A musician underwent a complex “awake” brain surgery for brain cancer in a private hospital in Rome. However, this wasn’t like any normal brain surgery since he was awake and conscious throughout the entire operation. Surprisingly, this musician played his saxophone throughout the 9-hour-long procedure, making this the first-ever type of surgery ever done.
On October 10, a brain tumor was removed from a 35-year-old man at Paideia International Hospital. The surgery was led by Dr. Christian Brogna, a neurosurgeon specializing in complex cancers and awake surgeries.
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The patient, whose name is “G. Z.,” was not born in Italy but was adopted by a Roman family. He is an avid music lover, and since he was left-handed, the already difficult extraction became even more complicated. However, the hospital press release says that Brogna and his team successfully performed the surgery without affecting the patient’s neurological functions.
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The hospital discharged G. Z. on October 13, who is now starting to make a full recovery. He said that during the 9-hour surgery when he was awake and playing his saxophone, he felt “calm.” His music eased his nervousness and diverted his attention away from the procedure.
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It was reported that the patient’s music helped the surgery go well. He played the theme song from the 1970 movie “Love Story” and the Italian national anthem, which helped surgeons see how his brain worked at different times.
Brogna said, “When we operate on the brain, we are operating on the sense of self, so we need to make sure that we do not damage the patient as a person: their personality, the way they feel emotions, the way they get through life. The patient will tell you what is important in his life, and it is your job to protect his wishes.”
Brogna said that the surgery required a lot of planning and cutting-edge technology. “Paideia International Hospital is equipped not only with the technology I needed but also with a 100-square-meter operating room, and we also had the opportunity to organize a tailor-made team for this intervention,” he added.
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Brogna chose ten professionals from hospitals all over the world to be on his team. These professionals included neurosurgeons, anesthesiologists, neuropsychologists, neurophysiologists, and engineers. Specialized tools like neuronavigation with tractography, ultrasound aspirators, and intraoperative ultrasound were needed for the surgery.
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A tracer was used to tell the cancer cells apart from the healthy cells around them. During the operation, G. Z. was constantly checked to make sure his brain was functioning optimally.
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Brogna said that each person’s brain is very different from another’s because of the brain’s “complex architecture” and “remarkable plasticity.” With awake surgery, it’s possible to make a very accurate map of the neuronal networks that control brain functions like playing, talking, moving, remembering, and counting.
He said, “Every awake surgery not only allows [us] to obtain the maximum result in terms of removal of the pathology, but it is a real discovery. Each time, it offers us a window into the functioning of this fascinating, but still in many ways mysterious organ, which is the brain.”
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Awake surgery is a type of surgery on the brain that is done while you are awake and fully conscious. This surgery is also known as “Awake craniotomy.” Some brain (neurological) problems, such as certain brain tumors or epileptic seizures, can be fixed with awake brain surgery.
If your tumor or the part of your brain where your seizures start (called the epileptic focus) is close to the parts of your brain that control your vision, movement, or speech, you may need to be awake during surgery. Your surgeon might ask you questions and monitor how your brain’s activities as you answer.
Your answers help your surgeon make sure that they are operating on the right part of your brain. The procedure also reduces the chances of parts of your brain being damaged in the process, especially those parts responsible for functions that help you see, move, or talk.
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Suppose a tumor or part of your brain that causes seizures needs to be removed through surgery. In that case, doctors have to ensure they don’t damage a part of your brain that controls your language, speech, or motor skills.
It’s hard to know exactly where these areas are before surgery. But when you are awake during brain surgery, the doctor can figure out which parts of your brain control those functions and avoid them.
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If you had awake brain surgery to treat your epilepsy, your seizures should get better after the surgery. Some people no longer have seizures, while others have less than they did before the surgery. For brain tumor removal, this type of surgery allows your neurosurgeon to remove most of the tumor. But you may still need other treatments, like radiation therapy or chemotherapy, to kill any remaining parts of the tumor.
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