Brain surgery of a marine engineer while he was awake
A 49-year old non-diabetic, non-hypertensive, right-handed, gentleman
of Indian origin, Master Mariner by profession was on a holiday in
US when he developed sudden onset symptoms of speech impairment
with letters / numbers recognition diffi culty. The patient could not even
do simple calculations. This impaired his professional life as well,
since as a Mariner number recognition was of utmost importance.
He was admitted to the Hospital and a CT scan was done which
revealed a Tumour. His MRI only confi rmed that Tumour was present
in the left frontal lobe of the brain. The Neurosurgeon there
advised immediate surgery.
The patient visited Dr. Rajan Shah at Nanavati Super Speciality
Hospital. After a battery of pre-op tests and a functional MRI, DTI
(tractography) with Navigational protocol. The patient was subjected to
Awake Craniotomy, ie surgery under local anaesthesia and is ‘awake’
during the surgery, so as to assess his neurological functions in real
time during surgery. The patient’s speech functions and calculations
were monitored for further worsening. The patient withstood the
procedure without any untoward event. The patient was asked several
questions during surgery which were answered correctly by him.
On completion of the surgery, the patient was transferred to CCU
for a day under observation.
24 hours later the patient was shifted to the room. The following day, he
was discharged. On follow-up the patient was found to be neurologically
intact with complete recovery of the speech and calculation functions.
The patient was then suggested to resume his profession.