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Michael T. Lawton, MD

@mtlawton • 22,730 subscribers

Neurosurgeon. Innovator. Author. Teacher. President & CEO @BarrowNeuro. Spetzler Chair of Neurosurgery. Co-Founder @MissionBrainOrg.

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I’ve long said, “successful bypass surgery is 1,000 perfect moves.” But perfection isn’t always attainable, which means we must know how to correct our mistakes. The mark of great surgeons isn’t perfection, but knowing those key moves that salvage a tough situation & get to success. Here, the “through stitch”….

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I’ve long said, “successful bypass surgery is 1,000 perfect moves.” But perfection isn’t always attainable, which means we must know how to correct our mistakes. The mark of great surgeons isn’t perfection, but knowing those key moves that salvage a tough situation & get to success. Here, the “through stitch”….

Michael T. Lawton, MD

2,009,670 просмотров • 22 дней назад

Sometimes color is so unique, you know the diagnosis the instant you see it. It’s a good thing w/hemangioblastoma, because these intensely orange & vascular tumors are handled differently than others - circumdissecting, staying extracapsular, interrupting feeding arteries like an AVM, rather than debulking it…

Sometimes color is so unique, you know the diagnosis the instant you see it. It’s a good thing w/hemangioblastoma, because these intensely orange & vascular tumors are handled differently than others - circumdissecting, staying extracapsular, interrupting feeding arteries like an AVM, rather than debulking it…

Michael T. Lawton, MD

65,222 просмотров • 1 день назад

Reading the subtle difference in color between grayish tumor and white matter is the key to separating spinal ependymoma from normal spinal cord, plus a delicate touch to gently work the pathology free. Sight and feel working in harmony with high stakes - this is the essence of microneurosurgery...

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Reading the subtle difference in color between grayish tumor and white matter is the key to separating spinal ependymoma from normal spinal cord, plus a delicate touch to gently work the pathology free. Sight and feel working in harmony with high stakes - this is the essence of microneurosurgery...

Michael T. Lawton, MD

167,587 просмотров • 8 дней назад

Everybody’s talking robotics. But robots are built to do one task w/precision, need simple, consistent anatomy to operate surgically, like w/cholecystectomy. This brain AVM extends from cortex to ventricle, is supplied by convexity arteries + deep perforators, sits next to motor strip. Good luck Optimus….

Everybody’s talking robotics. But robots are built to do one task w/precision, need simple, consistent anatomy to operate surgically, like w/cholecystectomy. This brain AVM extends from cortex to ventricle, is supplied by convexity arteries + deep perforators, sits next to motor strip. Good luck Optimus….

Michael T. Lawton, MD

623,551 просмотров • 29 дней назад

The best surgical bypasses mimic nature’s design, like anterior & posterior communicating arteries in the circle of Willis, drawing flow on demand. Arteries that run parallel and in close proximity can be joined w/ side-to-side anastomosis to create an intracranial-to-intracranial bypass, like this A3-A3 construct…#SevenBypasses

The best surgical bypasses mimic nature’s design, like anterior & posterior communicating arteries in the circle of Willis, drawing flow on demand. Arteries that run parallel and in close proximity can be joined w/ side-to-side anastomosis to create an intracranial-to-intracranial bypass, like this A3-A3 construct…#SevenBypasses

Michael T. Lawton, MD

70,471 просмотров • 7 дней назад

Some say medicine is not creative, but there are problems to be solved everywhere. Take this vertebral artery dolichoectasia compressing brainstem. Yrs ago, I devised this rig to pull the offending artery away from brainstem w/a sling, or “macrovascular decompression.” And being an aneurysm surgeon, of course I used clips to anchor the sling to clivus & adjust tension…#SurgicalCreativity

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Some say medicine is not creative, but there are problems to be solved everywhere. Take this vertebral artery dolichoectasia compressing brainstem. Yrs ago, I devised this rig to pull the offending artery away from brainstem w/a sling, or “macrovascular decompression.” And being an aneurysm surgeon, of course I used clips to anchor the sling to clivus & adjust tension…#SurgicalCreativity

Michael T. Lawton, MD

292,726 просмотров • 1 месяц назад

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…

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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, MD

946,318 просмотров • 4 месяцев назад

What you see preop isn’t always what you get intraop. With thrombotic aneurysms, dye only fills the aneurysm’s lumen to show its inner size on angiography. At surgery, you encounter the entire aneurysm, including the non-filling part, between the lumen and outer wall. Don't be surprised...

