A patient at King’s College Hospital in London has played the violin while surgeons removed a tumour from her brain, using a cutting-edge intraoperative ultrasound machine funded by King's College Hospital Charity.
Dagmar Turner, 53, was diagnosed in 2013 with a large, slow growing tumour after suffering a seizure during a symphony. The violinist, who plays in Isle of Wight Symphony Orchestra and various choral societies, underwent biopsy and then radiotherapy at her local specialist hospital to keep the tumour at bay. When it became apparent in autumn 2019 that the tumour had grown and become more aggressive, Dagmar was referred to Professor Keyoumars Ashkan, Consultant Neurosurgeon at King’s College Hospital, to discuss her options.
Dagmar’s tumour was located in the right frontal lobe of her brain, close to an area that controls the fine movement of her left hand. Precise and skilled use of this hand is essential for playing the violin as the fingers regulate the length of the strings by holding them against the fingerboard, producing different pitches. Professor Ashkan, who holds a degree in music and is an accomplished pianist, came up with a tailored plan to preserve Dagmar's musical skills while fulfilling the millimetre-precise needs of the operation.
Prior to the operation the neurosurgical team at King’s spent two hours carefully mapping her brain to identify areas that were active when she played the violin and those responsible for controlling language and movement. They also discussed with Dagmar the idea of waking her mid-procedure so she could play.
During the operation Professor Ashkan used a cutting-edge introperative ultrasound machine, funded by King's College Hospital Charity, which helped to minimise risk by providing detailed images that more accurately pinpoint the location of tumours and critical brain structures.
"The machine is enabling us to perform procedures deep within the brain, which may not have been possible just 12 months ago. Thanks to the Charity's support we can now provide our patients with neurosurgical care that goes over and above the normal standard of care."
Professor Keyoumars Ashkan, Consultant Neurosurgeon at King's College Hospital
Following the procedure Professor Ashkan said, “King’s is one of the largest brain tumour centres in the UK. We perform around 400 resections (tumour removals) each year, which often involves rousing patients to carry out language tests, but this was the first time I’ve had a patient play an instrument.
“We knew how important the violin is to Dagmar so it was vital that we preserved function in the delicate areas of her brain that allowed her to play. We managed to remove over 90 percent of the tumour, including all the areas suspicious of aggressive activity, while retaining full function in her left hand.”
Dagmar added, “The violin is my passion; I’ve been playing since I was 10 years old. The thought of losing my ability to play was heart-breaking but, being a musician himself, Professor Ashkan understood my concerns. He and the team at King’s went out of their way to plan the operation – from mapping my brain to planning the position I needed to be in to play. Thanks to them I’m hoping to be back with my orchestra very soon.”
Three days after the procedure Dagmar was well enough to go home to her husband and son. She will continue to be monitored by her local hospital.