Rare surgery performed for 17-year-old girl at Rajiv Gandhi GH

CHENNAI: After diagnosing a 17-year-old girl from Salem who came to them with complaints of severe headache and a seizure, doctors at the Rajiv Gandhi Government General Hospital (RGGGH) in Chennai found that she had a rare condition where the arteries and veins in her brain were fused.

The way to treat it was simple: Operate immediately to prevent the veins from rupturing, which could be life-threatening. But the decision was not easy because the spot where the arteries and veins were fused was close to the part of her brain that’s necessary for processing language.

That is, even if the surgery is successful, it could still leave the teenager, a good student no less, with a lifelong disability. Within few days after the surgery was her Class 11 exams. The girl attended it, scored decent marks and is now in Class 12. The worst time of her life is over, thanks to the experts at RGGGH.

The girl’s father is into cattle, goat sale and mother is a homemaker. “A private hospital in Coimbatore said that a surgery would cost around Rs 18-20 lakh, which we couldn’t afford. Doctors there referred us to RGGGH, where the surgery was performed for free under the Chief Minister’s Comprehensive Health Insurance Scheme,” said the girl who underwent surgery.

The neurosurgery team performed the rare surgery said that the patient was identified to have a giant arteriovenous malformation fistula (abnormal connection between artery and vein). “There was a giant aneurysm (an abnormal bulge or ballooning in the wall of a blood vessel, most commonly an artery) in her left side of the brain. And, it was closely associated with her language area and the motor area of the right side of the brain called dominant lobe and chances of it being affected,” said a doctor from the team.

Scans showed there was bleeding due to dilation and bulging of blood vessels which could be fatal or leave her with lot of morbidity. This caused the seizure and headache, for which she was advised a multi-stage endovascular procedure. Recovery time for that was around 4-6 weeks.

“We carefully dissected each and every blood vessel and disconnected the connections between the artery and the venous system. We removed the lesion without disturbing the language area. Sometimes it may be a permanent deficit also but the girl recovered soon after the surgery. We did a post-operative scan to ensure the lesion was completely removed,” doctor explained.

Despite a life-threatening surgery, the teenager was adamant about appearing for the Class 11 exam. However, considering the pressure it would put on her brain, school authorities were initially hesitant to acquiesce her request to write the exam. So, they approached from the district collector, received permission and allowed her to appear for the exam.

“She wrote the exam a few days after having a brain surgery, and came back to get her sutures and other things removed. She’s a brave girl,” the doctor smiled.