Chennai, June, 02: Rela Hospital performed the rarest cerebral micro–Arteriovenous Malformations (AVMs) surgery on a 16-year-old without opening the skull. The brain surgery has been performed through a tiny puncture in the girl’s thigh.
AVM is an abnormal tangle of blood vessels where arteries connect directly to veins instead of through capillaries.
The surgery was performed on a school student from Tiruvallur district after she was diagnosed with micro-AVMs through cerebral Digital Subtraction Angiography (DSA). It was found in the posterior frontal subcortical region with feeders from anterior choroidal artery and draining into the inferior sagittal sinus.
A surgical team performed the surgery by creating a small puncture in the girl’s thigh. Miniature tubes sized 0.007 inches were navigated through blood vessels to reach a rare abnormal blood vessel connection deep within the brain. A special medical glue called Onyx, liquid embolic agent, was used to seal the abnormal vessels responsible for bleeding and the normal circulation was preserved.
Only 0.9 to 1.4 cases per 1,00,000 people are diagnosed with AVMs every year across the globe. Of which, only 12-18% of the cases are pediatric AVMs. The prevalence in children is estimated to be at 14-28 per 1,00,000 children. A micro-AVM is considered an AVM within a small nidus which is often less than 1 cm and is rarer than the conventional AVMs.
A Surgical team headed Dr Muralidharan Vetrivel, consultant Neurosurgeon Cerebrovascular and Neurooncology performed the Endovascular embolization of the micro-AVM with onyx. Thel team also comprised of Dr Natesan Damodaran, senior consultant Neurosurgeon, Dr Anbuselvam, senior consultant Neurosurgeon, Neuroanesthesia, Dr Ramanan Rajagopal, senior consultant Neuroanesthesia, and Pediatric Critical Care, and Dr Ravi, senior consultant, Pediatric Intensivist.
Dr Muralidharan said,
“It is rare for a teenager to collapse due to bleeding in a brain secondary to micro-AVM. Our team has successfully performed the surgery by avoiding open brain surgery. Following the surgery that lasted only 1.45 hours, the girl is all set to resume her usual activities after taking the necessary rest.”
“Parents should seek immediate medical attention upon witnessing non settling headaches or headaches affecting routines in their children,” he added.