Brain Surgery

3-D Printed Model Allows Brain Surgeons to Rehearse

by Kim Krieger

Dr. Charan K. Singh, right, threads a catheter through a 3-D printed model of arteries in the brain while speaking with Dr. Clifford Yang, one of the  model's creators, at UConn Health.

Dr. Charan K. Singh, right, threads a catheter through a 3-D printed model of arteries in the brain while speaking with Dr. Clifford Yang, one of the model’s creators, at UConn Health. Peter Morenus


The first time a young surgeon threads a wire through a stroke victim’s chest, up through the neck, and fishes a blood clot out of the brain may be one of the most harrowing moments in their career. Now, a UConn Health radiologist and a medical physicist have made it easier for them to get some practice first. The team made a life-size model of the arteries that wire must pass through, using brain scans and a 3-D printer. They will make the pattern freely available to any doctor who requests it.

Five years ago, the Food and Drug Administration (FDA) approved mechanical thrombectomy — using a wire to pull clots out of the brains of stroke victims. A trap at the end of the wire opens like a little snare that captures the clot, which is then dragged out of the patient.

After a couple months of tweaking, a UConn Health radiologist and a medical physicist found they could print a true-to-life teaching model of the brain’s major arteries for about $14.

A lot can go wrong on that journey. One of the most dangerous complications is also one of the most likely: another clot can be accidentally knocked loose from the walls of the arteries and get stuck in the heart, the lungs, or elsewhere in the brain. Computer simulations of the procedure exist, but they are prohibitively expensive for many medical schools to purchase. Yet interventional radiologists and neurosurgeons need to train extensively before they work on a real person.

UConn Health cardiac radiologist Dr. Clifford Yang and medical physicist intern David Brotman knew they could help young doctors feel more comfortable with the mechanics.


Because of the prohibitive costs of computer simulation programs, often the first time a surgeon threads a wire into a stroke victim’s brain to remove a blood clot is during the doctor’s first surgery. Using brain scans and a 3-D printer, a UConn team made a life-size model of the arteries surgeons must navigate during the procedure so they can practice first. The pattern is available for free to any doctor who requests it.


“What matters is the ability of the doctor to be confident in guiding the wire,” says Brotman. He and Yang found a brain scan of a patient with typical blood vessel structure and used the scan to design a 3-D model of the blood vessels. Finding a good scan was easy: UConn has an immense library of scans from computed tomography (CT) and magnetic resonance imaging (MRI) of patients. The tough part was converting the data into something a 3-D printer could interpret. Brotman and Yang found and modified publicly available software to do that, and after a couple months of tweaking, they found they could print a true-to-life teaching model of the brain’s major arteries for about $14.

Technically called a brain perfusion phantom, the model is surprisingly delicate. Holding it in your hand brings home just how small the arteries are, even in an adult man. The top arch of the aorta in the chest, big enough to slide an adult’s pinky finger through, connects to the carotid in the neck and then on to the Circle of Willis in the brain, which is no thicker than a fat piece of yarn. The circle has six branches. Each branch supplies blood to one-sixth of the brain. It is in these branches that clots are most likely to get stuck and cause serious damage.

“We are using this model to teach students,” says UConn interventional radiologist Dr. Charan Singh. “Obviously, it won’t feel like the human body. But it will improve their knowledge of anatomy and give them basic technique on how to move the catheter.”

What matters is the ability of the doctor to be confident in guiding the wire.

Singh demonstrates how a slight twist can violently flip the catheter, which is dangerous. It could knock off new clots into the bloodstream. The model isn’t perfect — there are several different ways a person’s aorta can be shaped, and the other veins can vary too. But students can get good practice with it, Singh says.

Dr. Ketan Bulsara, UConn’s chief of neurosurgery, also likes the technology. He cautions that individual anatomy varies too much for it to be used as the only training tool to learn mechanical thrombectomy, but says that it could potentially be used to visualize other conditions, such as brain tumors. Surgery for brain tumors has significant lead time, and modeling the tumor in advance could personalize and improve patient care.

“Creating these high-level 3-D models customized for individual patients has the potential to significantly improve outcomes and reduce operative times by enhancing surgical planning,” Bulsara says.

New Epilepsy Monitoring Technology Tailors Patient Care

by Lauren Woods

Research At The Birkbeck Babylab Into Brain And Cognitive Development LONDON, ENGLAND - MARCH 03: Research assistant Katarina Begus, prepares a 'Geodesic Sensor Net' for an electroencephalogram (EEG) experiment at the 'Birkbeck Babylab' Centre for Brain and Cognitive Development, on March 3, 2014 in London, England. Researchers at the Babylab, which is part of Birkbeck, University of London, study brain and cognitive development in infants from birth through childhood. The scientists use various experiments, often based on simple games, and test the babies' physical or cognitive responses with sensors including: eye-tracking, brain activation and motion capture. (Photo by Oli Scarff/Getty Images)

The new epilepsy unit will feature a high-density geodesic EEG with more than 250 sensors in a cap like the one pictured. Oli Scarff/Getty Images


UConn Health is now home to a high-tech Epilepsy Monitoring Unit.

Located on the first floor of the new tower at UConn John Dempsey Hospital, the unit has two large patient rooms with state-of-the-art technology; 24-hour video observation capabilities; the latest in advanced electroencephalography (EEG) monitoring; and a dedicated team of neurology and neurosurgery doctors, nurses, and staff.

If needed, patients can be monitored for up to several days so doctors can determine whether the seizures are caused by epilepsy, what kind of seizures they are, and where they originate, says Dr. L. John Greenfield, chair of the Department of Neurology at UConn Health and a nationally-recognized epilepsy specialist. The monitoring information is critical to figuring out the best way to halt the seizures.

For patients with epileptic seizures, the information gathered helps doctors create a personalized clinical care plan and choose the most appropriate medications or adjustments for the patient’s seizure type.

For patients who may need surgical intervention to control their seizures, the new unit will allow doctors to precisely localize where the seizures start in the brain to see if neurosurgery might be a beneficial treatment option. According to Greenfield, if the seizure starts in the temporal lobe, there is a 70 to 80 percent chance the seizures can be cured with brain surgery.

Greenfield hopes the data and insights gained from the new unit’s video and EEG monitoring will advance future brain research and clinical care for epilepsy patients. The new unit will soon offer high-density geodesic EEG recordings that can sample patient brain wave data using more than 250 electrode sensors contained in a wearable, stretchy web that fits over the head like a swim cap. This device can pinpoint epileptic activity with much higher precision than traditional EEGs, which record signals using only 19 electrodes.

“With the combination of our state-of-the-art monitoring unit, clinical care, research, and our new chief of neurosurgery, Dr. Ketan Bulsara, UConn Health can now provide comprehensive care for patients with epilepsy and with seizures due to brain tumors or vascular malformations,” saya Greenfield. Bulsara specializes in skull base, endovascular, and tumor neurosurgery.