5-year-old becomes youngest patient to undergo 'awake craniotomy' at AIIMS Delhi
New Delhi, Jan 6: 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.
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Duleep Trophy: Pacers shine as India B beat India A by 76 runs
Bengaluru, Sep 8: KL Rahul's gumption, which helped him pile a patient fifty, found no resonance among his colleagues as India B pacers led by Yash Dayal pushed India A to a 76-run defeat on the fourth and final day of their Duleep Trophy match here on Sunday.
Chasing 275, India A were bundled out for 198 in their second innings as left-arm seamer Dayal (3/50), with able support from his colleagues Mukesh Kumar (2/50) and Navdeep Saini (2/41), led the India B attack.
Rahul top-scored for 'A' with a 51.
In the first session of the day, India B made 184 all out in their second essay to muster a handy overall lead of 274.
The India A chase began on a shaky note as Mayank Agarwal departed in the second over itself, wafting Dayal away from his body to Nitish Kumar Reddy, who made a wonderful diving catch at second slip.
That brought Riyan Parag to the middle and the right-hander followed the path set on Saturday by Rishabh Pant and Sarfaraz Khan.
Parag took on the bowlers and pacer Mukesh bore the brunt of his aggression, getting smoked for two sixes and the second maximum touched the roof of the Chinnaswamy Stadium over the mid-wicket region.
Parag added 48 runs for the second with a rather subdued Shubman Gill, who was dropped by Nitish Reddy at slips off Mukesh on 16, and 31 came off the former's bat in just 18 balls.
But the approach was tough to sustain considering the kind of assistance the bowlers were getting here, and soon his massive hoick off Dayal took an edge off Parag's bat en route to stumper Rishabh Pant.
Gill (21) departed soon, falling to Saini for the second time in the match and on this occasion, he edged the pacer to Pant.
Dhruv Jurel poked Dayal well outside off-stump to Yashasvi Jaiswal at gully, as India batters perished to a combination of bowlers' persistence on that channel and their own carelessness.
They took the lunch at a queasy 76 for four that soon transpired into 99 for six after the dismissal of Shivam Dube and Tanush Kotian, an hour into the lunch.
However, Rahul batted out 180 minutes 121 balls and milked 42 runs for the seventh wicket with Kuldeep Yadav to delay the inevitable.
The standout shot in an otherwise dour innings was a whistling on drive off Mukesh that fetched him a boundary.
But Mukesh had his revenge soon when Rahul feathered a cut off him to Pant, who completed five catches in this innings, soon after reaching his fifty with a single off Saini.
It effectively signalled the end of the road of for India A, though Akash Deep (43, 42b, 3x4, 4x6) gave a few moments of fun with a cavalier innings.
But beyond the entertainment value, it always was a case of when more than if.
Earlier, resuming from their overnight score of 150 for six India B could only 34 runs more to the total before getting bundled out.
Pacer Akash, whom Sarfaraz Khan carted around for five fours in a row the previous day, found his mojo to add the scalps of Washington Sundar and Saini to complete a five-wicket haul (5/56).
The spell will keep his name floating among the contenders when the selectors sit together soon to pick up squad for two-match Test series against Bangladesh.
