Brain tumour operated successfully with awake craniotomy technology
In what can be called as the medical miracle, a brain tumour operation was conducted on a talking patient at Vikram Jeev Hospital, Mysuru. The tumour was removed using a recently introduced technique of Awake Craniotomy with brain mapping. The anesthesia for this procedure is a combination of local anesthesia and Total Intra-venous Anesthesia (TIVA). This procedure allows the surgeon to keep talking to the patient and the patient is able to move hand when requested and the patient will have no pain at all while the procedure is on.
29 year old Arif (name changed), a native of Mysuru was brought to the hospital with history of seizures (fits) disorder and headache for the past several months. AMRI scan of the brain revealed that he had tumour in the left side of his brain. The left side controls the right half of the body and is therefore more important to preserve all functions.
Once the brain was exposed, the areas were mapped by stimulation, injection was administered to numb the scalp. The brain mapping was done by electrical stimulator with a tiny electrical probe where in first the speech area was stimulated followed by the limb area. The area around the tumour was marked and then it was removed without damaging the critical areas. Meanwhile, alongside a computer based software called the brain navigator was used to map the area as this helps to know the safety margin and helps to increase the safety further. . By mapping out the important regions of the brain first we can aim to avoid and protect them during the operation. Whilst we remove the tumour we will continuously test your function, and if anything changes we will be able to stop.
Dr Maqsood Ahmed AR, Chief Neurosurgeon, Vikram Jeeev Hospital, Mysuru who had conducted the procedure said: “This procedure is a recent advance and is done at very few centers. It involves lot of skill, technical expertise and patience to perform. I f this operation had been done normally we would be unsure if he would be able to talk or use his hand or be paralyzed after surgery. We may even had to put him on ventilator in the ICU. But in Arif’s case after few hours following the procedure he was sent to the ward and in the fourth day he was discharged from the hospital. Following which after a month he was back to work.”
When asked about the need of this new technique Dr Maqsood said: “The brain is packed with areas that control all parts of the body. They look the same to the eyes. While we know approximately which area controls which part, but we cannot be sure. This technique helps identify the critical area of the brain so that there are no damages caused during the surgery.”