Retrospectacle: A Neuroscience Blog

This video is one of the most amazing things I’ve ever seen on YouTube. It shows the oh-so-careful surgical removal of an egg-sized cyst (intact) from a person’s brain. The cyst is a hydatid cyst, which is the result of a parasitic infection by tapeworm larvae(Echinococcus). Generally speaking, it does not occur in the USA, but rather occurs in Mediterranean countries, the Middle East, the southern part of South America, Iceland, Australia, New Zealand, and southern parts of Africa. The cysts, which are initiated by one larvae, eventually come to house thousands of tapeworm larvae. So it is very important not to rupture the cyst during its removal, else the host could easily die. The cysts can occur in any organ, in this case, the brain. For more about the life cycle of the tapeworm, go here.

The video below uses saline to gradually “float” the cyst out of the brain. The neurosurgeon gently squirts small volumes of saline into the space around and behind the cyst until it neatly plops into the surgical pan, intact. The patient, a 16 year old girl, fully recovered.

Don’t forget to listen for the doctor’s remark at the end, when he sees the cyst. (The doctor was Dr P V Ramana , Neurosurgeon of Care Hospital, Visakhapatnam, India)

A few more tidbits

– I found out the precise location of the cyst in a comment by the doctor:

“It was intraparenchymal. I had to go transsulcal. I chose the place where the cortex was thinned out most.The cortical opening was done by just separation of tissue rather than cuting.”

– And, what happens to the hole the cyst left in the brain?

“The empty space initially gets filled up by the fluid which covers thr brain called CSF, then the brain which was compressed by the cyst expands to normal state filling up the space.”

Comments

  1. #1 Homie Bear
    January 8, 2008

    Yeesh! New Zealand? I’m glad no one told me that before I went. Probably associated with the sheep, I imagine. I am far too squeamish to actually watch the video though.

  2. #2 Shelley Batts
    January 8, 2008

    Homie Bear, you should watch it! Its not very bloody or gross, its just….amazing!

  3. #3 cope
    January 8, 2008

    Wow. Mrs. cope is an RN so I am used to HEARING about lots of weird things the human body can do and experience but this was pretty cool.

    I must admit to being a bit on the squeamish side myself. Hard to believe that given the fact that when I took AP bio in high school, we dissected pithed frogs, experimented on baby chicks by injecting them with testosterome and dissected all manner of dead, pickled creatures and I never thought anything of it at the time.

    Thanks. I will definitely share that with the bio teachers in my department.

  4. #4 Cuttlefish
    January 8, 2008

    A golf-ball sized hydatid cyst
    Is not the sort of thing I’d list
    As one I’d like to try.
    Indeed, I’d rather think it marvy
    Not to host so many larvae–
    I’m not that kind of guy.

    In juxtaposing these two posts
    Where humans serve unwilling hosts
    To tapeworms or bacilli,
    And treatment may be surgery
    Or bleeding, charms, or mercury,
    You make my spine go chilly.

    I won’t say much, but I concede
    That in the past, I’ve had the need
    To seek a doctor’s care;
    I’m fine, of course, but even so,
    I think: It’s not that long ago
    My “treatment” would be prayer.

    This girl here in your video
    (My daughter’s age, I’ll have you know)
    Is lucky as can be–
    To live in this, the present day
    Where science, not the church, holds sway
    I hope that you’ll agree.

    For her, and for my daughter’s sake
    I’d like to take this chance to make
    A science-based reply;
    For researchers, for doctors, nurses,
    Not for priests, or prayer, or curses
    The stakes are much too high.

    More here: http://digitalcuttlefish.blogspot.com/2008/01/juxtapositions-i-just-love-that-word.html

  5. #5 thumpthumpeyes
    January 8, 2008

    Although a little gruesome, it was a marvellous bit of dexterity by the doc, and to know that the patient survived, absolutely wonderful, thanks for sharing!

  6. #6 Ian
    January 9, 2008

    Homie bear,

    The chances of getting a significant tapeworm infestation in a country like New Zealand would be highly unusual….

    In fact, if you did get an infestation, it would probably just be a fluke….

    Chortle, chortle, tee-hee….

  7. #7 Jase Keydude
    January 9, 2008

    Never heard of these occurring in New Zealand (where I live), but very interesting indeed

  8. #8 Homie Bear
    January 9, 2008

    Okay I watched it- and you’re right it’s not too bad. Pretty amazing how they did it, actually. Brilliant and simple at the same time.

  9. #9 some internet guy
    January 9, 2008

    Fascinating!

    I was happy to read that the youth made a full recovery.

    But what I found most interesting (as I am not a neuroscientist, but an artist) was the juxtaposition between the high-level of surgery occurring as the cheesy background music played and played and played in the background. I mean, given the relatively short duration of the actual cyst removal, they could have been in an elevator for all I knew.

  10. #10 DrBadger
    January 10, 2008

    Cool. Check out the before and after CT of someone with multiple hydatid cysts! It’s amazing that people fully recover from it.

  11. #11 lily
    January 10, 2008

    I really like your blog!

  12. #12 cat
    January 10, 2008

    Your blog is very beautiful

  13. #13 pradeepsp
    January 10, 2008

    The surgeon was probably playing some music that inspired and/or calmed him. Sounded like either a devotional song or maybe a uplifting modern song. I’ve seen surgeons in the USA do the same in their operating rooms.

  14. #14 Kim
    January 15, 2008

    That was an amazing video – I was surprised at the actual size of the cyst; it looked much smaller than it turned out to be.

    Re the music, I suppose using “Head Games” by Foreigner would have been in bad taste.

    (Sorry, I couldn’t resist! : ) )

  15. #15 Dr P V Ramana
    April 28, 2008

    Thanks for the comments. I am the neurosurgeon who operated on this girl.
    The music in the back ground was Indian music.
    The poem by Cuttlefish is great.

    Ramana

  16. #16 oceanswimmer
    October 17, 2008

    Great job, Dr. Ramana!
    As an OR nurse who sees so many rush to get in and get out of a surgery, it is refreshing to observe your patient and most appropriate approach. Many, many blessings to you.

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    November 23, 2008

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