CIH‘s neurological surgeons has properly performed a successful 15-hour cerebrovascular surgery to remove a grade-IV Brain tumor found in Mrs. N.T.K.T female patient who was turned away by many other renowned hospitals due to her poor prognosis of the deadliest brainstem glioma.

Patient N.T.K.T's MRI  appearance  of Brain stem glioma

A 57-year-old woman from District 6, HCM City  was first admitted to City International Hospital 28 March 2019, first time she presented with paralysis on the right side of the body, left-side drooping eyelid (ptosis), lower cranial nerve palsies, and incontinence. Her physical examination was unremarkable. She was alert, interactive, oriented, slurred speech and able to answer questions appropriately. Her cognitive decline is gradual in the beginning and worsens with severe depletion due to difficulty chewing or swallowing over last several months. Before coming to City International Hospital, historically three years ago, the patient had been diagnosed with hemangioblastoma in the left temporal lobe. An emergency surgical intervention of the intramedullary hematoma and tumor was performed. Post-operatively, she developed hydrocephalus, and accordingly she was placed a Ventriculoperitoneal (VP) Shunt Surgery due to vascular compression in March 2018 and got discharged in June, 2018. However, an imbalance between the intra- and extra-cranial atmospheric pressures led to over drainage, and she has suffered cognitive disorders and extremity weakness since then. 

The patient and her family had been to almost every major hospital from all over Vietnam, and they had been told their loved one had little hope for survival and recovery. They were desperate. when CIH's City Plus program gave the patient a second diagnosis and unexpectedly chance to the cure, they were thrilled. But such cases were still rare, with the clinical, CT scan & MR imaging assessment usually matching that of the doctors. Even when faced with low survival cores, "through City Plus Program, we are able to gather everyone in one room — neurologist, interventional radiologist, top neuro-surgeons and intensivists— to discuss the patient's needs."  shared  Dr. Dao Thi My Van – CIH’s dynamic and enthusiastic Deputy Medical Director & Head of Intensive Care Unit.

City Plus Program's multidisciplinary second opinion diagnosis 

30 March 2019, a blood analysis, biochemical analyses, and an MRI investigation of the brain were performed by Dr. Tran Chi Cuong, senior consultant and  Director of CIH-SIS Stroke Center. Pathological examination confirmed the diagnosis of hemangioblastoma in the left temporal lobe. An emergency surgical intervention of the intramedullary hematoma and tumor was performed. 

Dr. Huynh Hong Chau, lead neuro-surgeon & Department Head, Neurosurgery "This case of adult malignant Grade 4 brain tumor are over-the-top challenging which has very little life expectancy. We guarantee to do our best for her long-term survival, although adults with of high-grade gliomas still have a poor prognosis similar to that glioblastoma multiform. We work with whatever long-term issues arise, whether it's double vision or diabetes insipidus or sleep disorders."

Intra-operative computed tomography image-guided navigation (Navigation) system helps the surgeon navigate and locate brain tumors compared to the position of the skull

According to the predetermined plan on March 31, 2019, Dr. Huynh Hong Chau, lead neuro-surgeon conducted surgery to remove a giant tumor utilizing intra-operative computed tomography image-guided navigation (Navigation). Several surgical techniques and technological innovations have been recently introduced to help the surgeon achieve the maximal safe resection of the tumor while reducing the odds of post-operative complications. Neuro-navigation has become an ubiquitous tool in the surgical management of brain tumors.

During neurosurgical operations, the soft material of the brain, the cerebrospinal fluid (CSF), the opening of the skull's cavity, the opening of the dura mater, the CSF loss along with gravity and other factors make the brain susceptible to the brain-shift phenomenon (displacement of the brain in relation with its natural position captured during imaging acquisition). Positioning device helps identify the tip and path of surgical instruments on all sections. Before surgery, the surgeon can simulate the path to injury; accurately assess the location of surgery before and during the operation. This system helped the surgeon navigate and locate brain tumors compared to the position of the skull. Accurate positioning of the skin incision, the opening of the skull, clearly distinguishing between tumor margins and the surrounding tissue which the least invasive tumor can be removed, by the nearest, limited maximizing brain damage during surgery, especially tumors deep in the brain

After a 15-hour-long surgery, patient has ongoing evaluations. "We work with whatever long-term issues arise, whether it's double vision or diabetes insipidus or sleep disorders," Dr. Hong Chau said. "Continuity of care is so important. We can seamlessly transition our patients into care from endocrinologists or neuro-ophthalmologists or whatever they need."

" We work with whatever long-term issues arise, Continuity of care is so important." Dr. Hong Chau said. 

Dr. Huynh Hong Chau sighed in relief after 15 hours long and tired but happier than ever. The humble surgeon was speechless after his marvelous surgical success. "There is plenty of room for hopefulness in  brain cancer," adds Huynh Hong Chau, MD, PhD. a country’s top neuro-surgeon at City International Hospital's Neuro-surgery Department "The news that a person has a high-grade brain tumor is always difficult. But I can tell the family that they are at a top medical center with a team of knowledgeable physicians who will see them today and outline a treatment plan.”here were no complications during the postoperative period and the patient achieved satisfactory recovery. We have nurses, radiation technicians and social workers who provide ongoing support. Our patients feel well looked after"  said Dr. Chau.

City International Hospital’s City Plus Program 

If you or your doctor would like a second opinion…. City Plus’s world class Medical Second Opinion program brings you Closest to the Cure. When you or your loved ones are diagnosed with a serious medical condition, you want the best medical advice from the country’s best hospital and top physicians. City Plus offers better quality of expert diagnosis help patients feel comfortable compared to the initial diagnosis. We utilize a collaborative and holistic medical review by our multidisciplinary team of expert physicians from all over the country, not just a single physician review; City Plus provides medical information and recommendations from expert physicians who practice at City International Hospital (CIH). City Plus’s premiere service offering, a remote medical second opinion (MSO) service provides our users the option of having their diagnosis and/or treatment plan evaluated by some of the top medical minds in the region, allowing them access to the most up to date clinical information available on almost any medical condition. CIH is renowned for leading the hospital in cutting-edge non-surgical and surgical treatments, and overall quality of clinical outcomes. Our Members do not have to travel or deal with healthcare systems, CIH’s City Plus brings answers and peace of mind to them. All it takes is a phone call to get started. Contact City Plus consulting hotline: (+84) 286 280 3333 (Press 0 and talk to the operator.)

 

  City International Hospital

• Add: No. 3, 17A Street, Binh Tri Dong B Ward, Binh Tan Dist. (Next to AEON Mall Binh Tan), HCM City.

• Tel: (+84) 286 280 3333 (Press 0 and talk to the operator.)

• Site: https://cih.com.vn/en/

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