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Member since Jun-04-08 · Last seen Dec-10-17
Good Day to All! Ma-ayong adlaw sa tanan. And my thanks to for this excellent website. Salamat Opinions:

1. World Chess Championship

The true Chess World Champions are the holders of the Traditional Title that originated with Steinitz & passed on in faithful succession to Lasker, Capablanca, Alekhine, Euwe, Botvinnik, Smyslov, Tal, Petrosian, Spassky, Fischer, Karpov, Kasparov, Kramnik, Anand, and Carlsen. The sacredness of this Title is what makes it so valuable.

And how does one become the true Chess World Champion? In general, by beating the previous Titleholder one on one in a Match! Matches are preferred over Tournaments because of the Tradition of the WC Succession & because the chance for pre-arranging a Tournament result is more likely. The only exceptions to this rule:

A. In case where the Candidates and World Champion participate in an event that all the participants agree to be a World Championship event because of extraordinary circumstances.

Thus, the 1948 World Championship Tournament was justifiable because of the death of the Title holder Alekhine.

Likewise, the 2007 WC Tournament was justifiable under the extraordinary circumstances of the Chessworld trying to heal its internal rift over the 1993 Kasparov Schism. Anand himself became the World Champion in this 2007 Tournament & not in 2000 when he won a knock-out FIDE Tournament. Caveat: Some chess fans deem the 2007 WC Tournament as illegitimate, considering that Anand became the World Champion only in 2008, when he beat the previous Titleholder Kramnik in a WC match. From this perspective Anand only became the Undisputed World Champion in 2008.

Karpov lost his Title to Kasparov in 1985, & never regained it in the 1990s events that FIDE labeled as 'world championships'. All solely FIDE Champions that emerged outside WC Traditional Succession elaborated on above, strong as they were, were not true World Champions (eg., Bogolyubov 1928, Khalifman 1999, Ponomariov 2002, Kasimdzhanov 2004, Topalov 2005).//

B. In case the previous Titleholder refuses to attend (or defaults) an event that the Chessworld largely deems as a World Championship event in the Tradition of the World Championship Succession. Thus, Karpov was the true successor to Fischer who resigned (or defaulted) their WC Match in 1975.

2. The strongest chess events in different eras of chess history?

Because of the brain's limitations explained below, the best professional (amateurs don't matter much in top level chess) chess players of each generation beginning in the Lasker era have always played at a similar level - near the maximum allowed by human standards. Now there are larger cohorts of chess professionals post WW2 than preWW2 thanks to government state funding in the Soviet era and presently corporate funding. The result is that large preWW2 tournaments had numerous 'bunnies', relatively weak players. By the Kasparov era, super-tournaments that featured most of the top ten, and no bunnies, had became more common. However, the top 4 or 5 since Lasker's time have always been very strong.

Consequently the smaller the top-player-only tournament, the stronger it gets. For any era. If there was a double round robin tournament in 1914 featuring Lasker, Capablanca, Alekhine, and Rubinstein, and no other, it would be as strong as any present day super-tournament.

Now weed out everyone except the two strongest players in the world. What we (usually) get is the chess World Championship match.

There has been talk of elite tournaments, composed only of the strongest top masters and no weaker bunnies replacing the World Championship match in prestige, probably because of the assumption that they would be the strongest chess events possible. False assumption. The strongest chess events in chess history generally have been World Championship matches. Even the strongest masters in each generation usually do not match the world champion and challenger in chess strength. In a World Championship match, the contestant has to meet the monster champion or challenger over and over again, with no weaker master in between. Capablanca vs Lasker 1921 was just as strong a chess event as the recent Carlsen vs Anand 2013, and far stronger than Zurich 2014. (Imagine having to play 14 straight games with a computer-like errorless Capablanca at his peak.)

3. The strongest chess players in chess history?

First, it's possible to compare chess players from different eras by 'using' players with long careers whose active playing spanned across at least three or four decades. Some historical examples involving World Champions and Almost World Champions are Lasker, Alekhine, Keres, Botvinnik, and Korchnoi. Specifically, Lasker as an old man man in the 1920s was beating the hypermoderns. An 'old' Alekhine meted out crushing defeats to young Flohr and Keres in the 1930s and 40s, and was clearly better than them. Keres whose peak was probably in 1938 to 1943 played terrific chess until the 1970s, and nearly got to be Challenger again in the 1950s and 60s, beating a whole slew of younger players. This included Korchnoi who until the 2000s could give good account of himself playing the teen Grandmasters of the turn of the century.

