An amazing video has emerged of a woman playing the violin during her own brain surgery operation. The unusual scene unfolded as surgeons hoped to avoid damaging the parts of her brain during the removal of a tumor that were integral to her lifelong hobby.
In 2013, 53-year-old violinist Dagmar Turner, who has been playing the violin since she was 10 years old, was diagnosed with a large, slow-growing glioma after suffering a seizure during a symphony. Initial treatment involved radiotherapy to slow the tumor’s progression. However, in autumn 2019 it became clear that this had been unsuccessful as the tumor was growing and becoming more aggressive, so Dagmar opted for radical surgery to remove it.
As a member of the Isle of Wight Symphony Orchestra and various choral societies, Dagmar was very keen to preserve her coordination so as not to lose the ability to play the instrument she loved. Unfortunately, as her tumor was located in the right frontal lobe, the area of the brain associated with delicate control of the left hand, the surgery wasn’t going to be an easy one.
Professor Keyoumars Ashkan, Consultant Neurosurgeon at King’s College Hospital and accomplished pianist, devised a plan with the neurosurgical team at King’s that involved carefully mapping Dagmar’s brain to identify which areas were active when playing the violin, as well as those linked to motor and speech function.
During Dagmar’s tumor removal operation, the team at King’s elected her for a procedure called an awake craniotomy. By waking her up part way through the surgery, the surgeons were able to assess where they could safely cut to remove her tumor without impacting her ability to move, speak or play the violin. In the astonishing video Dagmar can be seen playing the instrument as the operation unfolds, and the incredible performance paid off, as doctors reported the operation was a success.
Tumors and healthy brain tissue look extremely similar to the human eye, and as such separating the two puts surgeons at high risk of cutting into functional tissue that’s vital to cognitive or motor function. Surgery involves anesthetizing a patient in order to cut into the skull and reveal the brain tissue, before waking the patient up with their head still open in order to manipulate the brain and monitor how the patient is responding to the surgery.
Surgeons can test what the effects of cutting into parts of the brain will be by applying small electrical currents to stimulate the tissue. If a patient responds negatively to this area of the brain being stimulated, the surgeon knows not to cut into this part of the brain. Unfortunately, sometimes these risk areas crossover with tumor tissue meaning difficult decisions have to be made to weigh up the possible side effects of the surgery in pursuit of a favorable outcome for removing what could become a fatal tumor.
These tests are carried out with speech therapists who will continually test the awake patient for three types of errors relating to their speech. Error one is semantic, which means the patient gives the incorrect response when identifying an object, but the word they speak is related to the correct answer. For example, when shown a picture of a spoon the patient might say “fork”. Error two is phonemic, which means the incorrect and correct answers sound phonetically similar, for example saying “bed” when the correct answer is head. The patient is often completely unaware that they are saying the wrong words when this is happening.
The third type of error is a speech arrest, which means when trying to respond the patient loses the ability to speak entirely. This kind of error will be noticed by the patient and can be very distressing. As such, patients have to be extensively interviewed ahead of being elected for an awake craniotomy to assess if they’re emotionally able to cope with the stress of such a bizarre and unpleasant procedure. While the idea of being awake when your brain is exposed is pretty grim, patients undergoing the procedure don’t feel any pain. The approach is considered an extreme measure, but cases such as Dagmar’s just go to show the amazing results that can be achieved in removing tumors that once would’ve been considered inoperable, with little loss to quality of life.
On the topic of brains, did you know that some people who have a long history of antisocial behavior have different brain structures to others?