does something, but still there is a lot to discover?

why don't you do them?

that's an appropriate description
we know a shit ton, but it's still a black box in many respects
hence the need to be skeptical of people spewing about pineal calcification and other bullocks

training: i never did them
in my current practice, there's only a couple a year that need taking care of
that's not enough volume to stay current/safe

Ok - I'll bite, just in case you are for real.

>be me: Prolactinoma 2 cm x 2.5 cm diagnosed 2007, removed via endonasal approach 2008

>2010, they find Carconoid in my colon 3mm - removed and follow up ultrasound done for 3 years, no spread.

>2017, gall bladder nearly explodes, they decide to remove my Appendix since it "is enlarged" - find a 2.7 cm Carcinoid which invaded the mucosa.

Doctors say I'm fucked unless I have a hemicolectomy. No Men1 or Men2 present.

WTF is happening to me? Am I gonna die from this shit??

Do you work closely with other specialists (eg ear doctors and maybe spinal operators)

i'm surprised by that. what's your most frequent type of surgery then?

that's a stressful decade, user
i can't answer your question about WTF
as for the hemicolectomy, get a second and third opinion before going under the knife if you have any doubt about the rationale for the intervention. hope you get that shit sorted.
Why'd they take out the prolactinoma instead of medical management?

ENT for pituitaries, like user above
what's a 'spinal operator'? i do spine

surprised that i didn't do them in training? not too uncommon because the procedure is lower volume compared to others.
most frequent case is lumbar laminectomy. bread and butter is degenerative spine. but i do pretty much everything else except peripheral nerve, DBS and carotids

Simple question: The right side of my head hurts from time to time, my right eye hurts, and also the back right side of my kneck. Is it something i need to worry about? It usually goes away the next day or by taking some Panadol.
Oh, also, have you ever had a "god-complex" thought during surgery; like: "I can kill this person if I wanted to right now"?

Which has been the longest surgery you have ever done?

Prolactinoma was compressing Carotid artery on the left side - about 50% constriction. Treated for 5 months with Bromocriptine. Decide to have it removed by the "dream team" of docs at Pitt - Kassam and Snyderman.

Doc working on me now worked on Steve Jobs - said that the size of the Carcinoid on the Appendix was so large and the fact that it invaded the mucosa means it could be in the Lymph Nodes of my ascending colon, but they can't tell unless they do the Hemicolectomy.

This would be the 4th endocrine tumor I've had - which is scary since I don't have Men1 or Men2 - so, no one can tell me why I'm getting so many, even though I'm generally too young for this.

Figured maybe you would have had experience with neuroendocrine tumors which spread from the brain elsewhere.

I have a pet theory - the Neural Tube is part of the formation in the embryo which also forms the gut - what about that making the two so closely related that these types of cancer can spread - so if you ever have a neuroendocrine tumor patient, you should also order an Octreotide or Donatate scan too. Just my 2 cents as a non-doctor.