Rare Awake Brain Surgery Performed At Fortis Hospital

Awake brain surgery is a neuro surgical technique that is performed while the patient is awake to avoid brain damage

A 36-year-old patient, suffering from a motor area tumour, successfully underwent Awake brain surgery at Fortis Hospital, Bannerghatta Road. The surgery was performed by a team of doctors led by Dr Satish Satyanarayana – Additional Director- Neuro Surgeryalong with Dr Simha-Senior Anaesthetistat Fortis Hospital, Bannerghatta Road.

Awake Brain Surgery or Awake Craniotomy is a surgical technique that enables surgeons to avoid injury to critical regions of the brain during surgery and is helpful in cases where cortical mapping or continuous monitoring of neurological functions are expected to improve outcomes.

The patient was presented with a history of focal seizure of the right upper and lower limbs a year ago followed by a second episode of a seizure two months later. He started witnessing recurrent seizures coupled with the loss of consciousness for about 5minutes. Post thorough diagnosis at Fortis Hospitals, it was found that the size of the lesion has increased in the brain, hence he was advised surgical management.

Dr Satish Satyanarayana – Additional Director- Neuro Surgery at Fortis Hospital, Bannerghatta Road, explains, “The size of the tumour was found to have 2.14*2.51*1.79cm with perilesional edema. Therefore, we recommended him to undergo neuro navigation guided left posterior frontal navigation guided, awake craniotomy with neuro-monitoring for micro neurosurgical excision of the intrinsic brain tumour in motor cortex by 3D Zeiss operative microscope and intraopfluoresein imaging for safe surgery.
Normally, brain tumours are operated on patients under general anaesthesia which facilitates patients not be aware and cooperate for the procedure.”

“However, for certain tumours in or near the vicinity of vital brain regions like the Motor or speech area, the safety of surgery lies inpatient being able to be monitored in real-time by the neuro anaesthesiologist Dr Simha-Senior Anaesthetist. We used cutting edge other supports like 3D neuronavigation mapping out and avoided major pathways vital for functioning as well as intratumor fluorescence which highlighted tumour and differentiated it from neural structures. With the help of this technique, the surgery became extremely safe and we had a perfect neurological outcome,” Dr Satyanarayana added.

“Initially, the patient was very apprehensive, however, after several rounds of counselling and briefing session with doctors, he agreed to undergo surgery and was very cooperative during the procedure. Thus we were able to perform all the required tasks perfectly and ended up with zero deficits despite tumour being located exactly in the motor strip.”, he added.

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