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The Power of Multi-Disciplinary Team By Dr. Omkar Churi- Consultant Neurosurgery



Doctors at Manipal Hospital successfully treated a young lady, with severe headache and giddiness. The lady had a clot around the brain but it was treated by injecting blood in her spine.

This young lady is mother of two young school-going children who was struggling with headache. Her pain got worse over 8 months, so much so that she could not work, sit or stand. She also started getting nausea, giddiness and occasional vomiting. She visited various clinics and individual doctors. Her condition did not improve and she started waking up with severe headache from her sleep. At this stage, even the bed-rest offered no relief. No pain medication helped. Her brain CT scan, which was normal 8 months ago, now showed a clot on her brain. The treatment for which is generally brain surgery. This is where the treatment changed.

As it was an extraordinary case, consultant neurologist at MHG, Dr Safal Shetty, realized that patient must have developed a small leak somewhere in her spine. There is fluid surrounding our brain and spine. This fluid supports and nourishes our brain. Initial leak gave patient headache as pressure of fluid around brain reduced. The slow loss of fluid further resulted in the clot in her brain. This was confirmed with MRI scan by the experienced team of neuro-radiologists.

The multi-disciplinary team (MDT), which involved a neurologist, radiologist, neuro-anesthesia and neurosurgeon held a scientific meeting. They all discussed the treatment plan to stop the fluid leak in the spine by patching it with patient’s own blood. The details of how to perform this rare and delicate procedure- where and how much blood to inject the blood, the precautions were finalized in this meeting.

Later consultant neurosurgeon, Dr Omkar Churi, and consultant neuro-anesthesiologist, Dr Yogesh Gaude, visited the patient. They helped her understand this whole procedure. All her apprehensions were addressed and patient consented for this treatment plan.
In the operating room, under local anesthesia, patients’ fresh blood was injected around the membrane surrounding the spinal cord. Patient was discharged the next day. No surgery was done for the clot in the brain.

After a week, patient started feeling better. The leak stopped, the pressure in her spine normalized, and slowly clot in her brain dissolved on its own. After 3 months, patient is back on her feet leading her normal life.

All of this was possible because of the clinical diligence, knowledge and team work of the doctors involved. Patients need to understand that sometimes doctors have to work in tandem so as to help them better. The MDT is a common internationally recognized practice where multiple doctors sit together, discuss and chalk out the best treatment plans. Some complex cases of trauma, cancer, neurological diseases need an input from 3-4 super-specialty doctors. In India, this practice is followed at fewer centers. At MHG, we strive for the best communication and outcome for the patient. It is not always true that too many cooks spoil the broth…

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