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Balloon Helps Doctor Reach Brain Tumor
Anml4ixoye writes "A neurosurgeon at Cincinnati Children's Hospital has succesfully completed removal of a tumor in an previously thought inoperable part of the brain. The doctor, Kerry Crone expanded a balloon at the end of a cathader to push the neurons aside and remove the tumor, which was located at the thalamus. CNN is also running the story."
...how long it'll take Richard Branson to express annoyance that he hasn't taken a balloon there yet.
Kids these days. They don't know the difference between classic, and just plain old.
I am going to STRANGLE (Seriously Terribly Restrict Airflow 'N Get Lungs Exploding) the person who comes up with these witty acronyms. I'm pretty sure it's just one guy in some corner office.
Marxist evolution is just N generations away!
...an airhead guinea pig! But thank the Lord he is doing OK. It is wonderful to hear just plain good technologically-related news once in awhile amidst the controversy surrounding most news.
catheter, n. a hollow flexible tube for insertion into a body cavity, duct, or vessel to allow the passage of fluids or distend a passageway. Uses include the drainage of urine from the bladder through the urethra or insertion through a blood vessel into the heart for diagnostic purposes.
For further meanings, see here.
http://tinyurl.com/4ny52
Before now, these operations could only be done by miniaturizing a small submarine and 5-person crew and injecting them into the bloodstream, so that they could reach the clot and destroy it with a miniaturized industrial laser. This was an extremely expensive operation, and risky due to the fact that the miniaturization only lasted an hour.
It's rather sad that this brilliant breakthrough in neural surgery has generated such a lackluster response on this forum. Absolutely no sense of acknowledgement of what a completely righteous hack this is to deal with a rather fatal problem.
Quick, someone bring SCO up, I'm sure we can break the comments on this article up to at least low single digits instead of the twenty odd present.
..the doctor.. let him save many more children!
:)
God bless that kid.
Katherin
-Indian Programmer
This is similar to a technique that is used to create more skin for grafting in burn victims: a balloon is implanted underneath the scalp of the pediatric burn victim and is gradually inflated over time. The skin and subdermal tissues are stretched slowly and expand in size, much like the abdomen as we eat too much over the years.
After a month or so, you've got about two-thirds of a sphere of diameter of 8 cm, yielding maybe 128 cm^2 of usable skin for grafting onto the burn victim.
This is a great technique. The trick in surgery is not only taking out what doesn't belong there (the tumor) but leaving intact everything else which does belong there. The slow dissection into the brain teasing apart the structures without damaging them or putting too much pressure on them (which can also damage them by decreasing the blood flow into the area, and hypoxia for greater than a minute can be permanently damaging to neural tissue) or opening up vessels. Creating a tract and then allowing gradual pressure over a long period of time to separate the fascial (I know it's not really fascial, but the equivalent of it) planes seems like a great way to avoid damage. What the article doesn't address is how long a time period this takes place over (as I end this convoluted sentence a preposition with).
Hanging around a hospital for a few days with an inch-wide hole in your skull has got to just suck, but it sounds a lot better than the alternatives. I guess the doc still has to puncture through the brain, so there would be some residual effects, but again, it's better than just dying off.
There was a good bit of "support our favorite incumbent" back-patting in the Cincinnati article, RE: the MRI that was used (Docs use MRI to help save kid + Legislator "provides" funding for MRI == Legislator saves kid + Pork is good. Right?). That was kind of sickening, but I do have a question: Is high-res MRI technology a new development, or is the use of such tech to plan surgery a new application of existing tech?
The Three-Tesla MRI is okay, and clinical use of it is a new development. I've sat in one during its experimental phase and with the wrong pulse sequences, you can actually feel induced currents (or I guess the effects of the induced currents) in your nerves. There are Twelve-Tesla magnets used for imaging mice: one I've seen at CalTech, and quite a few others around the world. The 12-T MRIs can just about see intracellular structures.
The thing they were hyping was using fMRI (functional MRI) which involves making some baseline MRI image acquisitions of the brain (of the BOLD = blood-oxygen level deoxyhemoglobin signal) which depends on the oxygenation state of the hemoglobin molecules in red blood cells. Then, further fMRI images are acquired as the subject performs some mental task. Looking at the difference between these two images shows differences in blood circulation patterns. Initially, there is a drop in the BOLD signal as more oxygen is consumed, then an increase as the local vasculature opens up and more oxygenated hemoglobin flows into the local arteriolar bed. The later increase in BOLD signal is not as specific as the initial decrease in BOLD signal, but gives a general idea of which regions of the brain are activated in correlation with particular mental or physical activities.
This is also often done another way intraoperatively (with the patient awake) by electrically stimulating parts of the brain and seening if a patient's muscles move (if you stimulate the motor cortex) or if the patient senses anything (if you stimulate anteriorly in the sensory cortex). This requires the patient to be awake and is most often done when a patient has a tumor in just deep to the motor cortex or speech areas (Wernicke's / Broca's) in an attempt to avoid injury to "eloquent cortex". This is easier for the patient to deal with if they are adults. I bet pediatric patients wouldn't want to be awakened during surgery and wouldn't be emotionally comfortable with it, so fMRI is probably a cool thing to do for pediatric patients, and useful.
It is NOT, however, novel, as it is being done at almost every neurosurgical center in the US if it is possible and necessary. So their hyping of the fMRI is just hype, but the statements about using the balloon for slowly dissecting open a surgical pathway with pressure is novel and cool.
That must hurt! http://www.angelfire.com/goth2/cathader0/