27-year-old girl came to our hospital with complaint of severe headache and though it initially looked like a migraine case, she also mentioned about losing balance at times.
To investigate the condition comprehensively, Dr Amitabha Chanda, Neurosurgeon, CMRI hospital advised the patient to get an MRI done. The test results were shocking. There was a 35cm tumour in one of the most vital parts of the brain – the brain stem, compromising the pineal nerve and other surrounding blood vessel. The positioning of the tumour was extremely critical as the brain stem controls many vital functions, such as breathing, heart rate, and blood pressure, and the nerves and muscles used in seeing, hearing, walking, talking, and eating. This type of tumour is called meningioma and only one out of 100 patients have meningioma in such a critical part of the brain.
The tumour was diagnosed very late and it had already become unusually big. Since this was a slowly growing tumour, the brain functions start adjusting and keep compensating as the tumour grows. In such cases, symptoms only start showing when, at a certain point of time, the brain functions start to decompensate and the condition deteriorates rapidly.
The primary challenge of the surgery was that the tumour was located inside a critical structure of the brain and extracting it directly could cause serious injuries leading to paralysis, death or make the patient vegetative throughout life. In such a critical scenario, the surgeon had to keep slowly and carefully debulking the tumour till it reduced in size and could be gently separated from the adjacent structures of the brain. The tumour could only be removed once the separation was complete.
Another major challenge for the surgeon was that the tumour in the patient’s brain was harder than usual, which made the surgery even more difficult. Since the tumour was hard, the surgeon had to put extra force to debulk it and there was a risk that the transmitted force would tear adjacent tissues. The entire surgery went for over seven hours and the tumour was removed completely from the brain.
After undergoing a major surgery, the patient started recovering steadily. The doctors at CMRI constantly monitored her recovery through regular check-ups and CT scans. The most positive finding of the postoperative checks and CT scans was that there was no trace of tumour in the patient’s brain and it was completely removed.
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