A patient suffering from Brain Hemorrhage due to Giant Aneurysm was successfully operated at KRIMS Hospitals(Ketki Research Institute Of Medical Sciences) which has been continuously serving patients from central India for last twenty-five years. A well known Neurosurgeon and Cerebrovascular Specialist of KRIMS Hospitals, Dr. Akshay Patil successfully operated a forty year old female patient using microsurgical clipping treatment. Aneurysm arises due to the weakening of blood vessels in the brain. As it bursts, bleeding occurs inside the brain and creates pressure effects. This is called as Subarachnoid Hemorrhage due to Aneurysm, the doctor said.
Patient was taking irregular medication for hypertension, suddenly suffered headache associated with vomiting and was admitted to a hospital in Akola, in an unconscious state. During initial examination, a plain CT scan of the brain and an MRI with angiography(MRA) were performed which showed hemorrhage with giant aneurysm with dolichoectasia and calcification in the left middle cerebral artery(MCA). Persistent hypertension, diabetes and age related problems lead to aneurysms that eventually resulted in subarachnoid brain hemorrhage.
She was stabilised in akola and referred to the hospital in nagpur for the further treatment where digital subtraction angiography(DSA) confirmed giant aneurysm in left M1 MCA. Physician suggested stent assisted coiling treatment but it was expensive. So the patient’s relatives decided to shift her to the KRIMS Hospitals for microsurgical clipping treatment under Dr. Akshay patil. In KRIMS, she underwent left fronto-temporal craniotomy and clipping of Giant Aneurysm with reconstruction. Microsurgical clipping is age old-time trusted technique in which clip is used to occlude aneurysm with the help of surgical microscope.
Post operatively, she was discharged on the seventh day without any complications. Dr. Akshay Patil informed that giant Partially Thrombosed aneurysm cases are unusual. MCA with dolichoectasia which means dilated elongated and tortuous vessel is a rare condition. It usually affects vertebrobasilar artery and carotid artery. Patients with Giant aneurysm usually present with Subarachnoid Hemorrhage, Intracerebral Hematoma, Seizure, mass effect in the form of visual disturbances and weakness in limbs. Aneurysm can be treated by various surgical methods like microsurgical clipping, bypass surgery, interventional radiology. But, he also pointed out that a decision has to be taken after proper discussion with patient’s relatives considering expenses, clinical condition of patient, risk and long term outcomes in the surgery.