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New Lease of Life to a young patient; Cutting Edge Technology at Meditrina to the rescue.

  • Patient from Vidarbha
  • 3D Protocol MRI scan suggestive of centrally based brain tumor, involving the brainstem and the thalamus
  • Tumour was projecting into the ventricular system as well.
  • Neuronavigation System provides realtime guidance to a surgeon.
  • This kind of technology, & this kind of high-end neurosurgery was hitherto not available or heard of in our central India till date.

A 26-year-old male patient Mr. Pratik Pande, who was suffering from headache and visual diminishing since a month, went to a physician, who advised him a MRI Brain scan which was done. The scan was suggestive of a centrally based brain tumor, involving the brainstem and the thalamus and projecting into the ventricular system. This was a very precariously situated brain tumor and in the normal course of treatment, this patient, either would have been referred by many a neurosurgeon for radiotherapy directly or for a stereotactic biopsy, and then, depending upon the biopsy report, for any specific therapy.

This patient was referred to Meditrina Institute of Medical Sciences and the distinguished team of neurosurgeons comprising of Dr. Nilesh Agrawal and Dr. Sameer Paltewar studied the images and the patient, and then a 3D Protocol MRI scan was done in-house on their 16-channel, 1.5 Tesla MRI machine and all this data was transferred through LAN connection to the Stryker card II state of the art Neuronavigation System in the Neuro OT.

This by far is the latest computer guided neuronavigation system in Asia, and along with a surgical microscope provides a solid back-up while excising such tumours. Since it was an intrinsic brain tumour, it called for extra care, precision and vigilance as it had to be excised out completely leaving almost negligible cells of the tumour behind. Under ideal conditions a neurosurgeon must ensure not to touch good tissue, as that could do more damage than good to the patient. This navigation system allows for precise and complete excision of tumour without touching adjacent normal tissue. This system allows a neurosurgeon to reach the bed of the tumour from all directions that too under a magnification of 40-50 times under the operating microscope. This navigation system has a demarcation protocol, which keeps monitoring the expanse of the tumour during the surgery. This system produced image allows the surgeon to perform the surgery accurately and helps in preventing any damage to the normal tissue.

Banking on the accuracy and precision got out from this equipment and confidence on their own clinical acumen, the distinguished neurosurgeons of Meditrina Institute Of Medical Sciences, Nagpur, decided to have a go at complete excision of this brain tumor off this afflicted young patient, who was in the prime of his health, because excising of the brain tumor per se from the patient's body would be the best therapy and treatment for this young man.

“Accordingly the neurosurgeons planned out the course of treatment which instituted an initiation by making a very small half a cm hole in the skull surface and with the help of Neuronavigation System by realtime guidance, this tumor was reached and totally excised. The postoperative and the preoperative images speak about the finesse achieved. The patient postoperatively did extremely well. There is a postoperative video also, which shows the patient moving all around in the ward without any deficit on the postoperative day #2. This kind of therapy which encompasses preoperative planning, doing a virtual surgery on the computer before actually performing the surgery on the patient buoy’s the surgeon’s confidence with optimum results with precision and with minimal damage to the normal brain tissue. This is in total compliance to the oath that as a surgeon or physician we have taken which is "Primum non nocere" i. e. "First, do no harm" to the patient”, said Dr. Sameer Paltewar.

This by far is a classical example of a very difficult brain tumor centrally pressed within the brainstem and the thalamus, which was excised beautifully without any deficits to the patient postoperatively. This was possible because of the best preoperative planning, the noble team efforts, and the ‘will’ to do some challenging work in combination with the state of the art cutting edge technology. Dr. Nilesh Agrawal said, “Without the help of this Neuronavigation System, even reaching this tumor in the centre of the brain would have been a very difficult job, and that to, not only reaching, but also excision of the tumor in toto with precision, without causing any deficit to the patient has been achieved in a very good way for this patient. This state of the art technology coupled with unmatched clinical acumen, has made this kind of high-end neurosurgery, which was hitherto not available in our central India, thereby warranting that these patients go abroad or to the Metros, possible at Meditrina Institute of Medical Sciences, thus giving new horizons for healthcare solutions to all citizens of central India”.

For more information kindly contact Dr. Russel Lawrie, General Manager, Meditrina Institute Of Medical Sciences, Nagpur on 8237000947 or write into russel_mrkt@meditrinainstitute.com

A very challenging CAR0TID ARTERY STENTING in 68 yr old

A very challenging CAR0TID ARTERY STENTING in 68 yr old, was recently performed at Meditrina Institute Of Medical Sciences, Nagpur, by Interventional Radiologist Dr. Shrikaant Kothekar. This patient presented with repeated attacks of minor strokes inspite being on medication. More than 90% narrowing of main blood vessel which supplies blood to the brain was throwing small plaque/clot leading to repeated attacks of weakness of half side of body, disturbance in vision & speech. This procedure of CAS-(crossing narrowed area with wire, placing protection device, balloon dilatation and placing self expanding stent) was performed for prevention of major stroke-paralysis.

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