An Untold Story

It's unfortunate how the story of some children unfolds. This is the story of Neurofibromatosis.....

Weekly Report 4/02/18 to 4/08/18

I had never imagined that one day I would get the opportunity to stand next to a neurosurgeon and watch a surgery about a few inches away from the patient’s head. I never imagined that I would have the opportunity to watch an extremely rare case as my first observational procedure.

This past week was immensely intriguing due to the opportunity to watch a pediatric neurofibromatosis surgery. The condition is very rare and according to Dr. Braga, he only sees one or two of these surgeries a year. NF-1 is a genetic disorder that occurs from a dysfunction in chromosomal inheritance. A patient diagnosed with the disease, on most occasions, has a strong family history of the disease. The patient can have around thirty or more tumors. NF-1 is usually related specifically to peripheral tumors. The surgery process was a great opportunity to learn as I was able to observe each and every step of the procedure from opening the skull, to suturing the parts of the brain back together.

As soon as the skull had been opened and multiple layers had been cut in the brain, the tumor was clearly visible in comparison to the yellow matter of the brain. The entire process was amazing and the patient recovery was even more of a surprise. It is truly insane how doctors and scientists have developed technology at such an advanced level that we are able to make incisions into one of our body’s most important organs and still be completely stable after the surgery. The precision of each incision, each suture, and each movement of the saw to cut the skull was done with so much stability that it was truly insane to see how much hand stability a doctor must have. Brain surgeries are very difficult and that was clearly evident during the surgery as there were so many arteries and veins running through the brain and if any important nerves were cut, there would be no hope for regeneration.

This specific tumor was an optic glioma and centered in between the optic nerve, so if one incision had been done in the wrong place, it could have caused a huge amount of detriment to the patient’s eyesight. In addition, it was surprising how the doctors were able to make an incision into the brain exactly where the tumor was, considering that the MRI was from two weeks ago. The technology that neurosurgeons use is so advanced yet, there is so much room for mistakes. Dr. Braga used an ultrasound machine in order to ensure that all of tumor was removed and that the incision into the brain was done in the right area. There have been multiple surgeries when surgeons have made an incision into the head and the tumor has ended up not being there. Just like giving medicine to a patient without a condition, surgery done to a patient without a tumor can be very detrimental.

In addition, we reviewed the final product proposal in order to ensure that it was feasible and every portion of the proposal was accurate information. We discussed what the plan of action would be for the next several weeks and what could be researched for next year and over the summer. The goal is to get two research studies published by next year.

Overall, this week consisted of a great amount of exposure to clinical neurosurgery and actual surgeries. The next few weeks should be spent more on final product and developing the research process. Dr. Braga has shared his studies that he has done so far on Chiari, so the following week should be elaboration and more comprehensive studying on the topic of chiari.