UAE: Sayed Khorshed Alam, a 50-year-old Bangladeshi male patient who recently underwent a brain surgery spoke and sang with his doctors at Thumbay Hospital–Ajman throughout the surgery, while they were busy removing a tennis ball-sized tumour from his brain.
Known as “awake brain surgery” this procedure requires the patient to be awake, alert and cooperative, while doctors ask questions and monitor the activity in the patient’s brain as he responds.
The patient came to the hospital with complaints of weakness of the right lower limb followed by the right upper limb, which he had been experiencing since July 2017. He had focal seizure in the right leg in late August 2017, which lasted for about 2 minutes without loss of consciousness. Examinations revealed that the weakness on his right leg was more than that of his hand. He was unable to walk without support and his weakness increased gradually and he became wheelchair bound.
At Thumbay Hospital–Ajman, contrast MRI of the patient’s brain revealed a large tumour on the left side of brain which controls the movement of the right side of the body, particularly the leg. The team led by Dr. Ishwar Chandra Premsagar, Consultant (In-charge)–Neurosurgery, decided to perform “Awake Brain Surgery.” “The tumour was very close to the area controlling the movement of the body’s right side. Tumours in this position are especially critical for people who are right-handed,” said Dr. Ishwar.
The patient was operated on while he was awake, talking, singing and moving his hands and legs. Throughout the procedure of removal of the tumour, he was encouraged to talk and move his right hand and leg by Dr. Vinay, Neuroanaesthetist, to ensure that the procedure wasn’t causing further weakness or any speech problem. “The advantage of this type of surgery is that the surgeons can monitor the progress during the operation. The procedure also reduces the risk of damage to functional areas of your brain that could affect limb movements or speech, because as long as the patient doesn’t experience further weakness or inability to speak, the surgeons are reassured that they are on the right track,” said Dr. Ishwar.
“The bone of the skull just overlying the tumour was removed by Craniotomy, under local anaesthesia. Then the brain tumour was removed with his active cooperation. It was taken out bit-by-bit with special machine called CUSA. CUSA removes the tumour silently without affecting the surrounding brain and with minimum bleeding. After total removal of tumour, the bone was fixed back as before,” explained the doctor.
A little later after the surgery, the patient drank water and fruit juice. He had a full meal in the evening. He was able to stand up next morning and later started walking with support. “The awake brain surgery not only avoided increase in weakness but rather there was improvement in strength on the very same day. The side effects of general anaesthesia were also avoided. He was discharged from the hospital completely recovered, demonstrated by his ability to stand on his weak limb alone, without any support.”
Sayed Khurshid Alam is a happy man now. “This is a miracle God has given me. I am grateful to the doctors at Thumbay Hospital, Ajman for the treatment. I had given up hopes of being able to walk on my own ever again, prior to the surgery. Now I am also able to run,” he said with a beaming smile.
Headed by expert doctors with wide ranging experience, the Neurosurgery Department of Thumbay Hospital–Ajman is well-equipped to perform all types of neuro surgeries. The department offers a range of minimally invasive procedures including Endoscopic Lumbar Spine Surgery and Endoscopic Cervical Spine Surgery. These procedures take only 40 minutes to 1 hour through small incision and usually the patient is fine to be discharged from the hospital the very next day.
