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  • This is the sound a violin makes when it's being played by someone who's having their brain operated on.

  • Yep. This musician is awake and playing her violin in the middle of her own brain surgery.

  • But why?!

  • This is something called an awake craniotomyand get ready for some gory details here.

  • So, say there's a patient who needs to undergo brain surgery.

  • They're sedated for the beginning part, where the doctor makes an incision in the patient's scalp

  • and drills into their skull with specialized tools to remove a section of the bone from their skull.

  • And then, the patient is brought out of sedation by the anesthesiologist

  • so they can be conscious while the doctor operates on their brain.

  • Which apparently doesn't hurt because the brain doesn't have any nociceptors,

  • or the nerve cell endings that detect pain.

  • But again, why does the patient need to be awake?

  • Well, the doctor can ask the patient questions throughout the surgery,

  • or ask them to perform basic movements to ensure that what the doctor is doing back there

  • isn't affecting any of the patient's capabilities,

  • like in areas of the brain that control things like speech or finger movement.

  • And turns out, we've actually been doing craniotomies since ancient times, you guys.

  • The first archeological evidence of purposeful perforations of the skull

  • dates back to the Neolithic period.

  • The first written evidence we have of a craniotomy being performed as a surgery

  • is by Hippocrates in the 5th century BCE,

  • who produced guidelines for it to be used in the treatment of epilepsy,

  • which remained more or less common practice for the next 2,000 years or so.

  • The awake craniotomy heyday really began in the 1920s,

  • and the development of our modern anesthesia medications to be able to put the patient to sleep

  • for the beginning and end of the surgery have been essential, as you can imagine,

  • in making it a widely used neurosurgery technique around the world today.

  • Which brings us back to the violin.

  • Dagmar Turner is a violinist who was diagnosed with a brain tumor that had to be removed.

  • But it was in her right frontal lobe, smack in the middle of the spot in her brain

  • that controls the coordination in her left arm and hand

  • which, you knowis what you use to play the violin.

  • To make sure he was keeping these parts of her brain safe,

  • the brain surgeon asked Turner to play her instrument while he was operating on her.

  • How amazing is that?

  • But at the same time, it does still seem a little primitive, right?

  • I mean, these surgeries can take hours, and the patient has to stay awake

  • the whole time the surgeon is fiddling around in there.

  • Like, is this still the best way we currently have to give patients better outcomes

  • if their tumor is in an area near speech and motor centers?!

  • Well, it's a little more advanced than that these days,

  • because doctors are able to map brain activity before surgery using something called functional MRIs,

  • which lets them go into surgery with highly specific information about that patient's individual brain.

  • This is actually what they did for the violinist's tumor.

  • But fMRIs are also not a perfect solution,

  • because they don't get the clearest picture of what's going on to begin with.

  • And plus, the brain can actually shift during surgery.

  • I mean, it is basically just a hunk of really complex jello sliding around in brain juice in there,

  • which makes my head feel kinda…*funny face.*

  • Enter the next step up in brain surgery sophistication: intraoperative MRIs.

  • These are devices in specialized operating suites that let doctors take real-time MRIs

  • during the brain surgery.

  • They can basically stop at certain intervals to see what's going on with the brain during the procedure.

  • Surgeons use it to help them tell the difference between the tumor and healthy brain tissue,

  • and to make sure they're getting all the edges of the bad stuff that needs to be removed.

  • But can we get even better?

  • Some doctors think so, and are making strides with even more advanced brain mapping techniques.

  • One of those involves placing a grid of sensors directly on the brain.

  • These sensors detect and measure electrical signals and then the accompanying computer program

  • puts it all together to give the surgeons a digital map of the brain they're working on.

  • And now we're using robotics involved in neurosurgery, you guys.

  • Robots are helping brain surgeons give patients better outcomes in all kinds of ways,

  • including a robot that can operate inside an MRI machine,

  • which would give the robotand the doctor—a real-time look at what's going on in the brain

  • as they perform incredibly delicate manipulations of brain tissue.

  • Brain surgery is gettin' even more complicatedbut also better.

  • Awake craniotomy has been used for thousands of years for a reason,

  • and it's because it does a pretty good job of making sure that brain surgery goes as smoothly as possible.

  • And brain surgeons are looking to use it,

  • and the accompanying advancements that make it even more precise and even more safe,

  • to find better treatments for conditions like epilepsy and Parkinson's disease.

  • And there's good news from the violinist!

  • Doctors removed over 90% of her tumor,

  • and all of the especially aggressive areas,

  • and she still has total function of her left hand.

  • So, Turner will be playing the violin for a long time to come.

  • If you guys found those tidbits of science history cool, then boy have I got the show for you.

  • Go listen to Surprisingly Brilliant, my new podcast with Seeker,

  • all about the wonderful and weird unknown stories that have shaped science throughout history!

  • You can find it at the link in the description, on iHeart Radio, on Apple podcasts,

  • or literally anywhere else podcasts live.

  • Keep coming back to Seeker for all of your breaking medical tech news,

  • and thanks for watching. I'll see ya next time.

This is the sound a violin makes when it's being played by someone who's having their brain operated on.

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この医師は患者に脳外科手術でバイオリンを弾くように頼んだ (This Doctor Asked His Patient To Play Her Violin Through Brain Surgery)

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    Summer に公開 2021 年 01 月 14 日
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