A brave 25-year-old woman livestreamed her own brain surgery – while lying awake on the operating table.
Jenna Schardt suddenly suffered from a stroke – the same symptoms that helped patients as part of her occupational therapist training at Brenau University in Gainesville, Georgia.
Jenna even had an attack caused by a jumble of malformed blood vessels in her brain, called a cavernoma.
Doctors found the benign mass in Jenna's brain and tried to treat her symptoms with medication, but it didn't work.
So in order to enable Jenna to continue her studies uninterrupted unpredictable attacks, doctors advised that she should have the blood vessel nest removed through open brain surgery.
Moreover, the cavernoma was in an area of Jenna & # 39; s brain that controls her speech, so doctors had to map very precisely where it was safe to operate without Jenna being unable to communicate.
And to do that, they had to be able to watch her awake and talking, while her brains were exposed and (gently) punctured and punctured and waited to see how it would affect her speech.
Jenna, from Illinois, decided she wanted everyone to be able to watch her surgery, so Methodist Dallas Medical Center streamed her surgery on Tuesday.
Jenna Schardt, 25, was diagnosed with cavernoma, a malformed jumble of blood vessels in her brain. She and her neurosurgeons at Methodist Dallas Medical Center decided to stream the operation live, for which Jenna was awake to follow the language centers of her brain
While more than 1,000 people around the world watched from their smartphones and computers, the camera slowly zoomed in on Jenna & # 39; s face, the only part of her that wasn't hidden by blue surgical curtains.
Unlike most patients who underwent major surgery, Jenna was not intubated with a machine that breathed for her.
A single green tube ran under her nose and made sure she got enough oxygen.
Behind the surgical drape, hidden from the camera, Jenna & # 39; s exposed brain, a piece of her skull, was removed to give two neurosurgeons access to the organ.
A few minutes after the camera & # 39; s started rolling, Jenna & # 39; s unencumbered lips lifted to a smile, her eyelashes fluttered and she cast a dreamy look around her.
& # 39; Oh, she's awake! & # 39; someone in the operating room cried.
Jenna & # 39; s eyes closed a bit, the rest of her stock still thanks to a large halo-like clip that holds her head in place.
When she opened her eyes again, moments later, Jenna looked completely unmoved through the sterile environment or the special experience of lying awake while surgical instruments searched her brain.
An hour and a half before the anesthesiologist slowly brought Jenna back to consciousness, the surgical team worked carefully to cut away the required skull, thoroughly anesthetize the skull and the three layers of protective tissue – called the meninges – around her brain.
While working with stroke patients as part of her master's program in occupational therapy, Jenna developed some of the same symptoms as her patients – but she had no stroke but an attack caused by the maze of blood vessels in her brain
A brain scan revealed the jumble of blood vessels, called a cavernoma, on the left hemisphere of Jenna & # 39; s brain, near the brain's language center (lit on the right of the image)
Dr. Nimesh Patel, head of neurosurgery at Methodist Dallas Medical Center, explained during the Jenna procedure that the brain itself has very few pain receptors, so it is pretty insensitive to the sensation, even when pierced by metal tools.
In other words, Jenna did not feel much discomfort except that she was held tight by her head clamp and a mild dry mouth, a common side effect of anesthesia.
She smiled when the neural monitor, a man named John, was bent to position herself in her field of vision.
Jenna & # 39; s cavernoma was on the left hemisphere of her brain, where speech is formulated and processed for 95 percent of us.
It is estimated that one in 100 to 200 people has cavernomas, but about a quarter of them never have symptoms.
These vascular malformations are fairly rare in the general population, but often occur in comparison with other malformations.
Before the operation, 25-year-old Jenna was calm and collected, hoping that someone could learn from her experience. Pictured: traveling to the UK
There is no clear cause; blood vessels simply grow in a jumble rather than feeding to and from different regions as they should.
As the formation grows, it may be present on parts of the brain, disrupting functions, leading to loss of vision, double vision, confusion, nausea, headache, sleep problems, balance problems, and more.
The primary risk associated with a cavernoma is that one or more of the vessels in the tangle burst, bleed into the brain – or bleed – and cause neurological damage.
The size and location of a cavernoma determine the risks associated with its surgical removal.
And what measures, such as keeping the patient awake, such as Jenna & # 39; s case, are needed to safely remove the malformation.
If the surgeons tested part of the intended surgical route around the cavernoma and discovered that it disrupted Jenna's speech, it might be worth the risk of leaving part of the vascularization in place instead of an intact damage part of her language brain.
& # 39; What she will say and where (the surgeons test her brain) indicates where to go and, more importantly, where not to go, & # 39; explained Dr. Patel out.
During brain surgeries such as Jenna doctors use a digital guidance system to achieve the deformation with scans (photo), but Jenna was more sensitive than most due to the proximity of her brain's language center
As soon as surgeons started to remove the cavernoma, a neural monitor had a conversation with Jenna to distract her from the work done on her open brain – including about her beloved puppy, Paisley (photo)
& # 39; One millimeter to the left or right can affect her speech, so if she is unable to speak (when she is stimulating part of her brain), we know that it is a region that we want to avoid & # 39;
When it was clear that she was comfortable and ready, John instructed Jenna to look at an iPad and name the images she saw there.
Every image choice was preceded by a futuristic & # 39; bank! & # 39; sound, an indication that the surgeons were stimulating a new part of her brain.
& # 39; butterfly … turtle … banana … orange … man … four … shoe, & # 39; says Jenna, after every & # 39; bank! & # 39;
"We are really waiting for her to miss something, which is an indication that this is a no-go zone," Dr. Patel.
Jenna continues without problems for a while, before finally pausing a bit longer than normal and coming across a word.
A no-go zone. The surgeons mark it as such.
A few hours after the operation, Jenan was awake, recovered well and gave a grin to the camera. It will be closely monitored, but is expected to fully recover
After a few minutes of Jenna, who calls her instructions perfect, the surgeons are satisfied with the route they have mapped out. They announce that they are ready to begin the removal.
& # 39; Oh, great, & # 39; Jenna shouts, only audible about the machines and surgical tools.
The doctors decide that they leave Jenna awake for the first stages of the removal of the cavernomas.
Again, the brave master's student was not surprised.
The neural monitor crouched in front of her again and started chatting with Jenna.
The two had a remarkably informal conversation while Jenna spoke eloquently about her & # 39; baby & # 39; – a puppy named Paisley, walking across her hopes of graduating from her master's program and more.
The doctors finally reached the cavernoma, increased the anesthesia, let Jenna count to 20, and stopped the cameras to complete the operation.
& # 39; I feel pretty calm, I am at peace about the situation … if this can be a kind of learning moment for someone else … I am at peace about it, & # 39; Jenna said before the operation.
A few hours after the operation, Jenna woke up, smiled and gave the camera a thumbs up.
She will have to be followed for some time to ensure that the entire cavernoma has been removed and the path to the malformation was as clear as it seemed during the operation, but if everything goes according to plan, Jenna will fully recover and next year her master can complete occupational therapy.
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