Surgeons at the Hannah Joseph Hospital in Madurai came together and successfully performed a marathon surgery on a 11-year-old girl and removed a huge non-cancerous tumour from the brain-spine junction.
Speaking to mediapersons, chief neurosurgeon M.J. Arunkumar said the highly complicated surgery was performed in two stages a fortnight ago. “The patient is recovering well now,” he added.
Explaining the history, he said, when the child visited the hospital, she was unable to walk normally and had multiple episodes of tripping for the last three months. She also had difficulty in using the right arm for writing and other purposes.
An MRI and CT angiography of the brain and cervical spine revealed that she had a large tumour (schwannoma) growing in front of the spinal cord and extending to both left and right sides compressing the spinal cord and the brainstem. It was extremely dangerous to deal with as the tumour compressed and encircled the blood vessels, critical to the supply for the brain and brainstem, he said.
Approaching the tumour micro surgically through the back of the patient’s head and neck on the first day, the surgeons were able to remove 70% of it spread over a span of nine hours. Again, on the fourth day, they completely removed the tumour in about six hours, he explained.
Dr Arunkumar said large tumours arising in the brain-spine junction, also called Craniovertebral (CV) junction are difficult to deal with due to the location. The patient, he said, had a ‘ schwannoma’ which is a benign tumour arising from the nerve roots of the upper spinal cord. Some of them are ‘ dumbbell’ shaped and usually arise on one side causing compression of the spinal cord and get detected early. However, in this case, the tumour was growing on both sides in front of the upper cervical cord and brainstem.
Further, due to the large size of the tumour, the blood supply to the back of the brain was also distorted. The lower brainstem is a vital organ that deals with respiration and cardiac functions, the doctor said.
As the child was weighing only 23 kg, giving anaesthesia posed a stiff challenge, neuro anesthesiologists said as any complication during surgery could lead to permanent paralysis of all the four limbs or a vegetative state, they added.
The parents thanked the team of doctors including R. .Arun Kumar, P.Ramasankari, Naveen Karthik and M Kamalaretnam for performing the rare complex surgery on their child.
