Join physicians March 18 for our next live Twitter surgery event from Henry Ford Hospital

Dr. Kost Elisevich and Dr. Steven Kalkanis will lead a neurosurgical team from Henry Ford Hospital performing an awake craniotomy with speech mapping for the purpose of removing a brain tumor. The public will be able to receive updates and information from the operating room at Henry Ford Hospital and communicate with the surgeons via the Twitter microblogging service.

The case: The patient is a 47-year-old male with a history of seizures, dating back to when he suffered a stroke as an infant with resulting febrile convulsions. Over the last few decades, his seizures have been reasonably well controlled, and he has worked most of his adult life. He is married and has two grown children. However, his seizures have increased in frequency dramatically over the last several weeks.  MRIs revealed a lesion, most consistent with a low-to-intermediate malignant brain tumor.

The patient is left-handed, which increases the chance that his speech area would be located on the right side, as opposed to the more common left temporal lobe. 

In addition, his left frontal-temporal stroke as an infant likely caused any speech function to migrate to the right side. Unfortunately, this is the site of his tumor. An MRI confirmed his speech function was located near the tumor in the right temporal lobe.

A WADA test also showed the patient had right-sided speech function. His tumor is likely causing the recent increase in seizures and almost certainly would destroy his speech center if left unchecked. However, surgery to remove this potentially malignant lesion has an extremely high risk of damage to the speech area as well.

The procedure: An awake craniotomy with speech mapping allows the surgeons to assess, in real time, precisely which parts of the brain have a direct impact on speech function. The surrounding tumor can be removed as completely as possible while leaving speech and language functions intact. While initially asleep, the patient is slowly awakened during surgery through special anesthesia techniques. A specialized speech pathologist, along with the surgeons, begin talking to the patient and asking a series of questions - all while the brain is exposed and being monitored by a neurology expert to determine brainwave function near the site of interest.

The surgeons gently stimulate a region of the brain to determine if the patient's speech is adversely impacted. If no speech errors are detected, the surgeons then safely remove tumor from that particular part of the brain until as much of the tumor is removed as possible. Dr. Kost Elisevich is an epilepsy surgery expert with a large experience in awake neurosurgical cases. Dr. Steven Kalkanis has extensive experience in neurosurgical oncology.

How to follow the case: The case can be followed on Twitter. Information will be posted under @henryfordnews.  Posts will be identified with the #HFHNS tag. Questions for the surgeons are encouraged and should be addressed to @henryfordnews with the same tag. The procedure will begin at approximately 8:30 a.m. March 18 with the most active Twittering beginning at approximately 10 a.m. 

What is Twitter? Twitter is a free micro-blogging service that allows users to broadcast and exchange short messages (less than 140 characters). For more information or to sign up for an account to go Twitter.com.