Chennai : Gleneagles Hospitals Chennai one of the leading healthcare institutions in Chennai, conducted an innovative surgical treatment on a 13-year-old boy from Trichy who had arteriovenous malformation (AVM) measuring 4.5x 4.2 cms in his brain and was at risk of significant neurological impairment. The Team of Doctors spearhead by Dr. Dinesh Nayak, Director, Neurology and Dr. Nigel Symss, HOD, and Senior Consultant Neurosurgeon, Gleneagles Hospital Chennai performed the left-side craniotomy and micro neurosurgical excision procedure, which lasted for eight hours.
The young patient, a class topper from Trichy who had a no other complaints except an episode of generalized seizures. The boy’s parents took him to consult a Neurologist in Trichy where an EEG and MRI with angiogram of the brain was done. To the Doctor’s surprise boy had a large arteriovenous malformation (AVM) in the left side of the brain in a critical location in front of the motor cortex which controls movements of the boy’s right hand and leg. The AVM was a grade 3 malformation. Given the high risk of rupture and potentially life-threatening bleeding, immediate treatment was necessary, so the Trichy Neurologist referred the patient to Gleneagles Hospital Chennai for further consultation and Treatment
On Arrival, Dr. Dinesh Nayak, his team conducted thorough investigations, including EEG, MRI with angiogram, and Digital Subtraction Angiography (DSA), to assess the AVM’s complexity and the surrounding brain structures. The detailed analysis allowed for precise planning of the surgical approach. The child’s parents were counselled about the surgical procedure and its risks. Post the parents go-ahead, Dr Dinesh Nayak, Dr Nigel, Dr Ramanan Rajagopal and his team prepared for the complex surgery.
On the day of the surgery, the boy underwent a meticulous left-side craniotomy and micro neurosurgical excision of the AVM, performed by Dr. Nigel Symss, HOD, and Senior Consultant Neurosurgeon, along with his expert team. The surgery was conducted using microscope, navigation and Intraoperative neuromonitoring. It took nearly 8 hours to remove the AVM totally preserving the normal vessels of the brain. After the surgery the child was shifted to the cath lab were another angiogram as done to confirm total excision of the AVM.
“A brain arteriovenous malformation (AVM) is an abnormal mass of blood vessels that creates irregular connections between arteries and veins in the brain and it is present in boy since his birth without any major symptoms, said Dr Dinesh Nayak, Director – Neurology, Gleneagles Hospital Chennai.
In this age group for a grade 3 AVM, surgical excision is the best option available for the patient’s survival as the haemorrhage from untreated AVM can cause serious neurological problems or death”, said Dr Nigel Symss, Senior Consultant Neurosurgeon, Gleneagles Hospital Chennai. A craniotomy is a surgical procedure that involves removing a portion of the skull to access the brain, added Dr Nigel
The patient was closely monitored in the neuro ICU for 48 hours post the surgery and the patient showed excellent recovery with the ability to speak and move his limbs. He received rigorous post-operative care and a brief rehabilitation period. With no severe neurological abnormalities, he is now expected to lead a normal life and resume his studies, Said Dr Ramanan Rajagopal, Senior Consultant, Neuro Anaesthesia and Critical Care, Gleneagles Hospital Chennai
Speaking about the success of the surgery, Dr Nageshwar Rao, CEO, Gleneagles Hospital Chennai, said t “We at Gleneagles Hospital Chennai are pleased with how well our team handled this challenging case. Our commitment to offering state-of-the-art neurosurgical treatment is demonstrated by the boy’s complete recovery. We are overjoyed to see him resume his regular life and pursue his schooling, as it exemplifies the excellent care, we work hard to provide daily.
