D32 after trepanation which means. Craniotomy and its consequences. The recovery period in the hospital

Despite the fact that craniotomy (craniotomy) is the oldest medical operation, the mere mention of this procedure still evokes frightening associations in people. This fear is partly justified, since craniotomy is one of the most difficult surgical operations. It can cause irreversible consequences not only for physical, but also for mental health.

This procedure is resorted to only when a person's life is under threat. Modern medicine is still powerless to make craniotomy completely safe, there is a risk of complications in every case. The brain is too fragile and complex an organ to interfere with its work without leaving a trace.

Interesting fact! Judging by the archaeological finds, people have learned to do craniotomy tens of centuries before our era. The Incas achieved special skill in this matter. Craniotomy could be used both for therapeutic purposes (for headaches, mental illness, war injuries), and for magical purposes. It was believed that evil spirits could be expelled through a hole in the head.

In what cases is craniotomy necessary?

Indications for craniotomy are conditions that are associated with brain damage:

  • cancerous tumors of the brain and skull bones;
  • bleeding caused by an aneurysm;
  • bleeding from a stroke;
  • serious head injury (for example, due to a gunshot wound);
  • infectious brain damage.

Rehabilitation after craniotomy

Rehabilitation after surgery is difficult: with severe headaches, swelling of the head and face, a constant feeling of fatigue. The patient can get up one day after the operation. He spends in the hospital from two to three days to two weeks. Drugs are prescribed for seizures, edema and pain.

A sedentary lifestyle is undesirable, but you also need to be very careful with stress. Immediately after discharge, it is recommended to engage in walking and simple household chores, which involve a minimum of movement and mental effort.

The full recovery period takes approximately two months. Its duration depends on the type of injury or illness that caused the operation, as well as the age and health of the patient.

During recovery, you will have to give up some activities:

  • driving a car (not earlier than 3 months after the operation);
  • alcohol consumption;
  • long sitting position;
  • lifting objects weighing more than 2 kg;
  • active sports;
  • any activities in which you have to tilt your head for a long time.

Consequences of craniotomy

Craniotomy is just a process of opening the brain tissue. The consequences depend on the indications for which the operation was performed. For example, if a cancerous brain tumor is removed, an area of ​​the gray matter can be damaged.

By itself, craniotomy, like any other operation, can be dangerous by infection or bleeding. Unfortunately, no one is protected from the surgeon's mistake, and it will no longer be possible to restore the damaged brain tissue. And in the postoperative period, you can accidentally violate the integrity of the brain, since the skull at the beginning of recovery will not yet fully protect the brain from mechanical influences.

Unfortunately, no matter how smoothly the rehabilitation process proceeds, a person's thinking abilities will not return to their previous level. Memory, speech, coordination of movements suffer. In rare cases, a person loses the ability to take care of themselves and needs lifelong care.

Sometimes, after undergoing craniotomy, a person is assigned a disability. However, there is a possibility that in a few years the patient will fully recover and the disability will be canceled. It all depends on how severe the consequences of the operation are and how limited the patient is in his life. By itself, craniotomy is not a reason for the appointment of disability.

Even with the most favorable outcome of the operation, a person will have to make changes in their usual way of life. Restrictions apply not only to mental work, but also to physical work. Light loads will be beneficial, but all sports that involve a lot of tension or head tilting are contraindicated. Air travel is not recommended, as sudden changes in atmospheric pressure can cause complications.