What you see preop isn’t always what you get intraop. With thrombotic aneurysms, dye only fills the aneurysm’s lumen to show its inner size on angiography. At surgery, you encounter the entire aneurysm, including the non-filling part, between the lumen and outer wall. Don't be surprised...

Michael T. Lawton, MD

184,729 просмотров • 1 месяц назад

Militarily, the “surgical strike” is a precise attack at a specific target with no damage to surrounding people or structures. Clipping a dural arteriovenous fistula is the definition of surgical strike, plus simplicity. And DAVFs around the medulla and foramen magnum are spectacular for their varicosity & tortuosity. Check it out…

Militarily, the “surgical strike” is a precise attack at a specific target with no damage to surrounding people or structures. Clipping a dural arteriovenous fistula is the definition of surgical strike, plus simplicity. And DAVFs around the medulla and foramen magnum are spectacular for their varicosity & tortuosity. Check it out…

Michael T. Lawton, MD

41,612 просмотров • 13 дней назад

Observation is power in brain surgery. And the bright light & magnification of the operating microscope give us superpower. With AVMs, reading subtle differences in redness of vessel walls differentiates artery & vein; noting progressive change in draining vein color from red to blue indicates that few feeders remain. Surgical acumen uses senses to the fullest…

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Observation is power in brain surgery. And the bright light & magnification of the operating microscope give us superpower. With AVMs, reading subtle differences in redness of vessel walls differentiates artery & vein; noting progressive change in draining vein color from red to blue indicates that few feeders remain. Surgical acumen uses senses to the fullest…

Michael T. Lawton, MD

34,809 просмотров • 15 дней назад

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…

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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, MD

315,289 просмотров • 5 месяцев назад

What’s the secret to good outcomes w/brain AVM surgery? Choosing your battles wisely, and supplemented AVM grading - sum of Spetzler-Martin + Lawton-Young grades - is the starting point for patient selection. I draw the line at grade 6 and usually don’t operate > grade 7, but here’s an exception. Check out one of the best views of lateral recess & foramen of Luschka I’ve ever seen…

What’s the secret to good outcomes w/brain AVM surgery? Choosing your battles wisely, and supplemented AVM grading - sum of Spetzler-Martin + Lawton-Young grades - is the starting point for patient selection. I draw the line at grade 6 and usually don’t operate > grade 7, but here’s an exception. Check out one of the best views of lateral recess & foramen of Luschka I’ve ever seen…

Michael T. Lawton, MD

69,011 просмотров • 1 месяц назад

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…

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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, MD

115,161 просмотров • 3 месяцев назад

Large, wide-neck aneurysms treated endovascularly can recur. Microneurosurgeons need to be ready with solutions like bypass/flow reversal. Today’s challenge is to master these technically demanding procedures on the infrequent cases done these days, and remain at the ready…#SevenBypasses

Large, wide-neck aneurysms treated endovascularly can recur. Microneurosurgeons need to be ready with solutions like bypass/flow reversal. Today’s challenge is to master these technically demanding procedures on the infrequent cases done these days, and remain at the ready…#SevenBypasses

Michael T. Lawton, MD

34,370 просмотров • 27 дней назад

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…

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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, MD

94,361 просмотров • 3 месяцев назад

Insight = sudden reorganization of what you have already done into something you didn’t previously understand fully. That’s what happened when I reviewed 52 videos of my spinal AVM resections. We can’t transport insights that come later in our life back in time & inform earlier operations, but we can apply insight to future cases, which has a name: wisdom…

Insight = sudden reorganization of what you have already done into something you didn’t previously understand fully. That’s what happened when I reviewed 52 videos of my spinal AVM resections. We can’t transport insights that come later in our life back in time & inform earlier operations, but we can apply insight to future cases, which has a name: wisdom…

Michael T. Lawton, MD

12,609 просмотров • 20 дней назад

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…

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, MD

119,461 просмотров • 10 месяцев назад

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…

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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, MD

264,527 просмотров • 2 лет назад

Teslaconomics Seriously Elon, do you actually think a robot can do this? Keep believing in humanity...

Teslaconomics Seriously Elon, do you actually think a robot can do this? Keep believing in humanity...

Michael T. Lawton, MD

99,502 просмотров • 10 месяцев назад

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….

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, MD

260,135 просмотров • 3 лет назад