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Violinist plays instrument while tumour is removed from her brain at King’s College Hospital

A woman has successfully had a brain tumour removed while playing her violin during the procedure.

Professional musician Dagmar Turner underwent brain surgery at Kings’ College Hospital to remove a benign tumour.

After starting the operation under general anaesthetics, surgeons woke Ms Turner to play her instrument – helping the medics avoid the area of her brain used in playing the violin.

Mum Ms Turner, 53, a member of the Isle of Wight symphony orchestra, was diagnosed with the tumour in 2013.

In November 2019, doctors decided they would need to operate.

In consultation before the surgery, Ms Turner says she asked whether she was right or left handed to ascertain which side would be affected by the surgery.

The professional musician said after telling the medical team about her livelihood as a violinist, she suggested she play during the surgery.

She had been diagnosed in 2013 with a large grade 2 – slow growing – glioma after suffering a seizure during a symphony. She underwent biopsy and then radiotherapy at her local specialist hospital to keep the tumour at bay. When it became clear in autumn 2019 that the tumour had grown and become more aggressive Dagmar, who has a 13-year-old son, was keen for surgery to remove it.

Dagmar’s tumour was in the right frontal lobe of her brain, close to an area that controls the fine movement of her left hand. Precise and skilled use of this hand is essential for playing the violin as the fingers regulate the length of the strings by holding them against the fingerboard, producing different pitches.

Neurosurgeon Professor Keyoumars Ashkan has a degree in music and is an accomplished pianist, which Dagmar was aware of.

Dagmar said: “The violin is my passion; I’ve been playing since I was 10 years old. The thought of losing my ability to play was heartbreaking but, being a musician himself, Prof Ashkan understood my concerns. He and the team at King’s went out of their way to plan the operation – from mapping my brain to planning the position I needed to be in to play. Thanks to them I’m hoping to be back with my orchestra very soon.”

Prof Ashkan said it was all about the “finer details” of playing an instrument that they were wary of.

He said: “Length of the string, pressure on the string, all those fast movements moving from one string to another.

“So that is what was unusual for us.”

Two and a half weeks after surgery, Ms Turner is back playing the violin.

Before Dagmar’s operation the medics spent two hours carefully mapping her brain to identify areas that were active when she played the violin and those responsible for controlling language and movement. Playing during the procedure would ensure the surgeons did not damage any crucial areas of the brain that controlled Dagmar’s delicate hand movements specifically when playing the instrument.

During the operation Prof Ashkan and the team performed a craniotomy – an opening in the skull – and Dagmar was brought round from the anaesthetic. She played violin while her tumour was removed, while closely monitored by the anaesthetists and a therapist.

Following the procedure Prof Ashkan said, “King’s is one of the largest brain tumour centres in the UK. We perform around 400 tumour removals each year, which often involves rousing patients to carry out language tests, but this was the first time I’ve had a patient play an instrument.

“We knew how important the violin is to Dagmar so it was vital that we preserved function in the delicate areas of her brain that allowed her to play. We managed to remove over 90 percent of the tumour, including all the areas suspicious of aggressive activity, while retaining full function in her left hand.”

Three days after the procedure Dagmar was well enough to go home to her husband and son. She will continue to be monitored by her local hospital.

 


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