Dr. Rajan Shah

Director and Head Department of Neurosurgery Nanavati Super Speciality Hospital, Mumbai

THE CASE

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 PROCEDURE

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.

THE RESULT

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.