Sep 17, 2021

With shortest Door to OT time, we ensure timely medical attention to complex brain injuries

An 18-year-old boy was brought with a severe blood leak (hemorrhage) inside his brain due to a ruptured AVM (arteriovenous malformation). In such cases, every second is critical as if left untreated it allows blood to leak deep into the brain or surrounding tissues and reduces blood flow to the brain. With the shortest “DOOR-to-OPERATION THEATRE time”, doctors at Sarvodaya Hospital, Sector 8, Faridabad successfully treated the patient and gave him a new lease of life.

Patient, Yuvraj had an Arteriovenous Malformation (AVM), an abnormal cluster of arteries and veins inside his brain for a long time now. Such AVM formations can eventually weaken the walls of affected arteries and veins by putting extreme pressure on them. When blood passes through these weakened vessels the AVM ruptures and results in profuse blood leakage in the brain.


                                             Arteriovenous Malformation (AVM)

On AVM rupture, the patient was brought to our Emergency with sudden headache & dizziness, followed by loss of consciousness, gasping for breath, and was immediately intubated with a tube down his throat and into his windpipe to make it easier to get air into and out of his lungs and ventilated to stabilize his condition.

“The patient went in a deep coma state and on investigations we found a large intracranial bleed implies a large clot inside the brain which exerts pressure on the surrounding normal brain. This was a critical situation and demanded immediate action. Suggested door to OT time is less than 60 minutes and our team took only 40 minutes of time to shift the patient from “Emergency Door to Operation Theatre”, said Dr. Kamal Verma, Director – Neurosurgery.

"A CT Angiogram was done which clearly showed a large ruptured AVM. The hemorrhage occurred in the right side of the brain which is responsible for visual processing like distance and depth perception, color determination, object and face recognition, or memory formation. Any delay in the surgery could have damaged some vital body functions or may risk his life”, said Dr. Gaurav Kesri, Consultant – Neurosurgery.


                                                      CT Angiogram

In view of his young age, a lot of bleeding, and poor neurological status, doctors planned an emergency surgery on the complex vascular malformation (AVM). During the surgery, active profuse bleeding was noted from the abnormal bunch of vessels and the bleed was removed from the brain very carefully.

The vessels were cauterized one by one meticulously deep inside the brain under microscopic magnification without damaging surrounding normal brain tissues. It was technically challenging surgery which lasted around 4hours during which the whole bunch of vessels was carefully separated from the brain and removed. Post-operation the patient was ventilated and shifted to ICU.

The following day a repeat CT scan showed complete evacuation of the bleed and the patient became fully conscious. He was removed from the ventilator and rehabilitation was initiated.

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