Dr. Amitabha Chanda

MBBS(Gold Medalist), MS(Gold Medalist)

MCh(Neurosurgery)

Consultant Neurosurgeon

Apollo Hospitals, Dhaka

Bangladesh

Press

IANS - Awake brain surgery cures Kolkata girl's tumor
PTI- Doctors perform rare surgery with patient remaining awake / In Kolkata, brain surgery with patient awake
IBNS - New operation technique to cure brain tumor

June 20, 2012,

KOLKATA
Awake during brain surgery

Moubani Karmakar, an 18-year-old student who suffered frequent seizures, was diagnosed with a brain tumour and had to undergo a surgery. But unlike most patients, Moubani stayed awake as doctors worked at removing the tumour — moving her right arm or leg or counting up to 100 when instructed to do so.

The tumour in her brain was located in the motor area on the left side of the brain — the part responsible for movements on the right side of the body. The lesion was also critically close to the area in the brain that controls speech, said neurosurgeon Amitabha Chanda, who conducted an “Awake Craniotomy” on Moubani, said talking to journalists on Tuesday.

Doctors had warned the girl that if she went under the knife there was a high risk that the right side of her body would become paralysed or she may suffer a loss of speech. It was thus decided that the operation will be conducted under local anaesthesia and sedation so that she can interact with her doctors throughout the procedure, said Dr. Chanda.
“It sounds odd that somebody’s head is being opened up and the surgeon is fiddling in the brain while the patient is awake. But that was the need of the hour,” he added.

The problem lies in the fact that it is difficult to distinguish between the tumour and normal brain tissue, particularly at the junction, he explained. During the operation, if Moubani felt any discomfort in her right limbs she could tell Dr. Chanda and he would know that he had moved close to the brain tissue. The doctors could also ask her to move an arm or speak out loud so that they knew that they had not caused any damage.

The high-risk procedure depends on a great deal of coordination between the anaesthetist and the surgeon, as well as cooperation from the patient. Even a slight jerk could lead to the bruising of a blood vessel, causing significant damage.

There was also the chance of the patient having a fit during the surgery and so had to be administered high doses of anticonvulsants, Dr. Chanda said.

“Some phases of the operation — when the incision was made or when cutting through the bone — were painful. However, once access to the brain is achieved the surgery is painless. So the anaesthesia and the sedation had to be carefully regulated to keep her asleep during the painful parts and awake later on,” said anaesthetist Sucharita Chakrabarti. The four-hour-long procedure cost the Karmakar family Rs.2 lakh.

 
 
 

Mon, Feb 2 2009

By Bappa Majumdar

Dalai Lama taken to hospital with "discomfort" in arms

NEW DELHI (Reuters) - Tibet's exiled spiritual leader, the Dalai Lama, was taken to a hospital in New Delhi on Monday after complaining of "a mild discomfort" in both his arms, his aides said.

A spokesman said the 73-year-old leader had been diagnosed with a "pinched nerve", a condition caused by a slipped disc pressing against a nerve. It can cause a tingling sensation or pain in the arms and legs, doctors said.

The Dalai Lama has been advised to rest.

"He was feeling a tingling sensation in his arms and we therefore thought it necessary to get a thorough check-up done as soon as possible," Tenzin Taklha told Reuters from a New Delhi hospital.

"The doctors have said there was nothing to worry and he is fine and should be all right with some rest."

The exiled leader was taken to New Delhi's Apollo Hospital from his headquarters in Dharamsala.

Taklha said the Dalai Lama had been released from hospital and would spend the night in a hotel.

Chhime Chhoekyapa, another Dalai Lama aide, said the leader would return to Dharamsala on Tuesday and prepare for a trip to Italy and Germany beginning Feb. 8.

"Then he goes on an extensive tour of south India," Chhoekyapa said.

The Dalai Lama was admitted to hospital in August with abdominal discomfort and underwent successful gallstone surgery two months later.

Doctors said a "pinched nerve" is common among older people and often does not need corrective surgery.

"In 90 percent cases, patients respond to conservative treatment, including rest to reduce inflammation of the tissue surrounding the nerve," neurosurgeon Amitabha Chanda told Reuters.