Types of consequences

The consequences of the operation can be divided into the following types:

  1. Surgical. By itself, intervention in the cranial cavity can lead to consequences such as cerebral edema, damage to its tissues and blood vessels, bleeding, infection. In some cases, it is necessary to do a second operation in order to save a person's life.
  1. Neurological. This includes disorders of motor and mental functions, as well as convulsive syndrome. Many patients experience acute psycho-emotional discomfort, fall into depression, and need psychological support. Some may need the help of a psychiatrist.
  1. Cosmetic. The skull after the operation is deformed, a keloid scar is formed at the site of the incisions. Correction by a surgeon may be required. Cranioplasty (plastic surgery that removes the deformation of the bones of the skull) is important not only to restore appearance person. It helps to eliminate pain that aggravates during a change of weather, as well as to prevent complications such as protrusion of the contents of the skull during physical exertion.
  1. Side effects of taking medications after surgery. Weakness, weight loss, mental exhaustion, digestive disorders are far from full list troubles that can result from taking anticonvulsants and steroids medicines... Many patients are forced to take narcotic analgesics to get rid of an unbearable headache.

After craniotomy, not only the brain suffers, but also the lungs, intestines, bladder and other organs. This is due to the fact that the brain cannot fully control the functioning of organs for some time. The patient's lack of mobility and the use of numerous medications also contribute negatively.

Craniotomy or craniotomy is a complex medical operation known in antiquity. It is carried out in special cases when the doctor needs to gain access to the brain and its membranes, the pathologies and vessels that have arisen. Modern medicine makes surgery safer for the patient compared to the past, when it was accompanied by high mortality.

Craniotomy - what is it?


By right, craniotomy is considered one of the most difficult surgical procedures. Bone trepanation implies a violation of the integrity of the cranium, in which an opening is formed, an incision. The operation is performed under local or general anesthesia. The head is secured with a special holder for maximum precision. With the help of a navigation system, doctors expose exactly the part of the brain that is required. Craniotomy is most common in neurosurgery, which is responsible for the surgery of the central nervous system and brain.

Why is craniotomy necessary?

Doctors may need access to the skull, both routinely and urgently, for example, when severe injuries and cerebral hemorrhages. In these cases and others, craniotomy is performed, the indications for which are extensive, but every year they are narrowed due to the emergence of new, sparing methods of treatment. The operation is performed to correct conditions that will cause serious problems without surgery. These include:

  • (malignant and benign);
  • abscess and other purulent processes;
  • , bruise;
  • complex head injury;
  • hemorrhage;
  • vascular;
  • neurological events such as acute epilepsy;
  • malformation of the skull or brain;
  • craniotomy with (with hemorrhage).

Craniotomy - types


To eliminate many pathologies, trepanation is used, the types of which are named based on the localization of access to the brain and the method of performing the operation. The bones of the skull (on the vault) are represented by several plastics, covered with the periosteum from above and adjacent to the meninges from below. In case of damage to the periosteum, as the main nourishing tissue, there is a risk of necrosis and bone death. To avoid this, craniotomy is performed by the following methods:

  • classical osteoplastic;
  • resection;
  • for the purpose of decompression;
  • conscious operation;
  • stereotaxy - a study of the brain using a computer.

Osteoplastic craniotomy

The most famous type of craniotomy, the classic method of opening the skull, during which a small section of the parietal bone is cut out without damaging the periosteum. The sawn piece is connected with the periosteum with the cranial vault. The skin flap on the leg is folded back and after the operation is placed in place or removed. The periosteum is stitched. No bone defect is observed after surgery. Trepanation (osteoplastic) of the skull is divided into two types:

  1. With cutting out the skin-periosteal-bone flap simultaneously (according to Wagner-Wolf).
  2. With cutting out a skin-aponeurotic flap, which has a wide base, and then a bone-periosteal flap on a narrow leg (trepanation according to Olivecron).

Decompressive trepanation


One of the methods designed to reduce intracranial pressure and improve the condition (and work) of the brain is decompression craniotomy (DTC) or Cushing's trepanation, named after a famous neurosurgeon. With it, a hole is created in the bones of the skull through which the harmful element that caused the resulting hypertension is eliminated. It can be pus, blood, cerebrospinal fluid, edematous fluid. Negative consequences for health after surgery are minimal, rehabilitation is short-lived.

