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The tumour was removed without damaging the membrane during which the skull was reconstructed.
New Delh, January 08, 2019 :
Recently, Doctors at Fortis Hospital Shalimar Bagh faced an extremely challenging case. A 90 year old male, Mr. Narendra Kumar Kundu, presented with a large (5 cm) tumor, which needed to be removed. The patient’s age posed a great challenge but the complete tumour was removed through a minimally invasive microscopic brain surgery. The surgery was difficult and was performed by a team of doctors led by Dr. Sonal Gupta, Director and Head, Neurosurgery (Cranial), Fortis Hospital, Shalimar Bagh.
Mr. Narendra Kumar Kundu, 90 years of age presented to Fortis Hospital Shalimar Bagh with acute onset of slurred speech, followed by weakness in the right side of the body (Paralytic attack). He also came with complaints of increased frequency of micturition with bed wetting for over 12 hours. Patient was subjected to an urgent MRI Brain with a provisional diagnosis of stroke in view of the history, the MRI reports were shocking as it revealed large brain tumor sitting on the left side of the brain. The brain tumour was suggestive of meningioma (benign brain tumor arising from the layer of membrane covering the brain).
The tumour with swelling was pressing the part of the brain controlling the power on the right side of the body and also pressing the speech center in the brain. This likely caused a fit followed by a paralytic attack with slurred speech. In view of the brain swelling around the tumor, patient was given steroids and medications to suppress the swelling and to prevent fits. Thereafter, the patient underwent a 3 hour long brain surgery. The complete tumor was removed without damaging the inner membrane of the brain. The skull was reconstructed by putting back the bone flap and fixing it back with clamps.
Dr. Sonal Gupta, Director and Head, Neurosurgery (Cranial) said, “The patient’s age was the biggest challenge. Options of surgery and its risks versus conservative management with anticonvulsants was discussed in detail with the family. It was decided that the patient should be evaluated by anesthetist and cardiologist for risk assessment of the brain surgery and a call should be taken on the further course of surgery. As the patient had no co-morbidities, also anaesthesia and cardiology risks were not high, family agreed for the surgery and got the tumor removed. Despite his age, the patient responded very well to the treatment and was fully conscious within half an hour of surgery. The patient has now fully recovered, with his speech back to normal and is no more in a paralysed state.”
Patient Mr. Narendra Kumar Kundu said, “It all happened so quickly that I almost don’t recall any of it. I was walking normally and did not have any symptoms of any brain related ailment. The next day I was in the hospital undergoing a surgery. It was extremely scary for me. However, the doctors took good care of me and post 30 minutes of the surgery I gained consciousness. I had my warrior wound (surgery mark) on the head to show, this is the only thing which reminds me of my surgery. I am fine now and back to my normal life.”
Mr. Mahipal Bhanot, Facility Director, Fortis Hospital Shalimar Bagh said, “It is very heartwarming to see the patients not losing hope at such an elderly age. With our super specialized team of doctors, the surgery could be successful without any complications. The patient’s situation could have been life threatening, however these were successfully avoided due to the diligence with which the case was handled. I am proud to say that Neuro Surgery team is equipped to handle any such complicated cases with precision and intricacy with the most advanced technology and infrastructure.”
Meningiomas represent about a third of all primary brain tumors. Often benign, they tend to affect men and women between the ages of 40 and 70. It is extremely rare to see a meningioma causing symptoms for the first time at the age of 90 yrs. If you leave a meningioma untreated, it can grow in size and can cause persistent headaches, hearing or vision loss weakness and/or numbness and tingling on one side of the body, seizures, , balance problems, and muscle weakness. The symptoms of a meningioma depend on the location and its size. A small tumor pressing the optic nerve can cause sight loss while a tumor located on the surface of the brain, can be quite large before you notice any symptoms.
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