Patient’s skull opened to treat AVM and multiple Aneurysms

India, May 12, 2017: A 33-year-old patient was admitted at Fortis Hospitals, Bannerghatta Road with complaint of persistent headache and diagnosed with multiple weak and bleeding blood vessels under his skull.

The patient was suffering from ArteriovenousMalformation (AVM) -- tangle of abnormal and poorly formed blood vessels --which led to hemorrhage. Daunted by the complexity of his condition Emanuelcame to India from Ghana, Africa, to get the rare condition treated. During theoperation, the doctors clipped the aneurysms and excised AVM to prevent furtherbleeding. The condition was so complex that any bleeding during his travel toIndia or on the operation table, could have led to a stroke or death. 

An AVM is a tangle of abnormal blood vessels whichconnect arteries and veins. It disrupts this process of blood supply to thebody carried out by arteries and veins. It is most often seen in brain orspine. The cause for it remains unknown, but are usually formed later in life.When there is a rupture in AVM it lead to hemorrhage. This usuallycauses no symptoms and often goes unnoticed. Depending on the severity of thehemorrhage, brain damage or death may result.

Dr. Deshpande V Rajakumar Director, Neurosurgery,Fortis Hospitals, Bangalore, “During cerebral angiography, thepatient was diagnosed to have multiple Aneurysms with AVM (ArteriovenousMalformation). The size of the AVM was 5.5 centimeter and could keep increasingin size if left unattended. We started the treatment process with MRI and BrainAngiogram. The AVM along with other Aneurysms were present far from each otherunder the skull. Because of the distance between the Aneurysms, we had toconduct two Craniotomies (opening of the skull) with the help ofNeuronavigation. To get a better picture of the AVM during the surgery, a 3Dmicroscope was used. Indocyanine Green (ICG) was injected into the patient tospot the abnormality during surgery. The nine-hour surgery was successful andwe were able to clip all the aneurysms.” 

Dr Murali Krishna, Consultant, Neuro Surgeon,Fortis Hospitals, Bangalore, explaining the atypical casesays that, “Back in Ghana, Emanuel suffered partial paralysis attack in 2012after he had a brain hemorrhage. He was given a symptomatic treatment throughwhich he slowly recovered. But the last three months, he suffered fromsevere headache and was admitted at our hospital for further diagnosis.” 

Post-surgery, Emanuel informed thathe had persistent headache for three months which got severe with every passingday. “However, when I suffered paralysis, I got to know what it was exactly. AsI was not able to tolerate the headache anymore, I decided to get it treated. Ihad heard about Fortis Hospital and decided to get admitted here. The doctorswere supportive and understood my condition well and treated accordingly”.

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