• 3 year old baby Ayoob’s tumour had become life threatening
• The brain stem is the “No Man’s Land” in Neurosurgery – extremely complex and risky
• Brainstem lesion removal Surgery was performed to save her life
• Without microscopic surgery he could have developed several risks
• If diagnosed accurately, and at an early stage and treated with perfection, it is totally curable in several cases

Aakash Healthcare Super Speciality Hospital, Dwarka- leading healthcare service provider of West Delhi and nearby region, performed a complex life-saving brain tumor removal surgery on a 3-year-old baby Ayoob Khatar Shakir from Iraq (Diyala) on 16th April. The baby had a large tumor like mass in the brain stem with hydrocephalus (collection of water in the brain). The baby underwent emergency surgery for removal of the brainstem lesion and opening of channels for free drainage of brain water. Team of doctors lead by Dr. Amit Srivastava, Director – Neurosurgery and Dr. Nagesh Chandra, Senior Consultant and HOD, Neurosurgery & Spine, Aakash Healthcare Super Speciality Hospital, Dwarka performed this successful surgery.

Family of Ayoob approached Aakash Healthcare, Dwarka with complain of repeated passing out (unconscious state), difficulty in breathing and inability to move both hands and legs. He was critically ill as the tumor had spread to the important part of the brain which control limb movement (in Brain Stem) and had become life threatening. He was immediately attended by a team of neurologists who advised a MRI of the brain along with requisite blood tests. The tests revealed brain tumor on the brain stem and it was spreading gradually to critical areas of the brain. Further investigations and diagnosis revealed that removal of the tumor entails high risk to life and can develop complications to the body but was critical to his survival.

The baby was advised for brain surgery. Explaining about this critical case, said, Dr Nagesh Chandra, Senior Consultant and HOD, Neurosurgery & Spine, Aakash Healthcare Super Speciality Hospital, Dwarka, “The brain stem is the “No Man’s Land” in Neurosurgery as this small compact area controls breathing, heart activity, consciousness and movement of hands and legs. Any surgery in this area is technically challenging and even a minor mishap here can result in devastating complications, often irreversible. Hence, we planned for minimally invasive microscopic neuro surgery, this is an innovative surgical technique used to remove brain tumors through surgical removal of part of the bone from the skull to expose the brain. Specialized tools are used for removal of the brainstem lesion and opening of channels for free drainage of brain water. This purely microscopic approach of removing tumor is highly advantageous to the patients who are in a very critical stage and any mis-happening can happen from open surgery.”

Commenting upon this complex and challenging case, Dr. Amit Srivastava, Director – Neurosurgery further explained, “The surgery went for 05 hours and concluded successfully on 16th April, 2019 and within 3 days the child started moving his limbs well and taking oral feeds. On referring the international peer reviewed literature it is found that only one case of brainstem hydatid cyst was reported earlier and that too was in an adult patient, hence this is the youngest baby with case of hydatid cyst in brainstem. In the case of baby Ayoob the biggest disadvantage was that he approached us at later stage when the lesion has already spread to brain and things went beyond medical control. Though it was a challenging surgery, it was conducted successfully.”

These kind of surgery sometimes might develop risks such as weakness of one side of body, speech problem, etc. but he showed no signs of complications and is doing well now and recovering. His post-operative CT also showed no residual tumor. And after 08days of good post-operative care he recovered and has been discharged. He is under medication for the next 03months/days but can do all normal routine activities.