Resection trepanation

A less favorable prognosis for rehabilitation has a resection operation, craniotomy during it takes place by imposing a milling hole and then expanding it to the required size (for this, nippers are used). The cut off area is removed together with the periosteum without possible restoration. The bone defect is covered with soft tissues. As a rule, this technique is used when trepanning of the posterior cranial fossa is necessary, as well as the treatment of cranial wounds.

Conscious craniotomy


One of modern methods operations - trepanation without anesthesia. The patient is conscious, his brain is not turned off. He is injected with drugs to relax and injected local anesthesia... Such an intervention is required when the pathological area is located too close to the reflexogenic zones (and there is a danger of damaging it). During the operation, surgeons constantly monitor the patient's condition and organ activity, controlling the process.

Craniotomy - consequences after surgery

Craniotomy has been performed for a long time and successfully, but it is used in extreme cases when the patient's life is in danger. The fear of this operation is justified, because craniotomy can have the most negative consequences and they depend on the complexity of the operation, the patient's age and state of health. Each situation has a risk of complications, and no matter how steps medicine moves forward, it is not possible to make the intervention completely safe. The most common consequences after craniotomy are:

  • infectious complication, as in the case of other operations;
  • the appearance of blood clots;
  • bleeding;
  • neurological disorders;
  • deformation of the excised area of ​​the bone;
  • headache;
  • deterioration of vision and hearing;
  • paralysis of the limbs.

Coma after trepanation

The most serious complication after craniotomy is. A person can fall into it even before the operation and not leave after all the necessary manipulations have been carried out. When the contraction of the heart does not depend on the activity of the cerebral cortex, the patient's breathing is supported by the apparatus. The patient is warned in advance about the possible consequences of trepanation, including complications in the brain.

Stroke- this is a condition of the so-called "emergency pathological deviation", having discovered which, it is necessary to provide assistance as soon as possible, which includes not only the fight against symptoms, but often also surgical intervention. Such an ailment very often requires a surgical method of treatment, because it is not always possible to eliminate the cause with drugs.

A stroke affects the vessels of the brain, which can lead to unforeseen consequences, including paralysis, problems with speech, breathing, and even death.

If a stroke has caused a rupture of the vessel and a cerebral hemorrhage, only trepanation gives a chance to save the patient. Only by getting directly to the source of the problem can it be qualitatively solved.

Trepanation is used on the basis of such studies:

  • Duplex ultrasound of blood vessels;
  • CT or MRI;
  • Angiography.

These technologies enable doctors to deliver correct diagnosis, determine the localization, degree of damage, and make a prognosis for the patient.

With tumors in the brain, it is very difficult to do without surgery, even if it is benign. The neoplasm tends to increase in size, which will cause pressure on one of the areas of the brain.

No one can say for sure which function the tumor will disrupt and whether the process is reversible.
Trepanation- a very common procedure by which the skull is opened, and the doctor gains access to the education and cuts it out, trying to bypass healthy tissues as much as possible.

Now more and more the institution is switching to laser treatments, in which you do not even have to open the skull. But unfortunately, few hospitals, especially public ones, can afford such equipment.

- This is a pathology caused by the accumulation of blood in a limited area in the cranial cavity. Hematomas are divided by type, location, and size, but they are all associated with rupture of blood vessels and hemorrhages.

Trepanation in this case is necessary in order to pump out blood, detect a problem area, and bring it into proper form. Bleeding can be stopped in other ways, but it is impossible to eliminate the consequences of what has already happened without plunging into the cranial cavity.

Rehabilitation after trepanation

Rehabilitation after such a serious intervention is aimed at restoration of functions the damaged area and to improve the general condition of the patient.

This part is the final, and, one might say, the most important. Without the necessary measures after surgery full recovery is impossible. Moreover, the victim may revert to the condition that caused the problem.

Rehabilitation after trepanation is complex, and is aimed at consolidating the result of the operation and at neutralizing all kinds of negative consequences.

