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Johns Hopkins brain surgery hits prime time in science news show
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“It’s incredible that we can actually open the human brain and do surgery,” said Dr. Alfredo Quinones-Hinojosa, associate professor of neurosurgery and oncology at Johns Hopkins University. – Courtesy photo
BALTIMORE (Map, News) - Don Rottman was fully awake, reciting a series of letters and reading aloud simple words like “tree.”
But what’s unusual about this reading exercise is that Rottman’s head was cut open, and his surgeon was poking around his brain, listening closely and waiting for him to garble the words.
“I could feel him doing something up there, then I would stutter,” Rottman, 40, of Monkton, said of that day last October when Dr. Alfredo Quinones-Hinojosa removed part of a brain tumor.
The rare surgery, an awake craniotomy, was captured for this season of “NOVA scienceNOW,” a science news magazine show on PBS. Johns Hopkins neurosurgeon Quinones-Hinojosa will be featured on Wednesday’s episode at 9 p.m.
Quinones-Hinojosa, 40, emigrated from Mexico two decades ago, starting out as a farm worker in Southern California. Now he is among a small number of surgeons who perform brain surgery while the patient is awake.
The awake craniotomy was developed decades ago, but it requires a substantial amount of skill to ensure the proper-level lucidity during the procedure, said Dr. Steve Brem, director of neurosurgery at the Moffitt Cancer Center in Tampa, Fla. and a member of the scientific advisory board of the American Brain Tumor Association.
“It’s a balancing act,” he said.
The procedure is still rare, with fewer than 1,000 performed in North America each year, usually on areas responsible for speech or motor skills, said Dr. Gail Rosseau, a surgeon and spokeswoman for the American Association of Neurological Surgeons.
By keeping the patient awake, the surgeon can more easily determine what to remove. The patient is usually asked to recite words while the surgeon stimulates the brain, Quinones-Hinojosa said.
“A lot of the tumors I deal with, you can’t tell what is the difference between what is cancer and what is normal brain,” he said.
“If you really want to clean up well, you have to find out how far you can push it.”
Rottman, director of health and safety for staffing company Tek Systems in Hanover, was diagnosed with anaplastic astrocytoma, or brain cancer.
After the surgery, which left a 14-inch scar, Rottman couldn’t move his right arm, but he is slowly improving. Doctors also couldn’t remove the entire tumor, so he continues to undergo chemotherapy treatment.
Rottman said he agreed to allow the operation to be televised to promote awareness and raise money for a cure.
“It’s hard to find information. You go to Borders and try to get ‘Brain Cancer for Dummies’ and you won’t find it,” he said.
Rottman also wants his family to understand the severity of his disease.
“There’s no ‘get well soon’ with this,” he said.
smichael@baltimoreexaminer.com
Comments from Examiner Readers
8:35 AM MST on Tue., Jul. 8, 2008 re: "Johns Hopkins brain surgery hits prime time in science news show"
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12:12 PM MST on Thu., Jul. 3, 2008
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Workin Stiff said:
Do you think Dr. Hinojosa could do similar surgery on Owe'Malley. Open his skull and get him to say "Raise taxes", when the good doctor finds the area of his brain responsible for that thought---remove it. It might be the only hope for the working families of Maryland.
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Examiner Reader said:
The University of Maryland Medical Center was the first hospital in Maryland--and only the third in the United States--to perform a gall bladder removal in a minimally invasive way, using a laparoscope. That was in September 1989. Starting then, UM surgeons taught other surgeons throughout Maryland and the US how to perform the technique and worked with instrument companies to develop new tools specifically for that new approach to operations. Today, even some of the most complex surgeries--removal of kidneys from living donors for transplant and heart bypass surgeries--are performed without a big incision. It means much faster recovery for patients--a huge advance spurred almost 20 years ago by innovative University of Maryland surgeons who continue to work on new techniques to carry minimally invasive even further.
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