My young and inexperienced registrar rang me. ‘He’s gone off and blown both his pupils!’ he excitedly told me. ‘Well, if both pupils have blown that means he’s coned. He’s going to die. There’s nothing to be done,’ I told him. Coning refers to the way in which the brain is squeezed like toothpaste out of the hole in the base of the skull when the pressure in the skull becomes very high. The extruded part of the brain is cone-shaped. It is a fatal process.
