[Verse 1] Turn the head, fix the frame, map the field before the blade — Supine with a lateral tilt, park bench carefully laid, Prone and Concorde, three-quarter turn, the sitting position waits, But sitting courts a silent thief that slips through patent gates — Venous air embolism, read it on the Doppler's hum, End-tidal CO₂ dropping low, precordial mill-wheel drum, Screen the foramen ovale first, a PFO can send An air lock paradoxical up where the pathways end. [Chorus] Pin the Mayfield, check the torque — children need it gentle, Horseshoe for the smallest skull, protection elemental, Mannitol or hypertonic saline, open up the cistern, Dynamic retraction, never fixed — that's the surgeon's dictum. WHO checklist, imaging on the wall, side marking on the skin, Map the burr hole, strip the dura clean before you walk within. [Verse 2] Incision planned around the blood supply, galea kept intact, Craniotome follows the dura stripped, a tack-up suture tracked, Bone edge waxed and coagulated, hemostasis thorough-made, Then open dura leaf by leaf — cruciate or tapered blade, Bone flap plated, watertight closure, duraplasty if thin, Drain decisions made before you tie the final suture in. Every pressure point padded down, the brachial plexus clear, Eyes taped, jugulars uncompressed — venous drainage engineered. [Chorus] Pin the Mayfield, check the torque — children need it gentle, Horseshoe for the smallest skull, protection elemental, Mannitol or hypertonic saline, open up the cistern, Dynamic retraction, never fixed — that's the surgeon's dictum. WHO checklist, imaging on the wall, side marking on the skin, Map the burr hole, strip the dura clean before you walk within. [Bridge] Under the microscope — ergonomics, posture, both hands free, Bimanual dissection, sharp arachnoid, cottonoid debris Disciplined and counted, bipolar kissed with irrigation, Hemostatic agents chosen with deliberate moderation. The endoscope down a narrow corridor, lens fogged then cleared, Four hands through two nostrils, hemostasis — the thing most feared. The word is *tenebrous* — shadowed, obscure, difficult to see — That's the operative field before positioning sets it free. [Verse 3] Emergency cold: EVD placement, burr hole cracked at speed, Extradural clot, acute subdural — own the skill you need, ICP bolt threaded, lumbar drain for intracranial slack, Decompressive craniectomy when there's no pressure pathway back. Navigation registered, the workflow locked without a flaw — *Sternutation* of the checklist: reflexive, sharp, and raw — A sneeze of discipline that clears the system every time, No wrong site, no wrong side, no wrong patient on your line.
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