A neurosurgeon with rare perspective
An engineering background informs his skill in deep-brain stimulation and other complex treatments
November 11, 2013
Treating diseases of the brain may seem vastly different from tinkering with computers and electronic devices. But Dr. Frank P.K. Hsu has been making a connection between the two fields for almost 25 years.
Hsu, professor and chair of the UC Irvine School of Medicine's Department of Neurological Surgery, is one of the few neurosurgeons in Southern California who treat patients with Parkinson’s disease and other conditions with an advanced technique called “deep brain stimulation.”
His achievements grew from his studies as an undergraduate in electrical engineering and computer science at Johns Hopkins University. He went on to earn a doctoral degree in mechanical engineering and a medical degree from the University of Maryland.
"As surgeons, we view things a certain way," says Hsu, who leads the UCI Health neurosurgery team. "Having an engineering background enhances my understanding of how to bring technology into the process earlier to solve a problem."
A unique perspective
A biomechanical engineer's perspective is useful, for example, in devising ways to improve the treatment of a brain aneurysm, a weak spot on a blood vessel that can bulge and break, causing a stroke. To find better therapies, he says, it's necessary to study how an aneurysm forms, grows and ruptures and to devise sophisticated ways to intervene.
"If you give engineers a problem, they will solve it or improve on the problem," says Hsu. "That is what engineering does for me. It gives me a different perspective. It also ties into high technology, precision, innovation and discovery in medicine."
At UC Irvine Medical Center, Hsu is surrounded by top-notch colleagues and technological power — the necessary ingredients for conducting advanced neurosurgical procedures like deep brain stimulation to treat challenging neurological conditions, such as Parkinson’s disease.
Parkinson's disease is a chronic, progressive disorder of the nervous system that leads to tremors, stiffness and difficulty moving.
Surgery for Parkinson’s
Deep-brain stimulation involves implanting a medical device in the chest and electrodes in the brain. The device sends electrical pulses to the electrodes, stimulating for the source of the tremors. The operation requires a high level of neurosurgical skill and experience, as well as sophisticated technological resources.
Hsu uses stereotactic navigation — an advanced, three-dimensional imaging system — and magnetic resonance imaging (MRI) scans to identify and locate the exact target in the brain where electrical nerve signals generate the symptoms. He then inserts an electrical probe into the brain and guides it to the identified target. The probe is connected to wires that run down the skull to the neurotransmitter device implanted in the chest. When electrical stimulation occurs, the brain signals that cause the tremors are interrupted.
"We have a very good reputation for deep brain stimulation to treat Parkinson's disease, essential tremor and dystonia," he says. "This is all done by a great team. We have the academic resources and interest of researchers to put the best, most specialized people on the team.”
A collaborative approach with UCI Health Comprehensive Epilepsy Program colleagues also has guided advances in epilepsy surgery, which is an alternative treatment offered by UCI Health for people with severe seizures but who have not responded to medication. Hsu uses advanced imaging technologies — such as video EEG, functional MRI and BodyTom CT — to identify the dysfunctional brain tissue and remove it.
"For epilepsy surgery, we definitely put the patient through a multidisciplinary team approach," he explains. "There is a real depth of technology we're using to confirm if the patients can be helped through surgery."
Innovation in the operating room
The BodyTom is an example of the commitment to innovative technologies that allows Hsu to perform complex brain tumor and spine surgery with outstanding success rates. The device is a portable full-body CT scanner that captures precise, 3-D images of the brain and spine in the operating room. By providing real-time updates as the surgery unfolds, the scanner eliminates the need to move patients between the operating room and radiology suite and makes surgeries safer.
Hsu and his colleagues at the Comprehensive Stroke & Cerebrovascular Center also have adopted innovative surgical techniques to transform the lives of stroke patients. Through minimally invasive endoscopic interventions, cerebrovascular surgeons can remove clots that would have otherwise left patients severely impaired. Patients are treated in a sophisticated hybrid operating room containing digital imaging systems, designed to accommodate both catheter-based procedures and conventional surgery.
"When you talk about treating cerebrovascular disease, you need all those components and all the technology we have," he says. "We're trying to do similar operations but through smaller openings and through different corridors to minimize patient suffering and improve the outcome."
The cases he treats are often the most challenging in neurosurgery, and Hsu is gratified to know that no one in Orange County needs to leave the area to get state-of-the-art care.
"We have aneurysm patients who were near death and have had stunning outcomes," he says. "We took action and we didn't give up and continued to apply all we had to save those patients from doing poorly. They end up doing extremely well."
Learn more about the expertise of our UCI Health neurosurgeons >
To make an appointment, please call 714-456-6966. A team member will respond within 24 hours.