The main tasks of the rehabilitation period:

  • Neutralizing the cause what caused brain disease after surgery;
  • Smoothing the consequences surgical intervention;
  • Early identification of risk factors that can lead to complications;
  • Maximum recovery impaired brain functions.

The recovery process after trepanation is the most difficult, which is why it consists of many successive stages, each of which is equally important. The duration of treatment and the technique may differ in each case.

The duration and outcome of the operation are influenced by many factors, including:

  • The patient's initial state of health;
  • Doctor's experience;
  • The age of the patient;
  • The presence of complications and concomitant diseases.

The main thing to remember for those who have survived such an operation or have a relative who underwent trepanation is that stress and noise are an absolute contraindication.

The patient should not be overloaded for the first ten days, until the sutures are removed.

After this stage, it is necessary to gradually introduce more active measures along with drug treatment.

In addition to ensuring complete peace, it is necessary to take a number of such sequential measures:

  • Find pain relievers... The pain creates additional stress, which brings the patient back to the risk zone;
  • Antiemetic drugs are part of the treatment, since due to dysfunctions of some functions and an increase in sensitivity and sensitivity, the patient may suffer from bouts of vomiting and headaches;
  • Constant physical therapy required and testing of brain function;
  • Weekly consultations with a psychologist and neuropathologist... This stage is important, as it allows you to detect the slightest changes in consciousness or behavior, which is a signal of violations;
  • Testing neural connections of the brain;
  • Permanent keeping the wound clean, monitoring the healing and disinfection processes;
  • Preventive measures to prevent the development of complications.

After 14-20 days of stay in the hospital ward under strict supervision, the patient is discharged and sent for secondary rehabilitation on an outpatient basis.

The full range of rehabilitation procedures consists of:

  • control condition of the wound;
  • complex various physiotherapy procedures;
  • recovery lost or damaged skills;
  • occupational therapy and other approaches;
  • Exercise therapy and massages;
  • walks outside the hospital buildings;
  • control diet and lifestyle;
  • psychotherapy.

In addition, the patient is discharged medications , which help to cope with the disease and its consequences from the inside.

It is imperative for patients to constantly keep in touch with the doctor, who must be contacted at the slightest deviation from the norm, which may be as follows:

  • physical and mental (failures of thinking, logic, memory, motor processes and reactions, sensations);
  • inflammation and swelling of the scars;
  • the appearance of regular headaches;
  • nausea and vomiting;
  • difficulty breathing;
  • convulsions and fainting;
  • numbness of the face;
  • general weakness, chills, fever;
  • deterioration of vision;
  • chest pain.

When starting rehabilitation, you need to remember that even the right approach may not lead to a complete recovery, but it will teach you how to live with the problem in a quality manner, and gradually improve your condition.

What can be the consequences for children and adults

  • Asthenia- a constant feeling of fatigue, depression, sensitivity to atmospheric phenomena, insomnia, tearfulness;
  • Speech disorders- often occurs in both children and adults. It is difficult to immediately determine whether this is a temporary phenomenon. So you just have to wait and watch;
  • Psychosis;
  • Forgetfulness;
  • Paralysis;
  • Convulsions(more often in children);
  • Loss of coordination(more pronounced in children);
  • Hydrocephalus(in children, less often in adults);
  • ZPR(in children).

Infectious complication

As with any surgical intervention, trepanation negatively affects the protective functions of the body, which increases the risk of infection.

Brain infection- the phenomenon is extremely rare, but the wound itself is easy to infect by poorly processing the instruments
for surgery or materials for dressings.

The lungs, intestines, and bladder are affected. All of these organs tend to pick up infections in the first place.

After skull surgery, significantly rises the likelihood of developing a number of infections, and infection of the brain tissue itself occurs much less frequently, which is associated with the appropriate sterilization of the area undergoing surgery.

