Health, Healing & Hope

Conquering a Complex Brain Aneurysm with Advanced Endovascular Therapy

Brain aneurysms are often described as ticking time bombs—silent, unpredictable, and potentially life-threatening if left untreated. They pose one of the most complex challenges in modern neurosurgery, requiring both precision and cutting-edge technology for successful management.

A 60-year-old woman presented with multiple episodes of severe headache, prompting her to consult Dr. Sumantao Chaterjee (Neurologist). Given the persistence and pattern of her symptoms, a brain angiography was recommended and performed by Dr. Dibya Jyoti Mahakul (Endovascular Neurosurgeon).

The imaging revealed a complex brain aneurysm, one that demanded meticulous planning due to its size, shape, location, and blood flow dynamics. After careful evaluation, the patient was offered a scarless, minimally invasive endovascular treatment. A flow diverter stent was strategically placed across the neck of the aneurysm to divert blood flow away from the aneurysm sac, promoting healing and preventing rupture. While technically challenging, the procedure was greatly aided by our state-of-the-art biplanar cath lab, equipped with advanced imaging tools like Vaso CT, CBCT, and MAFA software. These technologies ensured maximum precision, safety, and speed for both the patient and surgical team. Remarkably, the patient was discharged the very next day in a stable condition—aneurysm secured, risk averted.

Today, she is back home with her family, free from the shadow of a life-threatening condition, and ready to embrace life on her own terms.

Treatment By:
Dr. Dibya Jyoti Mahakul, Dr. Sumantao Chaterjee

Date:
01 Oct 2025

A 51-year-old lady with left arm pain more than neck pain of 10 years duration, with BMI 44 and a short neck nearly the chin touching the chest, was diagnosed with OPLL C3-6 with myelopathy and fixed kyphosis of 20°. MRI showed cord signal changes at C5, and CT  confirmed OPLL C3 -6 with high probability of intradural mass ( double density sign). Conventional wisdom (K line, kyphosis, anterior pathology etc.) dictated towards an anterior surgery, but possibility of dural laceration (intradural OPLL mass), with potential for other complications (cord / trachea / esophageal compression by pseudomeningole, meningitis, spinal cord hernia etc.) were discussed in detail and a decission was taken to decompress and fix from the posterior aspect. The pre-op CT angio showed B/L high-riding vertebral arteries, which precluded the  C2 screw. 

 

Per operatively, the patient was positioned prone with the head clamped and a posterior exposure done. LM screw entry points were made from C3-6, followed by grade 1 facet resection at C3-4, C4-5, and C5-6 bilaterally. Further lordosis was achieved with manipulation of the head with the head clamp and closing the osteotomy gaps. LM screws (C3-6), a laminar screw at C2, and a pedicle screw at T1 & 2 were inserted and connected with rods. 

 

C3-6 laminectomy was done, and the surgical site was closed after bone graft mixed with vancomycin was applied laterally.

 

Postoperative x-ray showed adequate lordosis (approximately 10 degrees) attainment.

The patient reported complete pain relief in the left shoulder and arm postoperatively.

Treatment By:
Dr. Ankur Goswami

Date:
24 Jul 2025