Second and more important, I believe that we can rationally compare chess players from different eras by using objective computer analysis of their middlegames and endgames (not openings). We can 'ask' the computers how accurately the players are playing. They take the place of the stopwatch. As far as I know, nearly every computer study using various programs has always placed Capablanca at number one or two in terms of accuracy. Computers 'love' Capablanca's play.

Thus the 1919 version of Capablanca & the 1971 version of Fischer, both of whom played practically error-free chess, are it; updated in opening theory, they should beat anyone in a match.

If computers were self-aware, I have no doubt that they would unanimously choose the 1916 to 1924 Capablanca as the strongest chess player in history. And please no red herring remark that Capa played only 'simple' chess. This young Capablanca played some of the most complicated, sharp, double edged, and bizarre positions possible; and played them without making a single losing error (and by all accounts with unsurpassed quickness), something that has always befuddled my mind when I got to peruse through his games.

We have to take this question in the context of the limits of the human Anatomy and Physiology. A concrete example would be the one hundred meter dash. The human body is designed such that the limit it can run is about 9 seconds. In order for a human being to run faster, we would have to redesign the human anatomy into that of say a cheetah. One can rev up the human Anatomy and Physiology, say with steroids, but this regimen would hit an eventual Stonewall too; the same way that we could rev up human proficiency to learn openings with computer assistance.

Since the Nervous System has physiological limits (example of a limit- neuronal action potential speed don't go up much more than 100 m/s) and so limits the human chess playing ability, increasing the number human chess players, thus expanding the normal curve of players, simply creates more possibilities of players playing like a Fischer in his prime, but will not create a mental superman who plays chess at computer levels. This explains why human and computer analysis indicate that Lasker was playing on a qualitatively similar level as more recent WCs.

'Worse' in chess, any computer assistance ends once the opening is over. After a computer-assisted opening prep, every GM today has to play the game the way Lasker did a hundred years ago, relying on himself alone, with the same fundamental chess rules and chess clock. An Encyclopedic opening repertoire is not a necessity to be a top player. In fact, there are World Champions who did not do deep opening prep; they just played quiet but sound openings that got them into playable middlegames and then beat their opponents in the midlegame or endgame. Just look at Capablanca, Spassky, Karpov, and now Carlsen.

Because of subconscious adherence to the narcissistic generation syndrome, the belief that everything that is the best can only exist in the here and now, many kibitzers would not agree to the above theses. While it is true that there have been more active chess professionals and consequently larger cohorts of top chess masters on a yearly basis since WW2 thanks to Soviet state funding and present corporate funding, the very top chess masters since Lasker's time have always played at a similar level- within the limits imposed by the human brain. There is no physical law that bars a pre-WW2 chess master from playing chess as well as today's generation. The human brain has not changed in any fundamental manner in the past tens of thousands of years.

4. The greatest chess players in history?

A related question is who is the greatest chess player in history. The answer depends on the criteria one uses. Since I place great emphasis on the ability to play world class chess for the longest period of time, Lasker would be it. He was playing at peak form from 1890 age 22 (when he began a remarkable run of match victories over Bird, Mieses, Blackburne, Showalter, and culminating in his two massacres of Steinitz) until 1925 at age 57 (when he nearly won Moscow after winning new York 1924). Kasparov (high plateau from 1980 to 2005) and Karpov (high plateau from 1972 to 1996) would follow. (At their very peak though, I believe that Kasparov was stronger than Karpov, and both were stronger than Lasker; and the peak Capablanca and Fischer were stronger than any of them.)

5. Computers vs Humans, who is stronger?

Another related question is how history's top masters would fare against computers. It's obvious from Kasparov's time that computers would totally crush them all. Opening knowledge would not matter much. Computers swamp human opponents in the middle game, simply by calculating more variations more rapidly by several orders of magnitude.

6. On the game and chess players young and old, past and present:

The proposition that an older player would not be able to adjust to the openings and methods of a younger generation is false, as evidenced by the observation of strong masters whose careers happened to span generations beating the tar out of weaker masters of the next generations. (See #3 above.)

This 'inter generational knowledge/theory leveling phenomenon' holds true today and will probably still hold true two decades from now. As of 2017, Kramnik, Anand and Topalov, and a few years ago Gelfand are living smoking gun proofs that the speculation that the older generation cannot adopt to newer openings is false. Older players have always adapted and will always adapt to the latest openings in the vogue. The present day young players will do the same 20 years from now, faced with a future generation of rising chess players.