To a greater extent, the risk of infection is threatened lungs, intestines and bladder , the functions of which are regulated by parts of the brain. This circumstance is largely due to the forced restrictions on human mobility and changes in lifestyle after surgery. Prevention of such a complication is physiotherapy exercises, diet, sleep. Infections are treated with medication - the appointment of appropriate antibiotics.

Blood clots and blood clots

Pathological processes and changes in brain tissues, poor mobility in the postoperative period, can cause blood stagnation, which causes the formation blood clots... Veins in the legs are most often affected.

If a blood clot comes off, it can migrate through the body, settling in the lungs or heart. Very often, the separation of a blood clot leads to lethal outcome... There are cases of thrombosis pulmonary artery, which is a very dangerous consequence and requires immediate intervention. This disease leads to very serious consequences, up to and including death.

The best prevention against clots is physical exercise, plenty of fresh air and anticoagulants (blood thinners).

Neurological disorders

Temporary or permanent disorders of a neurological nature appear when, after craniotomy, there is swelling of nearby brain tissue... All this leads to different kinds of consequences,
causing symptoms of seemingly unrelated diseases. But fortunately, if the operation is successful, everything is restored to its original state.

To speed up the healing processes, they are prescribed steroid anti-inflammatory drugs.

With more serious mistakes made during the operation, pathologies may be of a longer duration. There are many reasons for the onset of symptoms, and they all depend on more than one factor.

Bleeding

Bleeding- This is one of the most common occurrences after trepanation. For several days after surgery, blood vessels may bleed. This problem is eliminated by drainage. Usually there is little blood and it does not cause problems.

But there are times when the bleeding is so profuse that you have to do repeated trepanation to stop it and prevent more serious consequences.

Blood that accumulates in the cranial cavity can touch motor centers or nerve endings that causes seizures. In order to avoid such manifestations during the operation, the patient should be given intravenous anticonvulsant drugs in advance.

13.09.2016

For most people, the phrase "craniotomy" is unpleasant. Many have heard that such operations were done in antiquity, but if necessary, they are successfully carried out today. What is being done What is it? In what cases is surgical intervention necessary, how scary is it and will a person be able to live a full life after such a procedure?

An operation performed with dissection of the soft tissues of the head and bones of the cranium for the purpose of penetration and further investigation or operation of the brain tissue is called "craniotomy". What does this mean and to whom is this treatment prescribed?

Indications for trepanation

Trepanation can be prescribed to patients who have various diseases of the brain, oncological formations, edema, blood clots, problems with blood vessels brain, nervous disorders, tissue infections and vascular disorders of the dura mater. An operation is also prescribed for fractures or indentation, as well as to relieve intracranial pressure. Another indicator for the procedure may be a biopsy. The craniotomy operation allows you to take a piece of brain tissue for further examination.

Operation types

The procedure is carried out in different ways, which one will be prescribed for a particular patient is determined by the general indications and the nature of the disease.

  • Osteoplastic craniotomy (traditional)... In the process, a separate section of the cranial bone is cut out. Then surgery is performed on the brain, after which the removed part of the bone is returned to its place. If the procedure is successful, additional intervention is no longer required.
  • Resection craniotomy... What does it mean? A small hole is made in the skull and expanded to the desired diameter. Unlike the first type, the opening of the skull does not close after the operation. The brain is no longer protected by the bones of the skull, this function is performed only by the skin and soft tissues.
  • Decompressive trepanation consists in making a small hole in the skull bone. This procedure is prescribed to patients in order to reduce intracranial pressure.
  • Conscious craniotomy- this is when a craniotomy operation is performed on a patient who is awake. Such a procedure is necessary to track the functionality and reaction of the brain to certain manipulations by the surgeon. At the same time, the patient does not experience pain.
  • Stereotaxy... This study uses a computer. With its help, an examination of the brain tissue is carried out, which will then undergo surgery.

