I remember the first time I saw the human brain. It was nothing like anything I’ve ever seen before. The grooves and intricacies were fascinating. How could this small object do so much? It can control how our body moves, how we communicate, and even how we breathe. I didn’t think I would ever get to do a study on the brain in depth, especially when in high school, but I was wrong.
When I was accepted into The Schiff Family Science Research Institute (SRI) at The Summit my sophomore year, I could not have predicted that I would get the chance to do research on the brain, specifically the brain of fetuses. Not many people my age can say that they work with a mentor to research fetal brains. My mentor, Dr. Charu Venkatesan, is a neurologist at Cincinnati Children’s Hospital whospecializes in fetal neurology; the research project I assisted with investigated fetal cerebellar hemorrhages.
Originally, I did not know a lot about cerebellar hemorrhages in adults much less fetal cerebellar hemorrhages. I did not understand how a fetus could even attain a bleed in their brain. This was because I always associated brain bleeds resulting from a force to the head. I soon learned that most people suffer from hemorrhages in their brain due to strokes. There are two different types of stroke: ischemic and hemorrhagic. Ischemic strokes are caused by a blockage of an artery which results in a loss of necessary oxygen to the brain, while hemorrhagic strokes are caused by a ruptured artery that may or may not be due to impact to the head.
Within the realm of strokes and hemorrhages in the fetal cerebellum, there is very little published literature on the topic. The technology to observe and diagnose a fetus while in utero is relatively new so gaps exist in the knowledge on fetal brain hemorrhages. Advancements in the field of fetal imaging will rapidly improve treatment options and health outcomes as well as patient counseling. Our goal is to gather observations on the outcomes of patients diagnosed with a fetal cerebellar hemorrhage to improve counseling for families in the future.
The study began with evaluating which patients could be included in the study. First, a broad search through Cincinnati Children’s Hospital charts was performed by my mentor to find any patient that was diagnosed with a hemorrhage in their cerebellum as a fetus. From there, my mentor and I evaluated deidentified data, starting with the fetus’s echocardiogram and MRI of the body and brain. Because our study is based on finding outcomes of cerebellar hemorrhages, we excluded any patient with severe body and/or heart malformations that could confound patient outcomes. Then, we looked at patient status and evaluations of those who were able to go back to Cincinnati Children’s Hospital after they were born. After analyzing clinical outcomes of these patients, we found that none of the patients had any severe health problems due to the hemorrhage in the cerebellum as a fetus. The major limitation to the study is the number of patients that we could include, it is a beginning to filling the gap in the knowledge.
This research project has been a transformative one for many reasons. First, it opened my eyes to how much effort and time goes into a research study. There are many variables that you have to evaluate, and you have to be very adaptable. It has also taught me the importance of doing research in fields that have not been thoroughly studied in the past. When one group initiates research in a field, it opens the door to many more ideas, many more projects and hopefully allows for doors to open in terms of greater understanding about a topic. From this project, I have also realized how lucky and fortunate I am for my health. Many of the patient charts I observed showed many challenges the patient was facing which can cause a lot of pain to families. Improving patient outcomes and minimizing family stress will positively impact society. Hopefully, the research I had the privilege of doing helps bring families comfort and hope for their baby’s future. I am very grateful for this experience and can’t wait to present my findings at the annual Schiff Family Science Research Institute Colloquium in January.
Megan Marburger is a senior in The Summit Country Day School's Schiff Family Science Research Institute.