Columbia neurosurgeon Dr. Sean Lavine is an expert at treating cerebral aneurysms. Dr. Lavine is skilled in the latest techniques and operates using sophisticated instrumentation and equipment that allow him to see the aneurysm inside the brain.
This is a far cry from how surgical treatment began for aneurysms in the early 1900s. Dr. Lavine recently gave a talk at Harvard Medical School about the progression of aneurysm treatment from its beginnings to the most recent neurosurgical techniques.
A cerebral aneurysm develops when a blood vessel in the brain thins out in one spot. This thinner section balloons outward into the brain. These “balloons” can press on sensitive areas, and sometimes they burst, resulting in a life-threatening bleed in the brain.
In 1931, surgeon Dr. Norman Dott performed the first intracranial (brain) aneurysm surgery. Dr. Dott dissected out his patient’s aneurysm and wrapped the bulging artery with muscle from the patient’s leg.
Dr. Lavine’s lecture, called “The Evolution of Cerebral Aneurysm Treatment and Current Controversies,” began by talking about that case and ended with a comparison of two current popular neurosurgical techniques: “clipping” and “coiling.”
In a coiling procedure, the patient’s brain does not need to be manipulated or even directly visualized. Instead a tiny metal coil is carried through the parent blood vessels by a catheter and placed inside the aneurysm.
Besides the interesting history behind aneurysm treatment, Dr. Lavine’s lecture was notable for another reason: the location. Dr. Lavine gave his talk in the Ether Dome in the Bulfinch Building at the Massachusetts General Hospital.
The Ether Dome served as an operating theater from 1821-1867, and it was the site of the first public demonstration of the use of inhaled ether as a surgical anesthetic.
When it’s not being used for medical talks, the Ether Dome is open to the public. There visitors can see a re-creation of the first public use of ether, as well as surgical instruments from the period and a mummy.
Following this Neurosurgical Grand Rounds talk, Dr. Lavine gave a second presentation to the neurosurgical residents and neuro-interventional fellows at the Massachusetts General Hospital, on “Recent Developments in the Endovascular Management of Acute Stroke.” In this presentation Dr. Lavine went in-depth into the endovascular procedure of going through blood vessels to treat blockages that cut off blood flow into the brain. These blockages produce what are called ischemic strokes.
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