Man told jokes as surgeons cut brain

Doctors recently gave a new lease of life to a man suffering from severe headaches and seizures when they removed a tumor from his head.

But the brain surgery that Joseph Karuri underwent on October 4 was different because he remained awake during the entire procedure.

The 33-year-old mason from Mathira in Nyeri spent the three hours that the operation took talking and joking as neurosurgeon Sam Njiru busied himself on the patient’s head.

What Mr Karuri underwent is called a craniotomy, which is the surgical removal of part of the bone from the skull to expose the brain. Craniotomy, however,  has a more specific name – an awake craniotomy – because the patient remains awake during the entire procedure, unlike during a conventional craniotomy where a patient is anaesthetised. In the conventional case, the operation also requires a life support machine.

During the brain surgery, Dr Njiru kept asking Karuri to speak and read more. He also conducted movement tests while stimulating Karuri's exposed brain. In the end, he removed an elongated tumor that was nestling in a functionally important part of Karuri’s brain.

Karuri told The Standard he felt like he had dodged a bullet.

“I thank God the operation went well. I was following everything and the doctor kept asking me questions about myself and where I come from,” he recalled.

During the operation, the mason said he spoke of his village, his childhood and family.

“Before coming to the hospital, I was scared. Initially I was not willing to undergo the surgery because people from my village had instilled fear in me, claiming that most such surgeries were not successful and often led to death,” he recalled.

He, however, found himself in the safe hands of Dr Njiru, who had first seen Karuri at his office where he went to complain of recurrent headaches.

On evaluation, the neurosurgeon found that Karuri had a tumour on the right side of the brain that measured 2.5cm. At first, the doctor decided to manage the condition with medication. 

But Karuri would book another appointment, this time complaining of severe headaches and giddiness.

The doctor decided that Kairu needed to undergo a craniotomy. Njiru and his team however ruled out a routine craniotomy to remove the tumour because Karuri was suffering from other health complications. Instead, they decided to do an awake craniotomy, which the hospital said went well.

Karuri was not the only patient on the operating table that day. Three other patients also underwent the surgery. The operations took approximately 12 hours, as surgeons spent three hours on each patient.

According to the hospital’s medical superintendent Joseph Mburu, the first awake craniotomy was conducted in Kenya in 2015.

“This surgery requires advanced neuro-surgical medicine, equipment and expertise," said Dr Mburu, adding that they expected the four patients to lead a normal life.

According to Njiru, the remarkable procedure allows surgeons to test how their operation is affecting the patient's brain and function at every step.

“Recovery is usually faster than in a general anaesthetised surgery because fewer drugs are used and so the body can spring back faster,“ the doctor said.