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Our Brains do not have pain receptors! So What? Brain surgery can be done without anaesthesia.

This article is written by a Registered Nurse with Intensive Care training and describes how brain surgery is possible in some cases without anaesthesia.

We all know that our brains are made up of grey and white cells which are made up of neurons and glial cells. The grey matter is for thinking and the white matter is generally for autonomic processes. The Brain located in the skull, medically referred to as the cranium. The total number of neurons is estimated to be about 100 billion in a healthy adult brain. The glial cells are much more and their function is to support and act as scavengers for the dead neurons.

Tag words: Awake surgery, glial cells, brain, schwann’s cells, microglia, oligodendroglia, astroglia, neurones, myelin, motor neurones, interneurones

GLIAL CELLS constitute 90% of the brain’s cells. Glial cells are “glue cells” which perform the following functions:

  1. digest dead neurons.
  2. Manufacture myelin for neurons
  3. Provide physical support and deliver nutrition.

Examples of glial cells are Microglia, Oligodendroglia, Astroglia and Schwann’s Cells.

During fetal development, a special type of brain cell called Neuroglia guides the neurons.

THE NEURONS

The brain is made up of many different types of neurons which vary in size from 4 microns (.004 mm) to 100 microns (.1 mm) in diameter. In length these cells can measure from a fraction of an inch to a few feet.

Neurons are not capable of regeneration after damage. The only cells (neurons) which are capable of regeneration are the neurons from the hippocampus.

Special Note: Skin cells and liver cells (if more than one quarter of liver is functional) are the other human cells which are capable of regeneration.

Below is a brief description of the different types of Neurons in the human body. The main function of neurons is to carry electro-chemical nerve signals. The different types of neurons have different structures and are found in different parts of the body. The structures – processes, or axons originating from the cell body.

  • Sensory neurons transmit impulses from the body’s sense receptors like the eyes and ears to the CNS. Sensory neurons have 2 processes. Sensory neurons constitute 0.9% of all neurons. Sometimes called bipolar neurons. Examples: retinal cells, olfactory epithelium cells.
  • Motoneurons carry signals from the CNS, muscles and body glands. These motoneurons have many processes which originate from the cell body. Motoneurons make up 9% of all neurons. Sometimes called Multipolar neurons Example: spinal motor neurons, pyramidal neurons, and Purkinje cells.
  • Interneurons have two processes and form all the neural wiring within the CNS. These have two axons (instead of an axon and a dendrite). One axon communicates with the spinal cord; one with either the skin or muscle. These neurons have two processes. Sometimes called Pseudopolare or Spelling cells. Eg. dorsal root ganglia cells.

Diagram 1: Representation and distribution of nerve pathways.

Our Brains do not have pain receptors! So what? So – Brain surgery can be performed without anaesthesia, when the patient is awake. Read the conclusion.

Conclusion: The brain is a complex organ but is itself not supplied with sensory neurons which are designed to pick up sensation of pain. Since there are no sensory neurons in the brain, it is theoretically possible to do brain surgery without anaesthesia. The meanings and blood vessels are supplied with sensory neurons so they are sensitive to pain. Some intestines in the abdomen are not supplied with sensory neurons and hence some abdominal surgery can also be performed without anaesthesia. The following is a quote from the web site of a major brain surgery unit, “in awake brain surgery. Neuroscientists at ____ developed many of the awake brain surgery procedures that have been adopted by medical centres around the world. This brain surgery team has performed hundreds of awake surgeries, with a high success rate in extending patients’ lives and improving their quality of life.” It is interesting that they do not mention that this is possible because there are no pain receptors in some parts of the brain.

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  1. Fabulous article, Shergill! Loved it. I have seen this type of awake brain surgery performed on television. An interesting element is asking the patient questions while the surgery is going on, which helps the doctors to hear the responses and know where to cut and where not to.

  2. Thank You for your very positive comments. They are appreciated. Your observation is right on. At a more personal level, I do find this to be ’scary and like science fiction”.
    Kristie, at a more personal level, I sincerely hope that you do not feel that I have a dislike for you or your articles. I have read many, if not all, of your articles. The following is my analyisis. Note, I used the word, “I”. I as an individual can be wrong. My view is that neither of us is wrong. I have worked as a Nurse, teacher, lecturer, scientist and have been disabled for five years of my working life.
    As a Nurse and Lecturer I tend to believe in the “Medical Model” which is usually “cause and effect”. Your articles seem to imply the “social model”. The Social model implies that there are other factors which are not clearly understood. I do not have any problems with this. BECAUSE My research interest is “Educational Outcomes in children”. There are so many variables which affect our performance as human beings – ? Genes or environment. I do not have an answer. You can read all the literature you want and you will still not find an answer. The answer(s) are in the inidiviual’s mind. This is the underlying reason as to why I do not have a problem with the social model.
    Witout offence, I hope this clarifies, our differences. I honestly respect your views.
    Shergill.

  3. Thanks, Shergill. I respect your views as well, and always have. I simply wanted to express the alternate medicine opinion because there are alternative ideas out there, whether they work or not, sometimes they are very interesting at least in my own opinion. I use some alternative products such as vitamins and minerals and I find occasionally that they are woefully lacking and do need further research. At other times I find them fabulously useful and am happy to express this to others. What works for me may not work on someone else, but it usually doesn’t hurt to try something new or at least research new things. On a personal level, you say you are disabled. Traffic accident? My Dad suffered a bad accident over a decade ago and his one leg is nearly two inches shorter than the other. He wears a lift and has a permanent metal rod in that hip. He gets around well with absolutely no prescription medications. I blame alternative medicine for his decent health. Enjoyed your comment on the home page too, by the way. Made one of my own.

  4. In Egypt we have anew invention in our physical therapy center it can and for the first time all over the world treat the difficult brain disease, paralysis from stroke or from any thing else, p.c. cases , brain atrophy, disc, and spinal cord so we ask you sir to look at this web site and feed us back

    http://www.albahy.info

    With all our respect
    Albhy’s center

  5. Good Day Albahy’s center,

    It is an honour and a privilege to be asked to review your center’s website and program. Please allow me until the weekend to give you feedback.

    Yours truly,
    Shergill

  6. The above article is very nice and informative. But I have one question. Why is anaestesia not necessary for brain surgeries?
    Please reply. Yours truly, M. Sumender Roy

  7. “The grey matter is for thinking and the white matter is generally for autonomic processes. \”

    That\’s where I stopped. Grey matter are neuron cell bodies. White matter are their myelinated axons. \”Thinking\” is a term used to describe a complex pattern of cross-talk which requires not only \”grey matter\” implying the cell bodies in the cortex, but many different areas of the brain. (For example, the limbic system.) White matter, if you must generalize, are the fiber tracts. Autonomic tracts originate in the thalamus and descend through the brain stem in the intermedio-lateral cell column and down the spinal cord to their respective points of exit.

    As for the rest, I don\’t know, because I stopped reading after the second sentence.

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