Vaniers: Neurosurgical resident hopes to save lives by detecting brain swelling earlier

Every year, 50,000 Canadians suffer traumatic brain injury, and 11,000 of them die because of it.

Dr. Daniel Yavin, a neurosurgical resident physician in the Department of Community Health Sciences, Faculty of Medicine, has received a Vanier award to study whether a simple hand-held device can detect whether patients have increased pressure in the brain, a leading cause of death. Yavin is one of eight researchers at the University of Calgary to receive Vanier scholarships this year.

“Swelling within the brain can be a very hard thing to recognize in patients who are comatose following severe multisystem injury,” says Yavin. “The problem is that delayed recognition of raised pressure within the brain puts patients at ongoing risk of not getting enough blood supply, and in about 45 per cent of patients, that’s a life ending event.”

Doctors determine the level of swelling in the brain by surgically inserting a monitor in the brain — a dangerous procedure that causes hemorrhaging in 15 per cent of patients and causes life threatening infections in another 10 per cent.

Another way to determine swelling is to measure the pressure in the eye, but there has been no simple way to do that in the emergency room — it has required cumbersome equipment and an ophthalmologist on hand.

But technological advances have delivered a simple, hand-held device that Yavin’s project will test. “Our project aims to enroll over 100 patients with severe traumatic brain injury and measure the pressure in their eye; these are patients who will have monitors in their heads already,” he says. “We will correlate the pressure in the eye with the pressure in the brain as measured by this hand-held measuring device.” Yavin is doing his PhD in epidemiology with doctors Sam Wiebe and Nathalie Jette, members of the Hotchkiss Brain Institute.

Eventually, the hand-held device could be used by neurosurgeons, emergency room doctors at the bedside, and even paramedics before the patient arrives at the emergency room, allowing for faster treatment of the swelling as well as avoiding the dangerous insertion of the monitor in the brain.

“From my clinical experience, I recognize this is a big potential opportunity to improve the care of the patient,” says Yavin. “I am pretty optimistic and grateful that Vanier recognized that and helped to support me, and I hope it turns out to be a success.”

Following the completion of his training, Yavin plans to continue to work to improve the care of patients suffering from neurologic disease as an academic neurosurgeon.