Okay! We have successfully prepared the patient for the
lowering of the electrode. We have the exact coordinates and angles
that will help us know where to drill a hole and reach the VIM
thalamus. It is incredibly important this is done correctly, or
else a blood vessel could be hit that can cause a stroke. Here, an
image of Dr. St. John dressed in a lab coat, with a mask and hair
net on, standing in a medical operating room. Text Bubble
Slide 3
Now, we must find the exact depth to which the electrode must
be lowered to stimulate the tremor cells. By lowering a testing
electrode into the brain, we can monitor the rate at which cells
fire as the electrode is lowered deeper into the brain. The tremor
cells fire at a rapid rate and a testing electrode can pick up this
feature. First, we must position the electrode for lowering. Text
Bubble Here, an image of Dr. St. John dressed in a lab coat, with a
mask and hair net on, standing in a medical operating room.
Slide 4
Based on data collected from images taken of the patients
brain, you must adjust the arc angle of the stereotaxic arc to 106
degrees. Tap the Left and Right arrow keys to adjust the arc angle
(this text should be large and bold with a different fond from the
text bubble)
Slide 5
Great job! Now, you must adjust the collar angle to 65.5
degrees. Tap the Left and Right arrow keys to adjust the arc angle
(this text should be large and bold with a different font from the
text bubble)
Slide 6
Slide 7
Here, the animation Kevin creates regarding the cutting of the
scalp and the boring of the hole is inputted, more information of
this storyboard will be provided when this animation is
available.
Slide 8
Now we are ready to lower the electrode into the brain. This
first electrode to be lowered is going to be used to test the depth
to which the electrode needs to be lowered. Notice the chart
recorder in the bottom of the screen. The electrode being lowered
will be able to sense the rapidly firing tremor cells which will
appear as spikes. Once the electrode has been lowered enough to
sense these cells, we know we are in the right place. These tremor
cells are responsible for the tremoring the patient
experiences.
Slide 9
Notes on Chart Recorder Animation The purpose of this animation
is to exemplify the idea that the testing electrode is used to find
the exact depth of the electrode since in reality, technology is
not precise enough to locate these cells independently without
using electrochemistry. This animation will look similar to this
image Take a look at the video clip here to get a good idea of what
the animation should look like. When the electrode is lowered on
Kevin's animation to a reading of around 25 (with units unclear, I
looked extensively but cannot come up with what units this in in),
there should be a spike reading on the chart recorder as seen in
the video below. If this could be created, it would accurately
describe the surgery.
Slide 10
Lower the electrode until a reading is obtained that indicates
that the testing electrode has reached the tremor cells. This
should be at a reading of 25 according to preliminary mapping.