A medical marvel: Columbia Asia

Columbia Asia Hospitals, Brain tumour, Dr Arjun Srivatsa, Hospital

Awake craniotomy at Columbia Asia rescued Samuel from speech problems

Fifty-year-old Samuel had started facing difficulty communicating with people for three months. He would often forget words or lose his train of thought while talking to people. This also made it difficult for him to communicate with his peers or clients at work and his performance levels started going down. Samuel’s condition worsened when he started facing regular headaches and speech impairment.

Dr Arjun Srivatsa

Worried about his condition, Samuel decided to consult a doctor in Nigeria where he was diagnosed with seizure activity in brain. Further to this, an MRI was done which confirmed a brain tumour affecting areas of speech. However, since he was a Jehovah's Witness (accepting external blood transfusion is prohibited), it further made the surgery complicated. He then decided to consult Dr Arjun Srivatsa, senior consultant – neurosurgery, Columbia Asia Hospitals, Bengaluru.

“I had heard of Dr Arjun from my community members who have done similar complicated surgeries. Since this was a complicated surgery, I decided to visit Bengaluru for the treatment,” recalled Samuel.

“We realised that Samuel was suffering from a brain tumour that was directly affecting the area responsible for communication skills. Since, Samuel was a Jehovah's Witness, we had an additional challenge of operating with no back-up of blood if any need would arise,” said Dr Arjun.

Newer technologies have evolved and techniques for surgery have notably improved today, helping in tackling tumours like this. The aim of surgery in this case was to make sure that we remove the tumour without affecting the patient’s speech. We also had to have the patient’s total cooperation and trust in doing this surgery, without using blood. Also, we had to prepare him mentally to undergo brain surgery without general anaesthesia.

On 14th April 2017, Samuel underwent awake craniotomy, a surgery performed while keeping the patient awake allowing doctors to test the patient’s functions continuously throughout the operation.

“Anaesthetic techniques being good, we could make his head pain-free with local anaesthesia injected at correct areas around the head. During the surgery, we performed cortical mapping that helped us in identifying the speech areas of the brain so that we could avoid and protect speech areas during the surgery. Also, we routinely used navigation to reach the tumour with as less exposure as possible. Stimulating various areas of the brain have different effects on the body like a motor region results in twitching of limbs or touching the speech areas would prevent the patient from speaking briefly. This helps us navigate to the main affected areas and perform the surgery accordingly. Hence, we made sure that during the whole procedure the team of doctors were continuously engaged in a conversation with Samuel,” added the doctor.

The surgery went on for three hours and Samuel went back home, the next day without any post-operative complications and also did not need any blood transfusion. Currently, he is on a medication for fits to avoid any further health problems. Samuel is now doing completely fine and is able to communicate without any complications.