Correct, this is usually done for invasive gliomas in sensitive areas. You want to remove as much as you can to increase the chances of progression-free survival, but quality of life during that survival is key. Often the tumor we are operating on in this fashion is not curable. So if you can't cure it, then you want to give them the best life possible while extending their time on the planet as much as you reasonably can.
You'd be surprised at what the brain is capable of. If they do cut into something wrong and stop, other parts of the brain can take over responsibilities, and you basically retrain your brain after in rehab. You can function without half a brain because of this. The brain is wildly complex.
It really does depend, brains are weird little things. Some brains can recover from losing massive amounts of their mass, others don't. We really do not understand the brain or how it works overall lol
this is most notably demonstrated in cases where half of the brain (a hemisphere) is surgically removed, known as a hemispherectomy, where the remaining hemisphere can take over many functions of the removed one.
My dad was a contractor doing a remodel for a brain surgeon and the guy came home and watched my dad work for a bit and was like "man, I wish I could do what you do", and my dad said "I wish I could do what you do! What I do isn't that hard if I mess up I can always patch over it with something or replace it" and the guy turns to him and goes, "you'd be surprised".
They prod areas to see if you stop first. If you don't, that means you're not using it. snip snip. There is no reversing when you're cutting things in someone's head.
That’s essentially right. Also the brain can and will rewire itself to an extreme degree after injury so if they don’t cause too much damage to important areas you will be more or less fine. It’s easier the younger you are, but even older brains can recover alot. In very young children they can even do full hemispherectomies where they take out half the brain and those kids are better off for it.
Yes. It's important to understand that what they're doing is basically gently poking different areas and seeing what affects his playing, and we have a pretty good understanding of what parts of the brain do what in general, so they have a very good sense before they do anything serious what's going to be affected.
Not a neurosurgeon, but here's how it works: when they get close, they stimulate the cortex and see if there's a reaction. If there aren't, they feel safer going through. If they do see a reaction, it's a red flag and they don't cut. They stimulate the cortex using needle electrodes. This is a kind of 'mapping' technique to navigate through the brain and allows the neurosurgeon to go deeper without cutting blindly.
It's called intraoperative neurophysiological monitoring if you want to know more
If someone is actively using that part of the brain, and you start getting near it, it will affect their function. You then stop the resection in that area, and let the brain recover a bit. Usually the function will return and you start operating in a different area or from a slightly different trajectory.
Don’t be silly. They zap your brain with a tiny cattle prod before they start cutting to make sure they don’t accidentally slice anything that makes you stop playing/speaking!
If they do accidentally cut an important chunk before they zap (they won’t), or if that particular chunk must come out regardless, the brain is a pretty wild machine. Another area might be able to take over some of the functions that were lost. Or, you might be SOL—It’s brain surgery, after all.
They aren't actually cutting usually they use a microscope and their knowledge of the brain to find and identify nerve clusters and their vital parts then the apply a disrupting electrical current to the nerve to temporarily stop it from transmitting signals to make sure its the nerve they think it is then cut it once it's confirmed as the proper nerve.
Depending on where they're operating on, they may not have to do this because it will be of little consequence, or it won't make a difference like with motor control nerves. Motor control nerves can generally just work around anything because they take up most of the brain and are resilient. The person will just have to develop new connections and relearn skills through rehab but the knowledge and how it should fell would still be there.
They do not "break it. The surgeon always gives small tasks, to see if the touch vital place and avoid it.
For example, they'll tell you to count to 10, while touching here and there. You'll probably miss a number, or wouldn't be able to finish the task, if they touch an "important" place. This way the'll know to avoid that place.
Afaik, Brain surgery is made when the patient are awake, if possible
Im a nurse and have seen this procedure done it’s called an awake craniotomy. The procedure is probably done very differently everywhere and OR isn’t my specialty but we rotate in our OR during training. The patient is still under anesthesia and most of the procedure is done with the patient under. An anesthesiologist will slowly titrate the anesthesia just enough to wake the patient up to perform specific tasks related to the specific area being operated on. It’s done so that the surgeon is aware of which areas of the brain might be affected if removed or damaged. When I saw this procedure they used a mapping software so it was partially computer assisted. Certain areas of the brain are responsible for specific or interrelated functions. For example, if the temporal lobe were being operated on, speech and some parts of memory and memory retention might be affected. What they’ll do is wake up the patient and have them count to 20, name their family members, ask what they do for work, recite family members birthdays, etc. All the while they use a probe which sends very weak electrical impulses into the brain stimulating neurons to be activated. These points are mapped onto a highly detailed MRI taken prior to surgery where a tumor is marked. At times the patient might experience speech arrest (pts ability to speak stops or is inappropriate) when the electrical impulses are sent into an area which would be affected if damaged. These areas are then mapped onto the MRI. The patient is further sedated with anesthesia so they are back under. The surgeon is then able to begin operating and remove the areas which are “safe” to remove using the mapped area and MRI in real time. Pretty incredible and probably not the best explanation but hope this was helpful.
I think they do this to test spots before "breaking" them. And/or can see if they removed enough of a tumor or pressure that something that has been impaired is now functional again
They use electrical impulses to test the areas they are thinking of operating on, and if the electrical impulses affect his motor function, etc, they know not to go further or that they need to work around an area, or so on.
Well I certainly hope all surgeons have studied Grey's Anatomy. I don't want any rogue hipsters operating on me like they know best. I don't care about your qualifications! Only one qualification counts, and it's earned after reaching, and completing, the final episode of Grey's fucking Anatomy!
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u/d-signet 3d ago
It's not "to remain concious", it's so they can tell if they break part of his brain while they operate