Imphal June 20: Stroke is the third leading cause of death in India. It is known to cause permanent disability to patient who survives it. Medical management including Recombinant Tissue Plasminogen Activator (RTPA), an enzyme that helps dissolve clots within the golden hour of 4 and half hours has been the main stay treatment. Now with advancing scientific & medical technology, a new technique of pin hole neurointerventional operations are now available in only selected metro cities in India.
Such an ultra modern & complicated neurointerventional operation called mechanical thrombectomy with aspiration (removal of blood clot from a blood vessel inside the brain) for acute stroke was performed for the first time in Manipur by Dr. Thangjam Gautam Singh, Consultant Interventional Radiologist & Neurointerventionist, Shija Hospitals, Langol. This operation was performed on a 52 year old male patient who came with left arm weakness, slurring of speech and facial deviation. After diagnosing as a case of Hyperacute Ischemic Stroke, he was immediately admitted in Neuro ICU under Dr. Chabungbam Gautam, Consultant Neurosurgeon. MRI brain with MR Angiography revealed complete (100%) blockage of Right Middle Cerebral Artery (artery supplying blood to the right side of the brain) leading to evolving hyperacute infarct on right side of the brain with potential sequelae of massive brain infarct/damage.
Immediately the patient was given intravenous RTPA but his neurological deficit didn’t improve. He underwent “Mechanical Thrombectomy with Aspiration” which was the done through a small pin hole entry at groin under local anaesthesia without any open brain surgery. The thrombus (blood clot) was captured and removed from the blocked artery inside the brain using the combination of stent retriever and aspiration. The blocked artery was completely opened with immediate restoration of brain blood supply. Just after the operation, patient was able to lift his arm, legs. Speech became normal & facial drooping was also restored back. Thus the patient s life was saved from this deadliest disease. The patient was discharged after 3 days without any neurodeficit (he walked back home).
Had this neurointerventional facility been unavailable, such patient would usually suffer massive irreversible brain infarct/damage with permanent paralysis (remain bedridden for long duration) and many a times dies. It is important to know that patient can be cured from Ischemic Stroke if the treatment is started within four and half hours.
For Shija Hospitals & Research Institute
Deputy Manager-Business Development