Nagpur: Dr.Amit Bhatti perform Intervention Neurology procedure on stroke patient Kalpana (name changed) came with a history of severe headache with vomiting for a few days and since few hours she had been drowsy and barely arousable. Alarmed with sudden deterioration, her husband rushed her to Wockhardt hospital, Nagpur, one of the few Stroke-ready hospitals in Nagpur.
She was diagnosed with cerebral venous sinus thrombosis with cerebral infarction by Dr Amit Bhatti who is the consultant intervention neurologist and Stroke specialist. According to him, almost 99% of strokes or brain-attacks are because of the pathology of the arteries which are the blood vessels that carry blood from heart to brain. However, in 1 to 0.5% cases, the problem occurs in the veins also known as cerebral venous sinuses which drain the blood from the brain back to the heart Dr.Amit Bhatti perform Intervention Neurology procedure on stroke patient.
The occlusion of these venous systems is called cerebral venous sinus thrombosis which can cause large venous infarcts as well as brain hemorrhage resulting in headache, coma, paralysis, uncontrolled seizures and even death. The traditional treatment options include use of anticoagulants which are drugs that reverse or slow the clotting process of blood. These are usually given for a period of a few months until the sinus recanalizes.
As per Dr Bhatti, for patients with mild symptoms this may be enough but for those with severe symptoms and extensive thrombosis like the case mentioned above, waiting for even a few hours can be dangerous because there is impending risk of brain infarction & hemorrhage. Fortunately, our patient underwent a novel procedure wherein the occluded sinus was directly accessed through the vein in her leg and mechanical aspiration of the clot together with in situ thrombolysis was done using advanced endovascular intervention without any surgery or opening of the skull. This led to reopening of the sinus within 24 hours which otherwise used to take weeks to months with systemic anticoagulation.
All this done through a tiny needle puncture in the femoral vein of the leg without any open surgery of the brain. Due the prompt opening of blockage, our patient who had come in a near comatose state was discharged within 3 days of the procedure with complete recovery; which even the patient and relatives consider a miracle in itself. All thanks to the advances in neurointervention.
