Neurosurgeon Answers Brain Surgery Questions From Twitter | Tech Support | WIRED

I'm Dr. Brian Kopel,

neurosurgeon

, today I'll be answering

questions

from Twitter. This is

support

for

brain

surgery

. Si Fianel asks how the

brain

feels to the touch. If tofu and gelatin had a baby, this is what your brain feels like. As a patient breathes or the heart pumps blood, the brain pulses accordingly. In Stony P asks: Did everyone know that they must be awake for brain

surgery

when operating on areas especially related to language? We literally ask them

questions

. Some patients have played instruments. to show that they are fine. A patient played the guitar in my operating room.

We want to see when we try to perform surgery. Tremor, which is a rhythmic swing of the hands or feet, the patient may drink from a cup or sign their name, which are things they would not be able to do if you stimulate them and the patient can still respond, they may repeat a question, they may repeat a phrase that tells us that it is safe to move forward. When they scream in pain, the answer is no, the brain itself has no pain receptors to Blake and the gang asks him which is harder, rocket science or brain surgery.

Well, that's an easy answer. Brain surgery is more difficult. Consider that there are one hundred billion neurons. In the brain, the number of connections between those hundred billion neurons is greater than all the estimated stars in the universe, which is why it is more difficult with lightning. Anthony asks if

neurosurgeon

s practice with fake rubber brains before trying the real ones, no, we don't learn. At work, the first time I entered an operating room, I was struck by the smell that we use, that is, electricity to control bleeding in the brain, in essence, what you are doing is cooking meat and, well, the beings Humans have a very particular smell when they are cooked, which is a quite revealing experience.

The first time you walk into an operating room, it would be very difficult to replicate it. Even the best simulation

tech

nology is not the same, at least currently. that lechem V's own operating room asks just look at the resection of a brain tumor brother, how do neurosurgeons do it and was it done perfectly? The skill must be crazy. Nature has inconveniently placed the brain inside a box called the skull and is trying to get inside. that skull is like carrying out a heist, you have to enter the brain, do no damage, remove the tumor and leave, leaving the patient no worse than you found him, depending on the tumor, it can look very similar to a normal brain and healthy.

It takes an experienced eye and some new

tech

nologies so we can see in the operating room where the tumor ends and the normal brain begins. Sometimes, because the tumor is particularly soft, we would remove it little by little using suction. The suction is essentially a metal instrument that is a straw. which also has ultrasonic energy applied to its tip which helps suction once all the bleeding stops essentially then we close the covering of the brain which is called the dura mater we fix the bone flap back to the skull let me close the scalp and we get Lunch at Lydia Bohaya asks what happens if you need to sneeze during awake brain surgery or are you given something to stop you from sneezing.

Sneezing is often accompanied by something called the Valsalva maneuver, where the pressure inside the brain temporarily increases and then decreases. Again I do deep brain stimulation, there is a relatively small hole that is made in the skull, about the size of a dime. Sometimes when a patient sneezes or coughs, you can see the brain pulsing a little, which can potentially be a problem, but it's pretty rare. at willmium asks how they fill the hole in his skull after brain surgery. The most common way we fill that hole is with the patient's own skull. We generally fix that piece of skull called a bone flap to the rest of the skull with titanium. miniplates sometimes we have to remove a piece of skull permanently, very often this can occur in the context of trauma.

We used to do this with titanium mesh to essentially get a screen door, fold it into place and attach it to the rest. of the skull to cover the hole most recently we can get a CT scan of a patient and computers can design a perfect plastic replacement for what we remove that looks as good as the real thing in darkwise asks why most brain tumors trigger Food Smells are delicious brain tumors, sometimes tumors can create seizures in the brain and depending on where the seizures arise, they can involve smell. Associated oil faction. Associated areas of the brain.

Very often, these smells are actually bad smells, so it is very, very unusual to cause a hallucination that smells good but it can happen in Kazu Dingus asks me if I'm doing brain surgery. I'd run my finger through the guy's brain just to see what happens. I mean, dear Lord, really run a finger across the surface of the brain if they are very, very gentle, they will do very little if there is pathology near the surface. The surface of the brain can be friable, where just the closest touch can cause bleeding, but a healthy brain can be touched with very little recourse in zeldovitz.

