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New Technology Helping To Treat Brain Tumors

PITTSBURGH (KDKA) - Treating brain tumors can be difficult, especially if they're rare or are in a particularly complicated part of the brain.

Now, a combination of technologies is helping to map out a better treatment.

Auto parts store owner Jeffrey Kowalski was dizzy and staggering. His heart checked out. So, he went for a brain scan next. An unexpected finding drastically changed his life.

The doctors saw a tumor, deep in the brain, the size of a golf ball.

"I was scared. I didn't want to die," he said.

Surgery to remove it was complicated because of its location. It was in the ventricle, a fluid filled space in the central part of the brain.

"With deeper-seated tumors, it becomes an issue of getting to the tumor safely without injuring important brain structures," Forbes Regional Hospital Neurosurgeon Dr. Eugene Bonaroti said.

To get there safely, the brain surgeons rely on several types of technology.

One is neuro-navigation, which you can think of as GPS for the brain

"We feed the patient's MRI scans into the computer like a map. So, we know where we're going. We know behind structures. We know what's under the bone," Dr. Bonaroti said. "It's almost like having X-ray vision in the operating room."

In addition to the anatomy, the doctors want to see function.

So, they do cortical brain mapping, which involves checking electrical impulses from the brain with electrodes, so areas that control movement and sensation can be identified.

Then, functional MRI scans help to show the interconnections between brain centers.

To prevent injury from pressing on the brain with retractors, tubes can be gently inserted to get to the tumor. The surgical instruments go through the tube to get deep into the brain.

"So, by combining all these technologies, what we were able to do in this particular patient was identify a safe surgical corridor to the tumor, someplace where we know we can make a brain incision, insert that tubular device, and get to the deep-seated tumor, without injuring any kind of important nerve centers or important tracts," Dr. Bonaroti said.

Before this technology was available, surgeons would use their knowledge of neuroanatomy, but there is variation from person to person.

Of course, even having all of this at their fingertips, the brain may not come out unscathed.

"He warned me, that during surgery, I'd probably have a stroke or something similar to that, and I did," Kowalski said.

It turns out that Kowalski had a very rare type of tumor - an intraventricular rhabdoid meningioma.

"He did tell me it was a tough surgery. It was a long and grueling surgery. And the tumor was like a rock, and he had to chip it out, chisel it out," Kowalski said.

His left sided weakness is slowly getting better. While he hasn't been able to work since his surgery in September, he is looking forward to returning to his business.

"I don't think I'll ever be able to get back to my 12-hour days, but you never know," Kowalski said "I'm coming back. I'm coming back. I don't know when, but I'm coming back.

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