How to prepare for surgery

What does a patient need to know when a craniotomy is prescribed? What is this procedure, how it will be carried out and how to organize your life for a speedy recovery after it - all these questions should be discussed with your doctor in advance. Before the operation, you should undergo all the necessary examinations of the brain and nervous system, and be tested.

Blood thinners and anti-inflammatory drugs should be discontinued one week before surgery. Taking medications should be strictly controlled by a doctor; self-medication during such a period is unacceptable. Before the operation itself (12 hours before), you need to stop eating and drinking.

Care should be taken of who and how will be able to pick up the patient from the clinic after discharge, who will be able to help around the house during the recovery period and provide other assistance with care.

Anesthesia

"How is craniotomy done and is it painful?" is perhaps one of the most common questions asked by patients. In most cases, the operation is performed under general anesthesia. The patient will not feel either the trepanation itself or the manipulation of the brain tissue by the surgeon. After trepanation, pain relievers will be prescribed.

In the case of stereotaxia, pain relief is given topically. If a craniotomy is prescribed, in which the patient must be conscious, it will be provided for the period of the operation when the person's stay in consciousness is not required.

Operation process

After the patient is anesthetized, the scalp is carefully treated with an antiseptic. An incision is made to expose the required area of ​​the skull. The trepanned bone of the skull is excised, removed, and an operation on the brain is performed.

Upon completion of the intervention, the exposed brain area is closed. The removed part of the cranial bone returns to its original place, and surgical sutures are applied to the scalp. To ensure the outflow of fluid and the removal of blood, drainage tubes are inserted into the operated area, and a bandage is applied to the head. After a few days, the drain can be removed. The operation itself takes several hours.

After the patient is sent to the recovery room, where his vital signs are carefully monitored. Pulse, body temperature, breathing and blood pressure are checked regularly. After a while, the operated person will be transferred to the intensive care unit, and then to the hospital ward.

Postoperative period

After the end of the operation, in which craniotomy was used, the patient's health recovery begins immediately. The operation itself is quite complicated and takes a lot of effort from the patient, therefore the rehabilitation process is very important. The patient will stay in the clinic from 3 to 7 days, the period depends on the severity of the operation and the patient's health. If complications arise, the period of stay under the supervision of a doctor will be increased.

Hospital care

It will boil down to the following:

  • The patient's head should be kept in an elevated position to lower blood pressure.
  • Fluid intake will be limited and antiemetics are prescribed if vomiting occurs.
  • Drugs that reduce the amount of fluid in the body (steroids) may be prescribed.
  • Antibiotics are used to prevent infection from occurring.
  • A day later, the bandage can be removed from the head of the operated patient. The wound must be kept clean and monitored constantly.
  • The patient should start walking a little as early as possible. This will prevent pneumonia or blood clots from forming.

Upon returning home

Excessive stress after such a complex operation is contraindicated, as well as playing sports. It will be very good if someone from the family helps the person to organize their life during the first time they stay at home. People after craniotomy often experience psychological stress and depression. They need to communicate with a positive person. Who else, if not close ones, will be able to help in this. In some cases, you cannot cope with depression on your own, then you should seek professional help from a psychologist or psychotherapist.

It is equally important to follow the directions and follow the doctor's recommendations, which will monitor the patient who has undergone surgery and the speed of recovery largely depends on the postoperative care. The operated head area should be kept clean. You cannot wet the wound for a long time. If the scar has changed color or something else has gone wrong, you should see a doctor immediately.

Sports are contraindicated, you can not even do yoga, because many exercises are associated with tilting the head. But light loads and walks in the fresh air will do good. They will disperse blood and prevent blood clots from forming. It is important to lead a healthy lifestyle, eat right and on time.

It is necessary to take medications that have been prescribed by a specialist. Decoctions of medicinal herbs will be good helpers in recovery, but you should consult your doctor before using them.

