Art is popular. There are many people that enjoy, support, or make a living off of art. It has the power to evoke emotion and also to allow one to express emotion through shapes, color, and patterns. Brains are popular too, but in a different sense. Everyone has a brain. Some may use it more than others, but it is something that all humans possess.  This is, of course, excluding the various other life forms on earth that  make use of a brain. What is not so popular is brain art. Especially brain art that is anatomically correct. The Museum of Scientifically Accurate Fabric Brain Art claims to be the largest collection of anatomically accurate representations of the brain made entirely from fabric. How exciting! The inspiration for each piece comes from dissections of the brain, functional magnetic resonance imaging (fMRI), neuroscience research, and positron emission tomography or PET (another medical imaging technique). These self-deemed “neuroartists” employ traditional art techniques such as quilting, knitting, and rug hooking to create their cranial masterpieces. Although extremely talented, these artists do warn not to use the accuracy of their art as a guide for any kind of surgical medical endeavor.

Check out one of the pieces:

"The Knitted Brain" by Karen Norberg

Check out some more of the collection here:

The Museum of Scientifically Accurate Brain Art

If you were asked to describe the consistency of the human brain, how would you describe it? Like jelly? Cottage cheese? Dr. Katrina Firlik would say tofu—the “soft variety.” In her book, Another Day in the Frontal Lobe (Random House, 2006) Dr. Firlik, a practicing neurosurgeon, offers an insider’s perspective on the world of neurosurgery and recounts the journey that got her where she is today. Through her biting wit and the compassionate nature with which she describes her many patients, Firlik paints a vivid and engaging picture of a field about which many know only a little.

Of the approximately 4,500 neurosurgeons in the United States, only about 200 of them are women—a fact that Dr. Firlik confronts head-on when describing her experience in the seven-year neurosurgery residency program at the University of Pittsburgh Medical Center. In fact, Firlik was the first woman to be admitted into the program—the largest and one of the most prestigious in the country. However, it is evident that she did not let the fact that she was a minority effect her in a negative way.

Much of the book is filled with Firlik’s accounts of the many cases she encountered during her lengthy time as a resident—from a carpenter who was shot in the head with a nail gun to a man with a gaping infectious wound on his forehead (one of the more gruesome encounters of her career), Firlik profiles numerous interesting patients and their prognoses.

Each case is filled with compassion and intrigue, as well as a handful of clever analogies to illustrate her points—for example, the comparison of glioblastoma multiforme (GBM) tumor to a spilled bag of popcorn kernels. It is incredibly difficult (if not impossible) for a neurosurgeon to remove an entire GBM in the course of a surgery because of its diffuse nature. As for the popcorn, she says, “the relatively focused part of the mess would be easy to clean up. Over the next few days, though, you would be amazed to discover individual kernels that made it all the way […] into the living room. That’s what a glioblastoma is like.”

Dr. Firlik also provides insight on the incredible number of technologies available for use in neurosurgery today, from high-tech 3D imaging systems and expensive drill bits to less complex but equally important suction devices and clamps. She discusses the cutting-edge techniques that are gaining popularity in the field, for example, the Gamma Knife, and also makes predictions about the not-so-distant future of neurosurgery. It’s entirely possible, she postulates, that it will soon become the standard for patients to elect to undergo procedures to enhance their cognitive abilities beyond the societal norm—“brainlifts,” as she refers to them.

Whether you are interested in becoming a neurosurgeon, or you are simply intrigued by the intricacies and pathologies of the brain and the many ways of treating them, Dr. Firlik’s book is a fascinating look into the world of neurosurgery through the eyes of someone who’s seen it first-hand.

“Another Day in the Frontal Lobe” by Katrina Firlik
– NYTimes.com
Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside – Amazon.com

August 25, 2009 marked the day that America, and most importantly Massachusetts, lost one of its greatest senators, Ted Kennedy. Kennedy was diagnosed with a type of brain cancer called glioblastoma multiforme (GBM) in May 2008 after suffering from a seizure. GBM is a tumor formed in the glial, or supportive, brain cells; there is no current evidence for a genetic predisposition to this type of cancer. The American Cancer Society believes that 21,000 Americans are diagnosed with brain tumors, and about 10,000 are GBMs. They are the most aggressive and common type of brain tumor, which are resistant to many types of treatments. Only 3% of patients diagnosed with these tumors generally survive five years after diagnosis.

Almost two years after Kennedy’s death, doctors are using the drug Avastin to treat GMBs. Avastin blocks the growth of new blood vessels, a necessary component for the survival of tumors. In one study conducted on Dennis Sugrue, physicians thread a fine tube through his blood vessels and into his head to spray the drug on the location where the tumor had been cut out. They did this experiment because the tumor began growing back even after treatment with surgery, radiation, and chemotherapy. The FDA has approved the use of this drug on GMB, based on the results of 2 phase II clinical trials that showed reduced tumor size in the patients, but it can only be administered after a prior treatment is performed on the tumor.

One of the biggest challenges facing the treatment of GBM is the blood-brain barrier, a separation of the circulating blood and the brain’s extracellular fluid. It occurs along the capillaries and prevents the diffusion of many cells into the brain. Dr. John Boockvar, a brain surgeon at New York-Presbyterian/Weill Cornell, is administering the Avastin to Mr. Sugrue by first injecting mannitol, a drug that opens the blood-brain barrier, and then flooding the tumor with the drug. In the future, other drugs may be combined with Avastin to combat GBM. Although it is unknown whether it improves disease-related symptoms or survival in people under this treatment, it is promising.  Mr. Sugrue’s tumor has decreased in size and his treatment is still an ongoing process.

Although the survival rate for GBM is very low, it is unfortunately the reason why there is a push to try more treatments and expand experimental trials. One can only hope that this treatment leads to more breakthroughs, and more patients like Mr. Sugrue will be able to live longer, healthier lives.