Columbia neurosurgeon Dr. Guy McKhann is an expert in a fascinating surgical technique called brain mapping. The most amazing aspect of this technique? It takes advantage of the patient being awake and interactive during brain surgery.
Since the brain cannot sense pain, the patient doesn’t feel any discomfort. He or she can interact with the surgeon during the operation. And this interaction is key for brain mapping.
In brain mapping surgery, the patient is heavily sedated while the skull is opened, and then awakened once the brain is exposed. Dr. McKhann then stimulates individual brain regions while the patient carries out language or motor tasks to map out the parts of the brain responsible for these functions. This type of mapping is especially important for brain tumor or epilepsy surgery involving “eloquent” areas of the brain.
The “eloquent cortex” consists of areas that control functions like vision, feeling, language, and movement. When one of these areas has a tumor, a surgeon’s aim is to remove as much of the tumor as possible while preserving the most function. This is where Dr. McKhann excels: his expertise and delicate touch is recognized worldwide.
During awake surgery, the surgeon and a multidisciplinary team of neuropsychologists and neurophysiologists work together with the patient to test out functions like language or movement while different brain areas are stimulated. This helps the surgeon decide how to approach the tumor or area causing epilepsy, and how much can be safely removed, while preserving the function of the eloquent cortex.
Known for his expertise in awake brain mapping, Dr. McKhann has directed educational courses at both the Congress of Neurological Surgeons (CNS) and American Academy of Neurological Surgery national meetings for much of the past decade.
His most recent course on brain mapping for his fellow neurosurgeons at the 2014 meeting of the Congress of Neurological Surgeons was called “Surgical Management of Tumors in Eloquent Regions.” It covered brain mapping, planning, and how to avoid common technical errors.
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