One of the amazing and fun things about having textbooks out there in this digital age is that you hear really interesting things from the professors and students using your books.
In my email inbox today was a really nice note from a professor using Discovering Behavioral Neuroscience. His son had noticed one of our images of a child with hydrocephalus, and asked Dad how the photo was taken (I think we can all assume the son will go far). I had originally chosen this image for hydrocephalus for the first edition of my book, back in 2006, because it was relatively less disturbing than most of the others our photo research found. If you do a quick Google search for images of children with hydrocephalus, you will see that many of the images are just so wrenching to view. Fortunately, treatments are becoming more effective and available.
I began my efforts to answer the son’s question by searching the photo credit (Phototake). It was surprisingly easy to search hydrocephalus on the Phototake site and find our image. The caption states “Head of a child with hydrocephalus (also called water on the brain) shown through transillumination, lateral view.”
As I tell my students, I know a lot about a little and a little about a lot, so the term “transillumination” was new to me. A further search showed me that transillumination is a medical test in which you shine light on a structure of interest while the patient is in an otherwise dark room. I also learned that light penetrates to the inside of an infant’s skull (really?) and so if there is excess cerebrospinal fluid (CSF), the light you shine on the skull scatters in a characteristic pattern that is different than the pattern resulting from shining light on a healthy infant.
The transillumination technique articles I read referred to a “Chun gun.” Okay, when you see a term like that, you HAVE to keep searching. Apparently, the Chun gun was named after neurologist Ray Chun, who invented the device to test children for hydrocephalus. Prior to Chun’s invention, children with suspected hydrocephalus had to undergo a very gruesome sounding test called pneumoencephalography. In this procedure, the CSF is drained from around the brain through a lumbar puncture (ouch! Poor baby!) and replaced with air, oxygen, or helium. This made the structure of the brain easier to see on x-ray (this procedure predates the invention of CT scans).
So hooray for Dr. Chun for saving infants from pneumoencephalography, and hooray for our professor’s son for asking such a cool question!
11 Comments
chunsdor · September 27, 2015 at 9:31 am
We discussed pneumoencephalography a little bit in class on Thursday and spoke of how treatment was not probably not good for the brain. This lead me to look up the various side effects of the procedure. The main side effects were short term, such as headaches and vomiting. Other side effects included neurological disorders, such as unequal pupils. I found this information from a study done in 1973 on pneumoencephalography patients to determine side effects and the normal duration of found side effects. I found many of the side effects interesting, here is a link to the study: http://jnnp.bmj.com/content/36/1/146.full.pdf
Laura Freberg · September 27, 2015 at 12:47 pm
Wow! Thanks for sharing! That’s really interesting. I’m actually surprised that the side effects weren’t worse, as the procedure seems really extreme.
Ariana Altman · October 14, 2015 at 10:55 am
Coincidentally, while perusing this blog I came across this entry. In a past episode of House M.D.that I watched they mention this procedure of pneumoencephalography. They comment on how this is regarded as an extremely dangerous type of procedure. Although this type of treatment is basically obsolete due to the invention of the Chun Gun, it makes me wonder what technologies and treatments we have now will soon be obsolete in the future.
Laura Freberg · October 14, 2015 at 2:44 pm
So many of my students have found interesting things on House that I may just need to add this to my watch list. I have very little time for television, and I confess to being a fan of Dr. Who and Blacklist, but I probably should fit House in!
I think both pneumoencephalography and the Chun Gun have been replaced by imaging by now.
saraportnoy · October 14, 2015 at 7:08 pm
It’s so inspiring that there’s new technology in the neuroscience field, such as the chun gun. It seems as though the chun gun was such a better alternative than pneumoencephalography. My guess is that it would be pretty traumatic to administer pneumoencephalography to a newborn with hydrocephalus. Maybe in the future doctors or neuroscientists will figure out a way to prevent hydrocephalus from occurring in the womb.
jennylu18 · October 18, 2015 at 7:01 pm
I would really like to see more awareness on this since these treatments are often too expensive for people in developing countries and many can go untreated. With more awareness, funding can grow and potentially save thousands of lives.
kathryngreenup · October 21, 2015 at 1:30 pm
The Chun gun seems like a great way to gain information about the brain. I wonder if it’s a technological advance that will stimulate new diagnostic techniques. By that, I mean other intelligent people piggy-backing on Dr. Chun’s technology to create similar but better technologies that could aid in diagnoses of other conditions. Scientists are great at taking technology and making it better. It seems very possible given its noninvasive nature and relative procedural ease.
Laura Freberg · October 24, 2015 at 2:02 pm
Hi, Jenny.
Interesting that you brought up the developing countries issue. I have a former student who is with Peace Corps in Africa, and one of the things she’s working on is surgeries for hydrocephalus! I’m glad that some treatment is available, but there are probably many untreated cases, unfortunately! The Chun gun seems easy and cheap, so I wouldn’t be surprised if it is still used where resources are really tight.
EricaFinfer · October 25, 2015 at 8:35 pm
I think that the technology behind the Chun Gun is very interesting. I am curious if age and development has anything to do with its effectiveness. Infants have a soft spot on their skulls due to their bones not fully developed and I am curious if that allows the imaging to be more easily seen.
Laura Freberg · October 29, 2015 at 1:18 pm
Hi, Erica.
I think you’re probably right about the developmental effects. Adults do in fact get hydrocephalus from scar tissue, tumors, etc. and I don’t know if the Chun gun would be an option.
vimorris@calpoly.edu · May 23, 2016 at 7:34 pm
Transillumination is a new term to me too and I was also unaware of hydrocephalus until we discussed the condition this quarter. I’m learning that there is vast pool of rare disorders and conditions like hydrocephalus that I feel oblivious too. However being curious has helped expand my knowledge but I have found that Google, although very helpful, can be a bit much as mentioned in the post when coming across photos of rare conditions such as hydrocephalus. Thankfully there are ways to treat hydrocephalus without having to use pneumoencephalography anymore.