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Old 2nd September 2019, 11:39 AM   #1
wasapi
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First brain surgery not cutting into skull.

http://www.peacefmonline.com/pages/l...edium=facebook

Ghana performed the first ever brain surgery that did not involve cutting into the skull. It is historic. And to me, of great importance.

When my granddaughter, Zaira, was 7, she was airlifted to have immediate brain surgery when her brain started bleeding. She was diagnosed with an Arachnoid Cyst on her brain. Now, 5 yrs later, it has continued to cause her frequent seizures. Some violent ones. Outside she must wear a helmet. She always must wear Depends. She is in a special school.

OK, it breaks my heart, but back to the OP, This is hopeful news, the first I have read about since I started researching the condition the past 5 years. What we have always heard is the condition is inoperable, only the seizures are treaded with medicine. Medicine with nasty side effects.

But I have a question. Now that this has been successful in Ghana, realistically, how long may it take to be available elsewhere? I really have no idea. Thanks.
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Old 2nd September 2019, 11:53 AM   #2
bruto
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Very nice, but I'm not sure it's the first of any kind of brain surgery done without cutting into the skull, though I guess it's the first time for this particular problem. My wife's niece just recently had a brain tumor removed with surgery going through the nose. This in the Houston, TX area. The tumor is apparently benign, but threatened her vision. She'd had previous surgery but it hadn't gotten the whole thing. They think they got it this time, and she's happy that it doesn't involve skull healing and hair loss and all that.

Anyway, it's certainly a grand thing not to have to cut holes in the skull. It seems as if miniaturization of viewing and the like has been quite a boon
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Old 2nd September 2019, 12:24 PM   #3
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"a process known as endovascular coiling or coil embolisation." It's old hat. Basically stick a wad of steel wool in there, and the blood will clot to it and stop the excess flow.

oops, eta: "has performed the first-ever brain surgery in the country, without cutting the skull."

I've been interested for the last few years. First thinking I had Acromegaly, a growth in the Pituitary gland, and recently an MRI turned up water on the brain. It makes the optical nerve swell, and push in the nerves that control the eye muscles. Probably mental/brain stuff too. I THINK the fix for mw will be neck surgery, seems the bad disc can squeeze the spinal canal enough to make the fluid back up into the brain, while meantime pinching the spinal cord proper, causing musculus-skeletal probs allovermy body. I'll see the latest MRIs of brain/eyes/neck in two weeks. I wish a coil embolization would fix it, It may require a laminoplasty, splitting the vertebra and screwing them in the open position. Cool pics on the net though. See the spinal cord: (alert, it is a red & white photo)

https://www.hindawi.com/journals/aor...2/508534/fig4/
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Old 2nd September 2019, 12:36 PM   #4
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Originally Posted by bruto View Post
Very nice, but I'm not sure it's the first of any kind of brain surgery done without cutting into the skull, though I guess it's the first time for this particular problem. My wife's niece just recently had a brain tumor removed with surgery going through the nose. This in the Houston, TX area. The tumor is apparently benign, but threatened her vision. She'd had previous surgery but it hadn't gotten the whole thing. They think they got it this time, and she's happy that it doesn't involve skull healing and hair loss and all that.

Anyway, it's certainly a grand thing not to have to cut holes in the skull. It seems as if miniaturization of viewing and the like has been quite a boon
No miniaturization involved. It's done under Fluoroscopy, the Doc can see the arteries in his monitor. Because of a dye they inject. I've had it done 3-8 times, defending on how you count count: just pics or install a stent. I'm non-sedated, wide awake up to when they inflate the stent. And watching it on the monitor set up for the patients.
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Old 2nd September 2019, 01:02 PM   #5
bruto
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Aha, I missed "in the country" in the linked article. That clarifies a bit. It's still good stuff, though.
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Old 2nd September 2019, 02:57 PM   #6
wasapi
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Originally Posted by bruto View Post
Aha, I missed "in the country" in the linked article. That clarifies a bit. It's still good stuff, though.
Now I feel really stupid! The link was emailed to me by a friend, who titled it, 'Hope For Zaira?' And, I didn't get that it was just new to a certain country. I do keep hoping though.
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Old 2nd September 2019, 04:43 PM   #7
Delvo
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Originally Posted by casebro View Post
Fluoroscopy, the Doc can see the arteries in his monitor. Because of a dye they inject. I've had it done 3-8 times, defending on how you count count: just pics or install a stent. I'm non-sedated, wide awake up to when they inflate the stent. And watching it on the monitor set up for the patients.
I've been in on a few of those as an X-ray student. It's one of several distinct areas of medical radiography that any radiography student must get some experience with before graduating (the others being plain old flat images, plain old flat images from portable equipment including in surgery, fluorscopy, and CT). They call it "interventional" radiography/radiology, commonly "IR". It's actually considered separate from surgery around here because not only are the patients not unconscious but also there's no cutting beyond the skin and a blood vessel, so its impact on the patient's body is hardly more than that of phlebotomy. At least in the hospitals I've worked/studied at, it's handled in the radiology department, not the surgery department. That separation is actually something they chose to deliberately emphasize when they named it "IR", because they're intervening in cases where real surgery would otherwise be needed; it's a way of intervening to avoid real surgery.

It's so routine in my experience that I think there must be an IR suite in every hospital in each of at least the top few dozen countries you'd think of if you were trying to list the world's "rich" or "advanced" countries. I'd even be surprised if this is really the first IR in Ghana, since I'd be hard pressed to name a country I think is so undeveloped that there isn't even one proper hospital in its biggest city. Given that there are a variety of different specific IR procedures, I think what it must be the "first" of in Ghana is not IR in general but this particular IR procedure.

What's relevant to Zaira here is that IR is a specific set of kinds of procedures, not a new no-skull-cutting way of doing other kinds. When you stick tiny tools into blood vessels, you're limited to doing stuff you can reach with tiny tools in blood vessels. For problems outside of blood vessels, you need some other method that does stuff outside of blood vessels.
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