I WILL GO BACK to some of the old established rules of neurosurgery, because, although we have accumulated much new and extremely reliable information in the last few years, we must not forget the lessons of the past. There is one rule which states that if one explores an intracranial tumor one must provide an adequate internal or external decompression if the patient is to survive the operation. In other words, an anesthetic and simple craniotomy may upset the delicate pressure and placement adjustments between a tumor and the brain in such a manner as to cause death. For example, a surgeon approaching a moderate or large acoustic tumor should be prepared to deal with it definitively by whatever approach he selects at the time of the initial surgery. Staged surgery with decompression is safe. Staged surgery without decompression is not safe. The following case illustrates that even an anesthetic
MULLAN JF. Intracranial Removal of Acoustic Tumors. Arch Otolaryngol. 1966;83(6):591. doi:10.1001/archotol.1966.00760020593019
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