The notion that computers are more advantageous to younger players IMO is not quite right. Younger players should have more energy and stamina in studying chess openings and endgames for long hours everyday compared to older players without computers, but the use of computers would tend to make the learning process easier for every one including the older ones.

As a corollary, computers also make it easier today for very young players in their early teens to peak at a younger age than in past eras, although they tend to level off in their early 20s to their high plateau, defined by their inborn talents and determination.

In brief. computers tend to level chess learning for everyone, young and old.

This is not a rigid rule. The best games I have ever seen played by a 12-13 year old are Capablanca's; and Tal, Karpov, and Kasparov reached their high plateau in their early 20s in a computer-less era, similar to computer age Carlsen. However let it be noted that Carlsen reached his peak sidestepping intensive computer-prepped tactical openings and beating his competitors in the old fashioned way in the middlegame and endgame. These masters peaked early not because of computers by because of their immense chess talent. Perhaps normal rules do not apply to these geniuses.

Another false notion is that the nature of the middlegame today is somehow different from the middlegame in the past. The easiest way to prove the wrongness of this proposition is by observing CG's daily puzzles. Do not peek at the names of the players that played these puzzles, and don't look at the dates. Can you glean from the middlegame play and combinations in the puzzles the date they were played? You can't. You would not know if it was played in 2016, 2000, 1950, or 1900. Chess combinations don't just suddenly change their stripes just because a hundred years have passed.

Another observation is that when the best masters of the past, Lasker, Capablanca, and Alekhine met the occasional 'modern' structures of the Sicilian Scheveningen and Dragon, KID, Modern Benoni, Benko Gambit, they played strategically perfectly, in just the way these opening structures should be played. So how did these masters play openings and the resulting middlegame structures that are deemed incomprehensible to them by some of today's dogmatically 'modern' kibitzers? The answer is that chess rules and principles have not changed. Center, rapid development, open files and diagonals, holes, weak pawns, piece activity, initiative and attack, positional sacrifices and all types of combinations were as familiar to them as to us.

Note that it is the frequencies of a few middlegame pawn structures that have changed since WW2. Not the Ruy Lopez or QGD, but obviously Sicilians and KIDs are much more common post-WW2. Since so many games nowadays begin with the Sicilian and KID, people associate these with being 'modern' (which is a rather vague undefined term IMO). But certainly Lasker and Capablanca understood the middlegame principles behind them and when they did get these positions they played them excellently, like the top masters they are.

Moreover, Keres is another smoking gun, bomb proof evidence of the fallacy of Watson's speculation that 'the best players of old were weaker and more dogmatic than the best players today', and Larsen's assertion that he would crush everyone in the 1920s. The glaring fact is that Keres is a pre-WW2 master who began his career in the late 1920s, and played competitively up to the 1970s, and he did learn (and contributed) to the newer opening variations (the most famous of which is the Keres attack which he invented in 1943). The ideal way for Watson and Larsen to prove their statements is to beat a top pre WW2 master such as Keres. They failed. Tellingly enough an aging Keres beat both a rising Watson and a peak Larsen when they happened play each other.

7. Regarding the topic on Physical compared to Mind prowess.

IMO improvement in 'physical' prowess, is mainly based on muscles and sports equipment and apparel.

So the same methods can't be done for the 'mind'.

Most people miss this out, but there is a big difference between improving muscles and the brain.

Muscles can hypertrophy. One can input in better ways to hypertrophy them, such as specialized gym equipment and exercises, and steroids.

On the other hand neurons do not hypertrophy.

Furthermore the 'hardwiring' of our nervous system mostly occurs when we were kids. Although we keep on learning throughout our lives, the last major upgrade was when the myelinization of our nerve fibers was completed when we were about 4 years old.

The above is the reason why I believe that if we are to produce an upgrade of the Capablanca type of chess genius (extremely rapid and accurate way of playing), we would have to start with kids 4 years old and below.

8. On ratings:

Elo ratings reflect relative and not absolute chess strength.

Chessplayers are naturally arranged in populations partitioned by geopolitical regions & time periods that have infrequent contacts with one another. Within such a population, players get to play each other more frequently, thus forming a quasi-equilibrium group wherein individual ratings would tend to equilibrate quickly; but not with outside groups. With caveats & in the proper context, FIDE/Elo ratings are simply fallible descriptors & predictors of an active player's near-past & near-future performances against other rated players, & only within the same quasi-equilibrium group.

