Tucker Marr’s life took a dramatic turn last October. He had been attending a wedding reception when he suffered a severe fall down a steep flight of metal stairs. The impact caused him to go into a coma, with a fractured skull and a large blood clot forming on the opposite side. Urgent surgery was required to relieve the pressure on his brain and remove the clot. What happened next was nothing short of remarkable.
Instead of leaving Tucker without a piece of skull or reattaching the old bone, both of which come with high costs and infection risks, a new development in neurosurgery was utilized. Tucker received a prosthetic piece of skull created using a 3-D printer. However, this prosthesis was unlike most used in such cases. Embedded under his skin was an acrylic window that allowed doctors to see into his brain using ultrasound.
Several medical centers are now offering similar acrylic windows to patients who have undergone skull removal procedures to treat brain injuries, tumors, brain bleeds, or hydrocephalus. This groundbreaking technique enables doctors to use ultrasound to assess the brain’s condition without the need for expensive and time-consuming CT scans or MRIs. With an ultrasound probe, doctors can quickly and easily see the state of a patient’s brain right in the office.
Dr. Mark Luciano, a neurosurgery professor at Johns Hopkins, has been using ultrasound to monitor hydrocephalus patients for proper drainage of cerebrospinal fluid. In a recent study, he found no risk of infection over a year in patients with the acrylic windows. The next challenges are improving the quality of ultrasound images and determining their long-term safety.
Not everyone is convinced of the technique’s effectiveness. Dr. Ian McCutcheon, a neurosurgery professor at the University of Texas MD Anderson Cancer Center, points out the need for a rigorous clinical trial to prove ultrasound’s accuracy in detecting changes, such as tumor growths. Until then, he remains skeptical.
Despite some reservations, many surgeons see the value in these acrylic windows. Dr. Netanel Ben-Shalom at Lenox Hill Hospital in New York believes the windows are reliable for assessing brain cavities above tumors. As a consultant for Longeviti, the company that produces these windows, he has implanted them in several patients without issue.
One of those patients is Tucker Marr. During a recent ultrasound scan, his brain appeared perfect. The structures were normal, and even the midline, which had been pushed aside by his injury, was in the correct position. The ultrasound scan even showed his brain pulsing. Dr. Ben-Shalom emphasizes that anyone who has undergone brain surgery requires ongoing surveillance, and the acrylic window allows for quick and easy examinations.
Researchers at the University of Southern California are taking the ultrasound concept further. Dr. Charles Liu and his team are studying the use of ultrasound as a simpler and more affordable alternative to functional MRI scans of brain activity. In a research project, they used a specially designed window to examine tiny signals indicating changes in blood flow during different activities. The hope is that this approach could provide unprecedented insights into brain functions.
One patient in this study is Jared Hager, who suffered a traumatic brain injury from a skateboarding accident. For two and a half years, Jared had been missing a large piece of his skull. Dr. Liu offered him the choice of a standard prosthesis or one with a window optimized for brain studies. The Rancho Los Amigos Foundation provided free housing for Jared during his recovery and Dr. Liu secured him an apartment afterwards.
Jared has become an active participant in Dr. Liu’s lab, allowing the scientists to learn as much as possible about his brain. He expresses gratitude for the opportunity to contribute and vows to continue assisting in any way he can.
In conclusion, the use of acrylic windows in neurosurgery has brought new possibilities for evaluating brain conditions through ultrasound. While some remain skeptical and call for further research and clinical trials, many surgeons see the potential benefits. Patients like Tucker Marr and Jared Hager have experienced firsthand the positive impact of this innovative technique. As ultrasound technology continues to advance, it has the potential to revolutionize the way we explore and understand the human brain.
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