Shots into the Brain

To Navy weaponeers used to thinking in terms of quick-firing 5-in. guns or huge Polaris missiles, the assignment at the Naval Research Laboratory in Washington was far out of line. Their task: to make a gun that could be fired point-blank inside the human head--not to kill but to save. The unusual technical feat required even more unusual ammunition: a piece of hair only one two-hundredth of an inch in diameter and one-fourth of an inch long, which had to pierce something even less resistant than a toy balloon, and do it with such delicate force that it would not come out the other side.

But Harrison P. Hagemeyer, 62, a retired lab machinist, took on the job, for a good personal reason, and made the gun. Last week the Navy was confident that eventually it will save many lives.

The man behind the gun was Georgetown University's Neurosurgeon John P. Gallagher, who wanted a safe way to treat aneurysms in the brain. Aneurysms are like blisters in tubeless tires: at a weak spot in its wall, an artery balloons out. The stretched wall is so thin that any rise in blood pressure caused by excitement or strain may burst it. Occasionally and unpredictably, the break is self-sealing and the scar may make the artery wall stronger than before, but more often a fatal flood of blood is spilled into the brain cavity. Usually, the aneurysm first develops a warning leak that causes a severe headache and stiff neck, and a test will then show blood in the spinal fluid. Among the estimated 100,000 cases of brain aneurysm each year in the U.S.--most of them caused by congenital weakness of an artery--probably 50,000 patients' lives might be saved if the patients could be treated effectively in the aneurysm's early stages. But how?

Hair of the Hog. Even getting at the aneurysm, which is nearly always at the base of the brain in the arterial traffic rotary ("circle of Willis"), is a major operation. It involves sawing through and lifting a flap of skull and moving the brain out of the way. The commonest method of treatment has been to tie off the aneurysm at its stem with a tiny silver clip, or close the artery with clips on each side of the stem. Dr. Gallagher was not satisfied with these methods because merely touching the aneurysm to attach a clip might cause it to burst with disastrous results. To destroy the aneurysm with no risk of bleeding, he wanted to clot all the blood inside it. To make the blood clot, he needed to get a foreign body into it--such as a hair. And to get the hair in without disturbing the aneurysm, he needed a hair gun. So the Navy made him an air hair gun. It is a muzzle-loader, works on air at 50 lbs. pressure.

The hair, though thin, had to be stiff. Dr. Gallagher tried hair from the heads of Orientals. No good. He tried coarse eyebrow hairs. Not much better. Then he found that hog's hair was scaly enough to cause clotting, and stiff enough to be fired from the gun. So is hair from a horse's tail.

Dangerous Leak. Last June Dr. Gallagher operated on a man of 40 with a dangerously leaking aneurysm. After opening the patient's skull, he fired a hog's hair into the aneurysm which was ten times as big across as its parent artery. Within 15 minutes, clotting had set in and the aneurysm was shrinking. Dr. Gallagher fired in five more hairs. By the time he finished closing the patient's skull, the aneurysm was less than one-third its original size. The patient later died of causes unrelated to the operation. But within a month, Gallagher performed a second operation at Washington's Providence Hospital, on a farm wife of 71. Her aneurysm was smaller to begin with. Now it is drastically shrunken, with two hog's hairs left in it, and the woman is fully active again. A third patient has gone back to work as an electrician, and a fourth is expected to go back to work soon.

Machinist Hagemeyer jumped at the chance to make the lifesaving gun because his own son died of a brain aneurysm at the age of 32. Other neurosurgeons have not yet had a chance to try the new technique because Dr. Gallagher's gun is the only one in existence. But he has already had requests for hair guns from interested colleagues.

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