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Glasgow Institute of Neurological Sciences

In 1974 the Institute of Neurological Sciences, Glasgow, was a world leader in brain injury research and clinical care. Professor Jennett and Mr Teasdale, (at that time a neurosurgical senior registrar), published a paper in the Lancet on the Assessment of Coma and Impaired Consciousness that proposed a structured method of assessment that would become known as the Glasgow Coma Scale. Forty years on, Sir Graham led a project to understand the current use of the Glasgow Coma Scale, its successes and its perceived shortcomings.

see http://www.glasgowcomascale.org


Patient archives were reviewed to identify the number of admissions and procedures performed at the Institute of Neurological Sciences, Glasgow, in the years 1988, 1997 and 2011. Death certificate records were used to identify mortality in the unit in the year 2011. Patient records were used to obtain details of diagnosis, time from admission to death, and the presence and timing of a TLD.

The results show an increase in the use of TLDs, with decisions made for 89% of those who died in 2011, compared to 68% in 1997 and 51% in 1988. The number of admissions has increased substantially since 1988 as has the percentage of patients undergoing surgery (46, 67 and 72% in 1988, 1997 and 2011, respectively).

There is a trending increase in the number of patients who have a TLD in this regional neurosurgical unit. This demonstrates an increased willingness of clinicians to recognise poor prognosis and to withdraw or withhold treatment in these cases. Continued appropriate use of the TLD is recommended but it is to only ever reflect the best interests of the patient 1).


Southern General Hospital, Glasgow

The Neurosurgery unit for Glasgow is based at the Institute of Neurosciences in the Southern General Hospital, Glasgow. The Institute of Neurological Sciences provides Neurosurgical, Neurological, Clinical Neurophysiology, Neuroradiology and Neuropathology facilities for the West of Scotland. It serves a population of 2.7million.

The neurosurgical department comprises three wards (Wards 63, 64 and 65), with 66 beds and an ITU and HDU facility catering for a further 12 patients. There are three dedicated neurosurgical theatres.

There is an outpatients clinic within the unit where consultant-led neurosurgery clinics are held on a daily basis. There are also clinics run by Extended Scope Physiotherapy Practitioners.

The Institute is equipped with two Magnetic Resonance Imaging Suites, SPECT Scanner, two Computerised Axial Tomography Scanners, and angiography facilities.

There are currently 14 neurosurgeons based in the unit. Approximately 60% of the unit's workload is emergency care. The adult unit has close links with the Royal Hospital for Sick Children, Glasgow. Four consultants work between the adult unit and the children's unit at Yorkhill hospital. In 2015 the children's hospital will move to the new hospital at the Southern General.


Mr Likhith Alakandy, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Mr Laurence Dunn, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Mr Calan Mathieson, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Mr Roddy O’Kane, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Mr Jerome St George, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Mr William Taylor, Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

1)
Wilson WT, McMillan T, Young AM, White MA. Increased trends in the use of treatment-limiting decisions in a regional neurosurgical unit. Br J Neurosurg. 2016 Sep 1:1-4. [Epub ahead of print] PubMed PMID: 27580674.
glasgow.txt · Last modified: 2016/09/16 18:29 (external edit)