Morning Medical Update 5-25-23 Brain Surgery Without an Incision – How Focused Ultrasound is Restoring Steady Hands for Patients with Tremors

Kansas City, Kan- The University of Kansas Health System is treating a total of 19 COVID patients today, 16 yesterday. Other significant numbers:

•           6 with the active virus today, 3 yesterday

•           1 in ICU, 0 yesterday

•           1 on a ventilator, 0 yesterday

Key points from today’s guests:

Carlene Kirkwood, focused ultrasound patient

  • Carlene’s hands shook so badly that she had to give up her favorite activity – painting – until she heard of an innovative procedure that could make her hands steady again.
  • The focused ultrasound procedure was 240 miles away at The University of Kansas Health System, but it was worth the trip for her.
  • The procedure only took less than three and a half hours, but it completely stopped the tremors on the right side of her body.
  • She will be going back for a separate procedure to take care of the left side.
  • Just having her right hand be steady has allowed her to get back to doing the things she loves.

Dr. Michael Kinsman, neurosurgeon, The University of Kansas Health System

  • We always get a special CAT scan of the of the head before we begin focused ultrasound treatment. It provides a complicated calculation that involves thickness of the bone and shape of the head and ultimately gives us a number that lets us know where we're going to focus the soundwaves and how strong they must be to penetrate to the spot where we want.
  • For focused ultrasound, the patient lies down on an MRI table and wears a helmet with 1,024 ultrasound transducers incorporated.
  • All those waves intersect at a specific spot in the brain to try to help that tremor – without surgery.
  • Those waves disrupt normal signals that pass through that portion of the brain and calms down those tremors.
  • The results of this treatment are amazing because patients are struggling with very simple everyday actions like eating, drinking, writing, or their hobbies like painting and golf – and for them this treatment is life changing.

Dr. Rajesh Pahwah, neurologist & movement disorder specialist, The University of Kansas Health System

  • Right now, when a patient has tremors, it does not necessarily mean that we need to treat it because some people have very little tremors, and they can get by on their daily life without any interruptions in the activity.
  • Some people only have tremors when they are doing certain tasks like being on television and talking. They may take medications before their show and they're fine and usually the medication is like a beta blocker.
  • Other medications can be used, but they are not very effective. In fact, with all the medications we have, more than half of our patients continue to have tremor that interferes with their daily life.
  • Those are the patients where we look at other options, whether it is using a peripheral nerve stimulator, which is like a watch that you put it on your wrist, and it provides electrical currents that go back in the brain and is helpful for the tremors.
  • Options for treatment also include surgical procedures, focused ultrasound, and deep brain stimulation.

Special Section – Stop the Bleed Day

Israel Mendoza, RN, trauma education specialist, The University of Kansas Health System

  • As part of National Stop the Bleed Day, The University of Kansas Health System is providing a few tips to educate people on how to stop bleeding that could save a life.
  • First, put pressure on a wound to stop the bleeding using your entire body weight on the wound until help arrives. Do not let up on the pressure!
  • For serious, deep wounds, “packing” may be necessary, where you put a towel, shirt, or anything porous into the wound before you apply pressure.
  • Only use approved tourniquets for stopping the bleed.
  • Trauma is the number one cause of death and preventable death in anyone ages one to 44 nationwide. And bleeding is the number one cause of preventable deaths in an injury.
    Friday, May 26 at 8 a.m. is the next Morning Medical Update. Stomach pain led to a colon tumor diagnosis for a 37-year-old dad. Learn more about his cancer journey.

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