Consequences

This is the kind of treatment that is prescribed when you need to choose the lesser of two evils. Operation on the skull allows you to get rid of the most difficult diseases, but at the same time a person is inflicted with an injury that will accompany him throughout his life. has not been studied as well as we would like, because any intervention can have the most unpredictable result, namely, craniotomy. The consequences of the operation can be very different or not manifest themselves at all.

People who have undergone brain surgery are prone to increased intracranial pressure, they cannot perform difficult mental and physical work. Many have to change labor activity and move to a less paid, but easier one. It can be difficult to give up your usual way of life.

The success of the procedure is due to many factors. First, it is the severity of the disease or injury that the patient has encountered, and, of course, the qualifications of the surgeon. Physical health and a healthy lifestyle before surgery are also important. Smokers are most susceptible to postoperative complications.

Frequent problems

  • Constant headaches.
  • Hearing and vision impairment.
  • The operated area of ​​the skull is deformed.
  • Speech, behavior, thinking, memory can change.
  • Coordination disorders.
  • Problems with bladder and intestines.
  • Paralysis, convulsions, weakness.
  • Blood clots may form or bleeding may open.
  • Possible infection or swelling of the brain.

Disability

Does a person face disability after such a procedure as craniotomy? Yes. A patient who has undergone such treatment is given a disability. Subject to full recovery, it can be canceled within three years. But it should be remembered that trepanation is a difficult and dangerous operation, the results of which can be very deplorable. Therefore, each case is considered individually.

Craniotomy cannot be called an ordinary operation, not every surgeon will undertake it. But for especially zealous "difficult" and "dangerous" has never been a reason to abandon a dream.

Craniotomy is a complex operation that is performed by a few surgeons and only for medical reasons. However, in 1965, a medical student from Amsterdam, Bart Hughes, wanting to confirm his scientific theory that trepanation can be used to expand the functionality of the brain, did brain trepanation on his own. Since then, for many decades there has been controversy around Hughes' theory. Some say that Hughes was right, others criticize him vehemently. In a number of countries, Hughes was even declared persona non grata. However, this didn’t make him fewer supporters.

"Third Eye"

Craniotomy - surgery the formation of a hole in the skull. As a rule, the operation is used to provide access to intracranial formations with the aim of their subsequent removal.

Trepanation is known both in mystical and therapeutic practices of many archaic civilizations. Archaeologists have found fragments of skulls with elements of trepanation on all continents, except perhaps Antarctica. Some of the samples are dated to the tenth millennium BC.

Roman physician. Surgeon and researcher Galen used trepanning to relieve intracranial pressure caused by a cerebral hemorrhage.

Most often, trepanation is done in the region of the vertex (the upper point of the cranial vault) and in the region of the occipital bone. Variants with trepanation on the temporal bones are less common.

Interestingly, modern studies of the behavior and abilities of people who at one time underwent craniotomy for medical reasons also revealed the presence of paranormal abilities ( prophetic dreams, predictions, telepathy, obtaining knowledge from incomprehensible sources, etc.). True, it should be noted here that the use of these abilities depends on upbringing, cultural tradition, character and much more. Perhaps there is something in this. Indeed, in the ancient Tibetan books it is said that by making a hole in the area of ​​the vertex (it is called by the Tibetans "the hole of Brahma") the surgeon opens the third eye.

Window for the brain

The founder of the modern trepanation movement is a Dutchman named Bart Hughes. While still a medical student (in 1962), he developed the theory that the level of consciousness directly depends on the volume of blood entering the brain.

In 1964 he published scientific articles: "Correction of homo sapiens" and "Trepanation - a cure for psychosis." In them, he proposed using trepanation to expand the functionality of the brain by balancing blood pressure and cerebrospinal fluid pressure.

My theory is, Hughes said, that trepanation increases the level of blood circulation in the brain. With each heartbeat, the brain receives more blood, the capillaries enlarge, and the flushing of toxins increases. In turn, an increase in the volume of the capillaries of the brain promotes the expansion of consciousness. However, sealing the skull suppresses the pulsation of blood in the arteries of the brain. Our brain is choking inside our own skull!