As corollaries: the best way to evaluate a player's strength is to analyze his games & not his ratings; one cannot use ratings to accurately compare the quality of play of players from the past and present, or even the same player say a decade ago and today; & care should be taken in the use of ratings as a criterion in choosing which players to seed into the upper levels of the WC cycle. All the above often entail comparisons between players from different quasi-equilibrium groups separated by space and/or time.

Regarding inflation deniers, they imply that Elo ratings reflect absolute and not relative chess strength. Professor Elo himself would condemn their view. If the top 20 players were to suffer a serious brain injury and begin playing like patzers, but play no one else for the next decade, they would more or less retain their 2700s ratings, although they would be playing terrible patzerish chess.

9. Best Qualifiers?

The credible, fair, tried & tested Zonals - Interzonals - Candidates (with known strong players directly seeded into the Interzonals & Candidates; & here ratings may be used with caveats) over the random World Cup 'lottery' and the elitist Grand Prix. If possible long Candidate matches and 16 to 24 game World Championship matches. However, with the passing of the state-funded chess era of Soviet times, I begin to doubt if the strict money guzzling qualification process above can be re-installed.

10. The 1993 Chess Rift and Kramnik:

Regarding the Rift in the chessworld after Kasparov split in 1993, I believe that Kramnik has done more than any other individual in helping heal it by concrete actions - agreeing to a WC Match with Topalov in 2006 & not walking out when he could have done so with the support of most of the world's top GMs after getting accused of cheating; & agreeing to Defend his Title in a WC Tournament in 2007, the first time a living Titleholder has agreed to do so in chess history. My eternal gratitude to him.

11. Finances of a would-be Challenger:

Regarding all kinds of problems chessplayers outside of Europe & the USA face in their quest for the Title, Capablanca & Anand have proven it's possible for a non-European non-USA chessplayer to be World Champion; but apparently only if you have the chess talent of a Capablanca or Anand! For others, I guess they would have to try to get monetary support & good seconds somewhere to have some hope for a Title shot.

12. Ducking a World Championship re-match:

Alekhine vs. Capablanca - Not definitively resolved. If pushed, I would tend to favor Capablanca given that pre-WW 2, there was no definitive cycle to choose the Challenger &, after all is said and done, it was the Champion who set the conditions & who chose his Challenger. AAA could & should have chosen Capa; & there was ample time, more than a decade, to do so before WW2. On the other hand, Capa's pride may have caused him to behave arrogantly & thus offend AAA. The issue is very much debatable. //

Kramnik vs. Kasparov - For me, it's resolved. Kudos to Kramnik for trying his best to install a decent Qualifying Event. Kasparov for his reasons clearly did not want to go through the Qualifying Event that he himself had pledged before losing his Title; & did not even seem serious in playing the solely FIDE champions. Why? I can only speculate that Kasparov would rather retire than risk a loss in a Qualifier or a match to either a FIDE champion or to Kramnik. If he regained his Title, he would be the greatest Champion in history, but there was risk involved. If he retired, he would still be the greatest Champion in history, but there would be no risk involved. Kasparov chose the latter & no one should blame him for that decision; & more so don't blame Kramnik!

13. Predictions for Hypothetical World Championship Matches:

Lasker vs. Pillsbury, Rubinstein, Maroczy - Lasker wins 2, loses 1 match //

Lasker vs. Capablanca (inexperienced) 1914 - Lasker close win //

Capablanca (not overconfident & not having TIAs) 1929 to 1937 vs. Alekhine or any other master - Capa win //

Alekhine (sober & prepared) vs. Capablanca (w/ severe HPN & numerous past strokes), Botvinnik, Keres, Fine, Reshevsky, Flohr 1939 - Alekhine win //

Alekhine (alcoholic, ill, & depressed) vs. Botvinnik 1946 - Botvinnik win //

Fischer (inactive for 3 years) vs. Karpov 1975 - Karpov win//

Kasparov vs. Shirov 2000 - Kasparov win. (But GKK should still have given it to Shirov. And don't blame Kramnik. Had Kramnik declined, GKK would have chosen another; & Shirov would still be frustrated.)

