Sunday, January 24, 2010

'I Can't Get Clear Readings: Remove the Patient's Skull'

Well, part of it. Not today, but maybe soon.

"Removing Part of Skull Makes for Better Brain Scans"
Wired Science (January 22, 2010)

"Removing a chunk of the skull can make way for stronger, clearer signals from a common method of monitoring brainwaves. The skull-free electroencephalography could make neural prostheses like bionic arms or eyes less invasive.

" 'It's notoriously hard to have a long-term electrode implanted in the brain,' said University of California at Berkeley neuroscientist Bradley Voytek, lead author of the study to be published in a forthcoming issue of the Journal of Cognitive Neuroscience. [']So if you can get around that by just having a small hole drilled into the skull, that would be very helpful.'..."

That gives a whole new meaning to 'checking under the hood.'

Then, there's a procedure called a hemicraniectomy. When the head gets damaged, near the brain, there's a possibility that the brain could swell. That would be very bad.

So a surgeon removes part of the skull, about the size of your palm or a little smaller, implants the bit of skull in the patient's abdomen to keep it fresh, and the patient wears a helmet for maybe four to six months - sort of an temporary external skull. The the original equipment is recovered from the abdomen and reattached where it belongs.

As my oldest daughter said, "eww!" - but it sure beats a squeezed brain.

Turns out, the skull is a sort of insulator, or shield, that keeps quite a lot of signals from the brain from getting out.

"...UC Berkeley psychologist Robert Knight, a co-author of the study, first noticed 28 years ago that EEG signals from patients with holes drilled in their heads 'looked really weird because they were freakishly strong,' Voytek said. But he only thought to quantify the difference after he saw the unusually strong EEG signals from a recent hemicraniectomy patient, one who was brought in clinically dead but revived with the surgery...."

Yeah: "clinically dead." I've watched generally-accepted definitions of when a person is dead change a lot. Used to be, some kid is dragged out from under the ice after being under water for maybe a quarter-hour: there wasn't much to do except arrange for a funeral.

That happened in Fargo, North Dakota maybe 20 years back. Medics got the kid to a hospital - fast. He recovered. Water near the freezing point and the mammalian dive reflex helped, of course.

Life may be a bit more complicated now, than it was in the 'good old days,' but I don't mind.

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