In a remarkable and unprecedented medical feat, a 72-year-old patient who had been in a coma for 11 days was successfully revived and brought back to full health after undergoing 11 surgeries, at Artemis Hospital Gurugram.This patient's case is likely to be the highest number of intra-arterial vasodilation procedures performed on a single patient in India.
The patient, whose identity is being kept confidential, was admitted with a critical brain haemorrhage caused by a burst blood vessel within her brain. In the pastmedical team under performed open surgery to address the issue, a traditional approach for such cases. However, in recent years, a less invasive technique known as neurointerventional coiling has become the standard of care for such conditions. This procedure involves inserting a micro catheter through a leg blood vessel to place coils within the burst blood vessel, effectively sealing the leak.
Although the coiling procedure initially appeared successful, complications arose due to the presence of chemicals released by the leaked blood into the brain fluid space, causing the blood vessels to narrow over time. This condition, known as vasospasm, typically occurs 4 to 5 days after the bleeding and can persist for up to 10 days. In this patient's case, the vasospasm became severe, leading to neurological deterioration and limb weakness.
The neurointervention team, led by renowned neurointerventionist Dr. Vipul Gupta Director – Stroke unit at Artemis Hospital, attempted to mitigate the vasospasm by administering medications to dilate the blood vessels. While there was initial improvement, the patient's condition deteriorated once again, and she fell into a deeper coma.
Dr. Vipul Gupta and his team then performed an intra-arterial intervention, directly delivering medication into the narrowed blood vessels within the brain. This procedure, known as intra-arterial vasodilation, had to be repeated multiple times, ultimately totalling 11 procedures over 10 to 11 days due to the persistent and severe vasospasm.
During this challenging period, the patient's condition deteriorated to a deeper level of coma. However, brain imaging studies indicated that vital brain tissue was still preserved. The medical team decided to continue aggressive treatment, which included placing a drain into the brain fluid space to reduce brain pressure and maintain blood flow. Subsequently, this drain was converted into a ventriculoperitoneal shunt, permanently redirecting the fluid into the abdominal cavity.
After nearly two weeks of intensive treatment, the comatose patient began to show signs of improvement. Her progress was slow but steady, and after a few months, she made a remarkable recovery, regaining her independence and returning to a normal lifestyle.
Dr. Vipul Gupta commented on the significance of this case, stating that modern neurointerventional techniques have made conditions like brain hemorrhages highly treatable. He stressed the importance of medical persistence, even in cases of comatose patients, highlighting that with the right treatment and clinical judgment, many such patients can make remarkable recoveries.
He also addressed a common misconception in society, noting that patients on ventilators or in comas still deserve full treatment efforts, as demonstrated by this case. This extraordinary medical success story serves as a testament to the dedication and expertise of the neurointervention team at Artemis Hospital and showcases the potential for recovery, even in the face of seemingly insurmountable odds.
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