Complicated surgery saves girl with rare moyamoya disease

Nagpur: A “complicated” surgery performed in the city saved life of a 17-year-old sickle cell patient who suffered from seizures and paralysis of left side along with continuous headache due to a rare blood vessels disorder of brain called moyamoya disease. The patient, Riya Choudhary who lives in the city, was also relieved of paralysis.
It is also centra India’s first direct revascularization procedure which was performed at Neuron Hospital by neurologist Dr Pramod Giri and his team.
Moyamoya is a rare blood vessel (vascular) disorder in which the artery in the skull is blocked or narrowed, eventually reducing blood flow to the brain. Surgery is needed to ensure proper blood supply to the brain. It’s like performing bypass surgery of the brain.
The surgery restores blood flow by diverting it from a vessel in the scalp or nearby muscles to the oxygen-starved part of the brain. After this surgery, the brain is able to produce new blood vessels taking advantage of the new source of blood supply.
In this particular case, a superficial temporal artery was attached to the middle cerebral artery by conducting a bypass surgery. “This is a very complicated surgery, especially in children,” said Dr Giri.
Dr Giri said, “The procedure went on for almost three hours and made possible due to teamwork.” The team comprised Dr Sourabh Varshney, Dr Sanjog Gajbhiye, Dr Shivaji Deshmukh, Dr Manjusha Giri, Dr Sushant and Dr Tushar. “Like any brain surgery, this too has a risk of bleeding or stroke. But as the surgery was performed by an experienced team, complications were avoided,” Dr Giri said.
Veteran neurosurgeon and national president of Neurological Society of India (NSI) Dr Lokendra Singh appreciated this effort. “Congratulations to Dr Pramod. The STA-MCA bypass he performed is a difficult task. It is used to correct the vascular supply of brain for vascular pathologists like ICA aneurysm and skull base giant tumour,” he said.
Doctors said the surgery has shown good outcomes and the patient has already been discharged. “She is not having further symptoms or strokes and her paralysis is also cured. No further treatment is needed, although she will continue her sickle cell treatment.
A new lease of life
- Moyamoya is found in one among one lakh people in the world; even rarer in India
- Major blood vessels emerging from carotid arteries were blocked due to moyamoya
- A direct revascularization procedure was performed, which means a bypass surgery of the brain
- The superficial temporal artery was connected to the middle cerebral artery
- This improved the blood circulation of the brain and relieved the patient from paralysis