14. My thoughts regarding the quick game tiebreakers for the World Championship Match:

i. Ideally the Champion must have beaten the old one to be Champion.

ii. I hate these FIDE quick game tie-breaks to decide the Classical Champion.

iii. The tiebreakers should be as fair as possible.

Notice that in the traditional Champion-retains-Title-in-a-tie, all the Champion needs is a tied match to retain his Title. Advantage Champion.

My recommendation is we give more Whites to the Challenger. Advantage Challenger.

So things even out.

We still retain the tradition of the Challenger beating the Champ to get the Title.

The Challenger gets to do it in a classical game, not a quick game.

Thus suggestion if the World Championship match ends in a tie:

Additional classical games with a limit, wherein the Challenger receives more Whites. If the Champion manages to tie or win at the end, he retains the Title.

Thus the tiebreaker can be one extra White game for the Challenger. Or two, three, or four. We could even vary further, say one Black followed by one to three Whites for the Challenger. Studies can be made in order to determine the best specific format (of Blacks and Whites) that can afford the Challenger a fair chance at winning.

IMO this would probably be welcomed by most of the chess world in terms of the sporting excitement it affords. Here we have the Challenger; forced to try all means to win in classical games against a sitting Champion that only needs to draw all the tiebreak games (or game). A real drama at the end of the match. If the match still ends in a tie, the Champion retains his Title, and deservedly so since he got more Blacks.

This way the Challenger must beat the Champion in a classical game (not a quick game) in order to grab the Title, and in so doing win the match outright.


I have opened a <'multi-experimental' forum> below. Its nature is that of several secret social and psychological experiments, whose objectives and parameters, and the rules that follow, are strictly defined and which I may or may not reveal. Readers of this forum might be able to deduce some of these rules. Accordingly messages shall be retained or removed with or without explanation, even those from my dear friends here in CG, although I am making it clear here that absolutely no offense is intended to any one in this experiment. I may or may not respond to certain questions and messages, also according to the rules. To my friends: Please bear with me in this matter.


Ongoing project to preserve and teach non-Tagalog minority Philippine languages (in danger of disappearing).

>> Click here to see visayanbraindoctor's game collections. Full Member

   visayanbraindoctor has kibitzed 9423 times to chessgames   [more...]
   Dec-10-17 Alekhine vs B Verlinsky, 1918
visayanbraindoctor: Another game that highlights Alekine's superb tactical vision and abilities. After 17. Nf1 g5 Verlinsky has attained a nearly ideal Stonewall-type attack. If he can get the in g4 (typical in Stonewall type of attacks) White would be busted. I do not think he expected AAA
   Dec-10-17 L R Eisenberg vs Capablanca, 1909
visayanbraindoctor: From Capablanca vs C Jaffe, 1909 <zanzibar: Capa played a series of exhibition games prior to his Marshall match at the club. This game was played on the day before: L R Eisenberg vs Capablanca, 1909> <the score-sheet of Capablanca v Jaffe, written in pencil by ...
   Dec-10-17 twinlark chessforum
visayanbraindoctor: <optimal play: highly-paid cosy positions would end up going to white-skin suburban 'aboriginals' who are about 1/16th indigenous> I am not sure but if I got your meaning right, we have 'equivalent' problems. Philippines has a 'National Commission of Indigenous ...
   Dec-08-17 visayanbraindoctor chessforum
visayanbraindoctor: 8 December 2017. 23M, motorcycle fall, driver, alone. Lots of broken skulls leaking cerebrospinal fluid recently. (Right temporal craniectomy, repair of dura for CSF leak with temporalis muscle flap. 12/8/17 10:08 to 11:34 am.)
   Dec-07-17 Jose Raul Capablanca (replies)
visayanbraindoctor: <MissScarlett: <Casual> and <classical> are not mutually exclusive; casual/offhand should not be considered a value judgement on the quality/seriousness of the play> I very much agree. It's just that the term <casual/offhand> might give some ...
   Dec-02-17 O Bernstein vs Alekhine, 1933 (replies)
visayanbraindoctor: <paladin at large: A masterful queen ending by Bernstein, worthy of Maróczy. Not a bad master over the age of 50 who can draw a four game match with Alekhine in his prime.> Surprise! I did not know Alekhine played a match while still a reigning World Champion. Does ...
   Dec-01-17 Jonathan Sarfati chessforum
visayanbraindoctor: To be more specific, IMO Carlsen style tends to: 1. Set up a sound pawn structure. If possible set this up as a classic pawn-occupied center. If not, make sure it is sound anyway. 2. Maneuver pieces behind and around this sound pawn structure, always prepared to grab more
   Dec-01-17 Kevitz vs Capablanca, 1931 (replies)
visayanbraindoctor: <maxi: I work as a theoretical physicist> I would much appreciate it if you might want to comment on some of the physics topics that <twinlark> and I are discussing in his forum.
   Dec-01-17 FIDE Grand Prix Mallorca (2017) (replies)
visayanbraindoctor: <beatgiant: the old Zonal/Interzonal/Candidates system.> I also happen to think this is the best system.
   Nov-22-17 Vladimir Kramnik (replies)
visayanbraindoctor: What's the Rusians Federation's 'price' for seeding in Kramnik to the Candidates? I wonder if the Russian Federation will now 'require' Kramnik to play in the upcoming Russian Chess Championship.
(replies) indicates a reply to the comment.

