Thiruvananthapuram: A one-and-a-half-year-old girl has survived a life-threatening condition after undergoing a rare brainstem cavernoma surgery at KIMSHEALTH Trivandrum. Diagnosed with brainstem cavernoma, a rare congenital defect where clusters of blood vessels in the brain bleed, the child was brought to the hospital in a comatose state and gasping for breath.
The child’s condition was managed with a Transnasal Endoscopic Brainstem Cavernoma Removal Surgery, a complex procedure previously performed only in the US and Japan, with fewer than 20 cases reported globally.
Dr. Ajith R, Senior Consultant, Department of Neurosurgery, who led the surgical team, explained, “This is one of the most inaccessible areas of the brain, and surgery in this region is extremely risky, as any accidental damage to the nearby cardio-respiratory center could be fatal.”
He further emphasized the significance of the procedure, adding, “The endoscopic approach through the nasal cavity to this region has been attempted at only a few centers in the United States and Japan. This is the first time such a surgery has been performed in the country, and the challenge was compounded by the child’s smaller nasal cavity compared to that of an adult.”
Dr. Vinod Felix, Consultant, Endoscopic Skull Base Surgery and Rhinology, highlighted the technical challenges, stating, “The surgery was performed using a 4 mm endoscope, which was navigated through the nasal cavity to access the brainstem area. The area was then drilled open, and the defective blood vessels were identified and removed under endoscopic visualization, relieving the baby of the compression.”
The six-hour-long procedure was supported by a team of experts, including Dr. Abu Madan, Dr. Navas N.S., and Dr. Bobby Iype from the Department of Neurosurgery, Dr. Susanth B from Neuro-anesthesia, and Dr. Bency Benjamin from the Department of ENT.
The child was discharged after a month-long hospital stay and has since made a full recovery. She now walks independently during her follow-up visits.
The procedure, which carried inherent risks due to the complexity of the brainstem’s anatomy and the child’s young age, was completed successfully, demonstrating the potential of advanced medical techniques in addressing rare conditions.