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Stanford University School of Medicine

New simulations may guide future brain surgeries

A team of researchers, led by Ellen Kuhl, PhD, a Stanford professor of mechanical engineering, is developing a new simulation tool to help guide surgeons to more safely relieve brain swelling.

Brain swelling can be caused by a trauma, such as a stroke, tumor or traumatic brain injury. This swelling builds up pressure inside the skull that can lead to brain damage or death, so surgeons sometimes perform a decompressive craniectomy — removing a large portion of the skull to allow the brain to mushroom out. But the surgeons need to know where and how big to cut the skull, which is no easy task.

A recent Stanford news release explains:

...The shape of the brain is essential to its function. It consists of billions of fragile filaments, called axons, bundled together in purposeful patterns. When parts of this amalgam bulge out, axons stretch and shear. Surgeons currently rely on experience to limit the collateral damage that might occur when dire circumstances force them to perform a decompressive craniectomy.

'This is a new tool to help surgeons decide where and how big to make the hole, by giving them a way to visualize the effects of the procedure on the brain tissue,' Kuhl said.

Kuhl is working with Johannes Weickenmeier, PhD, a postdoctoral research fellow at Stanford, and Alain Goriely, PhD, a professor of mathematics at the University of Oxford, to create mathematical models based on magnetic resonance brain images. These simulations will predict how an injury affects specific parts of the brain — showing the predictions on a color-coded brain map, with extreme damage in red, mild damage in green and minimally affected areas in blue.

The team then used these maps to "play what-if scenarios to illustrate how skull openings of different sizes in different regions affect the axons inside the brain," the news release states.

The researchers plan to work with neurosurgeons to improve their simulation tools, hoping one day to allow neurosurgeons to accurately peer beneath the skull and make more informed surgical plans.

Previously: A detailed look at latest advancements in treating brain tumors, Gold particles light the way for brain surgeons: Adam de la Zerda presents at TEDxStanford and A Stanford neurosurgeon discusses advances in treating brain tumors
Video courtesy of Stanford University

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