One thing is certain: The human brain doesn’t come with a color coding system, or with different areas of the brain marked according to what functions they control.
Neurosurgeons know which part of the brain does what, but no two brains are exactly the same, and there are limited visual clues to help neurosurgeons target a precise spot.
This is why neurosurgeons have developed a way to make a map of a patient’s brain during surgery. This technique is called “awake brain mapping,” and Dr. Guy McKhann, Director of Awake Brain Mapping for Tumors and Epilepsy at Columbia University Medical Center/NewYork-Presbyterian Hospital, is an expert in the field.
Awake brain mapping is used when a neurosurgeon such as Dr. McKhann needs to operate on an area that is close to or directly involves the functionally important parts of the brain. These parts are called the “eloquent cortex,” and they control language, vision, movement, touch, and even subtle cognitive functions. Dr. McKhann’s challenge is to get to precisely the right part of the brain to take care of, say, a tumor, while avoiding the eloquent cortex.
How does he manage this? By having the patient awake and talking during surgery to let him know when he’s getting too close to a sensitive area.
During surgery Dr. McKhann stimulates parts of the patient’s brain while the patient performs an activity like reciting a list of words, or identifying a picture. When the patient starts to have trouble performing a task, Dr. McKhann knows he’s reached a delicate functional area and can avoid it. This gives him a sort of road map for the brain.
Every year Dr. McKhann brings his experience and expertise in brain mapping to the annual scientific meeting of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS). He has regularly directed a practical half-day workshop on brain mapping techniques at both these meetings over the past decade.
But this year there was a new feature as well. In the two days before the AANS Annual Scientific Meeting, faculty from major brain mapping centers all over the world gathered for the First International Brain Mapping Course. This was a brand-new program sponsored by both the AANS and the Neurosurgery Research and Education Foundation.
Dr. McKhann moderated a session of the course, on “Special Topics in Stimulation Research Techniques: the Future of Brain Mapping,” and also lectured in the “How I Do It” segment of the course.
Learn more about Dr. McKhann’s work with brain mapping at the following links:
Learn more about our doctors at the AANS meeting here.
Return to the Department of Neurosurgery here.
Image credit: © [ArtsyBee] /Pixabay
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