A courageous young Scot underwent a highly specialised brain operation while she remained awake.
During the summer Brooke MacFadyen, 24, had an Awake Craniotomy – a lifesaving procedure used to remove primary brain tumours – which lasted more than seven hours.
The goal of the surgery is to remove as much tumour tissue as possible while minimising risk of complications or longer-term effects on motor control and cognitive functions.
To do that Brooke was kept conscious during key parts of the surgery, to help ensure the procedure was going to plan.
Traditionally, clinicians rely on very simple, bedside type tests to gauge a patient’s cognitive ability and to monitor for any emerging deficits from the surgery, allowing the surgical plan to be modified to compensate.
However, these tests often lack standardisation and sophistication, and as a result NHSGGC teams have been the first in Scotland to pioneer a different approach.
Teams at the Institute for Neurological Sciences have been using a new system called NeuroMapper – a digital platform which allows monitoring across a wider range of functions such as language, attention, working memory, visuospatial and executive functions, during the awake stage of the surgery.
The result has been a better experience for patients and more accurate, more consistent data leading to improved outcomes.
During the entire procedure Dr Sharon Mulhern, Consultant Clinical Psychologist and Lead for Regional Neuropsychology Services, was there to support Brooke, holding her hand and keeping her calm during the awake phase of the procedure.
Dr Mulhern and Speech and Language Therapist Jen Bowers operated the NeuroMapper and worked with the rest of the theatre team to gauge Brooke’s reactions and ensure the procedure was going to plan.
Brooke praised the care of the whole team but had a special word of thanks for Dr Mulhern who was “like a second mum to me”.
She said: “I’ll never forget Sharon, She’s been amazing throughout this whole process, and I have such a clear memory of seeing her there with me during the operation.”
Brooke’s condition was diagnosed following a seizure earlier this year.
She said: “When I heard about the awake craniotomy, it took me a couple of weeks to get over the shock but then I decided ‘I’m going to do this’.”
She admitted the run-up to the operation was difficult, with a lot of ‘what-ifs’ circling in her head.
But she said that the support she received from the entire NHSGGC team was critical to her, and her whole family – mum Kelly, dad Graham, brothers Harry and Jack, boyfriend Dillon and best friend Robyn.
Brooke, needed to wait a number of weeks after her operation to find out how serious the tumour was but she has just been given the positive news.
Now looking to become a orimary school teacher, she said: “I will be getting looked after with some future treatment to prevent the tumour coming back but basically I can look forward now with real confidence.
“Before I doubted myself so much – I’d get into my own head with things, talk myself out of things. But not now. I now know I’m a really strong person – and super-independent.
“Making this decision – something I was so scared of – I’m going to use it as a positive from now on.”
Dr Mulhern said: “Awake Craniotomy is a highly specialised procedure often working to extremely fine margins.
“It’s early days, but NeuroMapper has real potential to be a revolution in intra-operative brain mapping, bringing real benefits for the surgical team, for the patient – and for longer-term outcomes.”
Consultant Neurosurgeon Mr Likhith Alakandy, who carried out Brooke’s operation, said, “By providing constant feedback, it allows the surgeon to push boundaries of tumour removal while preserving important neurological and cognitive function.
“Maximising tumour removal is known to improve survival in patients with intrinsic brain tumour, so it helps provide a better outcome in these patients.”
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