Michael T. Lawton, MD
@mtlawton • 21,388 subscribers
Neurosurgeon. Innovator. Author. Teacher. President & CEO @BarrowNeuro. Spetzler Chair of Neurosurgery. Co-Founder @MissionBrainOrg.
Videos
1:04
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Manual craftsmanship…it’s what makes performing a bypass so satisfying and what gives me confidence that microneurosurgery’s future is safe (for now). Bypass is “the hardest problem in surgical robotics” and has yet to be fully performed by a robot. Surgeons, suture on…
Michael T. Lawton, MD945,877 views • 3 months ago
1:16
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Pulled out all stops for this basilar aneurysm: rapid ventricular pacing to soften aneurysm; tandem curved clipping to reduce its girth; tentorium disassembly to increase transsylvian exposure for proximal control lateral to trochlear n.; aneurysm clipping thru 3 triangles: optic-carotid, carotid-oculomotor, oculomotor-tentorium…
Michael T. Lawton, MD115,161 views • 1 month ago
1:12
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AVMs are endlessly variable, which is why taxonomy simplifies the confusion to 32 recognizable subtypes, each w/definable anatomy & surgical strategy. Types are the lobes/brain regions, subtypes are surfaces on which the nidus is based. Taxonomy informs learning, guides resection…
Michael T. Lawton, MD315,289 views • 4 months ago
1:15
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Neuroanatomy teaser: This patient presents w/atypical face pain unresponsive to microvascular decompression & C1 spinal cord stimulator. Weird!? Turns out a cuneate medullary cavernoma was triggering spinal trigeminal nucleus on its descent to C3 & its resection cured her…
Michael T. Lawton, MD94,222 views • 2 months ago
I recently reached a significant spinal cavernous malformation milestone: #100 resected microsurgically. These are the most common vascular malformation in my practice & teach so much about zones of entry into cord tissue, safe resection techniques, and handling of cord tracts…
Michael T. Lawton, MD119,338 views • 9 months ago
1:09
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Today’s big news is not this bypass, but the announcement by Neuralink that BarrowNeurological is the clinical partner in PRIME Trial. In January, we successfully implanted the N1 brain-computer interface device in 1st human patient, ushering in a future where this technology will change lives of countless patients & transform neurosurgery…
Michael T. Lawton, MD264,527 views • 2 years ago
1:14
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Once in a while, unique pathology appears & you look forward to seeing it, studying it in the operating room – like this spinal cord AV fistulous connection. When it unexpectedly ruptures while beginning the case, that clean pathology gets buried in blood. Fortunately, we were there to fix it quickly….
Michael T. Lawton, MD35,155 views • 2 months ago
Important tip: contralateral transcallosal-contralateral transchoroidal approach is the way to medial thalamic cavernomas but travels under fornix & requires forniceal retraction; Contralateral transcallosal-ipsilateral transchoroidal travels over fornix & avoids this retraction for better memory outcomes….
Michael T. Lawton, MD260,135 views • 2 years ago
1:10
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Sometimes in this job, life hangs in the balance & you must act on intuition, w/out the usual studies confirming your diagnosis. Here, fistulous connections b/w meningeal arteries & a cortical vein produced hypertension, venous dilation, rupture. DAVFs can be treated endovascularly, but hemorrhage often requires emergency surgery to close the fistula, evacuate clot, save a life….
Michael T. Lawton, MD23,431 views • 2 months ago
1:00
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Pathology isn’t supposed to look pretty, but the marginal sinus dural arteriovenous fistula is always a beauty to behold, with tortuous veins & varices winding through cranial nerves & around the medulla like a snake pit. As complex as they look, they’re simple to treat – one clip on the venous outflow & it’s cured…
Michael T. Lawton, MD10,911 views • 29 days ago
We like to be there when trouble strikes, as with this carotid injury during nasal polyp removal @ outside office. After control w/Foley balloon catheter in the nose, we performed bypass/carotid sacrifice, which treated the carotid-cavernous fistula and enabled safe removal of the balloon…
Michael T. Lawton, MD172,132 views • 2 years ago
1:11
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Complications when clipping basilar apex aneurysms come from compromising thalamoperforators, which arise from superior walls of P1 segments, away from SCA aneurysms. These are safer to clip w/better outcomes, but proximal control may be deeper down & SCA origin from the base may be harder to reconstruct….
Michael T. Lawton, MD25,231 views • 3 months ago
0:57
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Basilar trunk aneurysms are a long way in; we are called on to clip these only rarely. But we have the know-how for the young patient seeking a durable cure: extended retrosigmoid craniotomy, open the cistern + its triangles, & in this case, free dense adhesions around the aneurysm to place the clip blades…
Michael T. Lawton, MD28,485 views • 3 months ago
1:17
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Many would call this intraventricular AVM inoperable. The secrets to its safe removal from temporal horn & atrium are: throttling ant. choroidal artery early, finding other MCA feeders supplying it medially, preserving memory structures in the hippocampus/medial temporal lobe…
Michael T. Lawton, MD19,795 views • 2 months ago
“Dome protection,” or placing coils in the dome of a ruptured aneurysm, can prevent rehemorrhage but can complicate subsequent clipping. Coils ramp clips down onto the neck & constrict/block the parent artery. Here, I used posterior clinoid to anchor the clip & keep it from sliding…
Michael T. Lawton, MD21,055 views • 3 months ago
0:59
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This might be the most dramatic example of an anterior pial spinal AVM I’ve seen. They’re fed by ant. spinal artery, lie in ventral midline, arise from pia w/out cord infiltration. Laminectomy + traction sutures on the dentates enable cord rotation to bring the pathology into view...
Michael T. Lawton, MD14,141 views • 2 months ago
1:22
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1:05
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Learning curves are climbed 1 step at a time over 7 long yrs. Seeing a resident at the end of chief residency march thru a delicate aneurysm dissection is the mentor's reward. Surgery is delicate, technical demands are high, & w/the right coaching, they get there. #GraduationWeek
Michael T. Lawton, MD10,949 views • 1 month ago
The spinal cord is a scary thing to incise. The cord has a midline fissure that makes it easier there, but paramedian cord does not. However, myelotomy along dorsal root entry zone (DREZ) is safe for dorsal spinal cord cavernous malformations, entering posteromedial to descending corticospinal tract & dancing around posterior spinal artery…
Michael T. Lawton, MD33,254 views • 8 months ago