SLUCare patient Janice Thompson


Janice Thompson is back to her daily routine shortly after undergoing major brain surgery. The 71-year-old made history with SLUCare neurosurgeon Dr. Saleem Abdulrauf as the first patient to ever experience a new type of brain surgery without general anesthesia.

With the leadership and expertise of Abdulrauf, Saint Louis University professor and chairman of the department of neurosurgery at SLUCare, the physicians group is on the pioneering edge of brain surgery. The chief neurosurgeon literally has written the book—Cerebral Revascularization—on a new procedure he had a hand in creating: high-flow bypass brain surgery, a treatment for complex aneurysms.

As one of 10 medical centers in the nation performing the procedure, Saint Louis University is at the forefront of educating surgeons about the new technique. And with Thompson, Abdulrauf has taken the procedure a step further. “This is the single, biggest procedure in neurosurgery,” Abdulrauf notes. “Our challenge was to treat the aneurysm, but still let her have the same quality of life following the operation."

Because Thompson had a complex aneurysm, it could not be treated by traditional brain surgery. That’s where Abdulrauf and the new procedure came in. During high-flow bypass brain surgery, the surgeon makes small incisions in the patient’s head and arm, and uses an artery from the patient’s arm to replace the faulty blood vessel in the brain. “In many ways, the procedure is like bypass surgery for the heart,” Abdulrauf explains. “With a giant aneurysm involving a brain blood vessel or a tumor at the base of the skull wrapping around a blood vessel, the treatment involves the sacrifice of the diseased vessel. Before we eliminate the problem vessel, we replace it with an artery from the arm. We create another route for blood to flow.” This is a technique that is evolving, he continues. “We simply couldn’t do this in the past. It’s a new option for complex aneurysms and tumors deep in the base of the skull.”

And while the procedure previously always has required general anesthesia, Thompson was the first-ever patient to be awake during surgery. This way, the neurosurgeon can better monitor the patient’s neurological function—and even speak with him or her—at points in the procedure, ensuring its safety and effectiveness, Abdulrauf says. “I responded to all of their questions,” Thompson says. “And there was no pain whatsoever.”

Following such a big procedure, patients may spend up to two weeks recovering in the hospital. But not Thompson: She stayed in the intensive care unit for three days and the main hospital for two days before returning home. “What was amazing was, she was sitting up and joking with me the day after the surgery,” Abdulrauf recalls.

A short time later, the mother and grandmother is back to work—as a senior-care van driver—and back at play, with her favorite pastime: bridge. Thompson rises at 6:30 a.m. each Monday and Friday for work until noon, and then heads to bridge with friends. “I am amazed at how quick the recovery was,” Thompson says. And she’s already looking forward to enjoying her other favorite activities—camping and fishing—as soon as the weather warms up.

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