Tim Hartig, 54, an automotive tool engineer from Detroit, MI, has been a Tom Petty fan for years. He didn’t realize what a role Petty’s music would play when Mr. Hartig recently had to undergo an awake surgery to remove a glioma brain tumor. When the operating room staff at Lenox Hill Hospital asked him what kind of music he would like to hear during his brain surgery, Mr. Hartig requested Petty’s “I Won’t Back Down.” The music, which played softly in the background, helped soothe Mr. Hartig at a time when he needed it most.
The procedure which took place January 3, was performed by Lenox Hill’s multidisciplinary team including John Boockvar, MD, neurosurgeon and the hospital’s director, Brain Tumor Center; Peter Costantino, MD, executive director and senior vice president of Northwell Health’s New York Head and Neck Institute; Derek Chong, MD, vice chair, neurology; and, Virginia Ann DeSanctis, PhD, chief, neuropsychology.
Prior to January’s surgery, Mr. Hartig underwent an attempt to remove the brain tumor at a hospital in Detroit, but surgeons were only able to remove 10-20%. Mr. Hartig wondered if more could be done to remove the remainder. His daughter researched online and found Dr. Boockvar. Upon reviewing the magnetic resonance imaging (MRI) scans, Dr. Boockvar advised that he would be able to remove most of the remainder of the tumor with a safe surgical approach, but Mr. Hartig would need to be awake for the surgery.
“Awake craniotomy is often done when treating gliomas in order to avoid damaging parts of the brain that control language and movement,” said Dr. Boockvar. “In Mr. Hartig’s case, the glioma was located in the motor strip which is responsible for voluntary movement and muscle activation. It was necessary to keep Mr. Hartig awake with some local sedation during most of the surgery, so we could watch him move his limbs and recognize immediately if we were damaging vital movement centers.”
With the help of Drs. Chong and DeSanctis, brain mapping was done as well, which involves using a small electrical stimulation device to observe any changes in the patient when an area of the brain is stimulated. If an area of the brain is stimulated and the patient stops moving or loses the ability to speak, then the surgeon knows that the area is vital and cannot be removed or cut to access the tumor.
In Mr. Hartig’s surgery, during the points of motor stimulation, he was awake so that he could hear and follow the directions of Drs. Chong and DeSanctis asking him to move different body parts. Once the brain mapping was completed, Dr. Boockvar removed nearly all of the remaining tumor.“While I was at first nervous to have an awake craniotomy, I knew that by having this second procedure, it could add so much more time to my life,” said Mr. Hartig. “I remember the surgery and listening to Tom Petty music which helped me through the process.”
Mr. Hartig recently completed physical rehabilitation in New York City and is happily back home. He is walking with minimal assistance and has full functioning of his arms and hands.
“The data for gliomas tell us that survival is correlated to the amount of tumor that can be taken out,” said Dr. Boockvar. “It took a tremendous amount of courage for Mr. Hartig to have a second surgery, let alone one that needed to be done with him awake.”