Featured Research

from universities, journals, and other organizations

In The Middle Of Brain Surgery, Patients Wake Up And Begin Talking

Date:
September 13, 2009
Source:
Loyola University Hospital
Summary:
Kim Delvaux was undergoing surgery to remove a brain tumor when doctors woke her up. Her doctor talked to her about her favorite topics -- NASCAR and her kids during the surgery.

Kim Delvaux was undergoing surgery to remove a brain tumor when doctors at Loyola University Hospital woke her up. Dr. Vikram Prabhu talked to her about her favorite topics -- NASCAR and her kids.

"I can remember two distinct conversations," said Delvaux, who lives in Downers Grove. "My friends can't believe it, but it's true."

While she was awake, Prabhu gently probed brain tissue surrounding the tumor. If this affected Delvaux's ability to speak or move, Prabhu would avoid those areas when he later removed the tumor. "We call these areas "No Fly Zones,'" he said.

The technique allows the surgeon to map out sites that are essential for speech and motor skills. Surgeons have been doing various forms of brain mapping for decades. But advances in preoperative imaging, anesthesia and surgical tools and techniques have significantly improved outcomes. Consequently, surgeons are able to remove tumors in close proximity to critical parts of the brain, and patients are experiencing fewer cognitive and motor deficits, Prabhu said.

"Evidence in the medical literature supports the safety and efficacy of brain mapping," Prabhu said. Prabhu is a neurosurgical oncologist and associate professor in the Department of Neurological Surgery, Loyola University Chicago Stritch School of Medicine.

Some patients remember little or nothing. Others remember fragments. Theresa Shepherd of Plainfield remembers Prabhu saying: "Terry, I need you to talk." Carla Jones of Gary has just a vague memory. "I can remember Dr. Prabhu speaking to me, but it's a little blurry," she said.

Prabhu does brain mapping on especially difficult cases in which tumors are located close to critical brain structures. He has done about 35 cases since he began a brain mapping program at Loyola in 2004. The team includes anesthesiologists, neuropsychologists, radiologists, residents, nurses and biomedical technicians.

During the first part of the operation, while the surgeon is cutting an opening in the skull, the patient is in a state of heavy sedation close to general anesthesia. Once the surgeon reaches the brain, the anesthesiologist wakes the patient up. The patient does not need anesthesia during this part of the operation -- which lasts about one hour -- because there are no pain receptors in the brain, said Dr. W. Scott Jellish, chairman of the Department of Anesthesiology.

Jellish added that the use of newer, short-acting anesthetics enables the anesthesiologist to wake the patient in just five or six minutes.

The surgeon gently probes brain tissue surrounding the tumor. Monitoring equipment can detect the slightest muscle movements in the face, arms and legs. If a probe causes, for example, a leg muscle to twitch, the surgeon knows not to cut in that part of the brain.

Similarly, the surgeon will monitor speech effects when brain tissue is probed. A neuropsychologist assists in the monitoring. The patient will be asked, for example, to say the alphabet, count backwards from 10 or identify photos of common objects.

The neuropsychologist also chats with the patient to determine if speech is slowed when the brain is probed. Patients talk about jobs, families, movies, baseball -- whatever interests them. Most are remarkably coherent. "It's not unusual for patients to even crack a joke," said Margaret Primeau, Ph.D., chief of psychology.

Despite improvements and meticulous attention to detail, brain-mapping surgery is not risk-free. Between 10 percent and 15 percent of patients may experience problems such as weakness in an arm or leg or difficulty speaking or understanding speech. At times, these deficits can be permanent.

Delvaux, 45, has a small problem with depth perception on her right side, but has otherwise made a full recovery.

Researchers have found that brain mapping surgery is well tolerated. A study of 21 patients published in Techniques in Neurosurgery found that a month after surgery, every patient was "entirely comfortable" with the experience, despite a few difficulties. One patient was briefly terrified when her speech was temporarily disturbed and another worried about a temporary seizure. Two were disappointed they couldn't remember the operation better. And one was "blown away by the idea of being awake during brain surgery," researchers from Brigham and Women's Hospital in Boston reported.

Brain mapping allows the patient to move on to the next phase of treatment, which in some instances includes chemotherapy and radiation therapy, Prabhu said.


Story Source:

The above story is based on materials provided by Loyola University Hospital. Note: Materials may be edited for content and length.


Cite This Page:

Loyola University Hospital. "In The Middle Of Brain Surgery, Patients Wake Up And Begin Talking." ScienceDaily. ScienceDaily, 13 September 2009. <www.sciencedaily.com/releases/2009/09/090911132802.htm>.
Loyola University Hospital. (2009, September 13). In The Middle Of Brain Surgery, Patients Wake Up And Begin Talking. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2009/09/090911132802.htm
Loyola University Hospital. "In The Middle Of Brain Surgery, Patients Wake Up And Begin Talking." ScienceDaily. www.sciencedaily.com/releases/2009/09/090911132802.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins