A Cayman Islands man who underwent what has been described as the first brain surgery on an awake patient in the English-speaking Caribbean said he is feeling strong and getting back to his normal life.
After showing signs of a possible stroke, the watchmaker was referred to Dr. Romnesh de Souza at Health City Cayman Islands earlier in the year. Testing revealed the man had not experienced a stroke, but rather suffered from a tumor in the left side of his brain.
The growth, while not aggressively malignant, began impairing the right side of his body, provoked seizures, and threatened loss of speech and motor skills.
An “awake craniotomy” allowed doctors to operate on the tumor, while monitoring and preserving functions in surrounding areas of the brain. The procedure enables surgery in otherwise high-risk and delicate locations.
Dr. Susheel Wadhwa explained that conventional neurosurgery with general anesthesia can impair the ability to monitor brain activity during the procedure and can lead to significant loss of functions.
Keeping the patient awake and interacting with doctors provided greater certainty that damage was not being done to normal tissue.
“This is the first operation of this nature at Health City. But fortunately for us, we had the entire team. Right from the technicians to the nurses to the anesthetists to the surgical team, it was the same team which was performing these surgeries in India, and so the surgery could be carried out smoothly,” Dr. Wadhwa said in a Health City statement.
The patient’s scalp was numbed with local anesthetic and he was administered a small amount of anesthesia for sedation at the beginning of the procedure. During the middle part of the surgery, the patient was kept awake and guided doctors with verbal and motor commands.
Dr. Wadhwa said early diagnosis and removal of the tumor was a priority for doctors.
“By decompressing the tumor, we save normal and important areas of the brain. It also gives an opportunity to safely biopsy the tumor to understand its exact nature and plan further therapy,” Dr. Wadhwa said.
Doctors were able to remove a significant part of the tumor. The patient’s last follow-up showed no further growth.
Months later, the patient commended doctors for their quick response and his speed of recovery.
“For me it’s my livelihood, and to have those motor skills, it is extremely important for everybody, but especially my profession where I work with the smallest of pieces, being a watchmaker,” the man said.
“It has been over three months, and now I feel really good. It’s almost as if I never had an operation.… I am still having a hard time to see it as a major surgery, since I am feeling really good and I am back to where I was before.… It’s a lovely future. Life is good.”
The patient will undergo brain scans every three months for the next year to monitor the tumor. Additional appointments will focus on controlling seizures.