Kibitzer's Corner
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Premium Chessgames Member
  visayanbraindoctor: 24 September 2017.

57M, fell down while drunk.

GCS 7 pre-op, so I did a stat operation.

(Left parieto- fronto- temporal craniectomy, evacuation of acute subdural hematoma, bone transplant to left hemi-abdomen SQ layer. 9/24/17 8:13 to 9:26 am. No BT.)

Premium Chessgames Member
  thegoodanarchist: <visayanbraindoctor: ... motorcycle fall...

... motorcycle fall...

... motorcycle fall...

... motorcycle fall...

... motorcycle fall...>

Motorcycles seem deadly to me.

My first job. Very first job ever. Living in the US, I was employed by the Department of Social Services of one of our 50 states.

My job was to house sit for a fellow who had been in a motorcycle accident, so his mother could get out of the house, run errands, etc. without this poor fellow dying in a house fire or something like it.

Day 1 I met him. He was lying on the bed, on his back. I could see his face, but his head was wrapped and his black hair extended from beneath the bandage. His left arm was in a cast and elevated. His legs were in a cast. I think he had the right arm free, don't really remember.

He'd been that way for weeks. Age 19 or early 20s. He said he would never get on a motorcycle again.

I know for sure that I never did.

But even if he never rode again, his life was never the same after that.

Premium Chessgames Member
  Dionysius1: Hawd on there! What's this to do with chess? They're more like a surgeon's notes from day to day. What's up Doc?
Premium Chessgames Member
  visayanbraindoctor: <thegoodanarchist> If your patient's spinal cord was not injured, he would probably walk again.

Yes, most serious vehicular accidents involve motorcycles. If motorcycles were banned, the mortality and morbidity rates from VAs would immediately and drastically drop.

Ironically for me, I would also be in danger of becoming financially bankrupt.

Premium Chessgames Member
  visayanbraindoctor: <Dionysius1: What's this to do with chess?> Nothing.

It's a long running experiment on my part.

Premium Chessgames Member
  Dionysius1: Ah yes, you said. I've just got to the bottom of your profile statement. Hmmm. Interesting, I'll use it as a hypothesis tester for an experiment I'm running. No offence of course!
Premium Chessgames Member
  visayanbraindoctor: 4 October 2017.

50M, sudden decrease in sensorium. GCS 12. With left hemiparesis.

(Right fronto- parietal craniectomy, cortisectomy, evacuation of right thalamic hemorrhage, bone transplant to left hemi-abdomen SQ layer. 10/4/17 9:40 to 11 pm.)

(Tracheostomy. 10/4/17 11:11 to 11:24 pm.)

Post-op, there was no ventilator (in the public hospital. Died suddenly next day.

Premium Chessgames Member
  visayanbraindoctor: 5 October 2017.

20M, whom I operated on for open skull fracture with CSF leak following a motorcycle fall last 5/7/17.

(Replacement of bone flap right frontal. 10/5/17 4:55 to 5:54 pm. No BT.)

Premium Chessgames Member
  visayanbraindoctor: 7 October 2017.

29M, growing scalp tumor, 7 months. I had already begun to ulcerate.

(Excision of mid to right fronto-parietal scalp tumor. 10/7/17 11:51 am to 12:52 pm.)

Fortunately I was able to cover the defect. I loosened the scalp by dissecting through the loose connective tissue layer. It looks malignant.

Premium Chessgames Member
  visayanbraindoctor: 20 October 2017.

36M, on a bicycle, hit by a motorcycle. GCS 9.

