Kovai Medical Center and Hospital here said on Saturday that its cancer wing recently used a high-dose radiation beam to treat a lesion in the brain of a 32-year-old woman. Hospital Chairman Nalla G. Palaniswami told presspersons that this path-breaking procedure helped in avoiding an open surgery of the brain.
Using the navigation technique, stereotactic radiosurgery (SRS) delivered the beam precisely at that spot on the tonsured skull of the patients beneath which was the deeply-seated lesion.
The lesion is an abnormal formation of tissue in the brain. Called arteriovenous malformation, this can be life-threatening. It is an abnormal formation where the artery meets the vein. There can be sudden and profuse bleeding that can cause death. Or, it can cause paralysis of a limb or loss of sensation on one side of the face.
But, the skull was not opened and the patient was awake during the procedure that was handled by a team of experts such as neurosurgeon, radiation oncologist, interventional radiologist, neurologist and medical physicists.
Neurosurgeon K. Madheswaran said open surgery could be done for brain tumour. But, there were accessible and inaccessible parts in the brain. While an entry could be made in certain areas, the exit after the surgery could cause damage in the brain – a neurological deficit that would leave the patient with a paralysed limb or impaired speech. The SRS is a safe alternative as it ruled out the risks that could come with the open surgery.
Interventional Radiologist Pankaj Mehta said an angiogram was done to spot the exact location of the lesion and mark it out from other vital portions of the brain so that precision was not a casualty in the treatment.
Explaining the procedure with a video clipping Director of the Comprehensive Care Centre at the hospital V. Kannan said that first the neurosurgeon's opinion was sought to ascertain whether the lesion was in the inaccessible part of the brain.
After imaging tests to locate the lesion, a specialised helmet was fixed on the head to immobilise it. “Though the patient was awake, we had to immobilise the head as much as anaesthesia could. Otherwise, the delivery of the beam would not have been precisely on the problem spot,” he said. This procedure could treat in 15-20 minutes the tumours deep inside the brain that were once considered untreatable.
