Western General Hospital

Hospital A&E Information

Neurosurgery

The neurosurgical service serves NHS Lothian, Borders, Fife, Forth Valley and Dumfries & Galloway (approximately 1.5 million). There are seven neurosurgeons (six wte) and six neuroanaesthetists, the latter having charge of an integral Intensive Care Unit. Most admissions fulfil the criteria of severe TBI, usually requiring intubation and ventilation and most neurosurgical intervention.

The average length of stay is of the order of two weeks. Individuals with mixed physical and cognitive problems (scenario B) are referred to the Astley Ainslie Hospital or the local rehabilitation unit in Fife, Forth Valley or Dumfries & Galloway. Those who have made a good physical recovery but have some persisting cognitive impairment would be seen by the neuropsychologist on the unit and referred as necessary to rehabilitation.

There are some who remain on the unit for prolonged periods. This may relate to combined brain and spinal injury or lack of availability of beds in the referring health board area especially in those in a vegetative or minimally conscious state (scenario E).

Acutely behaviourally disturbed individuals (scenario C) are seen by the Neuropsychiatrist and advice may be sought from the SNBRS. Similarly those fitting scenario D are referred to SNBRS but there may be a delay of several weeks before transfer is possible.

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