It is known that the intracranial pressure in a healthy adult is between 7-15mmHg, and the atmospheric pressure is about 760mmHg.

Hughes theorized that a hole in the skull raises pressure inside the head, which in turn squeezes out some of the cerebrospinal fluid (CSF), thus increasing the ratio of blood to cerebrospinal fluid in the head (he called it "brainbloodvolume").

According to Hughes' theory of increase in brainbloodvolume increases the supply of oxygen to the brain. And the more oxygen, the faster the process of cerebral metabolism goes and the more psychic energy a person has.

Schizophrenic or genius

Wanting to prove his theory, on January 6, 1965, Hughes underwent trepanation of the brain. He used a dental drill for this.

The operation lasted forty-five minutes. He later said that the operation was short-lived, but it took four hours to clear the blood from the walls and ceiling.

Shortly after surgery, Hughes went to a local hospital for an X-ray as evidence of trepanning. However, there he fell into the hands of psychiatrists, who suggested that the guy was schizophrenic. Bart was locked up in a mental hospital for three weeks. However, the doctors were soon forced to release him. Psychological tests showed that he was completely normal.

Followers

In 1966, Bart Hughes met Amanda Fielding (at the time she was 22 years old)

The girl becomes an ardent supporter of the theory of Hughes and his girlfriend. It is Hughes who introduces Fielding to the science of consciousness, and in particular to his theory of how blood circulates in the brain.

Around the same years, Oxford student Joe Mellen also became a follower of Bart Hughes.

We met with Hughes in Ibiza, - Mellen will write later in his book. - At that time I was taking soft drugs, but Hughes introduced me to his developments and convinced me that drugs are not at all what I need. Bart showed me a letter from a renowned professor of psychiatry from Amsterdam. This scientist asked Bart to become his assistant. Bart then refused. This scientist was not a genius, he was a good chemist. And Bart was a genius.

A few months later, Amanda Fielding decided to shake herself and herself. She was 23 when she expressed willingness to drill a hole in her skull. This time the operation was taped. Joe filmed the entire operation on camera.

For the next four hours after the operation, - Amanda will share her impressions, - I felt as if I had fallen into childhood ...

Revelations of fate

Like any genius, Bart was a difficult person and soon Amanda Fielding broke up with him ...

Shortly after Amanda split from Hughes, she married Mellen.

In marriage, they had two children. However, Hughes' influence continued to dominate their lives.

In 1970, Joe Mellen followed Hughes' lead and also underwent trepanning.

After trepanation, I had a feeling of growing lightness, - recalls Mellen. - It was quite an exciting feeling. Will it continue? I went to bed and the next morning was amazed to find that the feeling of lightness was still with me. In the days that followed, I realized that the changes in my consciousness would not disappear, that they would be forever. I felt better than ever and was ready for anything.

Photo: Mellen and Amanda on a walk in London.

Convinced

Fielding and Mellen have been married for 28 years, but then separated. Moreover, both of them convinced their subsequent partners to do trepanation for themselves.

In 1995, Amanda Fielding married a former Oxford professor and an English lord. The husband suffered from severe headaches, which stopped after trepanation

In 2000, Fielding traveled to Mexico City, where she underwent repeated trepanning. The European doctors to whom she made this request refused her.

Bart Hughes died in 2004 at the age of 70 from heart disease and was buried in Amsterdam. His scientific archive for the period 1934-1989 was transferred to the Amsterdam City Archives.

Joe Mellen is alive and well! In 2015, at the Third International Conference on the Psychedelic Aspects of Consciousness, held at the University of Greenwich in London, he presented his new research in this area.

Amanda Fielding is the founder and director of the Beckley Foundation, which funds consciousness research and drug development. She has run twice for the British Parliament on the importance of trepanning to national health.