Fillers A memorable patient

Long ago, at another hospital

BMJ 2002; 324 doi: (Published 15 June 2002) Cite this as: BMJ 2002;324:1437
  1. Munchi Choksey, consultant neurosurgeon
  1. Walsgrave Hospital, Coventry

    She was a vicar's wife in her 50s who had developed a sudden agonising headache. Her general practitioner diagnosed a subarachnoid haemorrhage, which was confirmed by computed tomography. Angiography revealed a right posterior communicating artery aneurysm. She remained well, and because of the risk of re-bleeding we decided to operate as soon as possible. My usual consultant anaesthetist was away on holiday, and a relatively junior (but experienced) registrar standing in. (The level of cover provided when seniors were away had long been a source of contention.)

    From the outset conditions were difficult: she was tachycardic; the skull, bone edges, and extradural space bled profusely; the brain bulged. I complained that conditions …

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