Lauren asks why lobotomies were ever a Lobotomies were not just a thing, they are the only case in which neurosurgery won the Nobel Prize in the early days of the 20th century. Psychiatric care was extremely rudimentary. There were many, many institutionalized patients. It was a huge burden on families. Yale physiologist John Fulton discovered that the frontal lobe was really important in creating the manifestations that we associate with psychiatric illnesses, and Monet speculated that if we disrupted certain fibers within that frontal lobe, we could actually help patients: Insert in the lobe an instrument called a leucotome. brain and then a hole was made within the deep portions of the frontal lobe.

Once Thorazine was invented, the use of lobotomy as a treatment for psychiatric illnesses fell out of favor, but the entire process actually helped humanity truly understand the physiology of psychiatric illnesses. It is the first time that psychiatric illness was not a weakness in a patient's soul but a real illness like diabetes and it actually led to a great understanding and treatment that we are using today on dibs on Debs question hearing the term neurosurgery seems to have such a different meaning. Do they have the same meaning as brain surgery or are they completely different entities? The term neurosurgery covers brain surgery, so when we all become neurosurgeons, we actually learn the entire surgical technique to treat surgical conditions of the brain, spine and peripheral nerve, which is the entire nervous system brain surgery It is just a segment of neurosurgery itself.

The blue tsunami asks what is a craniotomy a craniotomy is a temporary window that we make in the skull to allow us to access the internal contents of the brain to remove a brain tumor or to cut an aneurysm, we begin by placing holes or small holes around the periphery of the window we intend to make, then we take a type of saw called a craniotome and essentially connect the points or holes and create a window called a craniotomy itself, don't try this at home in Gladstone, the writer asks me for brain surgery on the way, this time my neurosurgeon is going to go through my nasal passages, it is a procedure known as endoscopic endonasal surgery, so one of the areas they find tumors and other types of pathology is in the pituitary gland at the bottom of the brain and is located within this little bony pouch called the pituitary fossa at the back of the nose, you find these pouches called air cells inside the skull itself and So by inserting a tube and a camera through the tube, we can unclog this air from our cell and We are right at the base of the pituitary gland and we can remove a tumor without having to alter the normal anatomy of the skull.

One of the most common restrictions is limitation. the use of things like straws that can develop a lot of suction inside the air cells while the healing process occurs and yes, don't blow your nose either Chris Conway asks what neurosurgeons wear Brain Gore-Tex lol I start I take off wearing my surgical cap. I also wear my surgical gown. The sterile layer of our clothing is the one that includes a surgical gown and a pair of surgical gloves, and this entire process of dressing in a sterile manner is assisted by an instrumentalist or a technician once we are fully dressed we can begin the operation at Peggy Trill X.

Did you know that when they do brain surgery and need to remove part of your skull for an extended period of time, they simply make an incision in your abdomen? and we put it there, sometimes there is so much inflammation in the brain that we have to give it room so that patients can survive the injury, we have to remove the entire side of the patient's skull over a long period of time, ultimately, if we want to be able to reattach that skull has to remain sterile and what is the most sterile place for a patient's body part, their own body, what you are referring to is something that is falling out of favor, but it is still done , the neurosurgeons would make an incision in the abdomen and place the bone flap inside this temporary pocket and close it and as long as there is no wound infection, that bone flap will remain absolutely sterile, so Ricky asks, so I heard somewhere in a random conversation and I'm not sure if it's true that he was having brain surgery and the doctor touched something and he remembered being at a party many years before in great detail.

Well, in fact, this happened during an operation called deep brain stimulation. The electrode was to be placed in a part of the brain. brain called the hypothalamus the trajectory passed through a structure that connects areas of the brain that involve memory called the fornix a patient awake on the table remembered a series of events from his childhood and the amount of detail was so surprising to both the patient and Researchers and surgeons have developed a technique to stimulate this particular area of ​​the brain and have created trials that seek to help patients with Alzheimer's disease in Rock Cox 64 asks how during brain surgery doctors will have the patient play the violin if he is a violinist. or whatever so they don't get brain damage, do you think they would make a player speedrun Super Mario 64 during brain surgery if they are a famous athlete from this video game?