(Left temporo- parietal craniectomy, evacuation of acute subdural hematoma, bone transplant to left hemi-abdomen SQ layer. 10/20/17.)

Premium Chessgames Member
  visayanbraindoctor: 21 October 2017.

70F, motorcycle fall, backrider by themselves, 3 months ago.

(Right fronto- parietal craniectomy, evacuation of chronic subdural hematoma, bone transplant to left hemi-abdomen SQ layer. 10/21/17 7:15 to 7:51 pm.)

Premium Chessgames Member
  visayanbraindoctor: 27 October 2017.

23M, motorcycle fall, backrider, by themselves. GCS 9.

(Right temporo- parietal craniectomy, evacuation of epidural hematoma and acute subdural hematomas, left frontal craniectomy for decompression, bones transplant to left hemi-abdomen SQ layer. 10/27/17 2:27 to 3:50 pm.)

I decided to also open up on the left because the CT scan showed a severely contused ads swollen brain on that side, although with no clear large hemorrhage.

Premium Chessgames Member
  visayanbraindoctor: 4 November 2017.

56M, pedestrian hit by SUV, 10-25-17. He complained of persistent headache and progressive malaise. I decided to remove the large right subdural hygroma the CT scan showed, and decompress the swollen left brain.

(Right frontal craniectomy, evacuation of right frontal subdural hygroma, left frontal craniectomy for decompression, bones transplant to left hemi-abdomen SQ layer. 11/4/17 2:51 to 3:57 pm.)

Premium Chessgames Member
  visayanbraindoctor: 7 November 2017.

40M, working place accident, fell down a slope while clearing trees for a mining company.

(Left fronto- temporal craniectomy, repair of dura for CSF leak with temporalis muscle flap, bone transplant to left hemi-abdomen SQ layer. 11/7/17 11:36 pm to 12:44 am.)

Premium Chessgames Member
  visayanbraindoctor: 10 November 2017.

44M, hit by the bottom end of a red horse grande beer bottle in a fight.

(Right frontal craniectomy, repair of dura for CSF leak with periosteum flap, bone transplant to left hemi-abdomen SQ layer. 11/10/17 10:39 am to 12:02 pm.)

In these repair operations, I almost always make a much wider scalp incision compared to the craniectomy itself, so that I can harvest the periosteum or temporalis muscle needed for repairing the dural tear.

Premium Chessgames Member
  visayanbraindoctor: 15 November 2017.

66M, sudden decrease in sensorium.

CT scan showed a right thalamic hemorrhage that had ruptured into the third ventricle. The resulting intraventricular blood was blocking the CSF flow and so causing hydrocephalus. In such cases it is often helpful to draw out some of the blood-admixed CSF in order to relieve the HCP. The intracranial pressure decreases, the patient wakes up and there is less chance for pneumonia and sepsis, which are almost always inevitable among stroke patients that are bedridden for more than a week.

(Left frontal tube ventriculostomy. 11/15/17 6:43 to 7:20 pm.)

I almost always do tube ventriculostomies on the non-dominant right side, except if the bleed is located there, in which case I do it on the left. In my setting where there is no silastic tubing available, so I use ordinary Foley catheter.

Premium Chessgames Member
  alexmagnus: I invite you to a private, one to one chat. To clear everything up. I'm not there to argue. Not with you and not with anybody. So a bit of clarification is needed.
Premium Chessgames Member
  visayanbraindoctor: <alexmagnus> Appreciate the invite, but I don't know what we ought to talk about. I just don't want you following me around, posting contradictory statements right after I post, on topics that for me were already resolved with you a hundred times in the past (like Elo ratings, the format for qualifiers and the institution of the WC match, quick game tie breaks, etc.). If a kibitzer I have never written to before comes up with a old topic, I would sometimes comment and engage in a little discussion. But for you- we've been discussing the same topics forever, and I don't have much free time on my part. I only post nowadays if I think they are constructive, if I think I will learn something new, if I think I am educating those who lack knowledge of certain things, or to give analysis and opinions on interesting (to me) games. Lately I have become even more busy than ever.
Premium Chessgames Member
  alexmagnus: I wonder based on what you discard my posts as attempts at a constructive discussion. Yes, I do contradict, because how else <do> you start a constructive discussion? By offering your point of view. I know we discussed some points to death. I don't bring them up a lot. And I don't contradict you unless I see factually wrong information ("Alekhine beat multiple masters in a blind simul", "Pillsbury played chess and whist while reciting a list of random words backwards", "narcissistic generation syndrome" ). Can we be honest to each other? And believe me, constructive discussion is all I am interested at. And learning, as you appear to be clearly stronger than my 1700. Don't suspect stalking or malice in my responses to you. While I do reply to you disproportionately often, it is because your posts are interesting and not because I follow you around for the sake of contradiction.

