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An Eye Doctor’s Tool Helps With Brain Tumor Removal

Dr.Kaiser Mr. Mueller Dr.Johnson

Has your child’s primary care doctor seen him for eye pain or a scratch on the cornea? If so, she may have used a dye and a fluorescent light to look for problems.

It turns out that this same dye may help neurosurgeons to identify and more easily remove brain tumor tissue. Dr. Neil Feldstein, Dr. Jeffrey Bruce and their team recently reported on their experience using the dye, known as fluorescein sodium, to aid in the safe removal of a brain tumor called a tectal plate glioma.

A glioma is a tumor of the brain involving cells that hold the nerves in place. The tectal plate lies in an area of the brain called the midbrain. As its name implies, it’s located below the frontal area, which controls thinking, and above the base area, which controls functions such as breathing. However, many important parts of the brain are located near the tectum, including those that control hearing, vision and movement of the eyes.

Also nearby is a canal that helps drain fluid from the brain. When a tumor grows, the fluid doesn’t drain as easily, leading to a condition called hydrocephalus (excess fluid in the brain), which can cause symptoms such as headache and vomiting.

Many tectal plate gliomas can be watched or controlled without surgery. Most commonly, chemotherapy is used. However, the patient described by Drs. Feldstein and Bruce had a potentially more serious type of tumor that needed to be removed. Because of the structures near the tumor, surgery would be more difficult than in many other areas of the brain.

Fortunately, fluorescein sodium dye—that same orange dye used by doctors to view scratches on the cornea—will enter tumor tissue, but not normal brain tissue, when given through a peripheral vein (intravenously). Cells of normal brain tissue keep many chemicals from entering the brain from the bloodstream. However, tumor cells don’t have this ability and will let the fluorescein enter. When it does, the surgeon can view the dye by using a special light filter, which turns the tumor tissue a bright green.

As they reported in the Journal of Neurosurgery: Pediatrics, Drs. Feldstein and Bruce and their team used fluorescein dye during surgery on the patient. Since the surgeons were able to more accurately see what was tumor tissue and what was normal, they were able to completely remove the tumor and leave normal brain tissue intact. They have found fluorescein to be both safe and effective.

Check out our related blog post: Shining a (Blue) Light on the Brain

Learn more about Dr. Neil Feldstein on his bio page here.

Learn more about Dr. Jeffrey Bruce on his bio page here.

Image Credit: kdshutterman /Dollar Photo Club

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