Brain surgery saves life of boy with rare condition

A six-year-old boy has been saved from the worst, amidst non-stop abnormalities, when rushed to the hospital.

“We are thankful to all who guided us. It was a rollercoaster of emotions. Our son is back to being energetic and curious. No more life-threatening symptoms,” said the boy’s parents who requested anonymity.

“Our patient is doing well. He is attending school. We see him on a regular basis,” said Neurosurgery and Spine Surgery consultant Dr. Gopalakrishnan CV on Tuesday.

Dr Gopalakrishnan, who led the emergency Endoscopic Third Ventriculostomy (ETV) at the Medcare Orthopaedics & Spine Hospital in Dubai, added, “This case is not about medical success. It is about the resilience of children, the importance of trust between families and their healthcare providers. We can achieve remarkable outcomes, even in the face of rare and challenging conditions.”

Dr Gopalakrishnan termed the boy’s situation as “rare and challenging,” because the eventual brain magnetic resonance imaging (MRI) revealed that he had been suffering from Aqueduct Stenosis (AS).

The MRI debunked the earlier analysis of abdominal problems, manifested by his marked decrease of appetite amidst persistent bouts of headache and vomiting. From the International Society of Paediatric Neurosurgery website, AS, discovered in 1961 as linked to the X chromosome and transferred from mother to son, “occurs in one for every 30,000 births.” A quarter of male patients with AS have X-linked Hydrocephaelus.

According to the Bern University Hospital Inespital-Department of Neurosurgery website, AS is acquired when it results from “cerebral haemorrhage, brain injury or inflammation and nearby cyst or tumour.”

It is congenital when the glial cells that bind and protect the neurons in the central and peripheral nervous system, get stuck in the aqueduct region located in the middle of the brain, preventing the 24/7 free circulation of over 500 milliliters of cerebrospinal fluid (CSF) for brain protection, among other functions.

Dr Gopalakrishnan explained, “AS narrowed the aqueduct of Sylvius, a vital channel. CSF did not flow between the brain’s third and fourth ventricles of our patient. The accumulated CSF increased the pressure within his skull, known as Hydrocephaelus, which must be addressed promptly.”

The ETV, which “avoids the need for implants and significantly reduces the risk of long-term complications,” had to be accomplished soonest. If not, possible consequences are “vision loss, developmental delays, and even death,” he also said.

With ETV, the tiny incision on the third ventricle let the free flow of the stuck CSF “into its natural reservoirs at the base of the brain.”