Bengaluru doctors claim it to be first-of-its-kind on a child

Seven-year-old Nitin (name changed), who complained of a persistent headache and frequent bouts of fits, was diagnosed with a brain tumor around vital blood vessels in the speech area. He required surgery immediately, without which he would lose the ability to talk.

Doctors at the Institute of Neurosciences, Sakra World Hospital, where he was admitted, realized that the patient’s speech and limb movements had to be monitored during resection of a tumor.

“This is a preferred technique for operations to remove lesions close to or involving functionally important regions of the brain,” institute director Satish Rudrappa told The Hindu.

A team of neurosurgeons, led by Dr. Rudrappa and neuro-anesthetists led by Sunil Kumar, who performed the awake craniotomy surgery, claimed it to be the first in the world on a patient so young.

“Awake craniotomy has been a great success in adults, but among children, a different set of challenges are involved like the ability of a seven-year-old to be able to cooperate during the five-hour procedure,” Dr. Rudrappa said.

Nitin was given regional skull block anesthesia and the craniotomy was performed using conscious sedation (sleeping and easily arousable). Once the brain and the tumor were reached, the boy was kept awake to speak, answer simple questions and identify simple objects using pictures, while the surgeons removed the tumor and preserved important blood vessels without coagulation, Dr. Rudrappa explained. At the end of the procedure, after a closure of the skull, the boy could talk normally without pain or discomfort. He was discharged within 48 hours and is on regular follow-up, he added.

The patient plays guitar during surgery

Meanwhile, 37-year-old musician Abhishek Prasad, who had musician’s dystonia (difficulty in moving left-hand fingers), a rare nervous disorder, underwent a brain circuit surgery at Bhagwan Mahaveer Jain Hospital recently.

During the surgery, the patient was fully awake and played the guitar, to give the doctors feedback to locate the exact location of the target to be lesioned. 

Media Coverage: 

1. http://www.thehindu.com/news/national/karnataka/seven-year-old-undergoes-awake-brain-surgery/article19319203.ece

2. http://www.newindianexpress.com/cities/bengaluru/2017/jul/25/7-yr-old-stays-awake-calm-while-doctors-operate-brain-1633032.html

3. http://bangaloremirror.indiatimes.com/bangalore/others/rare-surgery-that-gave-7-yr-old-his-speech-life/articleshow/59672730.cms