Rural Neurotrauma in Australia: Implications for Surgical Training

Abstract

A significant volume of neurotrauma is managed surgically in rural Australia as dictated by distance. However, neurotrauma training of rural surgeons has occurred on an ad hoc basis, with those most exposed and most distant developing some confidence. Evidence for specific adequate training is lacking, but this study suggests that it is necessary.

Neurosurgery in rural Nigeria: A prospective study

“…The procedures are detailed in Table 2 and included: Trauma craniotomy,[11] craniotomy for tumor excision,[12] elevation of depressed skull fractures,[11] decompressive laminectomies,[13] and burr hole for hematoma[4] and abscess[14] drainage. Other procedures are spinal stabilizations,[3] ventriculoperitoneal shunting,[11] and spinal tumor excision. [15] Two cases each of spina bifida and encephalocoele were repaired.…”

“…[1112] This is even more so in Africa. [4] In Nigeria, neurosurgical services have only been available in major cities before the commencement of neurosurgical services in our center.…”

“…[1112131516] A large number of our patients were admitted for injuries resulting from RTCs. This is the pattern from several other reports from developing countries.…”

Management of acute traumatic intracranial haematoma in rural and remote areas of Australia

“…On‐site neurosurgical assistance may be beneficial. Educational programmes for LMOs confronting neurotrauma emergencies available through the RACS can assist LMOs to achieve acceptable outcomes, as advocated in a survey of rural surgeons conducted by the RACS Division of Rural Surgery …”

Emergency burr holes: "How to do it"

“…Although there have been significant technical advances in the safety of the procedure since the time of "exploratory" burr holes, there has simultaneously been a reduction in the number of surgeons either having experience in or being willing to perform the procedure. A number of general surgeons working in remote areas of Australia are more confident in performing simple neurosurgical procedures even though they may have no greater training than general surgeons closer to neurosurgical centres [4]. This may paradoxically result in more optimal management in more remote regions.…”