5-year-old becomes youngest patient to undergo 'awake craniotomy' at AIIMS Delhi

Doctors at AIIMS, Delhi successfully performed a brain tumour surgery on a five-year-old girl while keeping her in a conscious state during the operation with the hospital claiming that she was the youngest patient in the world to undergo such a procedure.

The procedure termed as ‘awake craniotomy’ (conscious sedation technique) surgery for left perisylvian intraaxial brain tumour was performed on January 4, AIIMS said in a statement.

The child presented with a history of seizures and her brain MRI was done which showed a tumour in the left side of her brain adjacent to speech/language area, it said.

The surgery lasted three hours, including time taken for giving local anaesthesia to the child by neuroanaesthetists.

The tumour was removed successfully by a team of neurosurgeons as she remained conscious throughout the procedure.

”Technological adjuncts viz preoperative functional MRI brain, intraoperative ultrasonography, neuronavigation were used to localise tumour precisely during resection while mapping of functional areas was being carried out under awake conditions. Ice cold saline was used for the brain surface to prevent any seizures during the procedure,” the statement said.

“The child is doing well and will be sent home on Monday,” it said.

A long discussion was held between team members, patient’s family and the child before taking a decision to go ahead with the surgery. They were counselled at length on steps of procedure, it stated.

She was shown common objects, common animals and given some tasks for language and sensorimotor assessments before surgery, which were repeated during the surgical procedure also.

She is a first standard student and was quick in identifying the picture of Prime Minister Narendra Modi during the surgery, the statement said.

”Awake surgeries for brain tumours are done for maximising tumour removals and minimising neurological deficits usually. During awake craniotomy, patients should feel a minimum level of pain while being completely able to cooperate in neurological tests,” it said.

”Although this method is called awake craniotomy, this method requires even more collaboration in perfect harmony of the surgical and anaesthesia teams than other operations under general anaesthesia said,” Dr Deepak Gupta, Professor of Neurosurgery who performed this operation with his team with neuroanesthesia team led by Dr Mihir Pandia and Dr Gyanendra Pal Singh.

”Akshita happens to be the youngest child in the world to undergo successful brain tumour surgery under awake conditions at this age at AIIMS, Delhi,” Dr Gupta said.