She played the violin while doctors removed a brain tumour

It sounds a little creepy, but being awake during brain surgery can ensure you come out with all the abilities you went in with.

Diana Duong 3 minute read February 25, 2020

Musician Dogmar Turner playing the violin during brain surgery at King's College Hospital in London, UK. Photo by King's College Hospital/AFP via Getty Images

In the middle of a room filled with surgeons, staff, and medical equipment, there lay the patient, softly playing scales and symphonies with her scalp cut open and her brain completely exposed.

The stunning video of a patient playing the violin while surgeons at King’s College Hospital in London operated on a tumour went viral last week.

Surgeons were removing her tumour while protecting the adjacent motor cortex, which controls function of her left hand, says Dr. Sunit Das, a neurosurgeon at St. Michael’s Hospital and the University of Toronto. This awake brain surgery, also called an awake craniotomy, ensured that her hand movement and coordination were not damaged during the operation. Because it is difficult to know exactly the areas of the brain that affect vision, movement or speech, by playing the violin, doctors were able to monitor brain activity and avoid doing damage to these areas.

An awake craniotomy is not routine but it is a common surgery in the repertoire of surgeons, says Dr. Das. Patients are deeply sedated during the parts of the procedure that are painful and woken up once their brain is exposed.

“Surgery is a painful thing. It hurts to cut the skin, open the skull and cut the dura mater, the covering over the brain,” says Dr. Das. “But the brain itself doesn’t have any pain receptors. I have had conversations with people where they tell me remarkable stories about their childhood and we’ve talked for hours while we’re resecting their tumour.”

In another case of awake craniotomy, neurosurgeons preserved another patient’s musical abilities by asking him to identify musical notes from an iPhone during his epilepsy surgery. Courtesy of Figure 1

Awake craniotomies represent a coordinated effort between many different elements of the healthcare system, not just the skills of the neurosurgeons, says Dr. Das. Physiologists, anesthetists, and the nursing team all play a dedicated role.

An awake craniotomy is not routine but it is a common surgery in the repertoire of surgeons. Patients are deeply sedated during the parts of the procedure that are painful and woken up once their brain is exposed

The goal of awake surgeries is to resect as much of the tumour as safely possibly while trying to maintain someone’s functional integrity, he says. Whenever removing a tumour, there is a risk to parts of the brain that could result in a disability.

While this was far from the first procedure of its kind, it’s still visually and audibly dramatic. In 2018, South African jazz musician Musa Manzini strummed his guitar during surgery to provide real-time feedback of his movements to his surgeons. On Figure 1, a medical photo-sharing app, a Mexican neurosurgeon shared a case where he performed an awake temporal lobectomy on an epilepsy patient — also a musician — who identified piano notes produced from an iPhone throughout his surgery.

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