Doctors at a Gurugram hospital recently came across a highly complex case of a two-year-old from Tajikistan suffering from congenital hydrocephalus with megalencephaly, a growth development disorder in which the brain becomes abnormally large.
Struggle
“Maryam was born with hydrocephalus, a condition in which fluid gets collected in the brain causing an increase in the size of the head. Mobility was next to impossible for Maryam and she had been struggling with this condition since she was one-month-old,” said Sandeep Vaishya, executive director, Neurosurgery, Fortis Memorial Research Institute (FMRI) .
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Dr. Vaishya led the team that diagnosed Maryam and carried out the surgery. The common treatment for such a condition is to perform a VP shunting procedure of surgery. The surgery was performed in Tajikistan when Marayam was 11-month-old. It reduced the circumference of her head from 72 cm to 64 cm. However, brain damage had already occurred and bones had fused together, due to which her brain size could not be reduced further. She was also unable to sit or hold her head up.
Risks galore
Dr. Vaishya said: “We were reluctant to perform VP shunting, which involves installing a small tube in the brain to drain excess fluid as chances of improvement in such cases are extremely low and risk factors extremely high.”
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However, the family gave its consent despite the risks. Maryam underwent eight surgeries over a period of five months.
“We managed to reduce the size of her head but the surgery proved to be extremely challenging. We almost lost her at one point but she fought back. Though it is still too early to say anything, we have noticed some positive changes. Her last CT scan showed good brain development and she has started lifting her head. While there are chances of brain damage, this was also her best chance to live a nearly normal life,” said Ritu Garg, zonal director, FMRI, Gurugram.