Rachel Matthews - Dr. Gauthier - Week 2

 This week, I shadowed several neurosurgeries. The first surgery was the implantation of a vagus nerve stimulator for a patient with epilepsy. The implant consisted of an encased battery and control chip connected to leads wrapped around the nerve to provide direct stimulation (see attached picture of example device). 

The second surgery was the collection of cancerous brain tissue for a biopsy whose results will be used to create a treatment plan for the patient. The surgical team cut a hole in the skull and peeled back the dura layer to reveal a small 1-1/2-inch diameter window of the brain cortex near the region of the suspected tumor. A portion of the tumor was excised and sent for testing while the surgeons repaired the dura using sutures and a special collagen sealant. Once sealed, the surgeons fitted the removed portion of the skull with plates and screws to reattach and cover the surgical site. While the surgeons were working on closing the skull, the initial biopsy reports came back and identified the mass as a metastatic carcinoma. One of the attendees mentioned that the patient will probably get a full body scan to find the primary tumor site before determining the best course of treatment. The final surgery I saw this week was of a patient whose cervical vertebra was compressing the brain stem. The procedure removed a portion of one of the vertebrae to ensure it no longer compressed the brain stem and also implanted plates and screws to give the neck stability. Additionally, this surgery was unique because they used a combination of previously obtained MRI images and CT scans run during the procedure to guide the surgeons and helped them only remove what was necessary, as well as get precise placement for the screws to provide maximum support without impairing the brain stem and spine. 

For research, I got access to two different pipelines that I will use for my research project. Both pipelines identify lesions in the brain from MRI scans but use differing methods to isolate and identify these lesions. It took a while to download all the programs I needed, but I was able to set up the necessary software and image sets that I would be using to test and alter these pipelines. 

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