South African jazz artist plays guitar with a hole in his scull

Musa Manzini, a jazz bassist, was fully conscious when surgeons opened a hole in his skull to remove a tumor lodged in his brain. Local media showed him unhurriedly plucking his acoustic guitar as they operated.

The surgical method used on Manzini is called awake craniotomy. The procedure facilitates the operation of delicate areas in the brain without causing damage. Manzini’s tumor was positioned at the right frontal lobe, considered to be one of the most delicate brain areas in humans.

Manzini’s left hand motor functions were the main concerns of the surgeons who attended him. “We wanted to make sure we took as much of the tumor as we safely could, but preserve his dexterity,” Dr. Rohen Harrichandparsad, one of the surgeons on the team explained.

The surgeons who operated on the artist said that there were more complications for Manzini, whose work demands synchronized activity in multiple areas of the brain. “We had to ensure that whatever pathways he was using for music were preserved,” Harrichandparsad said. “There’s no single pathway, but a multitude that interact.”

Estimates showed that the surgical team eliminated 90% of the tumor before stitching up Manzini. The musician remained awake until the end. He was discharged a few days later and is recovering at home. “I’ve been given a new opportunity,” Manzini said.

Awake craniotomy

A neurosurgical technique and type of craniotomy, it allows a surgeon to remove a brain tumor while the patient is awake to avoid brain damage. During the operation, the neurosurgeon carries out cortical mapping to spot crucial areas, like the “eloquent brain”, which should not be disturbed while taking out the tumor.

Specifically, awake craniotomy is utilized in mapping the cortex to prevent or trigger language or movement issues during or after the surgery. The method is considered to be more effective than surgeries carried out under general anesthesia as far as avoiding complications is concerned.

Awake craniotomy can be used in several types of brain tumors, such as glioblastomas, gliomas, and brain metastases. It can also be employed for surgeries involving epilepsy and get rid of a larger amount of the tissue section causing the seizures without damaging function, for deep brain stimulation placement, or for pallidotomy.