I guess why couldn't we do that, sure that's no problem, that billionaire. question I just saw a poster about gamma knife brain surgery where apparently they operate on the brain without cutting anything to open it the gamma knife is a type of what we call stereotactic radiosurgery point beams of radiation are focused deep in the brain and wherever these rays of the radiation crosses, they deposit a therapeutic dose of radiation which is a very important tool, especially in the area of ​​certain vascular disorders, brain tumors and certain functional disorders in the producer Danny, ask hello, yes, can a neurosurgeon weigh in here and tell me what part of my brain?

He's responsible for the Jurassic Park theme song getting stuck in my head. I'd like to remove it please, well that would be a very bad idea because the controller of attention is called the thalamus, it's a deep area of ​​gray matter within the brain and it actually acts as a gateway to whatever grabs our attention from a moment to another. I highly recommend keeping the thalamus on Danielle babe 26 question: is deep brain stimulation surgery worth the risk? So, like the heart, the brain is an electrical organ, everything we do. do, from writing a sonata to hitting a baseball, is the result of an electrical pattern of activity in the brain.

Diseases like Parkinson's disease or dystonia, or even things like depression and obsessive-compulsive disorder, are the result of abnormal electrical patterns of activity in the brain. What is deep brain stimulation? Basically what it is is a pacemaker for the brain. We could place an electrode through a very small hole in the top of the skull into deep structures in the brain. What we're trying to do is take a one millimeter electrode. and it hits a target of one millimeter inside the brain, so it's really super precise by regulating electrical activity, we can make patients' symptoms improve a lot.

The scariest risk is bleeding in the brain or a stroke, usually around one percent. I had Big Daddy on the air. asks a robot that can perform brain surgery was shown at the world robot conference hashtag how good are you at your job the robots are coming to take you away, believe it or not the robots are already in the operating room there are some limitations on theskull itself and other areas of the body where robots are used, such as the abdomen, the robots have a lot of access because the abdomen can be temporarily inflated with air and there is plenty of room for the robots to move around the skull.

It is inconvenient that there is a skull and then a brain. not much more, so for robots to be truly useful for brain surgery they will have to be greatly miniaturized, plus someone has to tell the robots where to go and that will probably remain a human process for many years. To attack the demon Mrs., the brain does not feel pain because it does not have pain receptors. If that is the case, why do we experience headaches? I have severe migraines and feel like I have an ax in my brain, sometimes in the case of migraines, my blood cells. it contracts and then when the blood cells start to relax, the physical relaxation stimulates the pain receptors and causes the pain in leemerg xrl question: can a neurosurgeon open my head and take out the pieces with adhd?

Please thanks. There is some non-invasive brain stimulation. techniques called transcranial magnetic stimulation that people have explored for ADHD but not neurosurgically so far quetzal cohette asks how the area of ​​the brain where the electrodes are implanted is chosen we place an electrode inside the brain to interact with the brain networks and networks of the brain are distributed bags of neurons that work together to create behavior. If we are talking about a network function related to motion, we are interested in placing these electrodes in motion. Associated areas of the brain, dark gray structures called the basal ganglia that can be seen here, other avenues of research are looking at placing electrodes along the surface of the brain to stimulate the network along the cortex because everything is connected, Even though you are stimulating locally, you are affecting things globally in a pristine way.

Martian asks how far away superhuman intelligence is with a brain-computer interface. I think we're pretty close now to brain-computer interfaces actually helping a process called neuroplasticity in the brain, and neuroplasticity is the brain's normal process of learning and adapting to the outside world. I think it's something we'll probably see in the next few years. The idea of ​​having a Bluetooth implant in your brain that helps you Google something on the go. We're talking decades and decades before we saw something like this happen. are all the questions we have today great questions thank you for watching brain surgery

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