Thursday, Oct. 16, 2003 | 11:04 a.m.
A prominent Las Vegas neurosurgeon and longtime acquaintance of Roy Horn confirmed that the Strip entertainer had a "life-saving" operation that required a portion of his skull to be temporarily removed.
Dr. Lonnie Hammargren, a former Nevada lieutenant governor, expressed confidence that Horn, who remains in critical condition at University Medical Center, will survive as a result of the procedure.
"I feel he will survive and he owes it all to the doctors treating him," Hammargren said.
But Hammargren also took issue with some descriptions of the operation as reported Wednesday in the New York Daily News.
The newspaper, relying on information initially supplied by an unidentified source to the Star tabloid, reported that Horn had an operation known as a hemicraniectomy on Oct. 4, a day after he was mauled by a 600-pound Siberian tiger during an evening performance at The Mirage. The Daily News also characterized the operation as "radical."
When he read excerpts of the story, Hammargren said he disagreed that Horn had a hemicraniectomy or that it was a radical procedure.
Hammargren said the newspaper was correct in reporting that a hemicraniectomy is a procedure whereby a C-shaped section of skull is cut away to relieve swelling of the brain. But he said roughly half of the skull is cut away in that procedure.
"It's not a common procedure," Hammargren said. "In 30 years I have done 10 to 20. Many of these are done in desperate circumstances when there are no other alternatives."
Instead, Hammargren said Horn had what he described as a "decompressive craniectomy" that involved removal of a portion of the skull but only about the size of a human hand.
In Horn's case the intent of the operation was to relieve pressure on the brain "from the stroke he had as a result of massive injuries," Hammargren said.
He said the Daily News correctly reported that the portion of the skull that was removed was placed in Horn's abdomen to keep the bone marrow alive for future reattachment.
But Hammargren said the procedure performed on Horn was not radical -- as the Daily News reported -- "because radical sounds like it was experimental, and this was not experimental."
"The surgery he had was not radical," Hammargren said. "It was unequivocally necessary."
The 6,500-member American Association of Neurological Surgeons, an education and scientific association based in Illinois, cited a Massachusetts hospital study that found that hemicraniectomy operations reduced deaths and disabilities associated with major strokes.
The association reported that once the skull portion is removed, the scalp and the hard inner membrane beneath the scalp are sewn together. The association said it is typical to store the removed portion of the skull in the patient's abdomen until the brain swelling ends.
Hammargren said that a high percentage of patients still die after having such operations. But he recalled a successful skull operation he performed in Las Vegas about 10 years ago on a young woman who suffered massive head injuries after she was beaten during a robbery at a video rental store where she worked. The woman, Lorraine Mosca, was left with a "heavy limp" but has survived, he said.
"She went on to earn an engineering degree and is employed in Las Vegas today in engineering," Hammargren said.
The UMC trauma center and a spokesman for Horn had no comment on the Daily News story. Hammargren said Dr. Derek Duke performed the operation. Duke did not return a phone call seeking comment.
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