Be friendly and don't perceive as an enemy or an annoying stalker. Relax, and our discussions will be much more enjoyable to both of us. Okay? Peace?

Premium Chessgames Member
  visayanbraindoctor: 16 November 2017.

46F, 1 week headache and decrease in sensorium.

CT scan showed hydrocephalus, and only hydrocephalus. The patient though has a liver mass, and the neurologist who referred to me suspected metastasis into the subarachnoid space.

(Right frontal tube ventriculostomy. 11/16/17 11:59 am to 12:33 pm.)

I sent samples of the CSF to the labs for cell block and cytology studies to see if there are cancerous cells.

After an initial improvement in sensorium, 3 days later she died suddenly of a pulmonary problem. I suspect her right lung had atelectasis because of the liver mass pressing on it, or perhaps because of metastases.

Premium Chessgames Member
  visayanbraindoctor: 24 November 2017.

21M, motorcycle fall, driver, alone. His scalp laceration was leaking CSF.

(Left fronto- temporal craniectomy, repair of dura for CSF leak with temporalis muscle flap, bone transplant to left hemi-abdomen SQ layer. 11/24/17 11:35 pm to 1:22 am.)

Premium Chessgames Member
  visayanbraindoctor: 26 November 2017.

42M, motorcycle fall, driver, alone. His scalp laceration was leaking CSF and brain tissue was oozing from out of his nose. (Which looks shocking to laymen, but is just seen by me as evidence of a dural perforation in the fronto-ethmoid-sphenoid sinuses that I have to find and repair.)

He had also aspirated, and this requires a tracheostomy.

(Right fronto- parietal craniectomy, evacuation of hemorrhagic contusion, repair of dura for CSF leak with temporalis muscle flap, bone transplant to left hemi-abdomen SQ layer. 11/26/17 8:14 pm to 9:52 pm.)

(Tracheostomy. 11/26/17 10:26 to 10:43 pm.)

Premium Chessgames Member
  visayanbraindoctor: 28 November 2017.

48M, two weeks repeated seizures and headache.

(Right parieto-frontal craniectomy, excision of menigioma, bone transplant to left hemi-abdomen SQ layer. 11/28/17 11:39 am to 1:22 pm.)

I began resecting the tumor by cutting off the parieto-frontal dura to which it was attached, and trying to debulk it by bipolar cautery. This is SOP.

Dang, but the bipolar would not work (equipment in the public hospital have a way of not working at critical times). The tumor was bleeding heavily. So I did the scoop-it-out method, something that I was taught can be dangerous. I do it anyway if I have no choice. I inserted my finger in between the tumor and normal brain, separating it and scooping it out in less than 5 seconds. I quickly cauterized the now exposed bleeding vessels with monopolar cautery (you're supposed to use bipolar, but monopolar wielded appropriately would do it.)

Fortunately the meningioma was not attached to the falx, or the inevitable bleeding from the sagittal sinus would have turned this operation into a nightmare.

Premium Chessgames Member
  visayanbraindoctor: 2 December 2017.

30M, fell off roof, working place accident, after got electrocuted by a live wire in a construction site. His nose was leaking CSF. CT scan showed brain tissue in the frontal sinus and a large fronto ethmoid fracture. He had trouble breathing because of a mandibular fracture. Moreover, the Anesthesiologist told me she is requiring a tracheostomy beforehand because of the patient's 'short neck'.

So this time around the Tracheostomy came first.

(Tracheostomy. 12/2/17 9:40 to 9:55 am.)

(Left frontal craniectomy, repair of dura for CSF leak with temporalis muscle flap, bone transplant to left hemi-abdomen SQ layer. 12/2/17 10:20 am to 12:50 am.)

Premium Chessgames Member
  visayanbraindoctor: 8 December 2017.

23M, motorcycle fall, driver, alone.

Lots of broken skulls leaking cerebrospinal fluid recently.

(Right temporal craniectomy, repair of dura for CSF leak with temporalis muscle flap. 12/8/17 10:08 to 11:34 am.)

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