Intraoperative Duplex Scanning Used For First Time To Treat Car-Jacking Victim

October 19, 1998

Brain Injury Awareness Month - October

LOS ANGELES (October 19, 1998) - A new type of technology known as intraoperative Duplex Scanning was used for the first time at Cedars-Sinai Medical Center last month, and played an important role in saving the life of carjacking victim Mark Watson*. "In fact," says Hrayr Shahinian, M.D., a skull base surgeon and director of Cedars-Sinai Medical Center's Skull Base Institute, "this patient probably would not have survived had he been 'carjacked' just a few years ago instead of this past September, or had he not been taken to a hospital with this type of cutting-edge imaging technology and highly skilled brain, cardiac and surgical intensive care teams."

Duplex scans combine two types of imaging technology - doppler and ultrasound - giving the physician both auditory and visual images of blood flow and enabling him or her to differentiate between blood vessels and other types of tissues. "When the probe is placed near an artery, you can hear a pulsing sound and the picture is bright red," says Dr. Shahinian.

"When the probe is near a vein, the sound is steady rather than pulsing, and the visual image is more of a yellow-red. If there is no signal, it indicates that the flow has been interrupted by the injury, and that's the area that will need ligation or repair."

In Watson's case, he had sustained critical gunshot wounds to his brain which had resulted in injury to the left sigmoid sinus. "The bullet in his head had entered behind his left ear and exited behind his right ear, and he was hemorrhaging badly," says Dr. Shahinian. Compounding the problem was the fact that a second bullet had entered Watson's chest. "Because of the massive bleeding from both locations, either of these wounds could have been fatal."

Because the heart injury involved high-pressure, pumping-type bleeding from an artery, surgeons decided to use temporary packing to stop the brain hemorrhaging (which was venous) while they repaired his heart. During the heart surgery, however, Watson's body temperature dropped to dangerous levels and his blood was no longer clotting.

"It was too risky to try repairing the head wound at that point, so he was taken to the Surgical Intensive Care Unit (SICU) until his critical condition could stabilize and we could safely operate on his head wound," says Dr. Shahinian. The Duplex scan indicated that the sigmoid sinus was damaged, and a CAT scan of the patient's head showed that he had alson suffered a stroke in the cerebellum.

Because the patient's condition was so critical, it was important to make any operation as minimally invasive as possible. Using the Duplex scanning technology, Dr. Shahinian was able to pinpoint the injury before opening the patient's head surgically three days later. Then during the surgery itself, the technology was used again, this time intraoperatively, to confirm the area of injury and to minimize the invasiveness of the surgery.

"Without the information provided by the Duplex study, we would have had to open the patient much more invasively, and given his other injuries and his critical condition, that would not have been safe," says Dr. Shahinian Watson is expected to fully recover.

*Name and details have been changed to protect the patient's privacy.
-end-
Available For Interviews:
Hrayr Shahinian, M.D., Skull Base Surgeon and Director of Cedars-Sinai Medical Center's Skull Base Institute

For media information and to arrange an interview, please call 1-800-396-1002 (this number is not for publication).
-end-


Cedars-Sinai Medical Center

Related Brain Articles from Brightsurf:

Glioblastoma nanomedicine crosses into brain in mice, eradicates recurring brain cancer
A new synthetic protein nanoparticle capable of slipping past the nearly impermeable blood-brain barrier in mice could deliver cancer-killing drugs directly to malignant brain tumors, new research from the University of Michigan shows.

Children with asymptomatic brain bleeds as newborns show normal brain development at age 2
A study by UNC researchers finds that neurodevelopmental scores and gray matter volumes at age two years did not differ between children who had MRI-confirmed asymptomatic subdural hemorrhages when they were neonates, compared to children with no history of subdural hemorrhage.

New model of human brain 'conversations' could inform research on brain disease, cognition
A team of Indiana University neuroscientists has built a new model of human brain networks that sheds light on how the brain functions.

Human brain size gene triggers bigger brain in monkeys
Dresden and Japanese researchers show that a human-specific gene causes a larger neocortex in the common marmoset, a non-human primate.

Unique insight into development of the human brain: Model of the early embryonic brain
Stem cell researchers from the University of Copenhagen have designed a model of an early embryonic brain.

An optical brain-to-brain interface supports information exchange for locomotion control
Chinese researchers established an optical BtBI that supports rapid information transmission for precise locomotion control, thus providing a proof-of-principle demonstration of fast BtBI for real-time behavioral control.

Transplanting human nerve cells into a mouse brain reveals how they wire into brain circuits
A team of researchers led by Pierre Vanderhaeghen and Vincent Bonin (VIB-KU Leuven, Université libre de Bruxelles and NERF) showed how human nerve cells can develop at their own pace, and form highly precise connections with the surrounding mouse brain cells.

Brain scans reveal how the human brain compensates when one hemisphere is removed
Researchers studying six adults who had one of their brain hemispheres removed during childhood to reduce epileptic seizures found that the remaining half of the brain formed unusually strong connections between different functional brain networks, which potentially help the body to function as if the brain were intact.

Alcohol byproduct contributes to brain chemistry changes in specific brain regions
Study of mouse models provides clear implications for new targets to treat alcohol use disorder and fetal alcohol syndrome.

Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.

Read More: Brain News and Brain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.