A 19-year-old Iraqi girl was successfully operated for Spinal Arteriovenous Malformation (AVM) by Indraprastha Apollo Hospitals, Delhi
Ms. Nuha Mohanad Hani, a 19-year-old Iraqi girl got her wings back after a successful surgery performed for Spinal AVM by the doctors at Indraprastha Apollo Hospital, Delhi. Nuha was suffering from a rare spinal disease known as Spinal AVM in which there is an abnormal tangle of blood vessels in or near the spinal cord. The disease can permanently damage the spinal cord, if not treated properly and on time. Nuha was successfully treated for the disease by Dr P.N. Renjen, Senior Consultant – Neurology, Indraprastha Apollo Hospitals and his team recently.
Explaining about the disease, Dr Renjen said, “Spinal Arteriovenous Malformation (AVM) is a rare spinal blood vessel disorder which affects the blood supply in the spinal cord. It can cause a permanent damage to the spinal cord, if not treated in time. The oxygen-rich blood generally enters the spinal cord through arteries which further branches into smaller blood vessels called capillaries. The spinal cord uses oxygen from the blood in capillaries. The oxygen-depleted blood then passes into the veins that drain blood away from the spinal cord to the heart and lungs. However, in spinal AVM, the blood passes directly from the arteries to the veins, bypassing the capillaries. This disorder in blood flow deprives the surrounding cells of vital oxygen causing cells in the spinal tissues to deteriorate or die.”
“The arteries and veins in this disease can also rupture, causing bleeding in the spinal cord (hemorrhage). It can remain undiagnosed unless one begins to experience signs and symptoms. The condition can be treated with a surgery to stop or possibly reverse some of the spinal damage caused,” Dr. Renjen further added.
Talking about Nuha’s condition, Dr Renjen said, “When Nuha visited our hospital, she was suffering from progressive quadriplegia, paralysis caused by illness or injury resulting into partial or total loss of use of all the four limbs and torso. She was suffering from this condition for over a month. She also had urine and stool incontinence. On re-evaluation of history, we found out that she had an injury few months back followed by quadriplegia and breathing issues. She took treatment for this in her country but did not respond well to it and her condition kept on worsening. When she came here she had only 0/5 power in both of her legs.”
“Patient’s repeat MRI C- Spine revealed that she had longitudinally extensive hematomyelia (blood in spinal cord) with central cord lesion (C7-D1). Through her DSA angiography reports, we discovered that she had spinal AVM along C7-D1 as the cause of the hematomyelia. In order to treat her, we performed DSA with Embolisation of spinal AVM along C7-D1. She responded well to the treatment and was discharged within few days after the surgery, said Dr. Renjen.
After the surgery, Nuha Mohanad, the patient said, “I am grateful to Dr Renjen and his team at Apollo Hospital because it is due to their expertise and consistent efforts only that I am recovering now. Even the mere thought of that terrible pain, makes me shiver. I was unable to walk and used to be dependent on others even for my daily tasks. Now, I will be able to walk again freely. I cannot thank Dr Renjen enough for giving me this new life.”
“The incidence of AVM is estimated at 1 in 1,00,000 and the prevalence is estimated at 18 in 100,000 people. An estimated two-thirds of AVMs occur before the age of 40. Every year, about 4 out of every 100 people with an AVM will experience a hemorrhage and each hemorrhage poses a 15- to 20-percent risk of death or stroke, 30-percent neurological morbidity, and 10-percent mortality. When a hemorrhage occurs, it affects the following regions statistically: intracerebral (41%), subarachnoid (24%), intraventricular location (12%) and various combinations (23%),” further concluded Dr Renjen.
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