Mapping a Path
Technology Improves Accuracy in Brain Surgery
In the brain suite, Kerry Crone, MD, director, Division of Neurosurgery, uses a high-power microscope to enlarge the site of surgery. |
| 1972 The CT scanner was invented. The first scanners were used to image the head, making it possible for doctors to see inside the brain for the first time. |
| 2007 At Cincinnati Children's, the world's most sophisticated technology creates three-dimensional maps, helping surgeons define a precise pathway through the brain. |
Watching Meghan Jones, 13, cool off at the swimming pool and hang out with her friends this summer, you'd never know she had just had brain surgery.
Meghan was one of the first at Cincinnati Children's Hospital Medical Center to undergo complex brain surgery in our newly equipped neurosurgery operating room, called the brain suite.
Thanks to a multi-million dollar investment and a close collaboration with the vendor to customize the design, the brain suite has the most sophisticated technology available anywhere to enhance surgical precision. Our neurosurgeons now have unique tools for mapping a pathway through the brain to remove diseased tissue while doing the least possible damage to healthy tissue.
For children like Meghan, this technology means safer operations, faster recovery and better outcomes.
Living With Epilepsy
Meghan was 12 when she suffered a massive epileptic seizure. Tests at Cincinnati Children's showed areas of abnormal electrical activity in her brain and a benign tumor that was causing the misfiring.
For a year, the medical team treated Meghan with anti-seizure medications and monitored the tumor's growth. But despite the medications, Meghan continued to have as many as four mild seizures a week. As the year wore on, the burden of frequent, unpredictable attacks took its toll. "She was medicated all the time. She wasn't happy, and her school work suffered," her mother, Lisa Keegan, recalls. "Meghan is a teenager. She wants to go swimming with her friends, without a parent constantly watching her. She wants to be able to drive in a few years. With her seizures, she couldn't look forward to doing these things."
By spring 2007, Meghan, her parents and her physicians were ready to try a more aggressive approach: brain surgery to remove the tumor.
Lisa, a longtime nurse at Cincinnati Children's, felt confident, knowing that the procedure would be performed by renowned neurosurgeon Kerry Crone, MD, and that he would be aided by the most advanced technology.
Unprecedented Surgical Accuracy
The technology available for Meghan's operation was unimaginable when Dr. Crone began his career.
"CT scans had just been introduced when I started doing neurosurgery
Unprecedented Surgical Accuracy
The technology available for Meghan's operation was unimaginable when Dr. Crone began his career.
"CT scans had just been introduced when I started doing neurosurgery 30 years ago," he recalls. "It was remarkable to get images of the brain, but even if we could see the tumor on a scan, it was uncertain whether we could actually find it."
Today, computer software in the brain suite integrates anatomic and functional data from many sources into one three-dimensional image of the patient's brain. This extraordinary technology offers the neurosurgeon unprecedented guidance to map the most accurate, safest pathway through the brain while preserving areas that control important functions such as speech and movement.
During the operation, computergenerated images automatically match information from diagnostic tests with the patient's position on the operating table, showing the neurosurgeon the exact position of the surgical instruments in relation to the targeted brain tissue. Cincinnati Children's is the first in the world to have this auto-registration system. And a powerful MRI scanner integrated into the brain suite allows the surgeon to repeat MRI scans during the operation for guidance if the brain shifts.
For children with benign tumors, Dr. Crone explains, the best outcomes are achieved with complete removal of the tumor. In the past, patients would be scheduled for an MRI scan a day after surgery, and if more tissue needed to be removed, the child would have to return to the OR – increasing the risk of infection and other complications. Today, with a scanner in the brain suite for intraoperative MRI, the surgeon can confirm that all the tissue has been removed before concluding the operation.
A Brighter Future for Meghan
The integration of extraordinary navigation capabilities with intraoperative MRI contributed to a successful outcome for Meghan. In 10 hours of surgery, Dr. Crone removed the area where her brain was misfiring and removed the tumor that was the source of the problem. While her brain heals, Meghan must take anti-seizure medications for six months. Then over the next year, she'll gradually be weaned from the drugs. For now, all the signs are positive. Meghan has been seizure-free since the operation.