In November, the Dalai Lama said he would not retire, putting an end to speculation about his future after the surgery. He also said he was losing faith in the Chinese government's desire to resolve the issue of Tibet's autonomy.

Chinese troops occupied Tibet in 1950 and the Dalai Lama fled the mountainous region in 1959 after a failed uprising against Chinese rule.

The Dalai Lama said in January he still had faith in the Chinese people and held out hope for an eventual change in policy towards Tibet.

China has stepped up its defence of its rule over Tibet.

Demonstrations by monks in Lhasa in March last year escalated into deadly riots and triggered protests against Chinese rule across the world and the Tibetan plateau, particularly in the run-up to the summer Olympics in Beijing last August.

China blamed the unrest on the Dalai Lama, whom it regularly brands a "splittist" or separatist. The Dalai Lama denies the charge, saying he is only seeking greater autonomy.

 
 
Monday, June 06, 2005 |
This week: neurosurgery
Doctor's Desk
Dr Amitabha Chanda is a consultant neurosurgeon
Severe headache
Recently, my mother had a sudden onset of a severe headache. A CT scan showed bleeding in the brain. A doctor says it is probably due to a rupture of an aneurysm and it needs immediate surgery. Will you please explain what aneurysm is? Is surgery the only way to treat this problem?
An aneurysm is an abnormal widening or dilation of a blood vessel caused by a swelling on its wall. The widened vessel is prone to rupture and severe bleeding any moment. This can lead to death or disability. A doctor can prevent the rupture by two techniques. The first one involves putting a clip across the neck of the aneurysm through an operation, guided by a microscope. The second technique, which does not involve an operation, uses a thin tube (microcatheter) to deliver coils to the site of the enlarged blood vessel which closes the aneurysm from inside. It’s up to the neurosurgeon to decide which technique to adopt. In any case, the treatment has to be done as soon as possible. Or else, her problems will worsen.
Tingling in fingers
My wife has been suffering from a tingling sensation in her fingers, accompanied with a nagging pain in the wrists. She has even been complaining of a strange numbness in the fingers. When we met a neurologist he asked her to get several nerve tests. What’s wrong with her?
Most probably she has got what is known as carpal tunnel syndrome. It is cused by the compression of a nerve in the wrist. Since this particular nerve supplies sensation to the fingers and strength to the muscles underneath them, the patient often experiences a tingling sensation, numbness and pain when the nerve gets compressed. The pain and numbness can be so severe that the patient may actually wake up from sleep in the middle of the night. She may also face severe problems while performing domestic chores like cooking, which require bending of the wrists. Sometimes this condition may be caused by diabetes, underactive thyroid gland, rheumatoid arthritis and so on. Certain medications like those used for birth control can also cause the problem. If the thyroid problem gets fixed, or the birth control pill is stopped, the symptoms often disappear. The treatment for this ailment includes rest, or using a wrist-splint during sleep. In some cases, a relatively minor operation under local anaesthesia relieves the pressure on the nerve.
Epilepsy surgery
My 20-year-old son has been suffering from convulsions off and on. We’ve consulted several neurologists. The prescribed medication only offered her a temporary relief. I have heard that there is a type of surgery which cures epilepsy. Is it true?
Surgery for epilepsy is possible these days. Usually when medical treatment fails, we evaluate a patient to see whether he or she is a candidate for surgery. A number of investigations are necessary for this evaluation. The tests will also help a surgeon pinpoint the focus of epilepsy in the brain and decide the mode of operation.
Bulging head
My son is eight months old. His head has been gradually bulging and now it has become quite large for his age. Our child specialist says it’s hydrocephalous and has referred him to a neurosurgeon. He didn’t explain much about the problem. We’re scared. Can you please enlighten me?
Hydrocephalous results from an excessive accumulation of fluid (cerebro-spinal fluid) in the brain. It can be diagnosed through clinical examination, ultrasonography and CT scan of the brain. In some cases MRI scan may be necessary. The common treatment for this ailment involves diverting the fluid to somewhere else in the body, using a tubular device called a shunt. Shunt operations are relatively safe and can be preformed under an endocope. However, they only manage the problem; they do not cure it. The success of the procedure depends on the extent of the symptoms and timeliness of the diagnosis.
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