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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."
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.
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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.