In the Middle of Brain Surgery, Patients Wake Up and Begin Talking

Ref: http://www.physorg.com/

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.
Provided by Loyola University

For more please visit: http://www.physorg.com/

Blind Programmer

ref: http://compsci.ca

Peter Lundblad, by all conventional definitions, would be considered a programming guru. He is a leading contributor to Subversion, an open sourced code management project - a widely used system. For his talents, Peter is also employed by Google (Google Code implements Subversion to host open source projects). Though what makes his story inspirational, is the fact that Peter is blind.

Information Week has published a short interview with Peter Lundblad. The interesting bit was an explanation of how he does it.

“I was trained as a finger typist. I know from the feel of the keys if I’ve made a mistake typing. When looking at code, I prefer Braille.” Lundblad uses a device that presents each line of code on the screen in Braille for him to read by touch.

While skimming through code is severely slowed down, as the field of vision is narrowed to a single line, it is still clear that with enough practise even visually challenged persons can master the art of computer programming. At first this all seems a little bit mind boggling, though then the blindfold chess would make an excellent analogy, and the latter has been around for a long time.

Sometimes computer science students would just stare at their code, wondering as to why something doesn’t work. This story brings up the point that one should think, I mean close your eyes and really think as to what’s going on. Programming is about logic - start running that logic through your head.

Of course the other inspirational bit is that even physical limitations don’t have to hinder your pursuit for something you really enjoy doing.

10 Tips for BRAIN HEALTH

There is a lot we can do to keep our brains healthy and potentially prevent from effects that are often comes with aging.

Here are 10 steps for improving your brain power.

·Eat a Brain-Healthy Diet - A diet rich in omega-3 fatty acids (commonly found in fish), protein, antioxidants, fruits and vegetables and vitamin B; low in trans fats; and with an appropriate level of carbohydrates will help keep your brain healthy.

·Stay Mentally Active - Activities such as learning a new skill or language, working on crossword puzzles, taking classes, and learning how to dance can help challenge and maintain your mental functioning.

·Exercise Regularly - Exercising often can increase circulation, improve coordination, and help prevent conditions that increase the risk of dementia such as heart disease, stroke and diabetes.

·Stay Social - Spending time with friends, volunteering, and traveling can keep your mind active and healthy.

·Get Plenty of Sleep - Not getting enough sleep can have a negative impact on brain health.

·Manage Stress - Participating in yoga, spending time with friends, or doing other stress-relieving activities can help preserve your ability to remember and learn.

·Prevent Brain Injury - Wearing protective head gear and seat belts can help you avoid head injury, which has been associated with an increased risk of dementia.

·Control Other Health Conditions - Maintaining a healthy weight, exercising, eating a well-balanced and nutritious diet, and controlling stress can help reduce your risk of diseases that affect your brain, including diabetes, heart disease, high blood pressure and hypertension.

·Avoid Unhealthy Habits - Smoking, heavy drinking and use of recreational drugs can increase the risk of dementia and cognitive decline.

·Consider Your Genes - If your family history puts you at risk for developing dementia, work with your doctor to find ways to maintain your brain health to help avoid or slow the progression of cognitive decline.

Be Healthy - Be Fit